Moderators of Cognitive Outcomes from an Exercise Program in People with Mild to Moderate Dementia

Area of Science:

• Gerontology
• Neurology
• Exercise Science

Background:

• Cognitive decline in mild to moderate dementia impacts daily living.
• Exercise interventions are explored for their potential to mitigate cognitive decline.

Purpose of the Study:

• To investigate if baseline participant characteristics moderate the impact of an exercise intervention on cognitive function in dementia patients.
• To identify specific patient subgroups that may benefit most from exercise for cognitive enhancement.

Main Methods:

• Subgroup analysis within a multicenter pragmatic randomized controlled trial involving 494 participants with mild to moderate dementia.
• Participants were assigned to a moderate- to high-intensity aerobic and strength exercise program or usual care.
• Cognitive function was assessed using the Alzheimer Disease Assessment Scale-Cognitive Subscale score at 12 months, with multilevel regression models used to identify moderators.

Main Results:

• A statistically significant interaction effect was observed for cognitive function as measured by the baseline number cancellation test.
• Participants with poorer baseline number cancellation test scores showed a significant interaction effect (-2.7 points).

Conclusions:

• Individuals with lower baseline number cancellation test scores may experience a greater benefit in cognitive function from moderate- to high-intensity exercise programs.
• Further research with adequately powered studies is recommended to confirm these findings and explore their clinical implications for dementia management.