Feasibility of high intensity exercise training in people with dementia and Mild Cognitive Impairment: a systematic review

BACKGROUND: The number of people with dementia is around 50 million worldwide and this number is expected to grow in the coming decades. To date, scientific evidence suggests that physical activity is an encouraging aid in slowing down the progression of dementia and has positive effects on many aspects: metabolic, independence in activities of daily living (ADLs), cognitive and muscle strength. However, few studies analyze the feasibility and the effects of high-intensity exercise programs in people with dementia. The aim is to synthesize evidence on the feasibility of high-intensity exercise training (HIET) in people with dementia and/or Mild Cognitive Impairment (MCI) and to evaluate its effects on cognition, physical performance, ADLs, neuropsychiatric symptoms and quality of life. METHODS: Clinical trials and RCTs published up to March 2025 were selected through searches in PubMed, Scopus and Google Scholar, using MeSH terms related to dementia and high-intensity physical exercise. Studies involving people with dementia and/or MCI undergoing high-intensity aerobic and/or strength training were included. Methodological quality was assessed using the PEDro scale, and risk of bias was evaluated with the Cochrane RoB 2 tool. RESULTS: 21 studies met inclusion criteria, including participants with dementia and/or MCI. Feasibility was generally supported and the dropout rate was 13% with high adherence to the programs. Regarding effectiveness, HIET showed cognitive improvements in some studies, while others reported no significant effects. Physical performance, such as walking speed and balance, improved, but there were no significant changes in activities of daily living or quality of life. CONCLUSIONS: The results of the literature analyzed show that HIET can be proposed to this population, furthermore it benefits on many parameters of interest. It can be concluded that HIET could be taken into consideration for training people with dementia and/or MCI.