Meta-analysis| Volume 85, ISSUE 10, P1694-1704, October 2004

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The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis1

  • Patricia Heyn
    School of Allied Health Sciences, Division of Rehabilitation Sciences, Galveston, TX, USA

    Department of Occupational Therapy, Transitional Learning Center, Galveston, TX, USA
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  • Beatriz C. Abreu
    School of Allied Health Sciences, Division of Rehabilitation Sciences, Galveston, TX, USA

    Department of Occupational Therapy, Transitional Learning Center, Galveston, TX, USA
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  • Kenneth J. Ottenbacher
    Reprint requests to Kenneth J. Ottenbacher, Div of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555–1137, USA
    School of Allied Health Sciences, Division of Rehabilitation Sciences, Galveston, TX, USA

    Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
    Search for articles by this author


      Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Arch Phys Med Rehabil 2004;85:1694–704.


      To determine by meta-analysis whether physical exercises are beneficial for people with dementia and related cognitive impairments.

      Data sources

      Published articles and nonpublished manuscripts from 1970 to 2003 were identified by using electronic and manual searches. Key search words included exercise, rehabilitation, activities of daily living, dementia, Alzheimer’s disease, aged, and geriatrics.

      Study selection

      Reviewed studies were limited to randomized trials evaluating exercise in persons 65 years of age or older with cognitive impairment. Studies included quantitative results (means, standard deviations, t tests, F tests) for physical fitness, physical functioning, cognition, or behavior outcomes.

      Data extraction

      One reviewer extracted data on study characteristics and findings. Selected articles were evaluated for methodologic quality by 2 raters.

      Data synthesis

      A total of 2020 subjects participated in the 30 trials that met the inclusion criteria. Summary effects were computed using a fixed effects (Hedge’s gi) model. Significant summary effect sizes (ES) were found for strength (ES=.75; 95% confidence interval [CI], .58–.92), physical fitness (ES=.69; 95% CI, .58–.80), functional performance (ES=.59; 95% CI, .43–.76), cognitive performance (ES=.57; 95% CI, 0.43–1.17), and behavior (ES=.54; 95% CI, .36–.72). The overall mean ES between exercise and nonexercise groups for all outcomes was .62 (95% CI, .55–.70).


      Exercise training increases fitness, physical function, cognitive function, and positive behavior in people with dementia and related cognitive impairments.


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