Moderators of cognitive outcomes from an exercise programme in people with mild to moderate dementia

Toby Smith, Dipesh Mistry, Hopin Lee, Sukhdeep Dosanji, Susanne Finnegan, Bethany Fordham, Vivien Nichols, Bart Sheehan, Sarah Lamb

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BACKGROUND/OBJECTIVES: Our aim was to estimate whether baseline participant variables were able to moderate the effect of an exercise intervention on cognition in patients with mild to moderate dementia. DESIGN: Subgroup analysis of a multicenter pragmatic randomized controlled trial. SETTING: Community-based gym/rehabilitation centers. PARTICIPANTS: A total of 494 community-dwelling participants with mild to moderate dementia. INTERVENTION: Participants were randomized to a moderate- to high-intensity aerobic and strength exercise program or a usual care control group. Experimental group participants attended twice weekly 60- to 90-minute gym sessions for 4 months. Participants were prescribed home exercises for an additional hour per week during the supervised period and 150 minutes each week after the supervised period. MEASUREMENTS: Multilevel regression model analyses were undertaken to identify individual moderators of cognitive function measured through the Alzheimer Disease Assessment Scale-Cognitive Subscale score at 12 months. RESULTS: When tested for a formal interaction effect, only cognitive function assessed by the baseline number cancellation test demonstrated a statistically significant interaction effect (−2.7 points; 95% confidence interval = −5.14 to −0.21). CONCLUSION: People with worse number cancellation test scores may experience greater progression of cognitive decline in response to a moderate- to high-intensity exercise program. Further analyses to examine whether these findings can be replicated in planned sufficiently powered analyses are indicated.

Original languageEnglish
Pages (from-to)2095-2100
Number of pages6
JournalJournal of the American Geriatrics Society
Issue number9
Early online date22 May 2020
Publication statusPublished - Sep 2020


  • Demential and Physical Activity trial
  • cognitive function
  • dementia
  • physical activity
  • prediction

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