Effects of a Multicomponent Exercise Intervention on Physical and Cognitive Function of Older Adults With Dementia

Although exercise interventions for IwD seem to be feasible and well tolerated, resulting in positive effects on ADL functionality for people at mild-to-moderate stages \[1, 2\], the therapeutic role of physical activity, particularly exercise, after dementia diagnosis still needs further evidence \[3-5\], - especially when considering community-based contexts and caregivers as participants on exercise sessions \[6\]. It also matters to highlight that the dose-dependent relationship remains unclear \[1, 7, 8\]. Therefore, research is needed to identify the triad: stage/type of dementia, FITT variables (frequency, intensity, type, and time) of exercise intervention, and target outcome \[7, 9\]. Regarding exercise modality, Multicomponent Training (MT) \[10\] - combining aerobics, strength and balance exercises - seems to be effective at improving functional and cognitive performances in older adults with neurodegenerative disorders, particularly dementia \[11-13\]. Exercise programs previously developed by our group confirmed that a 6-month MT intervention can positively impact the physical and cognitive function of institutionalized older adults with AD \[14, 15\] and can be beneficial in physical fitness and ADL functionality performance among community-dwelling patients \[9, 16\]. However, the extent to which IwD can retain these improvements after the cessation of MT intervention still need to be elucidated \[17\] in order to understand how detraining affects functionality and cognition following the cessation of MT stimulus. This study is a quasi-experimental controlled trial using a parallel-group design. The study sample consists of community-dwelling individuals aged ≥ 60 years who are clinically diagnosed with dementia or major neurocognitive disorder. Participants will be either allocated into the intervention group or the control group. The intervention group will participate in MT biweekly exercise sessions, whereas the control group will receive monthly sessions regarding physical activity and health-related topics for 6 months. The main outcomes will be physical function as measured by the Short Physical Performance Battery (SPPB) and cognitive function evaluated using the Alzheimer Disease Assessment Scale - Cognitive (ADAS-Cog) at baseline, after 6-months and 3-months after the end of intervention. Secondary outcomes will be body composition, physical fitness, daily functionality, quality of life, neuropsychiatric symptoms and caregiver's burden. Cardiovascular, inflammatory and neurotrophic blood-based biomarkers, and arterial stiffness will also be evaluated in subsamples.