CARMEL, CALIF. – Cognitively impaired older adults who take part in exercise rehabilitation programs have similar strength and endurance outcomes as cognitively intact peers, results from a large meta-analysis showed.
The finding suggests that cognitively impaired older adults should not be excluded from rehabilitation programs, Kyle E. Johnson reported at the Western regional meeting of the American Federation for Medical Research.
“It's a fallacy that cognitively impaired older adults are unable to follow instructions and that they will not benefit from physical therapy,” said Mr. Johnson, who is a second-year medical student at the University of Colorado, Denver.
He and his associate, Patricia C. Heyn, Ph.D., of the university's division of geriatric medicine, searched electronic and printed databases for randomized, controlled trials that included physical rehabilitation outcomes of cognitively impaired older adults (defined as those with a Mini-Mental State Examination score of less than 24) and cognitively intact older adults (defined as those with an MMSE score of 24 or higher).
Of the more than 500 articles reviewed, 41 met inclusion criteria. Of these, 21 trials involved 1,411 older adults with cognitive impairment and 20 trials involved 1,565 older adults who were cognitively intact. The mean age of the patients was 81 years.
The mean MMSE score among the cognitively impaired older adults was 16, compared with a mean score of 28 among those who were cognitively intact.
When the researchers combined the strength and endurance outcomes from the two groups, they observed an effect size of 0.51 for the cognitively impaired elderly and an effect size of 0.49 for the cognitively intact elderly. No statistically significant differences were seen in the strength and endurance outcomes between the two groups.
“Every study showed a positive result” from physical exercise, Mr. Johnson said. “We need more research to directly compare these two groups and to consider the need for different exercise guidelines for varying degrees of cognitive impairment.”
He added that exercise rehabilitation for older adults “should be aimed to positively affect participants' quality of life. By doing so, there should be significant functional improvements in activities of daily living in cognitively impaired individuals.”