Table 2

Clinically relevant recommendations from the review results

FocusRecommendation
WhoOlder adults with mild-to-moderate cognitive impairment.
If a person with dementia has the belief that exercise is advantageous, a positive attitude to exercise, the ability to understand the benefits of exercise or is able to identify the physical or functional changes from doing exercise, then they will perceive the benefit of doing exercise.
If a person with dementia perceives the benefit, they will participate in exercise-based intervention.
WhatMulticomponent exercise-based intervention that:
  • combines physical (including strength/resistance, balance, endurance/mobility, aerobic) and cognitive exercises.

  • is appropriately intensive and progressive.

  • is supported by suitable staff (who can interact, communicate and connect) and materials.

  • considers speed of initiation, length of intervention, encouragement of active lifestyle and enjoyment.

  • is delivered in a flexible manner for at least 15–20 min (or whatever can become or fit in with routine) 2–3 times a week for 6–12 months.

  • can be delivered at home (for those wanting or needing 1:1 support from the intervention staff) or in a group (for those wanting carer respite, increase in habitual physical activity or socialising aspects).

CircumstancesSupport can provide encouragement for completing an exercise-based intervention.
Sources of support can include but are not exclusively supplied by trained intervention staff, carer, spouse, family member.
If support is being provided by trained intervention staff, then they should have professional competence including:
  • time-management;

  • knowledgeable;

  • firm but encouraging;

  • kind, friendly and supportive;

  • understanding of the issues experienced by persons with dementia;

  • rapport development.

Trained intervention staff supporting an intervention should:
  • provide clear and repeated instructions.

  • optimally progress the exercises.

  • provide the amount of supervision required by that individual and their needs.

  • understand the needs of persons with dementia.

If support is being provided by a carer, then the intervention should provide information and ongoing support to enable them to continue.
Carers supporting an intervention should:
  • perceive and understand the benefit of the person with dementia doing exercise.

  • provide transport or consider practical arrangements for access to the intervention.

  • have a belief in the benefit of exercise.

  • implement supportive strategies and/or assistance in the manner required by the person with dementia.

If the carers or supporters perception of the benefits of doing exercise outweighs the risk, concern or burden of extra care duties, then the intervention will be encouraged.