Twenty RCTs (1,378 participants) were included in the review. Sample sizes ranged from 12 to 274. Three trials were judged to be high quality, six to be moderate quality and 11 to be poor quality.
Institutional care (10 RCTs, 575 participants): One high-quality RCT reported a slower decline in physical functioning in participants with dementia as a result of a physical activity intervention, while one moderate quality RCT reported a slower decline in mobility as a result of the intervention. Among the seven poor quality RCTs, physical activity interventions were associated with improvements or slower declines in several outcomes, including mobility (four RCTs), balance (one RCT), muscle strength (one RCT), and physical functioning (three RCTs). One poor quality RCT demonstrated improvements or slower decline in multiple functional limitations as a result of the intervention; this included balance, muscle strength, flexibility and gait. One poor quality RCT reported no differences between groups for mobility (ambulation) and two RCTs reported no differences for physical functioning.
Home-dwelling (10 RCTs, 803 participants): Two high-quality RCTs reported positive effects on functional limitations in participants with dementia in physical exercise groups compared to control groups. Four of five moderate RCTs also reported improvements in functional limitations (one RCT) or mobility (three RCTs) for physical exercise groups. Three of the moderate quality groups found no significant differences between groups for physical functioning (two RCTs) or mobility (one RCT). Three poor quality RCTs reported mixed effects with one RCT reporting improvements in physical functioning as a result of physical exercise, but two poor quality trials found no differences between groups in mobility.
Other outcomes were reported in individual studies.