Improving cognition and function through exercise intervention in Alzheimer's disease

Purpose: To analyze the effects of cognition on function and to explore the potential of aerobic exercise for promoting cognitive and functional capacities. Design: Integrative review of literature. Methods: Studies were selected based on an extensive search of electronic databases and manual cross-referencing for 1980 to 2006, using the combination of key words: Alzheimer's disease (AD), dementia, or cognitive impairment with function or activities of daily living. Findings: Three broad themes were identified from the literature analysis. First, global cognition has mainly been used to examine the effect of cognition on function, indicating an assumption that functional decline progresses in a hierarchical manner in AD. Second, specific cognitive domains affect functional decline in different ways. Executive functioning might have more effect on function than does memory. Third, aerobic exercise might promote cognitive and functional capacities in people with AD by modifying neuropathological changes in the brain. Conclusions: Specific cognitive domains such as executive functioning are important for understanding function in people with AD and are potentially modifiable by aerobic exercise.