Inclusion and reporting of people with dementia in trials of hospital-based exercise interventions for older adults: A systematic review

Introduction: Hospitalization is related to a reduction in functional status among older adults, of which the effect is more pronounced in people with dementia (PWD). Hospital-based exercise interventions are a proposed strategy to mitigate the risk of functional decline due to hospitalization. The applicability of trials of hospital-based exercise interventions for PWD is not well understood. Objectives: (1) To describe the inclusion of PWD in trials of hospital-based exercise interventions for older adults. (2) To describe the interventions of such studies, including aspects that would facilitate participation of PWD. (3) To determine if (and if so, how) such studies report the baseline cognitive status of the study population. Methods: I searched the CENTRAL and MEDLINE databases as well as ClinicalTrials.gov from May 2021 through April 2023 for RCTs of hospital-based exercise interventions for older adults (>65) to update a prior review’s search of such studies. I abstracted information regarding eligibility of PWD, characteristics of the intervention, reporting of cognitive ability among the study population, and any adverse events. Results: My search identified 3 new studies that met criteria for inclusion, which I analyzed alongside 24 studies from a prior systematic review (N=27). Eighteen studies included PWD and 17 reported some measure of cognitive status. Twenty-one studies had supervised interventions and 23 tailored the intervention to patient ability. Adverse events were rare and unlikely related to the intervention. Conclusion: People with dementia are often included in trials of hospital-based exercise interventions for older adults, but there is inconsistency in reporting of baseline cognitive status. Future trials should report cases of pre-existing dementia among the study population. Further research is needed to determine the applicability of hospital-based exercise interventions for PWD.Master of Public Healt