Systematic review into motivational strategies that support adherence to exercise for people with mild cognitive impairment (MCI) or dementia

Introduction: Physical exercise has a positive effect on cognitive functioning, mobility and activities of daily living in people with dementia (Forbes & al., 2013; Pitkälä & al., 2013). Most exercise studies employ motivational strategies to support adherence to the exercise intervention but it is unclear how effective these strategies are. The purpose of this systematic literature review was to establish the range and effect of motivational strategies used in exercise studies for people with MCI and dementia. Method: Articles were identified from the following databases: CINAHL, EMBASE, MEDLINE, PsychINFO and Web of Science. Independently, a minimum of two authors assessed relevant articles based on in- and exclusion criteria. Studies using quantitative as well as qualitative methods to evaluate the effectiveness of motivational strategies were included. Results: The review analysed 28 articles that were identified to report the use of motivational strategies in exercise studies and partly evaluated their effectiveness. Employed strategies included supervision of sessions by instructors, caregivers or students, group settings, goal setting, exercise diaries, tailoring of programme, telephone calls and music. The effectiveness of strategies was only evaluated in a minority of the studies (use of group setting, goal setting and music). Discussion: Adherence to exercise intervention and continuation of the physical activity after completion of the intervention is an ongoing issue in exercise research. Given the limited evidence regarding the effectiveness of motivational strategies, tried and new strategies should be evaluated for people with MCI and dementia to ensure optimal support of physical exercise in this group