Exercise for dementia and Mild Cognitive Impairment: methodological considerations


  • Juan Tortosa-Martínez Spanish Sport Science Association
  • Nuria Caus
  • Celeste Martínez-Canales
  • Miguel García-Jaén


The exponential worldwide increase in the number of older adults is causing a parallel rise in the number of cases of neurodegenerative diseases, such as mild cognitive impairment (MCI) and dementia. Exercise is a promising strategy for improving physical and cognitive function in healthy older adults, reducing the risk of developing MCI and dementia, and improving physical and cognitive function as well as decreasing neuropsychiatric symptoms in people with MCI and dementia. However, there are still some inconsistencies in the literature, especially in regards to the cognitive benefits, and there are currently no guidelines for prescribing exercise for older adults with cognitive impairment. In this article, a narrative review on the benefits of exercise for people with MCI and dementia was conducted, establishing some preliminary guidelines for prescribing exercise efficiently and safely in this population.


Download data is not yet available.


Metrics Loading ...


Allan, L. M., Ballard, C. G., Rowan, E. N., & Kenny, R. A. (2009). Incidence and prediction of falls in dementia: a prospective study in older people. PloS One, 4(5), e5521.https://doi.org/10.1371/journal.pone.0005521.

Aman, E., & Thomas, D. R. (2009). Supervised exercise to reduce agitation in severely cognitively impaired persons. Journal of the American Medical Directors Association, 10, 271–276. doi:10.1016/j.jamda.2008.12.053.

Andersen, C. K., Wittrup-Jensen, K. U., Lolk, A., Andersen, K., & Kragh-Sørensen, P. (2004). Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and Quality of Life Outcomes, 2(1), 52. https://doi.org/10.1186/1477-7525-2-52.

Anderson-Hanley, C., Arciero, P. J., Brickman, A. M., Nimon, J. P., Okuma, N., Westen, S. C., ... & Zimmerman, E. A. (2012). Exergaming and older adult cognition: a cluster randomized clinical trial. American Journal of Preventive Medicine, 42(2), 109-119.https://doi.org/10.1016/j.amepre.2011.10.016.

Anderson-Hanley, C., Barcelos, N. M., Zimmerman, E. A., Gillen, R. W., Dunnam, M., Cohen, B. D., ... & Maloney, M. (2018). The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial. Frontiers in Aging Neuroscience, 10. https://doi.org/10.3389/fnagi.2018.00076.

de Andrade, L. P., Gobbi, L. T., Coelho, F. G., Christofoletti, G., Riani Costa, J. L., & Stella, F. (2013). Benefits of multimodal exercise intervention for postural control and frontal cognitive functions in individuals with Alzheimer's disease: a controlled trial. Journal of the American Geriatrics Society, 61(11), 1919-1926. https://doi.org/10.1111/jgs.12531.

Arkin, S. M. (2003). Student-led exercise sessions yield significant fitness gains for Alzheimer's patients. American Journal of Alzheimer's Disease & Other Dementias®, 18(3), 159-170. https://doi.org/10.1177/153331750301800302.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub. https://doi.org/10.1176/appi.books.9780890425596.744053.

Baker, L. D. L., & Frank, L. (2010). Effects of Aerobic Exercise on Mild Cognitive Impairment: a controlled trial. Archives of Neurology, 67(1), 71–79. https://doi.org/10.1001/archneurol.2009.307.Effects.

Beltrán-Carrillo, V. J., Tortosa-Martínez, J., Jennings, G., & Sánchez, E. S. (2013). Contributions of a group-based exercise program for coping with fibromyalgia: a qualitative study giving voice to female patients. Women & Health, 53(6), 612–629. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23937732.

Blankevoort, C. G., Van Heuvelen, M. J. G., Boersma, F., Luning, H., De Jong, J., & Scherder, E. J. A. (2010). Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia. Dementia and Geriatric Cognitive Disorders, 30(5), 392–402. https://doi.org/10.1159/000321357.

Bossers, W. J., van der Woude, L. H., Boersma, F., Hortobágyi, T., Scherder, E. J., & van Heuvelen, M. J. (2015). A 9-week aerobic and strength training program improves cognitive and motor function in patients with dementia: a randomized, controlled trial. The American Journal of Geriatric Psychiatry, 23(11), 1106-1116. https://doi.org/10.1016/j.jagp.2014.12.191.

Bossers, W. J., van der Woude, L. H., Boersma, F., Hortobágyi, T., Scherder, E. J., & van Heuvelen, M. J. (2016). Comparison of Effect of Two Exercise Programs on Activities of Daily Living in Individuals with Dementia: A 9-Week Randomized, Controlled Trial. Journal of the American Geriatrics Society, 64(6), 1258-1266. https://doi.org/10.1111/jgs.14160.

Buchman, A. S., Boyle, P. A., Wilson, R. S., Fleischman, D. A., Leurgans, S., & Bennett, D. A. (2009). Association between late-life social activity and motor decline in older adults. Archives of Internal Medicine, 169(12), 1139-1146. https://doi.org/http://dx.doi.org/10.1001/archinternmed.2009.135.

Cadore, E. L., Casas-Herrero, A., Zambom-Ferraresi, F., Idoate, F., Millor, N., Gómez, M., ... & Izquierdo, M. (2014). Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. Age, 36(2), 773-785. https://doi.org/10.1007/s11357-013-9586-z.

Cadore, E. L., & Izquierdo, M. (2013). How to simultaneously optimize muscle strength, power, functional capacity, and cardiovascular gains in the elderly: An update. Age, 35(6), 2329–2344. https://doi.org/10.1007/s11357-012-9503-x.

Cancela, J. M., Ayán, C., Varela, S., & Seijo, M. (2016). Effects of a long-term aerobic exercise intervention on institutionalized patients with dementia. Journal of Science and Medicine in Sport, 19(4), 293-298. https://doi.org/10.1016/j.jsams.2015.05.007.

Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009a). American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise. https://doi.org/10.1249/MSS.0b013e3181a0c95c.

Chodzko-Zajko, W. J., Proctor, D. N., Singh, M. A. F., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009b). Exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7), 1510-1530. https://doi.org/10.1249/MSS.0b013e3181a0c95c.

Christofoletti, G., Oliani, M. M., Gobbi, S., Stella, F., Bucken Gobbi, L. T., & Renato Canineu, P. (2008). A controlled clinical trial on the effects of motor intervention on balance and cognition in institutionalized elderly patients with dementia. Clinical Rehabilitation, 22(7), 618-626. https://doi.org/10.1177/0269215507086239.

Chupel, M. U., Direito, F., Furtado, G. E., Minuzzi, L. G., Pedrosa, F. M., Colado, J. C., ... & Teixeira, A. M. (2017). Strength training decreases inflammation and increases cognition and physical fitness in older women with cognitive impairment. Frontiers in Physiology, 8, 377. https://doi.org/10.3389/fphys.2017.00377.

Cornelissen, V. A., & Smart, N. A. (2013). Exercise training for blood pressure: a systematic review and meta-analysis. Journal of the American Heart Association, 2(1), e004473. https://doi.org/10.1161/JAHA.112.004473.

Cotman, C. W., Berchtold, N. C., & Christie, L. A. (2007). Exercise builds brain health: key roles of growth factor cascades and inflammation. Trends in Neurosciences, 30(9), 464-472. https://doi.org/10.1016/j.tins.2007.06.011.

de Assis, G. G., & Almondes, K. M. D. (2017). Exercise-dependent BDNF as a modulatory factor for the executive processing of individuals in course of cognitive decline. A systematic review. Frontiers in Psychology, 8, 584. https://doi.org/10.3389/fpsyg.2017.00584.

Dijckmans, B., Tortosa-Martínez, J., Caus, N., González-Caballero, G., Martínez-Pelegrin, B., Manchado-Lopez, C., … & Clow, A. (2017). Does the diurnal cycle of cortisol explain the relationship between physical performance and cognitive function in older adults? European Review of Aging and Physical Activity, 14(1). https://doi.org/10.1186/s11556-017-0175-5.

Doi, T., Makizako, H., Shimada, H., Yoshida, D., Tsutsumimoto, K., Sawa, R., ... & Suzuki, T. (2013). Effects of multicomponent exercise on spatial–temporal gait parameters among the elderly with amnestic mild cognitive impairment (aMCI): preliminary results from a randomized controlled trial (RCT). Archives of Gerontology and Geriatrics, 56(1), 104-108. https://doi.org/10.1016/j.archger.2012.09.003.

Donnezan, L., Perrot, A., Belleville, S., Bloch, F., & Kemoun, G. (2018). Effects of simultaneous aerobic and cognitive training on executive functions, cardiovascular fitness and functional abilities in older adults with mild cognitive impairment. Mental Health and Physical Activity, 15, 78–87. https://doi.org/10.1016/j.mhpa.2018.06.001.

Ellison, J. M., Harper, D. G., Berlow, Y., & Zeranski, L. (2008). Beyond the “C” in MCI: Noncognitive Symptoms in Amnestic and Nonamnestic Mild Cognitive Impairment. CNS Spectrum 13, 66-72. https://doi.org/10.1017/S1092852900016175.

Erickson, K. I., Prakash, R. S., Voss, M. W., Chaddock, L., Hu, L., Morris, K. S., … & Kramer, A. F. (2009). Aerobic fitness is associated with hippocampal volume in elderly humans. Hippocampus, 19(10), 1030–1039. https://doi.org/10.1002/hipo.20547.

Erickson, K. I., Voss, M. W., Prakash, R. S., Basak, C., Szabo, A., Chaddock, L., … & Kramer, A. F. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017–3022. https://doi.org/10.1073/pnas.1015950108.

Singh, M. A. F., Gates, N., Saigal, N., Wilson, G. C., Meiklejohn, J., Brodaty, H., ... & Baker, M. K. (2014). The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. Journal of the American Medical Directors Association, 15(12), 873-880. https://doi.org/10.1016/j.jamda.2014.09.010.

Fissler, P., Küster, O., Schlee, W., & Kolassa, I. T. (2013). Novelty interventions to enhance broad cognitive abilities and prevent dementia: synergistic approaches for the facilitation of positive plastic change. In Progress in Brain Research, 207, 403-434. https://doi.org/10.1016/B978-0-444-63327-9.00017-5.

Fleiner, T., Leucht, S., Foerstl, H., Zijlstra, W., & Haussermann, P. (2017). Effects of short-term exercise interventions on behavioral and psychological symptoms in patients with dementia: a systematic review. Journal of Alzheimer's Disease, 55(4), 1583-1594.

Forbes, D., Forbes, S. C., Blake, C. M., Thiessen, E. J., & Forbes, S. (2015). Exercise programs for people with dementia. The Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD006489.pub4.

Gates, N., Singh, M. A. F., Sachdev, P. S., & Valenzuela, M. (2013). The effect of exercise training on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials. The American Journal of Geriatric Psychiatry, 21(11), 1086-1097. https://doi.org/10.1016/j.jagp.2013.02.018.

Geda, Y. E., Roberts, R. O., Knopman, D. S., Christianson, T. J., Pankratz, V. S., Ivnik, R. J., ... & Rocca, W. A. (2010). Physical exercise, aging, and mild cognitive impairment: a population-based study. Archives of Neurology, 67(1), 80-86. https://doi.org/10.1001/archneurol.2009.297.

Griffin, É. W., Mullally, S., Foley, C., Warmington, S. A., O'Mara, S. M., & Kelly, Á. M. (2011). Aerobic exercise improves hippocampal function and increases BDNF in the serum of young adult males. Physiology & Behavior, 104(5), 934-941. https://doi.org/10.1016/j.physbeh.2011.06.005.

Groot, C., Hooghiemstra, A. M., Raijmakers, P. G. H. M., Van Berckel, B. N. M., Scheltens, P., Scherder, E. J. A., ... & Ossenkoppele, R. (2016). The effect of physical activity on cognitive function in patients with dementia: a meta-analysis of randomized control trials. Ageing Research Reviews, 25, 13-23. https://doi.org/10.1016/j.arr.2015.11.005.

Guiney, H., Lucas, S. J., Cotter, J. D., & Machado, L. (2015). Evidence cerebral blood-flow regulation mediates exercise–cognition links in healthy young adults. Neuropsychology, 29(1), 1. https://doi.org/10.1037/neu0000124.

Guitar, N. A., Connelly, D. M., Nagamatsu, L. S., Orange, J. B., & Muir-Hunter, S. W. (2018). The effects of physical exercise on executive function in community-dwelling older adults living with Alzheimer’s-type dementia: A systematic review. Ageing Research Reviews. https://doi.org/10.1016/j.arr.2018.07.009.

Haan, M. N., & Wallace, R. (2004). Can dementia be prevented? Brain aging in a population-based context. Annual Review of Public Health 25, 1-24. https://doi.org/10.1146/annurev.publhealth.25.101802.122951.

Hageman, P. A., & Thomas, V. S. (2002). Gait performance in dementia: the effects of a 6-week resistance training program in an adult day-care setting. International Journal of Geriatric Psychiatry, 17(4), 329-334.

Hamer, M., & Chida, Y. (2009). Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence. Psychological Medicine, 39(1), 3–11. https://doi.org/10.1017/S0033291708003681.

Hess, N. C., & Smart, N. A. (2017). Isometric exercise training for managing vascular risk factors in mild cognitive impairment and Alzheimer’s disease. Frontiers in Aging Neuroscience, 9, 48. https://doi.org/10.3389/fnagi.2017.00048.

Heyn, P. (2003). The effect of a multisensory exercise program on engagement, behavior, and selected physiological indexes in persons with dementia. American Journal of Alzheimer's Disease & Other Dementias®, 18(4), 247-251. https://doi.org/10.1016/j.apmr.2004.03.019.

Hoffmann, K., Sobol, N. A., Frederiksen, K. S., Beyer, N., Vogel, A., Vestergaard, K., ... & Jacobsen, S. (2016). Moderate-to-high intensity physical exercise in patients with Alzheimer’s disease: a randomized controlled trial. Journal of Alzheimer's Disease, 50(2), 443-453. https://doi.org/10.3233/JAD-150817.

Holthoff, V. A., Marschner, K., Scharf, M., Steding, J., Meyer, S., Koch, R., & Donix, M. (2015). Effects of physical activity training in patients with Alzheimer’s dementia: results of a pilot RCT study. PLoS One, 10(4), e0121478. https://doi.org/10.1371/journal.pone.0121478.

Horikawa E, Matsui T, Arai H, Seki T, Iwasaki K, & Sasaki, H. (2005) Risk of falls in Alzheimer’s disease: a prospective study. Internal Medicine, 44, 717–721. https://doi.org/10.2169/internalmedicine.44.717.

Ijmker, T., & Lamoth, C. J. (2012). Gait and cognition: the relationship between gait stability and variability with executive function in persons with and without dementia. Gait & Posture, 35(1), 126-130. https://doi.org/10.1016/j.gaitpost.2011.08.022.

Ivy, A. S., Rodriguez, F. G., Garcia, C., Chen, M. J., & Russo-Neustadt, A. A. (2003). Noradrenergic and serotonergic blockade inhibits BDNF mRNA activation following exercise and antidepressant. Pharmacology Biochemistry and Behavior, 75(1), 81-88. https://doi.org/10.1016/S0091-3057(03)00044-3.

Jefferson, A. L., Byerly, L. K., Vanderhill, S., Lambe, S., Wong, S., Ozonoff, A., & Karlawish, J. H. (2008). Characterization of activities of daily living in individuals with mild cognitive impairment. The American Journal of Geriatric Psychiatry, 16(5), 375-383. https://doi.org/10.1097/JGP.0b013e318162f197.

Karssemeijer, E. E., Aaronson, J. J., Bossers, W. W., Smits, T. T., Rikkert, M. M. O., & Kessels, R. R. (2017). Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: a meta-analysis. Ageing Research Reviews, 40, 75–83. https://doi.org/10.1016/j.arr.2017.09.003.

Kemoun, G., Thibaud, M., Roumagne, N., Carette, P., Albinet, C., Toussaint, L., ... & Dugué, B. (2010). Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dementia and Geriatric Cognitive Disorders, 29(2), 109-114. https://doi.org/10.1159/000272435.

Kramer, A. F., & Erickson, K. I. (2007). Capitalizing on cortical plasticity: influence of physical activity on cognition and brain function. Trends in Cognitive Sciences, 11(8), 342-348. https://doi.org/10.1016/j.tics.2007.06.009.

Lam, F. M., Huang, M. Z., Liao, L. R., Chung, R. C., Kwok, T. C., & Pang, M. Y. (2018). Physical exercise improves strength, balance, mobility, and endurance in people with cognitive impairment and dementia: a systematic review. Journal of Physiotherapy, 64(1), 4-15. https://doi.org/10.1016/j.jphys.2017.12.001.

Lam, L. C., Chau, R. C., Wong, B. M., Fung, A. W., Lui, V. W., Tam, C. C., ... & Chan, W. M. (2011). Interim follow-up of a randomized controlled trial comparing Chinese style mind body (Tai Chi) and stretching exercises on cognitive function in subjects at risk of progressive cognitive decline. International journal of Geriatric Psychiatry, 26(7), 733-740. https://doi.org/10.1002/gps.2602.

Li, Y., Li, Y., Li, X., Zhang, S., Zhao, J., Zhu, X., & Tian, G. (2017). Head injury as a risk factor for dementia and Alzheimer’s disease: a systematic review and meta-analysis of 32 observational studies. PloS One, 12(1). https://doi.org/10.1371/journal.pone.0169650.

Lyketsos, C. G., Carrillo, M. C., Ryan, J. M., Khachaturian, A. S., Trzepacz, P., Amatniek, J., … & Miller, D. S. (2011). Neuropsychiatric symptoms in Alzheimer’s disease. Alzheimer’s & Dementia : The Journal of the Alzheimer’s Association, 7(5), 532–539. http://doi.org/10.1016/j.jalz.2011.05.2410.

Lindelöf, N., Karlsson, S., & Lundman, B. (2012). Experiences of a high-intensity functional exercise programme among older people dependent in activities of daily living. Physiotherapy Theory and Practice, 28(4), 307-316. https://doi.org/10.3109/09593985.2011.611217.

Logsdon, R. G., McCurry, S. M., Pike, K. C., & Teri, L. (2009). Making physical activity accessible to older adults with memory loss: a feasibility study. The Gerontologist, 49(S1), S94-S99. https://doi.org/10.1093/geront/gnp082.

Marshall, G. A., Rentz, D. M., Frey, M. T., Locascio, J. J., Johnson, K. A., Sperling, R. A., & Alzheimer's Disease Neuroimaging Initiative. (2011). Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease. Alzheimer's & Dementia, 7(3), 300-308.

Prince, A., Wimo, A., Guerchet, M., Gemma-Claire Ali, M., Wu, Y.-T., Prina, M., … & Xia, Z. (2015). World Alzheimer Report 2015 The Global Impact of Dementia an Analysis of Prevalence, Incidence, Cost and Trends. Retrieved from www.daviddesigns.co.uk.

Martyr, A., & Clare, L. (2012). Executive function and activities of daily living in Alzheimer’s disease: a correlational meta-analysis. Dementia and Geriatric Cognitive Disorders, 33(2-3), 189-203. https://doi.org/10.1159/000338233.

Mora, S., Cook, N., Buring, J. E., Ridker, P. M., & Lee, I. M. (2007). Physical activity and reduced risk of cardiovascular events: Potential mediating mechanisms. Circulation, 116(19), 2110–2118. https://doi.org/10.1161/CIRCULATIONAHA.107.729939.

Mueller, P. J. (2007). Exercise training and sympathetic nervous system activity: evidence for physical activity dependent neural plasticity. Clinical and Experimental Pharmacology and Physiology, 34(4), 377-384. https://doi.org/10.1111/j.1440-1681.2007.04590.x.

Nagamatsu, L. S., Chan, A., Davis, J. C., Beattie, B. L., Graf, P., Voss, M. W., ... & Liu-Ambrose, T. (2013). Physical activity improves verbal and spatial memory in older adults with probable mild cognitive impairment: a 6-month randomized controlled trial. Journal of Aging Research.

Nagamatsu, L. S., Handy, T. C., Hsu, C. L., Voss, M., & Liu-Ambrose, T. (2012). Resistance training promotes cognitive and functional brain plasticity in seniors with probable mild cognitive impairment. Archives of Internal Medicine, 172(8), 666-668. https://doi.org/10.1001/archinternmed.2012.379.Resistance.

Nascimento, C., Teixeira, C. V., Gobbi, L. T., Gobbi, S., & Stella, F. (2012). A controlled clinical trial on the effects of exercise on neuropsychiatric disorders and instrumental activities in women with Alzheimer's disease. Brazilian Journal of Physical Therapy, 16(3), 197-204. https://doi.org/10.1590/S1413-35552012005000017.

Netz, Y., Axelrad, S., & Argov, E. (2007). Group physical activity for demented older adults—feasibility and effectiveness. Clinical Rehabilitation, 21(11), 977-986.

Öhman, H., Savikko, N., Strandberg, T. E., Kautiainen, H., Raivio, M. M., Laakkonen, M. L., ... & Pitkälä, K. H. (2016). Effects of exercise on cognition: the Finnish Alzheimer disease exercise trial: a randomized, controlled trial. Journal of the American Geriatrics Society, 64(4), 731-738. https://doi.org/10.1111/jgs.14059.

Onor, M. L., Trevisiol, M., Negro, C., Alessandra, S., Saina, M., & Aguglia, E. (2007). Impact of a Multimodal Rehabilitative and Their Caregivers. American Journal of Alzheimer’S Disease and other Dementias, 22(4), 261–272. https://doi.org/10.1177/1533317507302071.

Palleschi, L., Vetta, F., De Gennaro, E., Idone, G., Sottosanti, G., Gianni, W., & Marigliano, V. (1996). Effect of aerobic training on the cognitive performance of elderly patients with senile dementia of Alzheimer type. Archives of Gerontology and Geriatrics, 22, 47-50. Archives of Gerontology and Geriatrics. https://doi.org/10.1016/0167-4943(96)86912-3.

Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256(3), 183-194. https://doi.org/10.1111/j.1365-2796.2004.01388.x.

Petersen, R. C., Roberts, R. O., Knopman, D. S., Boeve, B. F., Geda, Y. E., Ivnik, R. J., ... & Jack, C. R. (2009). Mild cognitive impairment: ten years later. Archives of Neurology, 66(12), 1447-1455. https://doi.org/10.1001/archneurol.2009.266.

Pettersson, A. F., Engardt, M., & Wahlund, L. O. (2002). Activity level and balance in subjects with mild Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 13(4), 213-216. https://doi.org/10.1159/000057699.

Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global prevalence of dementia : A systematic review and metaanalysis. Alzheimer’s & Dementia, 9(1), 63–75.e2. https://doi.org/10.1016/j.jalz.2012.11.007.

Radak, Z., Hart, N., Sarga, L., Koltai, E., Atalay, M., Ohno, H., & Boldogh, I. (2010). Exercise plays a preventive role against Alzheimer's disease. Journal of Alzheimer's Disease, 20(3), 777-783. https://doi.org/10.3233/JAD-2010-091531.

Ramírez-Campillo, R., Castillo, A., de la Fuente, C. I., Campos-Jara, C., Andrade, D. C., Álvarez, C., … & Izquierdo, M. (2014). High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women. Experimental Gerontology, 58, 51–57. https://doi.org/10.1016/j.exger.2014.07.001.

Rolland, Y., Pillard, F., Klapouszczak, A., Reynish, E., Thomas, D., Andrieu, S., ... & Vellas, B. (2007). Exercise program for nursing home residents with Alzheimer's disease: A 1-year randomized, controlled trial. Journal of the American Geriatrics Society, 55(2), 158-165. https://doi.org/10.1111/j.1532-5415.2007.01035.x.

Rimmer, J.H., & Smith, D. L. (2009). Alzheimer´s disease. In R. S. Durstine, J.L., Moore, G.E., Painter, P.L. (Ed.), ACSM´s management for persons with chronic diseases and disabilities (pp. 368–374). Champaign (Illinois): Human Kinetics.

Russell, M. A., Hill, K. D., Blackberry, I., Day, L. L., & Dharmage, S. C. (2006). Falls risk and functional decline in older fallers discharged directly from emergency departments. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 61(10), 1090-1095. https://doi.org/10.1093/gerona/61.10.1090.

Santana-Sosa, E., Barriopedro, M. I., Lopez-Mojares, L. M., Pérez, M., & Lucia, A. (2008). Exercise training is beneficial for Alzheimer's patients. International Journal of Sports Medicine, 29(10), 845. https://doi.org/10.1055/s-2008-1038432.

Scherder, E. J., Bogen, T., Eggermont, L. H., Hamers, J. P., & Swaab, D. F. (2010). The more physical inactivity, the more agitation in dementia. International Psychogeriatrics, 22(8), 1203-1208. https://doi.org/10.1017/S1041610210001493.

Scherder, E. J., Van Paasschen, J., Deijen, J. B., Van Der Knokke, S., Orlebeke, J. F. K., Burgers, I., ... & Sergeant, J. A. (2005). Physical activity and executive functions in the elderly with mild cognitive impairment. Aging & Mental Health, 9(3), 272-280. https://doi.org/10.1080/13607860500089930.

Schneider, N., & Yvon, C. (2013). A review of multidomain interventions to support healthy cognitive ageing. The journal of Nutrition, Health & Aging, 17(3), 252-257. https://doi.org/10.1007/s12603-012-0402-8.

Schwenk, M., Zieschang, T., Oster, P., & Hauer, K. (2010). Dual-task performances can be improved in patients with dementia A randomized controlled trial. Neurology, 74(24), 1961-1968. https://doi.org/10.1212/WNL.0b013e3181e39696.

Shaw, F. E., Bond, J., Richardson, D. A., Dawson, P., Steen, I. N., McKeith, I. G., & Kenny, R. A. (2003). Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial. BMJ: British Medical Journal, 326(7380), 73. https://doi.org/10.1136/bmj.326.7380.73.

Silsupadol, P., Siu, K. C., Shumway-Cook, A., & Woollacott, M. H. (2006). Training of balance under single-and dual-task conditions in older adults with balance impairment. Physical Therapy, 86(2), 269-281. https://doi.org/10.1016/S0966-6362(05)80442-4.

Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-Bohmer, K., ... & Sherwood, A. (2010). Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosomatic Medicine, 72(3), 239. https://doi.org/10.1097/PSY.0b013e3181d14633.Aerobic.

Song, D., Doris, S. F., Li, P. W., & Lei, Y. (2018). The effectiveness of physical exercise on cognitive and psychological outcomes in individuals with mild cognitive impairment: A systematic review and meta-analysis. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2018.01.002.

Sobol, N. A., Hoffmann, K., Frederiksen, K. S., Vogel, A., Vestergaard, K., Braendgaard, H., … & Beyer, N. (2016). Effect of aerobic exercise on physical performance in patients with Alzheimer’s disease. Alzheimers Dementia 12, 1207-1215. https://doi.org/10.1016/j.jalz.2016.05.004.

Spalletta, G., Musicco, M., Padovani, A., Rozzini, L., Perri, R., Fadda, L., … & Kawakami, N. (2010). Neuropsychiatric symptoms and syndromes in a large cohort of newly diagnosed, untreated patients with Alzheimer disease. American Journal of Geriatric Psychiatry 11, 1026–1035. doi: 10.1097/JGP.0b013e3181d6b68d.

Steinberg, M., Leoutsakos, J. M. S., Podewils, L. J., & Lyketsos, C. G. (2009). Evaluation of a home-based exercise program in the treatment of Alzheimer's disease: The Maximizing Independence in Dementia (MIND) study. International Journal of Geriatric Psychiatry: A Journal of the Psychiatry of Late Life and Allied Sciences, 24(7), 680-685. https://doi.org/10.1002/gps.

Suttanon, P., Hill, K., Said, C., & Dodd, K. (2010). Can balance exercise programmes improve balance and related physical performance measures in people with dementia? A systematic review. European Review of Aging and Physical Activity, 7(1), 13. https://doi.org/10.1007/s11556-010-0055-8.

Teixeira, C. V. L., Gobbi, L. T. B., Corazza, D. I., Stella, F., Costa, J. L. R., & Gobbi, S. (2012). Non-pharmacological interventions on cognitive functions in older people with mild cognitive impairment (MCI). Archives of Gerontology and Geriatrics, 54(1), 175-180. https://doi.org/10.1016/j.archger.2011.02.014.

Teri, L., Gibbons, L. E., McCurry, S. M., Logsdon, R. G., Buchner, D. M., Barlow, W. E., ... & Larson, E. B. (2003). Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. Jama, 290(15), 2015-2022. https://doi.org/10.1001/jama.290.15.2015.

Thomas, V. S., & Hageman, P. A. (2003). Can neuromuscular strength and function in people with dementia be rehabilitated using resistance-exercise training? Results from a preliminary intervention study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 58(8), M746-M751.

Toots, A., Littbrand, H., Lindelöf, N., Wiklund, R., Holmberg, H., Nordström, P., ... & Rosendahl, E. (2016). Effects of a high-intensity functional exercise program on dependence in activities of daily living and balance in older adults with dementia. Journal of the American Geriatrics Society, 64(1), 55-64. https://doi.org/10.1111/jgs.13880l

Tortosa-Martínez, J., Manchado, C., Chulvi-Medrano, I., & Cortell-Tormo, J. M. (2018). Exercise, the diurnal cycle of cortisol and cognitive impairment in older adults. Neurobiology of Stress, 9, 40–47.

Tortosa-Martínez, J. (2012). Alzheimer´s disease and dementia. In S. Clow, A., Edmunds (Ed.), Physical activity and mental health (pp. 185–208). Champaign (Illinois): Human Kinetics.

Tortosa-Martínez, J., Beltrán-Carrillo, V. J., Caus, N., Iglesias-Martínez, M. J., Lozano-Cabezas, I., Jimenez-Hernández, S., & Cortell-Tormo, J. M. (2017). Psychosocial benefits of exercise for older adults with amnestic Mild Cognitive Impairment: Innovative practice. Dementia, 1471301217725895. https://doi.org/10.1177/1471301217725895.

Tortosa-Martínez, J., Caus-Pertegaz, N., & Martínez-Canales, C. (2013). Group-based exercise for people with mild cognitive impairment: a pilot study. Journal of Human Sport and Exercise, 8, 702–710. Retrieved from http://www.redalyc.org/articulo.oa?id=301028375022.

Tortosa-Martinez, J., & Clow, A. (2012). Does physical activity reduce risk for Alzheimer’s disease through interaction with the stress neuroendocrine system? Stress, 15(3), 243–261. https://doi.org/10.3109/10253890.2011.629323.

Tortosa-Martinez, J., Clow, A., Caus-Pertegaz, N., Gonzalez-Caballero, G., Abellan-Miralles, I., & Saenz, M. J. (2015). Exercise Increases the Dynamics of Diurnal Cortisol Secretion and Executive Function in People with Amnestic Mild Cognitive Impairment. Journal of Aging and Physical Activity, 23(4), 550–558. https://doi.org/10.1123/japa.2014-0006.

Tortosa-Martínez, J., Clow, A., Caus-Pertegaz, N., González-Caballero, G., Abellán-Miralles, I., & Saenz, M. J. (2015). Exercise increases the dynamics of diurnal cortisol secretion and executive function in people with amnestic mild cognitive impairment. Journal of Aging and Physical Activity, 23(4), 550-558.

Toulotte, C., Fabre, C., Dangremont, B., Lensel, G., & Thévenon, A. (2003). Effects of physical training on the physical capacity of frail, demented patients with a history of falling: a randomised controlled trial. Age and Ageing, 32(1), 67-73. https://doi.org/10.1093/ageing/32.1.67.

Venturelli, M., Scarsini, R., & Schena, F. (2011). Six-month walking program changes cognitive and ADL performance in patients with Alzheimer. American Journal of Alzheimer's Disease & Other Dementias®, 26(5), 381-388. https://doi.org/10.1177/1533317511418956.

Verghese, J., Wang, C., Lipton, R. B., Holtzer, R., & Xue, X. (2007). Quantitative gait dysfunction and risk of cognitive decline and dementia. Journal of Neurology, Neurosurgery and Psychiatry, 78(9), 929–935. https://doi.org/10.1136/jnnp.2006.106914.

Who, W. H. O. (2010). Global recommendations on physical activity for health. Geneva: World Health Organization. https://doi.org/10.1080/11026480410034349.

Williams, C. L., & Tappen, R. M. (2007). Effect of exercise on mood in nursing home residents with Alzheimer's disease. American Journal of Alzheimer's Disease & Other Dementias®, 22(5), 389-397.https://doi.org/10.1177/1533317507305588.

Winchester, J., Dick, M. B., Gillen, D., Reed, B., Miller, B., Tinklenberg, J., ... & Cotman, C. W. (2013). Walking stabilizes cognitive functioning in Alzheimer's disease (AD) across one year. Archives of Gerontology and Geriatrics, 56(1), 96-103. https://doi.org/10.1016/j.archger.2012.06.016.

Woodhull-McNeal, A. P. (1992). Changes in posture and balance with age. Aging Clinical and Experimental Research, 4(3), 219-225. https://doi.org/10.1007/BF03324095.

Yágüez, L., Shaw, K. N., Morris, R., & Matthews, D. (2011). The effects on cognitive functions of a movement-based intervention in patients with Alzheimer's type dementia: a pilot study. International Journal of Geriatric Psychiatry, 26(2), 173-181. https://doi.org/10.1002/gps.2510.

Yoon, J. E., Lee, S. M., Lim, H. S., Kim, T. H., Jeon, J. K., & Mun, M. H. (2013). The effects of cognitive activity combined with active extremity exercise on balance, walking activity, memory level and quality of life of an older adult sample with dementia. Journal of Physical Therapy Science, 25(12), 1601-1604. https://doi.org/10.1589/jpts.25.1601.

Zhu, X., Yin, S., Lang, M., He, R., & Li, J. (2016). The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults. Ageing Research Reviews, 31, 67-79. https://doi.org/10.1016/j.arr.2016.07.003.