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Effects of physical activity and exercise interventions on Alzheimer’s disease: an umbrella review of existing meta-analyses

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Abstract

Introduction

During the last decade, physical activity (PA) (or “exercise”) has been identified as one of the main modifiable factors that influence the development of Alzheimer’s disease (AD) pathophysiology. We performed an umbrella review to summarize the evidence on the association between PA/exercise and the risk of developing AD risk, and the effect of exercise interventions on the progression of AD.

Methods

A systematic search was performed in PubMed, SportDiscus, Cochrane Library and Web of Science (March 2022) to identify meta-analyses assessing the association between PA and the incidence of AD, and assessing the effect of exercise interventions on patients with AD.

Results

Twenty-one studies were included. The results with strongest evidence revealed the positive effects of PA on AD risk. Specifically, meeting the WHO recommendations for PA was associated with a lower risk of AD. They also revealed positive effects of exercise on cognitive function, physical performance, and functional independence.

Conclusions

There is strong evidence of a protective effect of regular PA against AD risk; however, the dose–response association remains unclear. Physical exercise seems to improve several dimensions in patients with AD, although research is warranted to elucidate the exercise characteristics that promote the greatest benefits.

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Funding

Research by SL-O is funded by the Spanish Ministry of Science and Innovation (grant number FPU19/02117). Research by AL is funded by grants from the Spanish Ministry of Economy and Competitiveness and Fondos FEDER (Fondo de Investigaciones Sanitarias, grant number PI18/00139). Research by PLV is supported by a postdoctoral contract from Instituto de Salud Carlos III (Sara Borrell, CD21/00138).

Author information

Authors and Affiliations

  1. i+HeALTH, European University Miguel de Cervantes, 47012, Valladolid, Spain

    Susana López-Ortiz, Simone Lista, José Pinto-Fraga, Ricardo Carmona & Alejandro Santos-Lozano

  2. Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, 34295, Montpellier, France

    Simone Lista & Audrey Gabelle

  3. Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670, Madrid, Spain

    Alejandro Lucia

  4. Research Institute of the Hospital, 12 de Octubre (‘imas12’), 28041, Madrid, Spain

    Pedro L. Valenzuela, Ricardo Carmona, Alejandro Lucia & Alejandro Santos-Lozano

  5. Department of Drug and Health Sciences, University of Catania, 95125, Catania, Italy

    Filippo Caraci & Giuseppe Caruso

  6. Neuropharmacology and Translational Neurosciences Research Unit, Oasi Research Institute-IRCCS, 94018, Troina, Italy

    Filippo Caraci & Giuseppe Caruso

  7. Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133, Rome, Italy

    Nicola Toschi & Francesco Garaci

  8. Department of Radiology, “Athinoula A. Martinos” Center for Biomedical Imaging, 02129, Boston, USA

    Nicola Toschi

  9. Harvard Medical School, 02115, Boston, USA

    Nicola Toschi

  10. 2E Science, 27038, Robbio Pavia, Italy

    Enzo Emanuele

  11. Institute for Neurosciences of Montpellier (INM), INSERM Montpellier, 34000, Montpellier, France

    Audrey Gabelle

  12. Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, 00161, Rome, Italy

    Robert Nisticò

  13. School of Pharmacy, University of Rome “Tor Vergata”, 00133, Rome, Italy

    Robert Nisticò

  14. Casa di Cura “San Raffaele Cassino”, 03043, Cassino, Italy

    Francesco Garaci

Authors
  1. Susana López-Ortiz
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  2. Simone Lista
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  7. Giuseppe Caruso
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  8. Nicola Toschi
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  9. Enzo Emanuele
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  10. Audrey Gabelle
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  11. Robert Nisticò
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  12. Francesco Garaci
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  13. Alejandro Lucia
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  14. Alejandro Santos-Lozano
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Contributions

SL-O, SL: conceptualization, data curation, and writing—original draft preparation. PLV: writing—original draft preparation, and writing—reviewing and editing. FC, GC: writing—original draft preparation. JP-F: data curation. FG: data curation. RN: editing. RC, EE: writing—original draft preparation and editing. NT, AL: writing—reviewing and editing. AG, AS-L: conceptualization, methodology, supervision, and writing—reviewing and editing.

Corresponding author

Correspondence to Susana López-Ortiz.

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López-Ortiz, S., Lista, S., Valenzuela, P.L. et al. Effects of physical activity and exercise interventions on Alzheimer’s disease: an umbrella review of existing meta-analyses. J Neurol 270, 711–725 (2023). https://doi.org/10.1007/s00415-022-11454-8

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