International Psychogeriatrics

Review Article

The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda

I. C. V. Thuné-Boylea1 c1, S. Iliffea1, A. Cerga-Pashojaa2, D. Lowerya2 and J. Warnera2

a1 Research Department of Primary Care and Population Health, UCL Medical School, London, UK

a2 Central and North West London NHS Foundation Trust, London, UK


Background: Behavioral and psychological symptoms of dementia (BPSD) are common and are core symptoms of the condition. They cause considerable distress to the person with dementia and their carers and predict early institutionalization and death. Historically, these symptoms have been managed with anxiolytic and antipsychotic medication. Although potentially effective, such medication has been used too widely and is associated with serious adverse side-effects and increased mortality. Consequently, there is a need to evaluate non-pharmacological therapies for behavioral and psychological symptoms in this population. One such therapy is physical activity, which has widespread health benefits. The aim of this review is to summarize the current findings of the efficacy of physical activity on BPSD.

Method: Published articles were identified using electronic and manual searches. Rather than systematically aggregating data, this review adopted a rapid critical interpretive approach to synthesize the literature.

Results: Exercise appears to be beneficial in reducing some BPSD, especially depressed mood, agitation, and wandering, and may also improve night-time sleep. Evidence of the efficacy of exercise on improving other symptoms such as anxiety, apathy, and repetitive behaviors is currently weak or lacking.

Conclusion: The beneficial effect of exercise type, its duration, and frequency is unclear although some studies suggest that walking for at least 30 minutes, several times a week, may enhance outcome. The methodological shortcomings of current work in this area are substantial. The research and clinical implications of current findings are discussed.

(Received June 03 2011)

(Revised July 13 2011)

(Revised October 13 2011)

(Accepted October 16 2011)

(Online publication December 15 2011)


c1 Correspondence should be addressed to: I. C. V. Thuné-Boyle, Research Department of Primary Care and Population Health, UCL Medical School, Royal Free Hospital Campus, Rowland Hill Street, London, NW3 2PF, UK. Phone: +44 (0)20 7794 0500, ext. 36724; Fax: +44 (0)20 7794 1224. Email: