Adherence

Moderate to high intensity aerobic and strength exercise training does not slow cognitive impairment in people with mild to moderate dementia and may potentially worsen it, despite improving physical fitness.

For caregivers of individuals with mild to moderate dementia, prescribing moderate to high intensity aerobic and strength exercise is unlikely to slow cognitive decline and may slightly accelerate it on standard tests, though the clinical relevance is uncertain. However, this regimen significantly improves physical fitness (e.g., walking distance). Therefore, exercise should be prescribed primarily for physical health and functional independence, not for cognitive preservation, with careful monitoring for adverse events.