JMIR Publications

ABSTRACT

Background:

Participating in habitual physical activity can support people with dementia and mild cognitive impairment to maintain functional independence. Digital technology can continuously measure habitual physical activity objectively, capturing nuanced measures relating to volume, intensity, pattern and variability of habitual physical activity.

Objective:

To understand habitual physical activity participation in people with cognitive impairment, this systematic review aims to identify: (1). digital methods and protocols; (2). metrics used to assess habitual physical activity; and (3). describe any differences in habitual physical activity between people with dementia, mild cognitive impairment (MCI) and controls.

Methods:

3,394 titles were identified, with 33 articles included following systematic review. Articles were included if they included community-dwellers with dementia or MCI, reported physical activity metrics derived from digital technology, were published in English and peer-reviewed. Articles were excluded if they considered populations without a diagnosis of dementia or MCI, were based in aged care settings, did not concern digitally derived physical activity metrics, or if they were only concerned with physical activity interventions. The key outcomes extracted included the methods and metrics used to assess habitual physical activity, and the differences in habitual physical activity outcomes across the cognitive spectrum. Data was synthesized narratively. Due to significant heterogeneity in the field, a meta-analysis was not feasible.

Results:

Accelerometers worn on the wrist or lower back were the most prevalent methods (38% and 24% of studies respectively), while metrics relating to volume (e.g., daily steps) were most common for measuring habitual physical activity. People with dementia had lower volumes, intensities, and variability with different daytime patterns of habitual physical activity than cognitively-intact controls. Findings in people with MCI varied, but they demonstrated different patterns of habitual physical activity compared to controls.

Conclusions:

This review highlights the lack of standardisation in methods, protocols, and metrics used to measure habitual physical activity. Development of a core set of interpretable habitual physical activity metrics is required, which relate to clinically-meaningful outcomes for people with cognitive impairment and clinicians. Clinical Trial: This review was pre-registered on PROSPERO (Reference: CRD42020216744).