Online physical exercise and the neuropsychiatric symptoms in patients with dementia: a cross-sectional study during the COVID-19 pandemic

Social isolation is necessary during the COVID-19 pandemic but can be harmful to mental health, especially in people with neurocognitive disorders. Although physical exercise can alleviate neuropsychiatric symptoms and improve quality of life (QoL), sedentary behavior increased during the pandemic. Online interventions can contribute to improving physical activity and mental health. OBJECTIVE: The objective of this study was to compare the neuropsychiatric symptoms and QoL of older adults with neurocognitive disorders who participated in an online physical exercise program with sedentary patients during the COVID-19 pandemic. METHODS: In this cross-sectional study, 25 older patients with neurocognitive disorders (control group=11; online exercise group=14) were evaluated based on Neuropsychiatric Inventory (NPI) and the Quality of Life in Alzheimer’s Disease (QoL-AD) scale. RESULTS: There were differences between the two groups in the total NPI (U=36.50, p=0.025) and the nighttime behavior disturbances item (U=38.00, p=0.033), both with large effect sizes (ES=-1.03, 95% confidence interval [CI]:-1.83 to -0.16 and ES=-1.06, 95%CI -1.86 to -0.19, respectively). In terms of QoL-AD, a difference was identified only in the memory subitem (U=20.00, p=0.005), with a large ES (1.59, 95%CI 0.59-2.48). CONCLUSIONS: Older adults with neurocognitive disorders who participated in an online physical exercise program, during the COVID-19 pandemic, showed fewer neuropsychiatric total symptoms, fewer nighttime disturbances episodes, and better subjective memory, compared to their physically inactive counterparts. Randomized controlled trials should be performed to better understand the effect of physical exercise in neuropsychiatric symptoms in dementia patients during periods of social isolation.