Home › Research › Treatments
Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial
Lamb SE, Sheehan B, Atherton N, Nichols V, Collins H, Mistry D, et al.. BMJ, 2018-05-16
Topic: Risk, prevention and care in population studies
Plain-language summary
Objective To estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia. Design Multicentre, pragmatic, investigator masked, randomised controlled trial. Setting National Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions. Participants 494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care. Random allocation was 2:1 in favour of the exercise arm. Interventions Usual care plus four months of supervised exercise and support for ongoing physical activity, or usual care only. Interventions were delivered in community gym facilities and NHS premises. Main outcome measures The primary outcome was score on the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) at 12 months. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, health related quality of life, and carer quality of life and burden. Physical fitness (including the six minute walk test) was measured in the exercise arm during the intervention. Results The average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men. By 12 months the mean ADAS-cog score had increased to 25.2 (SD 12.3) in the exercise arm and 23.8 (SD 10.4) in the usual care arm (adjusted between group difference -1.4, 95% confidence interval -2.6 to -0.2, P=0.03). This indicates greater cognitive impairment in the exercise group, although the average difference is small and clinical relevance uncertain. No differences were found in secondary outcomes or preplanned subgroup analyses by dementia type (Alzheimer's disease or other), severity of cognitive impairment, sex, and mobility. Compliance with exercise was good. Over 65% of participants (214/329) attended more than three quarters of scheduled sessions. Six minute walking distance improved over six weeks (mean change 18.1 m, 95% confidence interval 11.6 m to 24.6 m). Conclusion A moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes. Trial registration Current Controlled Trials ISRCTN10416500.
What this study adds
Evidence grade: Null result
The record lists 494 participants. This large randomized trial tested a moderate to high intensity aerobic and strength exercise programme in 494 people with mild to moderate dementia. Reported effect size: ADAS-cog adjusted difference -1.4 (95% CI -2.6 to -0.2) favouring usual care.
Taken from this record’s own fields, not from reading the paper. The grade is assigned from the abstract’s wording; what that means.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Lamb, S. E., Sheehan, B., Atherton, N., Nichols, V., Collins, H., Mistry, D., et al. (2018). Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ. https://doi.org/10.1136/bmj.k1675
Vancouver
Lamb SE, Sheehan B, Atherton N, Nichols V, Collins H, Mistry D, et al. Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ. 2018. doi:10.1136/bmj.k1675. PMID: 29769247.
BibTeX
@article{lamb2018-29769247,
author = {Lamb, S. E. and Sheehan, B. and Atherton, N. and Nichols, V. and Collins, H. and Mistry, D. and others},
title = {{Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial}},
journal = {BMJ},
year = {2018},
doi = {10.1136/bmj.k1675},
pmid = {29769247},
url = {https://doi.org/10.1136/bmj.k1675}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
Key findings
- Results The average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men.
Why it matters
This large randomized trial tested a moderate to high intensity aerobic and strength exercise programme in 494 people with mild to moderate dementia. The study did not find that the exercise programme improved cognitive outcomes, so it does not support exercise training as a treatment to slow dementia in this group.
New to this subject? Start with our plain-English guide: Treatments →
Study details
- Study designRCT
- Participants494
- Effect sizeADAS-cog adjusted difference -1.4 (95% CI -2.6 to -0.2) favouring usual care
- Evidence strengthNull-result
Limitations
Four-month intervention with ongoing activity support only; ADAS-cog difference small and of uncertain clinical relevance; cannot be masked to participants.
How this study scored 78/100
Published in a leading specialty journal, and it is a randomized controlled trial. We have no data on free to read, so that was left out: it earned 76 of the 98 points we could judge it on, which is 78 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (BMJ) |
| Journal's citation record | 3 / 4 | BMJ: journal h-index 413 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomized controlled trial |
| Strength of evidence | 3 / 5 | Rated “null-result” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 494 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 1 / 2 | Randomized (as stated in the record) |
| Times cited | 6 / 7 | Cited 415 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 41.5 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 5 / 6 | Cited 32.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 3 / 4 | Cited 113 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Ranjit Lall: h-index 44 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Oxford: institution h-index 2,205 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29769247) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 76 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 76 of the 98 points we could judge it on is 78 out of 100. |
| Total | 78 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
15 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Treatments from nearby years
Also tagged “trial”
783 studies in the library carry the topic tag “trial”; these are this study's neighbours in a fixed, alphabetical-by-hash tour of them, not the closest in content. All 783 tagged studies.