Older adults' adoption of shared service platforms outside long-term care insurance in Japan based on technology acceptance model.

Dementia is a progressive condition marked not only by cognitive decline but also by functional impairment and behavioral changes that significantly affect quality of life (). Globally, an estimated 55 million people are currently living with dementia, and this number is projected to rise to over 139 million by 2050, driven largely by population aging and increasing life expectancy (). As life expectancy increases, the burden of dementia is expected to rise sharply, particularly in low- and middle-income settings where healthcare resources are often limited (). Although pharmacological therapies have advanced over the years, their impact remains largely symptomatic, with little effect on slowing disease progression. This has led to growing interest in lifestyle-based and non-pharmacological interventions (). Among these, physical activity has received considerable attention. Observational studies have consistently shown that individuals who remain physically active tend to have a lower risk of developing cognitive impairment and other non-communicable diseases (; ). Therapeutic exercise has been shown to slow physical and cognitive decline, and recent interventional studies suggest it may also benefit individuals already living with dementia. However, its sustained impact on functional outcomes and the persistence of benefits after discontinuation remain unclear (). The rationale for this approach is supported by a range of biological and clinical observations. Exercise has been linked to improved vascular health, enhanced neuroplasticity, and reductions in systemic inflammation—all of which may play a role in neurodegenerative processes (). However, translating these mechanisms into consistent clinical benefit has proven complex. To provide a clearer conceptual framework, the following section first defines the key terms used throughout this review before discussing the various exercise modalities, their biological mechanisms, clinical evidence, and practical applications in dementia care. is a progressive neurodegenerative syndrome characterized by deterioration in memory, executive function, language, attention, and other cognitive domains, resulting in impairment of daily functioning and loss of independence. Alzheimer’s disease is the most common cause of dementia, although vascular dementia, dementia with Lewy bodies, and frontotemporal dementia also contribute substantially to the global disease burden ().