Effects of a community-based structured group exercise program on cognitive and physical function among older adults with dementia: a randomized controlled trial study protocol

BACKGROUND: Dementia is a neurocognitive disorder that involves deterioration in cognitive and daily functioning, leading to loss of independence and reduced quality of life. While pharmacological treatments offer limited symptomatic relief, non-pharmacological approaches such as exercise have shown promise in improving cognitive and functional outcomes. However, evidence from community-based structured exercise interventions remains limited, particularly in low-resource settings. This trial aims to evaluate the effects of a community-based structured group exercise program on cognitive and physical function among older adults with dementia. METHODS: This assessor-blinded, community-based randomized controlled trial will be conducted from February to September 2026 in Bangladesh. A total of 120 older adults diagnosed with dementia will be randomly allocated (1:1) to either the experimental group (structured group exercise program with healthy lifestyle advice) or the control group (healthy lifestyle advice alone). The intervention will consist of supervised sessions three times a week for 12 weeks, followed by a 12-week follow-up period. The outcome will be measured on both cognitive and physical function bases. Cognitive function will be evaluated using the Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), Trail Making Test (TMT) A-B, and Digit Span Test (DST). Physical function will be measured using the Senior Fitness Test (SFT), Berg Balance Scale (BBS), Timed Up and Go (TUG) Test, and Instrumental Activities of Daily Living scale (IADLs). All outcomes will be measured at baseline, posttest (12 weeks), and follow-up period (12 weeks). Data will be analyzed using SPSS following the intention-to-treat principle. DISCUSSION: The findings are expected to support the integration of physiotherapist-led, community-based exercise into dementia care, offering a feasible, safe, and cost-effective approach for improving cognitive and physical function in older adults with dementia. Despite potential limitations in generalizability, the study's community implementation and follow-up design will contribute valuable insights into sustainable rehabilitation practices in resource-limited settings. TRIAL REGISTRATION: This trial is registered prospectively in the Clinical Trial Registry India; ID: CTRI/2025/10/096618; Registered on: 29/10/2025. Link: https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTQ0NDg3&Enc=&userName=.