通过运动促进大脑健康(PROMoTE):一项针对血管性认知障碍老年人进行有氧运动训练的概念验证随机对照试验。

Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment.

机构信息

Department of Physical Therapy, University of British Columbia, Vancouver, Canada.

出版信息

BMC Neurol. 2010 Feb 17;10:14. doi: 10.1186/1471-2377-10-14.

Abstract

BACKGROUND

Sub-cortical vascular ischaemia is the second most common etiology contributing to cognitive impairment in older adults, and is frequently under-diagnosed and under-treated. Although evidence is mounting that exercise has benefits for cognitive function among seniors, very few randomized controlled trials of exercise have been conducted in populations at high-risk for progression to dementia. Aerobic-based exercise training may be of specific benefit in delaying the progression of cognitive decline among seniors with vascular cognitive impairment by reducing key vascular risk factors associated with metabolic syndrome. Thus, we aim to carry out a proof-of-concept single-blinded randomized controlled trial primarily designed to provide preliminary evidence of efficacy aerobic-based exercise training program on cognitive and everyday function among older adults with mild sub-cortical ischaemic vascular cognitive impairment.

METHODS/DESIGN: A proof-of-concept single-blinded randomized trial comparing a six-month, thrice-weekly, aerobic-based exercise training group with usual care on cognitive and everyday function. Seventy older adults who meet the diagnostic criteria for sub-cortical ischaemic vascular cognitive impairment as outlined by Erkinjuntti and colleagues will be recruited from a memory clinic of a metropolitan hospital. The aerobic-based exercise training will last for 6 months. Participants will be followed for an additional six months after the cessation of exercise training.

DISCUSSION

This research will be an important first step in quantifying the effect of an exercise intervention on cognitive and daily function among seniors with sub-cortical ischaemic vascular cognitive impairment, a recognized risk state for progression to dementia. Exercise has the potential to be an effective, inexpensive, and accessible intervention strategy with minimal adverse effects. Reducing the rate of cognitive decline among seniors with sub-cortical ischaemic vascular cognitive impairment could preserve independent functioning and health related quality of life in this population. This, in turn, could lead to reduced health care resource utilization costs and avoidance of early institutional care.

摘要

背景

皮质下血管性缺血是导致老年人认知障碍的第二大常见病因,而且常常被漏诊和治疗不足。尽管有越来越多的证据表明运动对老年人的认知功能有益,但在痴呆高危人群中进行的运动随机对照试验非常少。基于有氧运动的锻炼可能通过降低与代谢综合征相关的关键血管危险因素,对有血管性认知障碍的老年人认知能力下降的进展具有特殊的益处。因此,我们旨在开展一项概念验证的单盲随机对照试验,主要旨在提供初步证据,证明有氧运动训练方案对轻度皮质下缺血性血管性认知障碍的老年人的认知和日常功能具有疗效。

方法/设计:一项概念验证的单盲随机试验,比较了 6 个月、每周 3 次的基于有氧运动的锻炼组和常规护理对认知和日常功能的影响。将从一家大都市医院的记忆诊所招募 70 名符合皮质下缺血性血管性认知障碍诊断标准(如 Erkinjuntti 等人所述)的老年人。基于有氧运动的锻炼将持续 6 个月。在锻炼训练停止后,参与者将再随访 6 个月。

讨论

这项研究将是量化有氧运动干预对皮质下缺血性血管性认知障碍老年人认知和日常功能影响的重要第一步,皮质下缺血性血管性认知障碍是痴呆进展的公认危险因素。运动有可能成为一种有效、廉价且易于获得的干预策略,副作用极小。降低皮质下缺血性血管性认知障碍老年人的认知下降速度可以维持该人群的独立功能和健康相关生活质量。反过来,这可能会降低医疗保健资源的利用成本,并避免早期的机构护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/142a/2830197/fc51c5f53c8f/1471-2377-10-14-1.jpg

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