Institute of Human Movement Sciences, University Medical Center Groningen, Groningen, The Netherlands.
Dement Geriatr Cogn Disord. 2010;30(5):392-402. doi: 10.1159/000321357. Epub 2010 Oct 28.
BACKGROUND/AIMS: Elderly individuals with dementia are vulnerable for a decline in physical functioning and basic activities of daily living (BADL) which can lead to a decline in autonomy and participation. This study reviews the effect of physical activity on physical functioning and BADL in elderly subjects with dementia.
A systematic search of the literature was performed. Key words related to the elderly, dementia, exercise interventions and physical outcome measures were used.
Sixteen studies were included. It was found that physical activity was beneficial in all stages of dementia. Multicomponent interventions (e.g. a combination of endurance, strength and balance) led to larger improvements in gait speed, functional mobility and balance, compared to progressive resistance training alone. BADL and endurance improved but were only assessed in multicomponent interventions. Lower-limb strength improved equally in multicomponent interventions and progressive resistance training.
Multicomponent interventions can improve physical functioning and BADL in elderly subjects regardless of the stage of dementia. The best results were obtained in the interventions with the largest training volume. However, the small number of high-quality studies, and heterogeneity of the participants and interventions prevent us from drawing firm conclusions. Recommendations are given with respect to methodological issues, further research and practical guidelines.
背景/目的：痴呆症老年患者身体机能和日常生活基本活动能力（BADL）下降的风险较高，这可能导致其自主性和参与度下降。本研究综述了身体活动对痴呆症老年患者身体机能和 BADL 的影响。
对文献进行了系统检索。使用了与老年人、痴呆症、运动干预和身体结果测量相关的关键词。
纳入了 16 项研究。结果发现，身体活动对痴呆症的各个阶段都有益处。与单纯渐进性抗阻训练相比，多组分干预（如耐力、力量和平衡的组合）可更大程度地提高步态速度、功能性移动和平衡能力。BADL 和耐力均有改善，但仅在多组分干预中进行了评估。多组分干预和渐进性抗阻训练均可同等改善下肢力量。
多组分干预可改善痴呆症老年患者的身体机能和 BADL，无论痴呆症处于哪个阶段。训练量最大的干预措施效果最佳。然而，高质量研究数量较少，参与者和干预措施存在异质性，这使得我们无法得出确定的结论。根据方法学问题、进一步研究和实践指南提出了建议。
