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轻度认知障碍患者的非药物干预措施:基于认知和运动干预的随机对照试验的荟萃分析

Non-pharmacological interventions for patients with mild cognitive impairment: a meta-analysis of randomized controlled trials of cognition-based and exercise interventions.

作者信息

Wang Chong, Yu Jin-Tai, Wang Hui-Fu, Tan Chen-Chen, Meng Xiang-Fei, Tan Lan

机构信息

Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China.

Department of Neurology, Qingdao Municipal Hospital, School of Medicine, Qingdao University, China Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, China.

出版信息

J Alzheimers Dis. 2014;42(2):663-78. doi: 10.3233/JAD-140660.

Abstract

BACKGROUND

Non-pharmacological interventions, including cognition-based intervention and physical exercise, are available for mild cognitive impairment (MCI), but their efficacy remains uncertain.

OBJECTIVE

To evaluate efficacy of cognition-based intervention and physical exercise on cognitive domains in patients with MCI.

METHODS

We searched MEDLINE, EMBASE, the Cochrane library, and BIOSIS previews to identify randomized controlled trials (RCTs) that involved cognition-based intervention and physical exercise for persons who were diagnosed with MCI. The pooled weight mean difference or standard mean difference (SMD) were calculated using a random-effect model.

RESULTS

We found significant effects of cognition-based intervention on global cognitive function (SMD 0.37 [0.07, 0.68] p = 0.02). Besides, cognition-based intervention produced significant effects on executive function reported with TMT-B (SMD 0.8 [0.09, 1.5] p = 0.03) and delayed memory (SMD 0.31 [0.01, 0.61] p = 0.05). A beneficial improvement in global cognitive function was also seen in the exercise group compared to the control group (SMD 0.25 [0.08, 0.41] p = 0.003).

CONCLUSIONS

Both of cognition-based intervention and physical exercise had the potential to improve global cognitive function. Weak evidence of improvements was also observed for the domains of executive function and delayed memory following cognition-based intervention. Nevertheless, future standard RCTs are still needed to identify the clinical value of our results.

摘要

背景

包括基于认知的干预和体育锻炼在内的非药物干预措施可用于治疗轻度认知障碍(MCI),但其疗效仍不确定。

目的

评估基于认知的干预和体育锻炼对MCI患者认知领域的疗效。

方法

我们检索了MEDLINE、EMBASE、Cochrane图书馆和BIOSIS预评数据库,以确定涉及对被诊断为MCI的患者进行基于认知的干预和体育锻炼的随机对照试验(RCT)。使用随机效应模型计算合并加权均数差或标准化均数差(SMD)。

结果

我们发现基于认知的干预对整体认知功能有显著影响(SMD 0.37 [0.07, 0.68],p = 0.02)。此外,基于认知的干预对用TMT-B报告的执行功能(SMD 0.8 [0.09, 1.5],p = 0.03)和延迟记忆(SMD 0.31 [0.01, 0.61],p = 0.05)产生了显著影响。与对照组相比,运动组的整体认知功能也有有益的改善(SMD 0.25 [0.08, 0.41],p = 0.003)。

结论

基于认知的干预和体育锻炼都有可能改善整体认知功能。基于认知的干预后,在执行功能和延迟记忆领域也观察到了微弱的改善证据。然而,仍需要未来的标准RCT来确定我们结果的临床价值。

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