Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, Sydney Medical School, The University of Sydney, Lidcombe, New South Wales, Australia; Hebrew SeniorLife, Boston, MA; Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA.
Private Neuropsychology Practice, Mosman, New South Wales, Australia.
J Am Med Dir Assoc. 2014 Dec;15(12):873-80. doi: 10.1016/j.jamda.2014.09.010. Epub 2014 Oct 23.
BACKGROUND: Mild cognitive impairment (MCI) increases dementia risk with no pharmacologic treatment available. METHODS: The Study of Mental and Resistance Training was a randomized, double-blind, double-sham controlled trial of adults with MCI. Participants were randomized to 2 supervised interventions: active or sham physical training (high intensity progressive resistance training vs seated calisthenics) plus active or sham cognitive training (computerized, multidomain cognitive training vs watching videos/quizzes), 2-3 days/week for 6 months with 18-month follow-up. Primary outcomes were global cognitive function (Alzheimer's Disease Assessment Scale-cognitive subscale; ADAS-Cog) and functional independence (Bayer Activities of Daily Living). Secondary outcomes included executive function, memory, and speed/attention tests, and cognitive domain scores. RESULTS: One hundred adults with MCI [70.1 (6.7) years; 68% women] were enrolled and analyzed. Resistance training significantly improved the primary outcome ADAS-Cog; [relative effect size (95% confidence interval) -0.33 (-0.73, 0.06); P < .05] at 6 months and executive function (Wechsler Adult Intelligence Scale Matrices; P = .016) across 18 months. Normal ADAS-Cog scores occurred in 48% (24/49) after resistance training vs 27% (14/51) without resistance training [P < .03; odds ratio (95% confidence interval) 3.50 (1.18, 10.48)]. Cognitive training only attenuated decline in Memory Domain at 6 months (P < .02). Resistance training 18-month benefit was 74% higher (P = .02) for Executive Domain compared with combined training [z-score change = 0.42 (0.22, 0.63) resistance training vs 0.11 (-0.60, 0.28) combined] and 48% higher (P < .04) for Global Domain [z-score change = .0.45 (0.29, 0.61) resistance training vs 0.23 (0.10, 0.36) combined]. CONCLUSIONS: Resistance training significantly improved global cognitive function, with maintenance of executive and global benefits over 18 months.
背景：轻度认知障碍（MCI）会增加痴呆的风险，但目前尚无药物治疗方法。
方法：精神和抵抗训练研究是一项针对 MCI 成年人的随机、双盲、双假对照试验。参与者被随机分配到 2 种监督干预措施：主动或假物理训练（高强度渐进式抗阻训练与坐姿健身操）加主动或假认知训练（计算机化、多领域认知训练与观看视频/测验），每周 2-3 天，持续 6 个月，18 个月随访。主要结局是整体认知功能（阿尔茨海默病评估量表认知子量表；ADAS-Cog）和功能独立性（拜耳日常生活活动）。次要结局包括执行功能、记忆和速度/注意力测试以及认知域评分。
结果：100 名 MCI 患者[70.1（6.7）岁；68%女性]入组并进行分析。抗阻训练显著改善了主要结局 ADAS-Cog；[相对效应量（95%置信区间）-0.33（-0.73，0.06）；P<0.05]在 6 个月和执行功能（韦氏成人智力量表矩阵）[P=0.016]在 18 个月。抗阻训练后，正常 ADAS-Cog 评分发生率为 48%（24/49），而无抗阻训练组为 27%（14/51）[P<0.03；比值比（95%置信区间）3.50（1.18，10.48）]。认知训练仅在 6 个月时减轻了记忆域的下降（P<0.02）。与联合训练相比，抗阻训练 18 个月的获益在执行域高出 74%（P=0.02）[z 分数变化=0.42（0.22，0.63）抗阻训练与 0.11（-0.60，0.28）联合]，在全球域高出 48%（P<0.04）[z 分数变化=0.45（0.29，0.61）抗阻训练与 0.23（0.10，0.36）联合]。
结论：抗阻训练显著改善了整体认知功能，在 18 个月时维持了执行和全球的获益。
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