Mavros Yorgi, Gates Nicola, Wilson Guy C, Jain Nidhi, Meiklejohn Jacinda, Brodaty Henry, Wen Wei, Singh Nalin, Baune Bernhard T, Suo Chao, Baker Michael K, Foroughi Nasim, Wang Yi, Sachdev Perminder S, Valenzuela Michael, Fiatarone Singh Maria A
Exercise Health and Performance Faculty Research Group, Faculty of Health Sciences, University of Sydney, Lidcombe, Sydney, New South Wales, Australia.
Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
J Am Geriatr Soc. 2017 Mar;65(3):550-559. doi: 10.1111/jgs.14542. Epub 2016 Oct 24.
To determine whether improvements in aerobic capacity (VO ) and strength after progressive resistance training (PRT) mediate improvements in cognitive function.
Randomized, double-blind, double-sham, controlled trial.
University research facility.
Community-dwelling older adults (aged ≥55) with mild cognitive impairment (MCI) (N = 100).
PRT and cognitive training (CT), 2 to 3 days per week for 6 months.
Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-Cog); global, executive, and memory domains; peak strength (1 repetition maximum); and VO .
PRT increased upper (standardized mean difference (SMD) = 0.69, 95% confidence interval = 0.47, 0.91), lower (SMD = 0.94, 95% CI = 0.69-1.20) and whole-body (SMD = 0.84, 95% CI = 0.62-1.05) strength and percentage change in VO (8.0%, 95% CI = 2.2-13.8) significantly more than sham exercise. Higher strength scores, but not greater VO , were significantly associated with improvements in cognition (P < .05). Greater lower body strength significantly mediated the effect of PRT on ADAS-Cog improvements (indirect effect: β = -0.64, 95% CI = -1.38 to -0.004; direct effect: β = -0.37, 95% CI = -1.51-0.78) and global domain (indirect effect: β = 0.12, 95% CI = 0.02-0.22; direct effect: β = -0.003, 95% CI = -0.17-0.16) but not for executive domain (indirect effect: β = 0.11, 95% CI = -0.04-0.26; direct effect: β = 0.03, 95% CI = -0.17-0.23).
High-intensity PRT results in significant improvements in cognitive function, muscle strength, and aerobic capacity in older adults with MCI. Strength gains, but not aerobic capacity changes, mediate the cognitive benefits of PRT. Future investigations are warranted to determine the physiological mechanisms linking strength gains and cognitive benefits.
确定渐进性抗阻训练（PRT）后有氧能力（VO ）和力量的改善是否能介导认知功能的改善。
随机、双盲、双模拟、对照试验。
大学研究机构。
患有轻度认知障碍（MCI）的社区居住老年人（年龄≥55岁）（N = 100）。
PRT和认知训练（CT），每周2至3天，共6个月。
阿尔茨海默病评估量表-认知分量表（ADAS-Cog）；整体、执行和记忆领域；峰值力量（1次重复最大值）；以及VO 。
与假运动相比，PRT显著提高了上肢（标准化均值差（SMD）= 0.69，95%置信区间 = 0.47，0.91）、下肢（SMD = 0.94，95%CI = 0.69 - 1.20）和全身（SMD = 0.84，95%CI = 0.62 - 1.05）的力量以及VO 的百分比变化（8.0%，95%CI = 2.2 - 13.8）。更高的力量得分而非更大的VO 与认知改善显著相关（P < .05）。更大的下肢力量显著介导了PRT对ADAS-Cog改善（间接效应：β = -0.64，95%CI = -1.38至 -0.004；直接效应：β = -0.37，95%CI = -1.51 - 0.78）和整体领域（间接效应：β = 0.12，95%CI = 0.02 - 0.22；直接效应：β = -0.003，95%CI = -0.17 - 0.16）的影响，但对执行领域无影响（间接效应：β = 0.11，95%CI = -0.04 - 0.26；直接效应：β = 0.03，95%CI = -0.17 - 0.23）。
高强度PRT可使患有MCI的老年人的认知功能、肌肉力量和有氧能力得到显著改善。力量的增加而非有氧能力的变化介导了PRT的认知益处。有必要进行进一步研究以确定连接力量增加和认知益处的生理机制。
