Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan.
J Am Med Dir Assoc. 2018 Jul;19(7):584-591. doi: 10.1016/j.jamda.2017.09.019. Epub 2017 Nov 17.
Although participation in physical and cognitive activities is encouraged to reduce the risk of dementia, the preventive efficacy of these activities for patients with mild cognitive impairment is unestablished.
To compare the cognitive and mobility effects of a 40-week program of combined cognitive and physical activity with those of a health education program.
A randomized, parallel, single-blind controlled trial.
A population-based study of participants recruited from Obu, a residential suburb of Nagoya, Japan.
Between August 2011 and February 2012, we evaluated 945 adults 65 years or older with mild cognitive impairment, enrolled 308, and randomly assigned them to the combined activity group (n = 154) or the health education control group (n = 154).
The combined activity program involved weekly 90-minute sessions for 40 weeks focused on physical and cognitive activities. The control group attended 90-minute health promotion classes thrice during the 40-week trial period.
The outcome measures were assessed at the study's beginning and end by personnel blinded to mild cognitive impairment subtype and group. The primary endpoints were postintervention changes in scores on (1) the Mini-Mental State Examination as a measure of general cognitive status and memory, (2) the Wechsler Memory Scale-Revised-Logical Memory II, and (3) the Rey Auditory Verbal Learning Test. We applied mobility assessments and assessed brain atrophy with magnetic resonance imaging.
Compared with the control group, the combined activity group showed significantly greater scores on the Mini-Mental State Examination (difference = 0.8 points, P = .012) and Wechsler Memory Scale-Revised-Logical Memory II (difference = 1.0, P = .004), significant improvements in mobility and the nonmemory domains and reduced left medial temporal lobe atrophy in amnestic mild cognitive impairment (Z-score difference = -31.3, P < .05).
Combined physical and cognitive activity improves or maintains cognitive and physical performance in older adults with mild cognitive impairment, especially the amnestic type.
尽管鼓励参与身体和认知活动以降低痴呆风险，但这些活动对轻度认知障碍患者的预防效果尚未确定。
比较 40 周认知与身体活动相结合的方案与健康教育方案对认知和移动能力的影响。
一项随机、平行、单盲对照试验。
参与者是从日本名古屋的一个住宅区大府招募的，基于人群的研究。
2011 年 8 月至 2012 年 2 月，我们评估了 945 名年龄在 65 岁或以上的患有轻度认知障碍的成年人，招募了 308 名参与者，并将他们随机分配到联合活动组（n=154）或健康教育对照组（n=154）。
联合活动方案包括每周进行 90 分钟的身体和认知活动，为期 40 周。对照组在 40 周的试验期间参加了 90 分钟的健康促进课程三次。
在研究开始和结束时，由对轻度认知障碍亚型和组均不知情的人员进行评估。主要终点是干预后（1）简易精神状态检查（MMSE）作为一般认知状态和记忆力的衡量标准、（2）韦氏记忆量表修订版逻辑记忆 II （WMS-R LM II）和（3） Rey 听觉言语学习测验（RAVLT）的评分变化。我们应用了移动性评估，并通过磁共振成像评估了脑萎缩。
与对照组相比，联合活动组的 MMSE 评分（差值=0.8 分，P=0.012）和 WMS-R LM II 评分（差值=1.0，P=0.004）显著更高，移动能力和非记忆域显著改善，遗忘型轻度认知障碍患者的左侧内侧颞叶萎缩减少（Z 分数差值=-31.3，P<0.05）。
联合身体和认知活动可改善或维持轻度认知障碍老年人的认知和身体表现，特别是遗忘型。
