Department of Neurology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
Department of Neurology, Inha University School of Medicine, Incheon, South Korea.
J Alzheimers Dis. 2018;66(1):249-261. doi: 10.3233/JAD-180333.
There is a lack of research on the effects of physical activity (PA) on the progression of Alzheimer's disease (AD).
We investigated whether PA is associated with progression of dementia and mortality in AD.
In the present study, 934 patients with mild-to-moderate AD were included. PA was evaluated using a questionnaire written by the caregiver. The outcome measures were the Clinical Dementia Rating-Sum of Boxes (CDR-SB), Seoul-Instrumental Activities of Daily Living (S-IADL), Caregiver-Administered Neuropsychiatric Inventory (CGA-NPI), a global composite score of neuropsychological subtests, and mortality. They were evaluated annually and received a maximum of three follow-up examinations.
Between-group differences compared with the no PA group in the change of CDR-SB scores were -0.431 (95% CI = -0.824∼-0.039; p = 0.031) for the moderate PA group (150-750 minutes per week of moderate intensity PA), and -1.148 (-1.656∼-0.639; p < 0.001) for the high PA group (>750 minutes per week). As PA increased, there was a significant trend to slow the rate of increase in the CDR-SB, S-IADL, and CGA-NPI scores. The patients with ≥150 minutes per week for each of non-recreational and recreational PAs had a lower risk of mortality compared to those with <150 minutes per week for each of the PAs (hazard ratio 0.22, 95% CI = 0.05∼0.88; p = 0.033).
More PA is associated with slower progression of dementia severity, functional decline, and abnormal behavior, and with a lower risk of mortality in AD.
目前缺乏体力活动（PA）对阿尔茨海默病（AD）进展影响的研究。
我们调查 PA 是否与 AD 患者的痴呆进展和死亡率相关。
本研究纳入 934 例轻中度 AD 患者。PA 由照顾者填写问卷进行评估。主要结局指标为临床痴呆评定量表-和总分（CDR-SB）、首尔工具性日常生活活动量表（S-IADL）、照顾者管理的神经精神问卷（CGA-NPI）、神经心理学子测试的综合评分和死亡率。每年评估一次，最多接受三次随访检查。
与无 PA 组相比，中等强度 PA（150-750 分钟/周）组 CDR-SB 评分的变化差异为-0.431（95% CI=-0.824∼-0.039；p=0.031），高 PA 组（>750 分钟/周）为-1.148（-1.656∼-0.639；p<0.001）。随着 PA 的增加，CDR-SB、S-IADL 和 CGA-NPI 评分的增加率呈显著下降趋势。每周进行≥150 分钟非娱乐性和娱乐性 PA 的患者死亡率低于每周进行<150 分钟 PA 的患者（风险比 0.22，95% CI=0.05∼0.88；p=0.033）。
更多的 PA 与 AD 患者痴呆严重程度、功能下降和异常行为的进展缓慢以及死亡率降低相关。
