Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
PLoS One. 2019 Jan 10;14(1):e0210036. doi: 10.1371/journal.pone.0210036. eCollection 2019.
This systematic review and meta-analysis examined the dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairments. We included single-modality randomized controlled aerobic, anaerobic, multicomponent or psychomotor exercise trials that quantified training frequency, session and program duration and specified intensity quantitatively or qualitatively. We defined total exercise duration in minutes as the product of program duration, session duration, and frequency. For each study, we grouped test-specific Hedges' d (n = 163) and Cohen's d (n = 23) effect sizes in the domains Global cognition, Executive function and Memory. We used multilevel mixed-effects models to investigate dose-related predictors of exercise effects. In healthy older adults (n = 23 studies), there was a small positive effect of exercise on executive function (d = 0.27) and memory (d = 0.24), but dose-parameters did not predict the magnitude of effect sizes. In older adults with cognitive impairments (n = 13 studies), exercise had a moderate positive effect on global cognition (d = 0.37). For older adults with cognitive impairments, we found evidence for exercise programs with a short session duration and high frequency to predict higher effect sizes (d = 0.43-0.50). In healthy older adults, dose-parameters did not predict the magnitude of exercise effects on cognition. For older adults with cognitive impairments, exercise programs with shorter session duration and higher frequency may generate the best cognitive results. Studies are needed in which different exercise doses are directly compared among randomized subjects or conditions.
本系统评价和荟萃分析考察了运动与认知功能在有和无认知障碍的老年人之间的剂量-反应关系。我们纳入了单模态随机对照有氧运动、无氧运动、多组分或精神运动锻炼试验，这些试验量化了训练频率、课程和方案持续时间，并定量或定性地规定了强度。我们将方案持续时间、课程持续时间和频率的乘积定义为总运动持续时间（以分钟为单位）。对于每项研究，我们将特定测试的 Hedges' d（n = 163）和 Cohen's d（n = 23）效应大小在全局认知、执行功能和记忆等领域进行分组。我们使用多层次混合效应模型来研究与剂量相关的运动效果预测因子。在健康老年人（n = 23 项研究）中，运动对执行功能（d = 0.27）和记忆（d = 0.24）有较小的积极影响，但剂量参数并不能预测效应大小。在有认知障碍的老年人（n = 13 项研究）中，运动对整体认知有适度的积极影响（d = 0.37）。对于有认知障碍的老年人，我们发现证据表明，短课程持续时间和高频率的运动方案可以预测更高的效应大小（d = 0.43-0.50）。在健康老年人中，剂量参数并不能预测运动对认知的影响程度。对于有认知障碍的老年人，短课程持续时间和高频率的运动方案可能会产生最佳的认知效果。需要在随机受试者或条件之间直接比较不同运动剂量的研究。
