Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
Department of Psychology, Heriot-Watt University, Edinburgh, EH14 4AS, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK.
Ageing Res Rev. 2019 Mar;50:110-130. doi: 10.1016/j.arr.2019.01.006. Epub 2019 Jan 29.
Activities running in community-based-settings offer a method of delivering multimodal interventions to older adults beyond cognitive training programmes. This systematic review and meta-analysis investigated the impact of randomised controlled trials (RCTs) of 'real-world' interventions on the cognitive abilities of healthy older adults. Database searches were performed between October 2016 and September 2018. Forty-three RCTs were eligible for inclusion with 2826 intervention participants and 2234 controls. Interventions to enhance cognitive ability consisted of participation in activities that were physical (25 studies), cognitive (9 studies), or mixed (i.e., physical and cognitive; 7 studies), and two studies used other interventions that included older adults assisting schoolchildren and engagement via social network sites. Meta-analysis revealed that Trail Making Test (TMT) A, p = 0.05, M = 0.43, 95% CI [-0.00, 0.86], digit symbol substitution, p = 0.05, M = 0.30, 95% CI [0.00, 0.59], and verbal fluency, p = 0.04, M = 0.31, 95% CI [0.02, 0.61], improved after specific types of interventions versus the control groups (which were either active, wait-list or passive controls). When comparing physical activity interventions against all control groups, TMT A, p = 0.04, M = 0.25, 95% CI [0.01, 0.48], and digit span forward, p = 0.05, M = 0.91, 95% CI [-0.00, 1.82], significantly improved. Results remained non-significant for all outcomes when comparing cognitive activity interventions against all control groups. Results therefore suggest that healthy older adults are more likely to see cognitive improvements when involved in physical activity interventions. In addition, TMT A was the only measure that consistently showed significant improvements following physical activity interventions. Visuospatial abilities (as measured by TMT A) may be more susceptible to improvement following physical activity-based interventions, and TMT A may be a useful tool for detecting differences in that domain.
在社区环境中开展的活动为向老年人提供超越认知训练计划的多模式干预提供了一种方法。本系统评价和荟萃分析调查了“真实世界”干预措施的随机对照试验（RCT）对健康老年人认知能力的影响。数据库检索于 2016 年 10 月至 2018 年 9 月进行。43 项 RCT 符合纳入标准，共有 2826 名干预参与者和 2234 名对照。增强认知能力的干预措施包括参与身体活动（25 项研究）、认知活动（9 项研究）或混合活动（即身体和认知活动；7 项研究），两项研究采用了包括老年人帮助学童和通过社交网站参与在内的其他干预措施。荟萃分析显示，连线测试 A（TMT A），p=0.05，M=0.43，95%CI[-0.00，0.86]，数字符号替代测试，p=0.05，M=0.30，95%CI[0.00，0.59]，和词语流畅性测试，p=0.04，M=0.31，95%CI[0.02，0.61]，在特定类型的干预措施与对照组（积极对照组、等待对照组或被动对照组）相比有所改善。当将身体活动干预与所有对照组进行比较时，TMT A，p=0.04，M=0.25，95%CI[0.01，0.48]，和数字跨度向前，p=0.05，M=0.91，95%CI[-0.00，1.82]，显著改善。当将认知活动干预与所有对照组进行比较时，所有结果均无统计学意义。因此，结果表明，健康老年人更有可能通过参与身体活动干预来提高认知能力。此外，TMT A 是唯一一项在进行身体活动干预后始终显示出显著改善的测量指标。视空间能力（如 TMT A 所衡量）可能更容易通过基于身体活动的干预措施得到改善，TMT A 可能是检测该领域差异的有用工具。
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