The School of Nursing, Zhejiang Chinese Medical University, China.
The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
Int J Nurs Stud. 2019 May;93:97-105. doi: 10.1016/j.ijnurstu.2019.02.019. Epub 2019 Mar 5.
Individuals with mild cognitive impairment have a heightened risk of developing dementia. Physical exercise, especially moderate-intensity aerobic exercise, is a promising lifestyle intervention to improve the cognitive function of this patient group. However, the mechanisms underlying the exercise-cognition relationship are not fully understood. Whether the cognitive benefits of physical exercise can improve the overall well-being of this group remains unknown. This study aims to address these research gaps in the under-researched Chinese population.
This study aimed to evaluate the effects of a moderate-intensity aerobic exercise programme on the cognitive function and health-related quality of life of Chinese elderly with mild cognitive impairment and to explore the mediating roles of depressive mood and sleep quality in the exercise-cognition relationship.
A single-blinded randomised controlled trial.
This study was conducted in two urban community healthcare centres in Hangzhou City, China. Elderly people aged over 60 years screened with mild cognitive impairment were included.
A total of 120 eligible participants were randomly assigned to receive either the group-based moderate-intensity aerobic exercise programme or the health education programme (as attention-placebo control). Montreal Cognitive Assessment, Quality of Life-Alzheimer's Disease, Geriatric Depression Scale and Pittsburgh Sleep Quality Index were administered at baseline before randomisation and immediately after the completion of the interventions. Analysis followed the intention-to-treat principle. Generalised estimating equation was used to compare the changes in the cognitive function and health-related quality of life over the pre-test and post-test periods between the groups. The mediating roles of depressive mood and sleep quality in the exercise-cognition relationship were examined with the PROCESS macro.
Participants in the intervention group had a significantly greater improvement in terms of cognitive function (β = 1.895; 95% confidential interval [CI] = 1.421, 2.368; p < 0.001) and health-related quality of life (β= 0.605; 95% CI= 0.295, 0.914; p < 0.001) compared with the control group over the pre-test and post-test periods. The exercise-cognition relationship was significantly mediated by reduced depressive symptoms (indirect effect: β= -0.705; 95% CI: -1.028, -0.382) and improved sleep quality (indirect effect: β=-0.205; 95% CI: -0.122, 0.831).
This study revealed the benefits and outlined the underlying mediating mechanism of an aerobic exercise programme to the cognitive function and health-related quality of life of Chinese elderly people with mild cognitive impairment. The findings provided insights into the development of public health initiatives to promote brain health amongst the elderly with mild cognitive impairment.
轻度认知障碍患者发展为痴呆的风险较高。身体活动，尤其是中等强度的有氧运动，是改善这群患者认知功能的一种很有前途的生活方式干预措施。然而，运动与认知关系的机制尚不完全清楚。身体活动的认知益处是否能提高这群人的整体幸福感尚不清楚。本研究旨在解决中文人群中研究不足的这些研究空白。
本研究旨在评估中等强度有氧运动方案对中国轻度认知障碍老年患者认知功能和健康相关生活质量的影响，并探讨抑郁情绪和睡眠质量在运动-认知关系中的中介作用。
单盲随机对照试验。
本研究在杭州市的两家城市社区医疗中心进行。纳入了经过轻度认知障碍筛查的 60 岁以上老年人。
共有 120 名符合条件的参与者被随机分配接受基于小组的中等强度有氧运动方案或健康教育方案（作为注意力-安慰剂对照）。在随机分组前的基线和干预结束后立即进行蒙特利尔认知评估、生活质量-阿尔茨海默病、老年抑郁量表和匹兹堡睡眠质量指数评估。分析遵循意向治疗原则。使用广义估计方程比较两组在预测试和后测试期间认知功能和健康相关生活质量的变化。使用 PROCESS 宏检验抑郁情绪和睡眠质量在运动-认知关系中的中介作用。
与对照组相比，干预组的认知功能（β=1.895；95%置信区间[CI]=1.421，2.368；p<0.001）和健康相关生活质量（β=0.605；95%CI=0.295，0.914；p<0.001）有显著改善。运动-认知关系通过降低抑郁症状（间接效应：β=-0.705；95%CI=-1.028，-0.382）和改善睡眠质量（间接效应：β=-0.205；95%CI=-0.122，0.831）而具有显著的中介作用。
本研究揭示了有氧运动方案对中国轻度认知障碍老年患者认知功能和健康相关生活质量的益处，并概述了其潜在的中介机制。研究结果为制定促进轻度认知障碍老年人大脑健康的公共卫生倡议提供了思路。
