Anglia Ruskin University, Cambridge, UK.
Positive Ageing Research Institute, FHSCME, Anglia Ruskin University, South London and Maudsley Foundation NHS Trust, London, UK.
Aging Clin Exp Res. 2020 Jun;32(6):969-984. doi: 10.1007/s40520-019-01457-3. Epub 2020 Feb 5.
Physical activity can improve cognitive function of older adults, but the influence of sedentary behaviour on cognition is less clear. This systematic review investigated associations between sedentary behaviour and cognitive function in older adults without dementia, and possible mechanisms involved.
Major databases were searched for studies in English between 01/01/1999 and 31/10/2019. The systematic review followed COSMOS-E guideline and a pre-registered protocol (CRD42019122229). Risk of bias was assessed using NICE Quality appraisal checklist. Findings were narratively synthesized and presented.
Eighteen studies comprised of 13 cross-sectional and five longitudinal analyses (n = 40,228). Evidence suggested varied associations between varied sedentary behaviours and cognitive function in older adults. 50% of study analyses did not control for physical activity. 3/18 studies demonstrated associations between higher sedentary levels and lower levels of brain biomarkers, while 1/18 showed auto-regulatory effect in the left hippocampus. Conducting a meta-analysis was not justifiable due to considerable methodological, participant, outcome and exposure heterogeneity.
There is a lack of clarity about the overall and independent association between sedentary behaviour and cognition in older age. Underlying mechanisms are similar to physical activity and probably multi-modal. More studies with robust designs and methodology are needed to confirm effect of sedentary behaviour on cognition.
身体活动可以改善老年人的认知功能，但久坐行为对认知的影响尚不清楚。本系统评价调查了无痴呆症的老年人久坐行为与认知功能之间的关联，以及可能涉及的机制。
在 1999 年 1 月 1 日至 2019 年 10 月 31 日期间，使用主要数据库检索英文研究。系统评价遵循 COSMOS-E 指南和预先注册的方案（CRD42019122229）。使用 NICE 质量评估清单评估偏倚风险。对发现进行叙述性综合和呈现。
纳入了 18 项研究，其中包括 13 项横断面研究和 5 项纵向分析（n=40228）。证据表明，不同的久坐行为与老年人认知功能之间存在不同的关联。50%的研究分析没有控制身体活动。18 项研究中的 3 项表明，较高的久坐水平与较低的脑生物标志物水平之间存在关联，而 18 项研究中的 1 项表明左海马有自动调节效应。由于方法学、参与者、结局和暴露的高度异质性，进行荟萃分析是不合理的。
关于久坐行为与老年人认知功能之间的整体和独立关联，尚不清楚。潜在机制与身体活动相似，可能是多模式的。需要更多设计和方法学稳健的研究来证实久坐行为对认知的影响。
