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运动锻炼对轻度认知障碍老年人认知功能的影响:系统评价和荟萃分析。

Effects of physical exercise on cognitive function of older adults with mild cognitive impairment: A systematic review and meta-analysis.

机构信息

Postgraduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.

出版信息

Arch Gerontol Geriatr. 2020 Jul-Aug;89:104048. doi: 10.1016/j.archger.2020.104048. Epub 2020 May 12.

Abstract

BACKGROUND AND PURPOSE

Mild Cognitive Impairment (MCI) is associated with a greater risk of dementia for older adults. However, systematic reviews have shown that some physical exercise (PE) seems to improve MCI symptoms and signs. Those reviews and meta-analysis could not explain what possible moderator influenced their results. This meta-analysis aims to identify the effect of PE over older people's cognition with MCI and explore sources of heterogeneity.

METHODS

Databases were searched from inception January 2020 for randomized clinical trials that evaluated the effects of PE over cognition of older persons with MCI. Random effect meta-analyses were performed for each cognitive outcome. Subgroup analyses and meta-regressions models explored the potential sources of heterogeneity.

RESULTS

A total of 2077 participants (mean age = 71.8 years) from 27 studies were included. PE improves global cognitive function (SMD = 0.348 [95 % CI 0.166 to 0.529]; p = 0.0001), executive function (SMD = 0.213 [95 % CI 0.026 to 0.400]; p = 0.026) and delayed recall (SMD = 0.180 [95 % CI 0.002 to 0.358]; p = 0.047). A trend towards beneficial effects of PE on verbal fluency (SMD = 0.270 [95 %, CI -0.021 to 0.561]; p = 0.069) and attention (SMD = 0.170 [CI -0.016 to 0.357]; p = 0.073) were also observed. Subgroup analyses showed a relationship between modality and intensity of physical exercise and changes observed in global cognitive function, executive function, delayed recall, verbal fluency and working memory.

DISCUSSION AND CONCLUSION

PE can ameliorate cognitive deficts of older adults with MCI. The most pronounced effects appear to arise from other types of exercise that included mind-body exercises and moderate intensity.

摘要

背景与目的

轻度认知障碍(MCI)与老年人痴呆的风险增加有关。然而,系统评价显示,一些体育锻炼(PE)似乎可以改善 MCI 症状和体征。这些综述和荟萃分析无法解释可能影响其结果的任何调节因素。本荟萃分析旨在确定 PE 对 MCI 老年人认知的影响,并探讨异质性的来源。

方法

从 2020 年 1 月开始,在数据库中搜索评估 PE 对 MCI 老年人认知影响的随机临床试验。对每项认知结果进行随机效应荟萃分析。亚组分析和荟萃回归模型探讨了潜在的异质性来源。

结果

共纳入 27 项研究的 2077 名参与者(平均年龄 71.8 岁)。PE 可改善整体认知功能(SMD=0.348[95%CI0.166 至 0.529];p=0.0001)、执行功能(SMD=0.213[95%CI0.026 至 0.400];p=0.026)和延迟回忆(SMD=0.180[95%CI0.002 至 0.358];p=0.047)。PE 对言语流畅性(SMD=0.270[95%CI-0.021 至 0.561];p=0.069)和注意力(SMD=0.170[CI-0.016 至 0.357];p=0.073)也有改善的趋势。亚组分析显示,体育锻炼的方式和强度与整体认知功能、执行功能、延迟回忆、言语流畅性和工作记忆的变化之间存在关系。

讨论与结论

PE 可改善 MCI 老年人的认知缺陷。最明显的效果似乎来自于其他类型的运动,包括身心运动和中等强度的运动。

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