HAVAE, EA 6310, Université de Limoges, Limoges, France.
IFMK EFOM, Universités de Paris, Paris, France.
Neurophysiol Clin. 2020 Nov;50(6):441-453. doi: 10.1016/j.neucli.2020.10.010. Epub 2020 Oct 26.
Ageing is associated with cognitive decline, ranging from normal to mild cognitive impairment or dementia. This leads to physical and cognitive impairments, which are risk factors for loss of autonomy. Therefore, cognitive and physical training are important for cognitively impaired older adults. The combination of both may represent an efficiency advantage. This overview aims to summarize the effectiveness of cognitive-motor dual-task (CMDT) interventions on cognitive, physical and dual-task functions in cognitively impaired older adults, as well as the safety, adherence, and retention of benefits of these interventions. We searched for systematic reviews or meta-analyses assessing the effects of CMDT interventions on cognitive or physical functions in older adults with mild cognitive impairment or dementia through eight databases (CDSR (Cochrane), MEDLINE, Scopus, EMBASE, CINAHL, PsycINFO, ProQuest and SportDiscus). Two reviewers independently performed the selection, data extraction and risk of bias evaluation. Nine reviews were included in this overview. CMDT interventions were found to be more effective than active control groups on cognitive and physical functions in older adults with cognitive impairment, irrespective of intervention dose and modalities; no information on dual-task functions was available. Retention of benefits, adherence, need for supervision and safety are still unclear. These results should be interpreted with caution, considering the low average methodological quality of included reviews. Future intervention research should follow more rigorous methodological standards and focus on other forms of CMDT.
衰老是认知能力下降的一个相关因素,认知能力下降的范围从正常到轻度认知障碍或痴呆。这导致身体和认知功能受损,这是丧失自主性的风险因素。因此,认知和身体训练对认知受损的老年人很重要。两者的结合可能具有效率优势。这篇综述旨在总结认知-运动双重任务(CMD)干预对认知受损老年人认知、身体和双重任务功能的有效性,以及这些干预措施的安全性、依从性和获益的持久性。我们通过八个数据库(Cochrane 协作网的 Cochrane 对照试验资料库(CDSR)、MEDLINE、Scopus、EMBASE、CINAHL、PsycINFO、ProQuest 和 SportDiscus)搜索了评估 CMD 干预对轻度认知障碍或痴呆老年人认知或身体功能影响的系统评价或荟萃分析。两名评审员独立进行了选择、数据提取和偏倚风险评估。本综述纳入了 9 项研究。无论干预剂量和模式如何,CMD 干预对认知受损老年人的认知和身体功能均比积极对照组更有效;但是没有关于双重任务功能的信息。获益的持久性、依从性、监督需求和安全性仍不清楚。考虑到纳入的综述的平均方法学质量较低,这些结果应谨慎解释。未来的干预研究应遵循更严格的方法学标准,并关注其他形式的 CMD。