Zhu Lin, Li Long, Wang Lin, Jin Xiaohu, Zhang Huajiang
School of Physical Education, Soochow University, Suzhou, China.
Department of Physical Education, Wuhan University of Technology, Wuhan, China.
Front Psychol. 2020 Dec 3;11:560461. doi: 10.3389/fpsyg.2020.560461. eCollection 2020.
The present study aimed to systematically analyze the effects of physical activity on executive function, working memory, cognitive flexibility, and activities of daily living (ADLs) in Alzheimer's disease (AD) patients and to provide a scientific evidence-based exercise prescription. Both Chinese and English databases (PubMed, Web of Science, the Cochrane Library, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were used as sources of data to search for randomized controlled trials (RCTs) published between January 1980 and December 2019 relating to the effects of physical activity on executive function, working memory, cognitive flexibility, and ADL issues in AD patients. Sixteen eligible RCTs were ultimately included in the meta-analysis. Physical activity had significant benefits on executive function [standard mean difference (SMD) = 0.42, 95% confidence interval (CI) 0.22-0.62, < 0.05], working memory (SMD = 0.28, 95% CI 0.11-0.45, < 0.05), cognitive flexibility (SMD = 0.23, 95% CI -0.02 to 0.47, < 0.01), and ADLs (SMD = 0.68, 95% CI 0.19-1.16, < 0.05) among AD patients. Subgroup analysis indicated that, for executive function issues, more than 60 min per session for 16 weeks of moderate-to-high-intensity dual-task exercises or multimodal exercise had a greater effect on AD patients. For working memory and cognitive flexibility issues, 60-90 min of moderate-intensity dual-task exercises 1-4 times/week was more effective. For ADL issues, 30-90 min of multimodal exercise at 60-79% of maximal heart rate (MHR) 3-4 times/week had a greater effect on AD patients. Physical activity was found to lead to significant improvements in executive function, working memory, cognitive flexibility, and ADLs in AD patients and can be used as an effective method for clinical exercise intervention in these patients. However, more objective, scientific, and effective RCTs are needed to confirm this conclusion.
本研究旨在系统分析体育活动对阿尔茨海默病（AD）患者执行功能、工作记忆、认知灵活性和日常生活活动（ADL）的影响，并提供基于科学证据的运动处方。中文和英文数据库（PubMed、Web of Science、Cochrane图书馆、EMBASE、中文科技期刊数据库、中国知网和万方）作为数据来源，检索1980年1月至2019年12月发表的关于体育活动对AD患者执行功能、工作记忆、认知灵活性和ADL问题影响的随机对照试验（RCT）。最终，16项符合条件的RCT被纳入荟萃分析。体育活动对AD患者的执行功能[标准均数差（SMD）=0.42，95%置信区间（CI）0.22 - 0.62，P<0.05]、工作记忆（SMD = 0.28，95%CI 0.11 - 0.45，P<0.05）、认知灵活性（SMD = 0.23，95%CI -0.02至0.47，P<0.01）和ADL（SMD = 0.68，95%CI 0.19 - 1.16，P<0.05）有显著益处。亚组分析表明，对于执行功能问题，每周16周、每次超过60分钟的中高强度双任务运动或多模式运动对AD患者的影响更大。对于工作记忆和认知灵活性问题，每周1 - 4次、每次60 - 90分钟的中等强度双任务运动更有效。对于ADL问题，每周3 - 4次、以最大心率（MHR）的60 - 79%进行30 - 90分钟的多模式运动对AD患者的影响更大。研究发现体育活动能显著改善AD患者的执行功能、工作记忆、认知灵活性和ADL，可作为这些患者临床运动干预的有效方法。然而，需要更多客观、科学和有效的RCT来证实这一结论。
