Department of Rehabilitation, Université Laval, Quebec, Canada.
Centre interdisciplinaire de recherche en réadaptation et en intégration sociale (CIRRIS), Québec, Canada.
Syst Rev. 2021 Jan 4;10(1):6. doi: 10.1186/s13643-020-01555-8.
The growing societal and economic impact of Alzheimer's disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations.
This systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol.
This review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD.
PROSPERO CRD42020175016 .
阿尔茨海默病（AD）给社会和经济带来的影响日益增加，而目前又缺乏能够改变疾病进程的干预措施。非药物干预方法，如运动，具有改善或减轻 AD 症状的潜力，且不会产生药物治疗相关的副作用或经济负担。目前已有文献报道了各种形式和方案的运动（即力量、有氧、多组分）；然而，相互矛盾的证据使得很难对运动作为 AD 老年患者的干预措施的价值和影响进行清晰的解释。本综述的主要目的将是评估运动干预对 AD 老年患者的效果。此外，本综述还将评估证据质量，并综合运动训练方案，以制定适当的临床实践指南和建议。
本系统评价和荟萃分析将由一个跨学科的集体进行，该集体代表了具有与神经退行性疾病和康复医学相关的各种专业知识的临床和研究利益相关者。文献来源包括：Embase、PsychINFO、OVID Medline 和 Ovid MEDLINE（R）和 Epub 提前在线、处理中及其他非索引引文和每日引文。纳入标准为参与者患有晚发性 AD 且接受了有规定持续时间、频率和强度的结构化运动干预。本研究的主要结果将集中在认知功能的改善或维持上。次要结果将包括与机构化相关的结果、日常生活活动能力、情绪和情感健康、生活质量、发病率和死亡率。本方案中描述了分析程序，包括测量偏倚、数据综合、敏感性分析和异质性评估。
预计本综述将为运动对 AD 老年患者的具体价值提供有临床意义的见解。对不同运动干预方法的理解以及它们对各种健康和功能相关结果的具体影响的提高，有望指导临床医生更频繁、更准确地为受 AD 影响的患者开出有意义的干预措施。
PROSPERO CRD42020175016。
