Kouloutbani Komanthi, Venetsanou Fotini, Markati Alexandra, Karteroliotis Konstantinos E, Politis Antonios
School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Dafni, Greece.
Professor, First Department of Psychiatry, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece.
Int Psychogeriatr. 2022 Feb;34(2):177-190. doi: 10.1017/S1041610221000193. Epub 2021 Apr 5.
The management of neuropsychiatric symptoms (NPS) in patients with dementia is a major challenge. Since no effective therapy has been found to date and drug treatments are associatedwith significant side effects, there seems to be a pressing need for alternative non-pharmacological interventions.
The current study aims to investigate and compare the effect of different types of physical exercise on the NPS.
A systematic review of the literature was conducted according to the PRISMA guidelines. Five databases (SCOPUS, PubMed, SPORT Discus, Web of science and ScienceDirect) were searched using the appropriate algorithm. What was sought out was randomized control trials (RCTs) that applied physical activity interventions with specific characteristics (type, frequency, intensity, and duration) in patients with dementia or mild cognitive impairment, studied the effect of exercise on their NPS and compared this effect with a control group that did not follow an exercise program.
From 512 articles, 13 studies were included in this review, involving a total of 1,925 patients. The results were analyzed and synthesized according to the type of exercise applied - aerobic exercise, multidimensional interventions and muscular strength training programs. In particular, the results showed that repetitive aerobic exercise three to five times a week had a positive effect on NPS, whereas multidimensional interventions combining different types of exercise did not appear to be as effective. Strength training programs have been found to significantly reduce depression symptoms and behavioral problems in demented patients with mobility problems.
There is clear evidence that physical activity and especially aerobic exercise may be effective in the management of NPS. However, it is necessary to apply specific practical recommendations and specially designed programs to incorporate physical exercise into the daily routine of these patients.
痴呆患者神经精神症状（NPS）的管理是一项重大挑战。由于迄今为止尚未找到有效的治疗方法，且药物治疗伴有显著副作用，因此迫切需要替代性的非药物干预措施。
本研究旨在调查和比较不同类型体育锻炼对NPS的影响。
根据PRISMA指南对文献进行系统综述。使用适当算法检索了五个数据库（SCOPUS、PubMed、SPORT Discus、科学网和ScienceDirect）。检索的是随机对照试验（RCT），这些试验对患有痴呆或轻度认知障碍的患者应用了具有特定特征（类型、频率、强度和持续时间）的体育活动干预措施，研究了锻炼对其NPS的影响，并将这种影响与未遵循锻炼计划的对照组进行比较。
从512篇文章中，本综述纳入了13项研究，共涉及1925名患者。根据所应用的锻炼类型——有氧运动、多维干预和肌肉力量训练计划对结果进行了分析和综合。具体而言，结果表明，每周进行三到五次的重复性有氧运动对NPS有积极影响，而结合不同类型锻炼的多维干预似乎效果不佳。已发现力量训练计划可显著减轻有行动问题的痴呆患者的抑郁症状和行为问题。
有明确证据表明体育活动，尤其是有氧运动，可能对NPS的管理有效。然而，有必要应用具体的实用建议和专门设计的计划，将体育锻炼纳入这些患者的日常生活中。
