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应对痴呆症:基于身体活动的干预措施的系统评价。

Tackling Dementia: A Systematic Review of Interventions Based on Physical Activity.

机构信息

College of Engineering, Nanjing Agricultural University, Nanjing, China.

Brunel Design School, Brunel University London, Uxbridge, England.

出版信息

J Geriatr Phys Ther. 2022;45(4):E169-E180. doi: 10.1519/JPT.0000000000000332. Epub 2021 Sep 24.

Abstract

BACKGROUND AND PURPOSE

Dementia prevalence is expected to increase dramatically with population aging. As a nonpharmacological therapy, physical activity is an appealing alternative to tackling aging and dementia. However, contradictions were found in previous studies. The aim of this systematic review is to gather the latest evidence of the effects of physical activity interventions on cognition and noncognitive functions of older people with dementia.

METHODS

PubMed, Cochrane, and Web of Science databases were searched to identify relevant studies. We followed the PRISMA guidelines to identify randomized controlled trials that reported original findings of physical activity interventions on older people with dementia (≥65 years of age). These studies were published in English between January 1, 2009 and November 9, 2019.

RESULTS

In total, 16 trials with 2085 participants were included in the review. Compared to baseline, cognitive function improved significantly in 2 studies, deteriorated in 3 studies, and remained stable in 11 studies. In the exercise relative to the control group, 5 studies showed no significant differences, 2 studies showed significantly greater deterioration in cognition, and 9 studies showed significantly greater improvement in cognition. However, most studies (n = 13.81%) had notable limitations (eg, with a high risk of bias, limited follow-up time, or unexplained high heterogeneity in their findings). Fourteen studies reported a positive impact on one or more areas of physical function, mobility, activities of daily living, depression levels, and behavioral/psychological symptoms of dementia.

CONCLUSIONS

Physical activity interventions have a positive impact on physical function, mobility, and activities of daily living. However, the available evidence is insufficient to support the conclusion that physical activity improves cognitive function of older people with dementia.

摘要

背景与目的

随着人口老龄化,痴呆症的患病率预计将大幅上升。作为一种非药物治疗方法,体育活动是应对衰老和痴呆症的一种有吸引力的替代方法。然而,先前的研究存在矛盾。本系统评价的目的是收集最新的证据,证明体育活动干预对痴呆老年人的认知和非认知功能的影响。

方法

在 PubMed、Cochrane 和 Web of Science 数据库中搜索相关研究。我们遵循 PRISMA 指南,确定了报告体育活动干预对老年痴呆症患者(≥65 岁)的原始发现的随机对照试验。这些研究发表于 2009 年 1 月 1 日至 2019 年 11 月 9 日期间的英文文献。

结果

共有 16 项试验纳入了 2085 名参与者。与基线相比,2 项研究的认知功能显著改善,3 项研究恶化,11 项研究保持稳定。在运动组与对照组相比,5 项研究无显著差异,2 项研究认知功能显著恶化,9 项研究认知功能显著改善。然而,大多数研究(n=13.81%)存在明显的局限性(例如,存在高偏倚风险、随访时间有限或研究结果存在无法解释的高度异质性)。14 项研究报告了对身体功能、移动性、日常生活活动、抑郁水平和痴呆的行为/心理症状的一个或多个方面的积极影响。

结论

体育活动干预对身体功能、移动性和日常生活活动有积极影响。然而,现有证据不足以支持体育活动能改善老年痴呆症患者认知功能的结论。

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