功能性任务锻炼对轻中度认知障碍老年人日常解决问题能力和功能状态的影响：一项随机对照试验。

Effects of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment-a randomised controlled trial.

机构信息

School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR.

Therese Pei Fong Chow Research Centre for Prevention of Dementia, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, Division of Neurology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR.

出版信息

Age Ageing. 2022 Jan 6;51(1). doi: 10.1093/ageing/afab210.

DOI:10.1093/ageing/afab210

PMID:34673918

Abstract

OBJECTIVE

To investigate the effect of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment compared to single exercise or cognitive training and no treatment control.

DESIGN

A single-blind, four-arm randomised controlled trial.

SETTING

Out-patient clinic and community centre.

PARTICIPANTS

Older adults with mild cognitive impairment aged ≥60 living in community.

METHODS

Participants (N = 145) were randomised to 8-week functional task exercise (N = 34), cognitive training (N = 38), exercise training (N = 37), or wait-list control (N = 36) group. Outcomes measures: Neurobehavioral Cognitive Status Examination, Category Verbal Fluency Test, Trail Making Test, Problems in Everyday Living Test, Activities of Daily Living Questionnaire, Instrumental Activities of Daily Living Scale; Chair stand test, Berg Balance Scale, and Short Form-12 Health Survey were conducted at baseline, post-intervention and 5-months follow-up.

RESULTS

Post-intervention results of ANCOVA revealed cognitive training improved everyday problem-solving (P = 0.012) and exercise training improved functional status (P = 0.003) compared to wait-list control. Functional task exercise group demonstrated highest improvement compared to cognitive training, exercise training and wait-list control groups in executive function (P range = 0.003-0.018); everyday problem-solving (P < 0.001); functional status (P range = <.001-0.002); and physical performance (P = 0.008) at post-intervention, with all remained significant at 5-month follow-up, and further significant improvement in mental well-being (P = 0.043).

CONCLUSIONS

Functional task exercise could be an effective intervention to improve everyday problem-solving ability and functional status in older adults with mild cognitive impairment. The findings support combining cognitive and exercise intervention may give additive and even synergistic effects.

摘要

目的

与单一运动或认知训练以及无治疗对照组相比，研究功能性任务锻炼对轻度认知障碍老年人日常解决问题能力和功能状态的影响。

设计

单盲、四臂随机对照试验。

地点

门诊和社区中心。

参与者

居住在社区的年龄≥60 岁的轻度认知障碍老年人。

方法

将参与者（N=145）随机分为 8 周功能性任务锻炼组（N=34）、认知训练组（N=38）、运动训练组（N=37）或候补组（N=36）。结局指标：神经行为认知状态检查、类别流畅性测试、连线测试、日常生活问题测试、日常生活活动问卷、工具性日常生活活动量表；椅子站立测试、伯格平衡量表和简明健康调查量表在基线、干预后和 5 个月随访时进行。

结果

ANCOVA 干预后的结果显示，与候补组相比，认知训练改善了日常问题解决能力（P=0.012），运动训练改善了功能状态（P=0.003）。与认知训练、运动训练和候补组相比，功能性任务锻炼组在执行功能（P 范围=0.003-0.018）、日常问题解决能力（P<0.001）、功能状态（P 范围=0.001-0.002）和身体表现（P=0.008）方面的改善更为显著在干预后，所有这些在 5 个月随访时仍然显著，并且心理健康状况进一步显著改善（P=0.043）。