JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Aging Ment Health. 2022 Nov;26(11):2129-2135. doi: 10.1080/13607863.2021.1998356. Epub 2021 Nov 28.
Depressive symptoms are common among mild cognitive impairment (MCI) patients. It is unknown how different the effects on depressive symptoms are among various pharmacological MCI interventions. This systematic review aimed to evaluate the comparative effectiveness of non-pharmacological MCI interventions on depressive symptoms among MCI patients.
A systematic review and network meta-analysis was conducted on randomized controlled trials (RCT) comparing the effect of different non-pharmacological MCI interventions on changes in depressive symptoms among MCI patients. RCTs were identified from MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and PsycARTICLES. Results were summarized as standardized mean differences (SMD) and 95% confidence intervals (CI). The surface under the cumulative ranking (SUCRA) was used to rank the effect of different interventions.
Twenty-two RCTs were included in the network meta-analysis. Compared with non-active control, cognition-based intervention (SMD=-0.25, 95% CI: -0.46, -0.04) and physical exercise (SMD=-0.33, 95% CI: -0.56, -0.10) had significant positive effects to reduce depressive symptoms. Health education, psychosocial intervention, and the combination of physical exercise and cognition-based intervention had non-significant overall effects. The SUCRA demonstrated that physical exercise had the highest SUCRA for the reduction in depression symptoms (0.815). In subgroup analysis, health education, cognition-based intervention, physical exercise, and the combination of physical exercise and cognition-based intervention showed significant longer-term effects (6-12 months).
Physical exercise and cognition-based intervention were effective interventions for depressive symptoms in MCI patients. This study can provide additional evidence for healthcare providers to make decisions for selecting available and appropriate interventions for MCI patients.
抑郁症状在轻度认知障碍（MCI）患者中较为常见。目前尚不清楚各种药物干预对 MCI 患者抑郁症状的影响有何不同。本系统评价旨在评估非药物性 MCI 干预措施对 MCI 患者抑郁症状的相对疗效。
对比较不同非药物性 MCI 干预措施对 MCI 患者抑郁症状变化影响的随机对照试验（RCT）进行了系统评价和网络荟萃分析。从 MEDLINE、EMBASE、Cochrane 图书馆、CINAHL、PsycINFO 和 PsycARTICLES 中确定了 RCT。结果以标准化均数差（SMD）和 95%置信区间（CI）表示。采用累积排序概率曲线下面积（SUCRA）来对不同干预措施的效果进行排序。
共纳入 22 项 RCT 进行网络荟萃分析。与非活动对照相比，基于认知的干预（SMD=-0.25，95%CI：-0.46，-0.04）和体育锻炼（SMD=-0.33，95%CI：-0.56，-0.10）对降低抑郁症状有显著的积极作用。健康教育、心理社会干预以及体育锻炼与基于认知的干预相结合，整体效果无显著差异。SUCRA 显示，体育锻炼对降低抑郁症状的 SUCRA 值最高（0.815）。亚组分析显示，健康教育、基于认知的干预、体育锻炼以及体育锻炼与基于认知的干预相结合均显示出显著的长期效果（6-12 个月）。
体育锻炼和基于认知的干预是 MCI 患者抑郁症状的有效干预措施。本研究可为医疗保健提供者提供更多证据，以便为 MCI 患者选择可行且合适的干预措施。
