Friedrich-Alexander-Universität Erlangen-Nürnberg, Interdisciplinary Center for Health Technology Assessment and Public Health (IZPH), Erlangen, Germany.
Department of Psychiatry and Psychotherapy, Center for Health Services Research in Medicine, University Hospital Erlangen, Erlangen, Germany.
Alzheimers Res Ther. 2022 Jul 22;14(1):97. doi: 10.1186/s13195-022-01040-5.
The prevalence of dementia is expected to increase dramatically. Due to a lack of pharmacological treatment options for people with dementia, non-pharmacological treatments such as exercise programs have been recommended to improve cognition, activities of daily living, and neuropsychiatric symptoms. However, inconsistent results have been reported across different trials, mainly because of the high heterogeneity of exercise modalities. Thus, this systematic review aims to answer the questions whether exercise programs improve cognition, activities of daily living as well as neuropsychiatric symptoms in community-dwelling people with dementia.
Eight databases were searched for articles published between 2016 and 2021 (ALOIS, CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, Web of Science). Randomized controlled trials evaluating the effects of any type of physical activity on cognition, activities of daily living, or neuropsychiatric symptoms in community-dwelling people with a formal diagnosis of dementia were included in this systematic review. Two authors independently assessed eligibility and quality of the studies. The methodology was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
Eight publications covering seven trials were included in this review with the majority investigating either a combination of strength and aerobic exercise or aerobic exercise alone. This review revealed that there is no clear evidence for the beneficial effects of exercise on cognition. None of the included trials found an impact on activities of daily living. Although different randomized controlled trials reported inconsistent results, one trial indicated that especially aerobic exercise may improve neuropsychiatric symptoms.
Our systematic review did not confirm the impact of exercise on cognition and activities of daily living in community-dwelling people with dementia. The results suggested that aerobic exercise might be effective to reduce neuropsychiatric symptoms. Well-designed trials including only community-dwelling people with a formal diagnosis of dementia, large samples, long-term follow-ups, and detailed description of adherence to the intervention are needed to improve the scientific evidence on the best type of exercise modality.
PROSPERO, CRD42021246598 .
痴呆症的患病率预计将大幅增加。由于缺乏针对痴呆症患者的药物治疗选择，因此推荐了非药物治疗方法，如运动方案，以改善认知、日常生活活动和神经精神症状。然而，不同试验报告的结果不一致，主要是由于运动方式的高度异质性。因此，本系统评价旨在回答以下问题：运动方案是否能改善认知、日常生活活动以及社区居住的痴呆症患者的神经精神症状。
检索了 2016 年至 2021 年期间发表的文章，包括 ALOIS、CENTRAL、CINAHL、Embase、MEDLINE、PsycINFO、PubMed 和 Web of Science。本系统评价纳入了评估任何类型的身体活动对认知、日常生活活动或社区居住的有正式痴呆症诊断的患者的神经精神症状的影响的随机对照试验。两名作者独立评估了研究的合格性和质量。该方法符合系统评价和荟萃分析报告的首选项目指南。
本综述纳入了 8 篇文献，涵盖了 7 项试验，其中大多数研究了力量和有氧运动的组合或单独的有氧运动。本综述表明，目前尚无明确证据表明运动对认知有益。纳入的试验均未发现对日常生活活动有影响。尽管不同的随机对照试验报告了不一致的结果，但一项试验表明，特别是有氧运动可能改善神经精神症状。
我们的系统评价并未证实运动对社区居住的痴呆症患者的认知和日常生活活动的影响。结果表明，有氧运动可能有效减轻神经精神症状。需要设计包括只有社区居住的有正式痴呆症诊断的患者、大样本、长期随访和详细描述对干预的依从性的试验，以提高关于最佳运动方式的科学证据。
PROSPERO，CRD42021246598。
