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运动干预对遗忘型轻度认知障碍患者认知功能的影响:系统评价和荟萃分析。

The influence of exercise interventions on cognitive functions in patients with amnestic mild cognitive impairment: A systematic review and meta-analysis.

机构信息

Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, China.

Key Laboratory of Sports and Physical Health Ministry of Education, Beijing Sport University, Beijing, China.

出版信息

Front Public Health. 2022 Nov 15;10:1046841. doi: 10.3389/fpubh.2022.1046841. eCollection 2022.

Abstract

INTRODUCTION

Patients with amnestic mild cognitive impairment (aMCI) are more likely to develop dementia compared to patients with non-aMCI (naMCI). Among the mixed samples of aMCI and naMCI, exercise interventions are effective for patients with MCI to improve cognitive functions. However, the influence of exercise interventions on patients with aMCI is still unclear.

OBJECTIVE

The objective of this systematic review and meta-analysis is to evaluate the influence of exercise interventions on cognitive functions in patients with aMCI.

METHODS

Four literature databases (PubMed, Web of Science, EBSCO, and Cochrane Library) and three Chinese databases (China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched from their inception to August 31, 2022. Based on the preliminary search of seven databases and their cited references, a total of 2,290 records were identified. Finally, 10 studies with a total of 28 data points involving 575 participants with aMCI were included in this meta-analysis. If the measurements of outcomes were different among studies, the effect size was synthesized using the standardized mean difference (SMD) with a 95% confidence interval (CI). If the measurements were the same, the weight mean difference (WMD) with a 95% CI was used to integrate the effect size.

DATA SYNTHESIS

The results showed that exercise interventions had no significant effects on improving several specific domains of cognitive functions including working memory (WMD = -0.05; 95% CI = -0.74 to 0.63; = 0.88; = 78%) and attention (SMD = 0.20; 95% CI = -0.31 to 0.72; = 0.44; = 60%). Additionally, exercise interventions had a significant effect on global cognitive function (SMD = 0.70; 95% CI = 0.50-0.90; < 0.00001; = 29%) and some specific cognitive domains including immediate recall (SMD = 0.55; 95% CI = 0.28-0.81; < 0.0001; = 0%), delayed recall (SMD = 0.66; 95% CI = 0.45-0.87; < 0.00001; = 37%), and executive function (SMD = 0.38; 95% CI = 0.16-0.60; = 0.0006; = 4%). Furthermore, subgroup analysis based on the intervention forms indicated that multi-component interventions (SMD = 0.44; 95% CI = 0.11-0.77; = 0.009; = 0%) appeared to be less effective than the single-component intervention (SMD = 0.85; 95% CI = 0.60-1.10; < 0.00001; = 10%) in terms of boosting global cognitive function.

CONCLUSION

This meta-analysis suggests that the exercise can help patients with aMCI improve global cognitive function. And exercise interventions have positive influence on enhancing several specific cognitive domains such as immediate recall, delayed recall, and executive function. http://www.crd.york.ac.uk/PROSPERO, identifier: CRD42022354235.

摘要

简介

与非 aMCI(naMCI)患者相比,有遗忘型轻度认知障碍(aMCI)的患者更有可能发展为痴呆症。在 aMCI 和 naMCI 的混合样本中,运动干预对改善 MCI 患者的认知功能有效。然而,运动干预对 aMCI 患者的影响仍不清楚。

目的

本系统评价和荟萃分析的目的是评估运动干预对 aMCI 患者认知功能的影响。

方法

从七个数据库的初步搜索及其引用的参考文献中,共确定了 2290 条记录。最后,纳入了 10 项研究,共 28 个数据点,涉及 575 名 aMCI 患者,纳入荟萃分析。如果研究之间的结果测量不同,则使用标准化均数差(SMD)和 95%置信区间(CI)合成效应量。如果测量相同,则使用加权均数差(WMD)和 95%CI 来整合效应量。

数据合成

结果表明,运动干预对改善工作记忆(WMD=-0.05;95%CI=-0.74 至 0.63; =0.88; =78%)和注意力(SMD=0.20;95%CI=-0.31 至 0.72; =0.44; =60%)等特定认知领域的效果不显著。此外,运动干预对整体认知功能(SMD=0.70;95%CI=0.50-0.90; <0.00001; =29%)和一些特定认知领域具有显著影响,包括即刻回忆(SMD=0.55;95%CI=0.28-0.81; <0.0001; =0%)、延迟回忆(SMD=0.66;95%CI=0.45-0.87; <0.00001; =37%)和执行功能(SMD=0.38;95%CI=0.16-0.60; =0.0006; =4%)。此外,基于干预形式的亚组分析表明,多成分干预(SMD=0.44;95%CI=0.11-0.77; =0.009; =0%)似乎不如单成分干预(SMD=0.85;95%CI=0.60-1.10; <0.00001; =10%)在提高整体认知功能方面有效。

结论

本荟萃分析表明,运动有助于改善 aMCI 患者的整体认知功能。运动干预对增强即刻回忆、延迟回忆和执行功能等特定认知领域具有积极影响。http://www.crd.york.ac.uk/PROSPERO,标识符:CRD42022354235。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27c9/9706097/e5a009623f57/fpubh-10-1046841-g0001.jpg

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