West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Alzheimers Dement. 2023 Aug;19(8):3679-3687. doi: 10.1002/alz.13005. Epub 2023 Mar 1.
Current randomized trial evidence on the effect of physical activity (PA) intervention on cognitive function is scarce and mainly found in well-educated populations, limiting its generalizability. Furthermore, the modification effect of education levels remains understudied. We conducted a cluster randomized trial to evaluate the effects of PA intervention on cognitive function in a general older population, and whether education modifies such effects.
Eight villages were randomized to the intervention (four villages, n = 240) or the control (four villages, n = 271). The intervention group received an 8-week multilevel PA intervention based on a socio-ecological model, while the control did not. The intervention has been condensed to three levels with activities occurring at the individual (telephone counseling, printed material, and training sessions), interpersonal (peer group), and community levels (group sharing and coaching). The primary outcome was changes in global cognition (overall cognitive function) measured by the Telephone Interview for Cognitive Status (TICS-10) at 12-month follow-up. Repeated measurements were modeled using the linear mixed model, which assumed that the missing values were missing at random.
The mean age was 70.94 years (standard deviation 5.71) and 55.6% were women. Compared to the control, the orientation improved from baseline at 12-month follow-up (0.24 points [95% confidence interval (CI), 0.03 to 0.46 points; P = 0.03]). Stratified analysis showed that the global cognition and orientation improved at 12-month follow-up among illiterate participants in the intervention (for global cognition, mean difference, 0.57 points [95% CI, 0.03 to 1.10], P = 0.04; for orientation, mean difference, 0.31 points [95% CI, 0.04 to 0.58], P = 0.03).
These results confirm the improvements in orientation in older adults, as well as in global cognition and orientation in the illiterate at 12-month follow-up.
目前关于体力活动（PA）干预对认知功能影响的随机试验证据很少，且主要在受教育程度较高的人群中发现，这限制了其普遍性。此外，教育水平的调节作用仍研究不足。我们进行了一项集群随机试验，以评估 PA 干预对一般老年人群认知功能的影响，以及教育是否调节了这种影响。
8 个村庄被随机分为干预组（4 个村庄，n=240）或对照组（4 个村庄，n=271）。干预组接受基于社会生态学模型的 8 周多层次 PA 干预，而对照组则没有。干预措施已浓缩为三个层次，活动发生在个人（电话咨询、印刷材料和培训课程）、人际（同伴小组）和社区（小组分享和辅导）层面。主要结局是通过电话认知状态测试（TICS-10）在 12 个月随访时测量的整体认知（整体认知功能）变化。使用线性混合模型对重复测量进行建模，假设缺失值是随机缺失的。
平均年龄为 70.94 岁（标准差为 5.71），55.6%为女性。与对照组相比，12 个月随访时定向有所改善（0.24 分[95%置信区间（CI），0.03 至 0.46 分；P=0.03]）。分层分析显示，在干预组中，文盲参与者的整体认知和定向在 12 个月随访时得到改善（对于整体认知，平均差异为 0.57 分[95%CI，0.03 至 1.10]，P=0.04；对于定向，平均差异为 0.31 分[95%CI，0.04 至 0.58]，P=0.03）。
这些结果证实，在 12 个月随访时，老年人的定向有所改善，文盲者的整体认知和定向也有所改善。
