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多领域生活方式干预与衰老过程中内在能力领域的关联:一项叙述性综述

Associations Between Multidomain Lifestyle Interventions and Intrinsic Capacity Domains During Aging: A Narrative Review.

作者信息

Fourteau M, Virecoulon Giudici K, Rolland Y, Vellas B, de Souto Barreto P

机构信息

Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.

UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France.

出版信息

JAR Life. 2020 Sep 3;9:16-25. doi: 10.14283/jarlife.2020.6. eCollection 2020.

Abstract

BACKGROUND

Recently, the World Health Organization defined five domains of intrinsic capacity (IC), composed of physical and mental capacities linked to body functions, and that contribute to healthy aging: locomotion, cognition, psychological, vitality and sensorial. In the past decade, studies investigating the effects of concomitant lifestyle interventions (also called multidomain interventions) on one or several IC domains have been developed. The aim of this study is to synthetize the scientific literature about the associations between multidomain lifestyle interventions and IC domains.

METHODS

We conducted a narrative review of randomized controlled trials examining the effects of multidomain lifestyle interventions on at least one IC domain among older people. Multidomain intervention was defined as the presence of at least two of the following lifestyle interventions: physical activity/exercise, nutrition, cognitive stimulation, and management of cardiovascular risk factors (eg, smoking, alcohol consumption).

RESULTS

Multidomain interventions were associated with improvements on locomotion (as measured by performance-based tests of lower-limb function) and vitality (as measured by handgrip strength); benefits on cognitive function were also found, in particular among populations at increased risk of dementia and when operationalizing strong multidomain interventions (eg, using regular exercise training instead of physical activity advices). No study investigated the effects of multidomain lifestyle interventions on the sensorial domain (hearing and/or vision). The modalities composing the multidomain interventions and intervention length, as well as study population, substantially varied across studies; the most common combination of interventions was physical activity- and nutritional-related interventions.

CONCLUSION

Available evidence is still limited, but literature suggests a positive effect of multidomain lifestyle interventions on IC domains, in particular locomotion. Further studies are still needed on this topic, in particular, studies exploring the effects of multidomain lifestyle interventions on the sensorial domain, as well as on a composite measurement of all IC domains.

摘要

背景

最近,世界卫生组织定义了内在能力(IC)的五个领域,由与身体功能相关的身体和心理能力组成,有助于健康老龄化:运动、认知、心理、活力和感官。在过去十年中,已经开展了一些研究,调查伴随生活方式干预(也称为多领域干预)对一个或多个IC领域的影响。本研究的目的是综合关于多领域生活方式干预与IC领域之间关联的科学文献。

方法

我们对随机对照试验进行了叙述性综述,这些试验考察了多领域生活方式干预对老年人至少一个IC领域的影响。多领域干预被定义为存在以下至少两种生活方式干预:体育活动/锻炼、营养、认知刺激和心血管危险因素管理(如吸烟、饮酒)。

结果

多领域干预与运动能力(通过基于表现的下肢功能测试衡量)和活力(通过握力衡量)的改善相关;还发现了对认知功能的益处,特别是在痴呆风险增加的人群中,以及在实施强有力的多领域干预时(如使用定期运动训练而非体育活动建议)。没有研究调查多领域生活方式干预对感官领域(听力和/或视力)的影响。构成多领域干预的方式、干预时长以及研究人群在各项研究中差异很大;最常见的干预组合是与体育活动和营养相关的干预。

结论

现有证据仍然有限,但文献表明多领域生活方式干预对IC领域有积极影响,尤其是运动能力。关于这个主题仍需要进一步研究,特别是探索多领域生活方式干预对感官领域以及对所有IC领域综合测量的影响的研究。

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