School of Nursing, Jinan University, Guangzhou, Guangdong 510632, China.
Department of Rehabilitation, Shenzhen Longgang District Maternity and Child Healthcare Hospital, Shenzhen, Guangdong 518172, China.
Geriatr Nurs. 2023 May-Jun;51:369-377. doi: 10.1016/j.gerinurse.2023.04.012. Epub 2023 Apr 30.
To date quantitative meta-analysis with large samples to investigate the effects and potential moderators of physical activity (PA) on executive function (EF) in older adults with dementia is insufficient. Therefore, we conducted this meta-analysis.
Meta-analysis of randomized controlled trials (RCTs).
Old people with Alzheimer's disease (AD) or related dementia of varying types and severity as the primary diagnosis.
PubMed, Web of Science, the Cochrane Library and Embase databases were searched for relevant studies published from 01 January, 2010 to 01 March, 2022. The results of executive function were reported in all RCTs. Random-effects meta-analysis was used to calculate the size of effects. Subgroup analyses of three moderators (including the specific sub-domains of EF, exercise prescription variables, and sample characteristics) were performed.
Eighteen RCTs were included with a combined sample size of 1366. Overall, PA interventions improved overall EF (standardized mean difference [SMD]=0.23, 95% confidence interval [CI] 0.05 to 0.41, p<0.05). The EF sub-domain "planning" was significant moderator (SMD=0.31, 95%CI 0.11 to 1.51, p<0.01), but inhibitory control, working memory and cognitive flexibility were not significant. Regarding exercise prescription variables, type of resistance training; moderate intensity; total duration ≤24 weeks and short (once or twice a week) frequency improved overall EF performance. Session length may be a moderator. Regarding sample characteristics, old-old, AD and both dementia and AD had significant benefits.
EF in older adults with AD or related dementia benefited from physical activity, and the benefit was affected by the type, intensity, total duration, frequency of exercise. Physical activity can be an alternative intervention in aging patients with dementia, to improve EF performance or prevent or EF decline.
迄今为止，针对体力活动（PA）对痴呆老年患者执行功能（EF）影响的大样本量定量荟萃分析以及潜在调节因素的研究还不够充分。因此，我们进行了这项荟萃分析。
随机对照试验（RCT）的荟萃分析。
以阿尔茨海默病（AD）或其他类型和严重程度的相关痴呆为主要诊断的老年人。
检索了 2010 年 1 月 1 日至 2022 年 3 月 1 日发表的相关研究，包括 PubMed、Web of Science、Cochrane Library 和 Embase 数据库。所有 RCT 都报告了执行功能的结果。采用随机效应荟萃分析计算效应大小。对 3 个调节因素（包括 EF 的特定子领域、运动处方变量和样本特征）进行亚组分析。
纳入了 18 项 RCT，总样本量为 1366 例。总体而言，PA 干预改善了整体 EF（标准化均数差 [SMD]=0.23，95%置信区间 [CI] 0.05 至 0.41，p<0.05）。EF 子领域“计划”是显著的调节因素（SMD=0.31，95%CI 0.11 至 1.51，p<0.01），但抑制控制、工作记忆和认知灵活性没有显著差异。关于运动处方变量，阻力训练类型；中等强度；总持续时间≤24 周和短（每周一次或两次）频率改善了整体 EF 表现。课程长度可能是一个调节因素。关于样本特征，老年患者、AD 和痴呆症及 AD 都有显著的获益。
AD 或相关痴呆老年患者的 EF 从体力活动中受益，获益受到运动类型、强度、总持续时间、运动频率的影响。体力活动可以作为痴呆老年患者的一种替代干预措施，以提高 EF 表现或预防或延缓 EF 下降。
