Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, GD 3015, the Netherlands.
Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18071, Spain; Faculty of Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2531015, Chile; Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Institute of Biosanitary Research of Granada (IBS), Granada 18014, Spain.
J Sport Health Sci. 2024 Mar;13(2):133-144. doi: 10.1016/j.jshs.2023.08.001. Epub 2023 Aug 7.
One of the pathological hallmarks distinguishing Alzheimer's disease from other dementias is the accumulation of amyloid beta (Aβ). Higher physical activity is associated with decreased dementia risk, and one potential path could be through Aβ levels modulation. We aimed to explore the relationship between physical activity and Aβ in middle-aged and older adults.
A systematic search of PubMed, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trials, and SPORTDiscus was performed from inception to April 28, 2022. Studies were eligible if they included physical activity and Aβ data in adults aged 45 years or older. Multi-level meta-analyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ levels.
In total, 37 articles were included (8 randomized controlled trials, 3 non-randomized controlled trials, 4 prospective longitudinal studies, and 22 cross-sectional studies). The overall effect size of physical activity interventions on changes in blood Aβ was medium (pooled standardized mean difference = -0.69, 95% confidence interval (95%CI): -1.41 to 0.03; I = 74.6%). However, these results were not statistically significant, and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid (CSF) and brain Aβ. Data from observational studies were examined based on measurements of Aβ in the brain using positron emission tomography scans, CSF, and blood. Higher physical activity was positively associated with Aβ only in the CSF (Estimate r = 0.12; 95%CI: 0.05-0.18; I = 38.00%).
Physical activity might moderately reduce blood Aβ in middle-aged and older adults. However, results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included studies. In observational studies, higher levels of physical activity were positively associated with Aβ only in CSF. Therefore, further research is needed to understand the modulating role of physical activity in the brain, CSF, and blood Aβ, as well as its implication for cognitive health.
阿尔茨海默病与其他痴呆症的病理标志之一是淀粉样β（Aβ）的积累。更高的身体活动与降低痴呆风险有关，一个潜在的途径可能是通过调节 Aβ 水平。我们旨在探索中年和老年人的身体活动与 Aβ 之间的关系。
从 2022 年 4 月 28 日开始，对 PubMed、Web of Science、PsycINFO、Cochrane 中央对照试验注册中心和 SPORTDiscus 进行了系统检索。如果研究包括 45 岁或以上成年人的身体活动和 Aβ 数据，则符合纳入标准。对干预和观察性研究进行多层次荟萃分析，以研究身体活动在调节 Aβ 水平方面的作用。
共有 37 篇文章被纳入（8 项随机对照试验、3 项非随机对照试验、4 项前瞻性纵向研究和 22 项横断面研究）。身体活动干预对血液 Aβ 变化的总体效应大小为中等（合并标准化均数差= -0.69，95%置信区间（95%CI）：-1.41 至 0.03；I²= 74.6%）。然而，这些结果没有统计学意义，并且没有足够的研究来探索身体活动对脑脊液（CSF）和大脑 Aβ 的影响。根据正电子发射断层扫描、CSF 和血液中大脑 Aβ 的测量，基于观察性研究的数据进行了检查。较高的身体活动仅与 CSF 中的 Aβ 呈正相关（估计 r=0.12；95%CI：0.05-0.18；I²=38.00%）。
身体活动可能会适度降低中年和老年人的血液 Aβ。然而，由于观察到一些纳入研究存在方法学限制，因此结果仅接近统计学意义，解释时需要谨慎。在观察性研究中，较高水平的身体活动仅与 CSF 中的 Aβ 呈正相关。因此，需要进一步研究以了解身体活动在大脑、CSF 和血液 Aβ 中的调节作用及其对认知健康的影响。
