College of Physical Education and Health, Guangxi Normal University, Guilin, China.
Guangxi University of Traditional Chinese Medicine, Nanning, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34905. doi: 10.1097/MD.0000000000034905.
To systematically evaluate the clinical efficacy of physical and mental exercise on cognitive performance in middle-aged people with mild cognitive impairment (MCI).
Computer searches of PubMed, Web of science, Embase, Cochrane Library, China Biomedical Literature Service, Wanfang database, China Knowledge Network, and VIP full-text database of Veep journals were conducted to obtain clinical randomized controlled trials on physical and mental exercise interventions in middle-aged and elderly people with MCI. The literature was screened according to inclusion and exclusion criteria, and the final included literature was subjected to data extraction and risk of bias assessment. Meta-analysis was performed using Review Manager 5.4.1 software, and publication bias test was performed using stata17.0 software.
A total of 27 publications with a total of 2565 cases of elderly people with MCI were included. The control group was conventional care, health education, or blank control, and the physical and mental exercise group was exercises including Tai Chi, dance, orthopraxia, and qigong for 30 to 90 minutes each time, 3 to 6 times per week, for a total duration of 8 to 36 weeks. Meta-analysis results showed that Montreal cognitive assessment scores (mean difference [MD] = 2.33, 95% CI [1.55, 3.10], P < .00001), the mini-mental state examination score (MD = 1.73, 95% CI [0.60, 2.86], P = .003), trail making test-A score (MD = -4.00, 95% CI [-6.75, -1.25], P = .004), trail making test-B score (MD = -18.46, 95% CI [-23.87, -13.06], P < .00001), global deterioration scale score (MD = -0.72, 95% CI [-1.09, -0.34], P = .0002), Wechsler Logical Memory Scale score (MD = 2.07, 95% CI [0.03, 4.10], P = .05), berg score (MD = -0.70, 95% CI [0.32, 1.07], P < .0003), cerebrospinal fluid Tau protein level (MD = -166.69, 95% CI [-196.93, -136.45], P < .00001), and cerebrospinal fluid levels of αβ1-42 protein (MD = 180.39, 95% CI [134.24, 226.55], P < .00001).
Mind-body exercise can improve cognitive performance, depressive status, and balance as well as increase αβ1-42 protein levels and decrease Tau protein levels in middle-aged and older adults with mild cognitive impairment.
系统评价身心锻炼对轻度认知障碍（MCI）中老年人群认知表现的临床疗效。
计算机检索PubMed、Web of science、Embase、Cochrane Library、中国生物医学文献服务系统、万方数据库、中国知网和维普期刊全文数据库中关于中老年 MCI 人群进行身心锻炼干预的临床随机对照试验。根据纳入和排除标准筛选文献，并对最终纳入的文献进行数据提取和偏倚风险评估。使用 Review Manager 5.4.1 软件进行 Meta 分析，使用 stata17.0 软件进行发表偏倚检验。
共纳入 27 篇文献，共 2565 例老年 MCI 患者。对照组为常规护理、健康教育或空白对照，身心锻炼组为每次 30-90 分钟、每周 3-6 次的太极拳、舞蹈、正位体操和气功等锻炼，总持续时间为 8-36 周。Meta 分析结果显示，蒙特利尔认知评估量表评分（均数差[MD]=2.33，95%置信区间[1.55, 3.10]，P<0.00001）、简易精神状态检查量表评分（MD=1.73，95%置信区间[0.60, 2.86]，P=0.003）、连线测试 A 评分（MD=-4.00，95%置信区间[-6.75, -1.25]，P=0.004）、连线测试 B 评分（MD=-18.46，95%置信区间[-23.87, -13.06]，P<0.00001）、总体衰退量表评分（MD=-0.72，95%置信区间[-1.09, -0.34]，P=0.0002）、韦氏逻辑记忆量表评分（MD=2.07，95%置信区间[0.03, 4.10]，P=0.05）、伯格平衡量表评分（MD=-0.70，95%置信区间[0.32, 1.07]，P<0.0003）、脑脊液 Tau 蛋白水平（MD=-166.69，95%置信区间[-196.93, -136.45]，P<0.00001）和脑脊液 αβ1-42 蛋白水平（MD=180.39，95%置信区间[134.24, 226.55]，P<0.00001）。
身心锻炼可以改善认知表现、抑郁状态和平衡能力，增加 αβ1-42 蛋白水平，降低 Tau 蛋白水平，从而改善中老年轻度认知障碍患者的认知表现。
