Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China.
Department of Geriatrics, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China.
Ageing Res Rev. 2023 Dec;92:102127. doi: 10.1016/j.arr.2023.102127. Epub 2023 Nov 17.
Physical activity (PA) is beneficial in reductions of all-cause mortality and dementia. However, whether Alzheimer's disease (AD) risk is modified by PA remains disputable. This meta-analysis aims to disclose the underlying relationship between PA and incident AD.
Pubmed, Embase, Cochrane Library, and Web of Science were retrieved from inception to June 2023. Random-effects models were employed to derive the effect size, represented by hazard ratio (HR) and 95% confidence interval (CI).
Twenty-nine prospective cohort studies involving 2068,519 participants were included. The pooled estimate showed a favorable effect of PA on AD risk decline (HR 0.72, 95% CI 0.65-0.80). This association remained robust after adjusting for maximum confounders (HR 0.85, 95% CI 0.79-0.91). Subgroup analysis of PA intensity demonstrated an inverse dose-response relationship between PA and AD, effect sizes of which were significant in moderate (HR 0.85, 95% CI 0.80-0.93) and high PA (HR 0.56, 95% CI 0.45-0.68), but not in low PA (HR 0.94, 95% CI 0.77-1.15). Regardless of all participants or the mid-life cohort, the protection of PA against AD appeared to be valid in shorter follow-up (<15 years) rather than longer follow-up (≥15 years). In addition to follow-up, the robustness of the estimates persisted in supplementary meta-analyses, meta-regression analyses, and sensitivity analyses.
PA intervention reduces the incidence of AD, but merely in moderate to vigorous PA with follow-up of less than 15 years, thus conditionally recommending the popularization of PA as a modifiable lifestyle factor to prevent AD.
身体活动（PA）有益于降低全因死亡率和痴呆症风险。然而，PA 是否能改变阿尔茨海默病（AD）的风险仍存在争议。本荟萃分析旨在揭示 PA 与 AD 发病之间的潜在关系。
从建库至 2023 年 6 月，检索 Pubmed、Embase、Cochrane Library 和 Web of Science。采用随机效应模型得出效应量，以风险比（HR）和 95%置信区间（CI）表示。
纳入 29 项前瞻性队列研究，共涉及 2068519 名参与者。汇总估计显示，PA 对 AD 风险下降有有利影响（HR 0.72，95%CI 0.65-0.80）。在调整最大混杂因素后，这种关联仍然稳健（HR 0.85，95%CI 0.79-0.91）。PA 强度的亚组分析显示，PA 与 AD 之间呈反向剂量-反应关系，其中中强度（HR 0.85，95%CI 0.80-0.93）和高强度 PA（HR 0.56，95%CI 0.45-0.68）的效应大小有统计学意义，但低强度 PA 则无（HR 0.94，95%CI 0.77-1.15）。无论所有参与者还是中年队列，PA 对 AD 的保护作用似乎在随访时间较短（<15 年）而非较长（≥15 年）时更有效。除了随访时间外，在补充荟萃分析、荟萃回归分析和敏感性分析中，估计值的稳健性仍然存在。
PA 干预可降低 AD 的发病率，但仅在随访时间<15 年的中高强度 PA 中有效，因此有条件地推荐将 PA 作为一种可改变的生活方式因素进行推广，以预防 AD。
