School of Sports Training, Wuhan Sports University, Wuhan 430079, China.
School of Physical Education, Minzu University of China, 100081, China.
Geriatr Nurs. 2024 Jul-Aug;58:352-360. doi: 10.1016/j.gerinurse.2024.06.001. Epub 2024 Jun 14.
There exists a deficiency in a distinct understanding of the intervention effects of Traditional Chinese Medicine (TCM) exercise therapies (Tai Chi, Yi Jin Jing, Ba Duan Jin, Liu Zi Jue, Qigong, Wu Qin Xi etc.) on cognitive function and its moderating variables in the elderly. This study aims to systematically evaluate the effects of TCM exercise therapies on the cognitive function of the elderly and further propose the best exercise intervention programme to delay the cognitive decline of the elderly.
PubMed, EBSCO host, Web of Science, EMbase, China National Knowledge Infrastructure and Wan Fang databases were searched for the effects of TCM exercise therapies on the cognitive function in older adults until July 2022. A meta-analysis of the included literature was performed using Stata 12.0 software, with a subgroup analysis of seven moderating variables: subject type, intervention content, intervention duration, intervention frequency, intervention period, study type and sample size. A random effects model was used to combine the overall effect sizes and to test for heterogeneity and publication bias across studies.
A total of 20 publications with 1975 subjects were included. The TCM exercise therapies delayed cognitive decline in older adults (d = 0.83; 95 % CI [0.62-1.04]; P < 0.001). Subgroup analysis found that intervention content, intervention duration, intervention frequency, and intervention period were significant moderating variables influencing the effectiveness of the intervention. Among them, the Ba Duan Jin intervention (d = 0.85; 95 % CI [0.65-1.06]; P < 0.001), the duration of each exercise session of 60 min or more (d = 0.86; 95 % CI [0.71-1.00]; P < 0.001), the frequency of exercise of more than 5 times per week (d = 0.80; 95 % CI [0.64-0.96]; P < 0.001) and exercise cycles of 6-9 months (d = 0.96; 95 % CI [0.80-1.12]; P < 0.001) produced the largest effect sizes.
TCM exercise therapies can effectively improve the cognitive function of the elderly. The best effect on the cognitive function of the elderly was achieved by choosing Ba Duan Jin and exercising at least five times a week for at least 60 min each time for a total of 6-9 months. The effect size of the TCM exercise therapy interventions on the cognitive function in older adults may be overestimated because of publication bias. In addition, large-sample, multicenter, high-quality randomised controlled trials should be conducted to validate this result.
对于中医（太极、易筋经、八段锦、六字诀、气功、五禽戏等）运动疗法对老年人认知功能的干预效果及其调节变量，目前尚缺乏明确的认识。本研究旨在系统评价中医运动疗法对老年人认知功能的影响，并进一步提出最佳的运动干预方案来延缓老年人的认知能力下降。
检索 PubMed、EBSCO 主机、Web of Science、EMbase、中国知网和万方数据库，截至 2022 年 7 月，获取有关中医运动疗法对老年人认知功能影响的文献。采用 Stata 12.0 软件对纳入文献进行 meta 分析，对 7 个调节变量（受试者类型、干预内容、干预持续时间、干预频率、干预周期、研究类型和样本量）进行亚组分析。采用随机效应模型合并总体效应量，并对各研究间的异质性和发表偏倚进行检验。
共纳入 20 篇文献，涉及 1975 名受试者。中医运动疗法可延缓老年人的认知衰退（d = 0.83；95 % CI [0.62-1.04]；P < 0.001）。亚组分析发现，干预内容、干预持续时间、干预频率和干预周期是影响干预效果的显著调节变量。其中，八段锦干预（d = 0.85；95 % CI [0.65-1.06]；P < 0.001）、每次运动时间 60 分钟或以上（d = 0.86；95 % CI [0.71-1.00]；P < 0.001）、每周运动 5 次或以上（d = 0.80；95 % CI [0.64-0.96]；P < 0.001）和运动周期 6-9 个月（d = 0.96；95 % CI [0.80-1.12]；P < 0.001）的效果最大。
中医运动疗法可有效改善老年人的认知功能。选择八段锦，每周至少运动 5 次，每次至少 60 分钟，共 6-9 个月，对老年人认知功能的效果最佳。由于发表偏倚，中医运动疗法干预对老年人认知功能的影响可能被高估。此外，应开展大样本、多中心、高质量的随机对照试验来验证这一结果。
