School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Int J Nurs Stud. 2024 Oct;158:104843. doi: 10.1016/j.ijnurstu.2024.104843. Epub 2024 Jun 24.
Multicomponent exercise has the potential to improve cognitive function in people with mild cognitive impairment. However, the effects of multicomponent exercise on specific cognitive subdomains in mild cognitive impairment and the optimal combination of exercise components remain unclear.
This systematic review aimed to (a) investigate the effects of multicomponent exercise on different cognitive subdomains in people with mild cognitive impairment and (b) investigate the effects of different combinations of multicomponent exercise on global cognition in people with mild cognitive impairment.
A systematic review and meta-analysis.
Six electronic databases, including PubMed, Medline, EMBASE, Web of Science, Cochrane Library, and CINAHL were systematically searched from inception to January 1st, 2023. Randomized controlled trials assessing the effect of multicomponent exercise interventions on cognitive function in people with mild cognitive impairment were included. The risk of bias was assessed using the Cochrane collaborative bias assessment tool. A random-effects model was used to calculate standardized mean difference. Subgroup analyses, meta-regression, and sensitive analysis were performed. If a meta-analysis was not feasible, studies were synthesized narratively.
Twenty studies were identified for systematic review and meta-analysis. Multicomponent exercise significantly improved global cognition [SMD = 1.04; 95 % confidence interval (CI): 0.53, 1.55], cognitive flexibility (SMD = -1.04; 95 % CI: -1.81, -0.27), processing speed (SMD = 0.43; 95 % CI: 0.04, 0.82), verbal fluency (SMD = 0.38; 95 % CI: 0.13, 0.63), attention (SMD = -0.90; 95 % CI: -1.68, -0.12) and memory (SMD = 0.36; 95 % CI: 0.04, 0.69) in mild cognitive impairment. The multicomponent exercise including cardiovascular (exercise that promotes cardiovascular health, such as endurance training or aerobic exercise) and motor (exercises that improve physical abilities, such as balance, coordination, agility, flexibility, etc.) components positively affected global cognition in people with mild cognitive impairment (SMD = 1.06; 95 % CI: 0.55, 1.57).
The findings of this study suggest that multicomponent exercise has a positive impact on various cognitive domains, including global cognition, cognitive flexibility, processing speed, verbal fluency, attention and memory in mild cognitive impairment. Specifically, the combination of exercises including cardiovascular and motor components was found to be effective in improving global cognition. However, further research is needed to investigate the optimal frequency and intensity of the multicomponent exercise intervention, and more detail about exercise combinations of the motor component (not classified in this study) for individuals with mild cognitive impairment.
The protocol was registered on PROSPERO (CRD42023400302).
多项成分的锻炼有可能改善轻度认知障碍患者的认知功能。然而,多项成分的锻炼对轻度认知障碍患者特定认知领域的影响以及锻炼成分的最佳组合仍不清楚。
本系统评价旨在:(a) 调查多项成分的锻炼对轻度认知障碍患者不同认知领域的影响;(b) 调查不同多项成分锻炼组合对轻度认知障碍患者整体认知的影响。
系统评价和荟萃分析。
从数据库建立起到 2023 年 1 月 1 日,系统地检索了 6 个电子数据库,包括 PubMed、Medline、EMBASE、Web of Science、Cochrane 图书馆和 CINAHL。纳入评估多项成分的锻炼干预对轻度认知障碍患者认知功能影响的随机对照试验。使用 Cochrane 协作偏倚评估工具评估偏倚风险。使用随机效应模型计算标准化均数差。进行了亚组分析、荟萃回归和敏感性分析。如果无法进行荟萃分析,则进行叙述性综合。
确定了 20 项研究进行系统评价和荟萃分析。多项成分的锻炼显著改善了整体认知[SMD=1.04;95%置信区间(CI):0.53,1.55]、认知灵活性(SMD=-1.04;95%CI:-1.81,-0.27)、处理速度(SMD=0.43;95%CI:0.04,0.82)、言语流畅性(SMD=0.38;95%CI:0.13,0.63)、注意力(SMD=-0.90;95%CI:-1.68,-0.12)和记忆(SMD=0.36;95%CI:0.04,0.69)。包含心血管(促进心血管健康的锻炼,如耐力训练或有氧运动)和运动(提高身体能力的锻炼,如平衡、协调、敏捷、灵活性等)成分的多项成分锻炼对轻度认知障碍患者的整体认知有积极影响(SMD=1.06;95%CI:0.55,1.57)。
本研究结果表明,多项成分的锻炼对轻度认知障碍患者的各种认知领域有积极影响,包括整体认知、认知灵活性、处理速度、言语流畅性、注意力和记忆。具体而言,包含心血管和运动成分的锻炼组合被发现对改善整体认知有效。然而,仍需要进一步研究来确定多项成分的锻炼干预的最佳频率和强度,以及更详细的关于运动成分(本研究未分类)的运动组合,以适用于轻度认知障碍患者。
该方案在 PROSPERO(CRD42023400302)上进行了注册。