Peng Junjie, Chang Renjie, Wei Xinghong, Yin Zhimin, Liu Qin
School of Nursing, Yunnan University of Chinese Medicine, Kunming, 650500, China.
Digestive Endoscopy Center, Department of Spleen and Gastroenterology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, 650021, China.
BMC Public Health. 2024 Oct 1;24(1):2684. doi: 10.1186/s12889-024-20079-7.
OBJECTIVE: To evaluate the effects of various non-pharmacological interventions on patients with cognitive impairment by systematic search and network meta-analysis, and to rank the effects of the included non-pharmacological interventions.
The databases of PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, WANFANG, and SinoMed were searched by computer. All randomized controlled trials (RCTs) of non-pharmacological interventions for people with cognitive frailty were collected. The search was conducted from 2000 to February 2024. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias of the included studies, and then used Stata15 and R4.3.1 software to conduct network meta-analysis, with physical function and cognitive function as the main outcome indicators.
A total of 19 randomized controlled trials involving 1738 patients were included. The results of network meta-analysis showed that among the non-pharmacological interventions, nutritional support had the best effect on improving frailty scores and cognitive function scores in patients with cognitive frailty. Aerobic training combined with resistance training is best for improving grip strength. For improving the patient's motor status, cognitive training had the best effect on improving TUG test scores. High-speed resistance training is best for improving walking speed.
This review analyses the current study of non-pharmacological interventions to improve physical performance in patients with cognitive frailty. Current evidence suggests that nutritional support is most effective at improving physical frailty and cognitive decline in patients with cognitive frailty, and that exercise and cognitive training interventions significantly improve grip strength and motor ability.
This meta-analysis was prospectively registered with PROSPERO (registration number: CRD42023486881).
目的：通过系统检索和网状Meta分析评估各种非药物干预措施对认知障碍患者的影响，并对纳入的非药物干预措施的效果进行排序。
通过计算机检索PubMed、Cochrane图书馆、Embase、Web of Science、中国知网、维普、万方和中国生物医学文献数据库。收集所有针对认知衰弱患者的非药物干预的随机对照试验（RCT）。检索时间为2000年至2024年2月。两名研究者独立筛选研究、提取数据并评估纳入研究的偏倚风险，然后使用Stata15和R4.3.1软件进行网状Meta分析，以身体功能和认知功能作为主要结局指标。
共纳入19项涉及1738例患者的随机对照试验。网状Meta分析结果显示，在非药物干预措施中，营养支持对改善认知衰弱患者的衰弱评分和认知功能评分效果最佳。有氧运动与抗阻训练相结合对提高握力效果最佳。对于改善患者的运动状态，认知训练对提高定时起立行走测试（TUG）评分效果最佳。高速抗阻训练对提高步行速度效果最佳。
本综述分析了目前关于改善认知衰弱患者身体表现的非药物干预的研究。目前的证据表明，营养支持在改善认知衰弱患者的身体衰弱和认知衰退方面最有效，运动和认知训练干预可显著提高握力和运动能力。
本Meta分析已在PROSPERO上进行前瞻性注册（注册号：CRD42023486881）。
