老年人衰弱改善的运动处方：基于《2024年老年人纲要》的循证方法

Exercise prescription prescriptions for frailty improvement in older adults: An evidence-based approach based on the 2024 older adult compendium.

作者信息

Zang Wanli, Fang Mingqing, Meng Lingyue, Kong Lingyu, Xiao Ningkun, Xue Jingxian, Liu Ziyi, Wu Jiarong, Zhang Yue, Wei Xinhui, Zhang Zijun, Zhang Qiuxia

机构信息

School of Physical Education, Soochow University, Suzhou, PR China.

Xiangya School of Medicine, Central South University, Changsha, PR China.

出版信息

Arch Gerontol Geriatr. 2025 Mar;130:105717. doi: 10.1016/j.archger.2024.105717. Epub 2024 Dec 5.

DOI:10.1016/j.archger.2024.105717

PMID:39671884

Abstract

OBJECTIVE

This study explored the dose-response relationship of exercise prescriptions for improving frailty in older adults, based on the 2024 Older Adult Compendium. It aims to provide evidence-based support for developing frailty intervention programs and their clinical application.

METHODS

A comprehensive search was conducted in PubMed, OVID, Cochrane Library, Web of Science, and Scopus from inception to November 5th, 2024. Randomized controlled trials (RCTs) related to exercise interventions in older adults were included. Relevant studies meeting the inclusion criteria were selected, and data were extracted for further analysis. The quality of the included studies was assessed. Meta-analysis was performed using R, and the standardized mean difference (SMD) with 95 % confidence intervals (95 % CI) was used to quantify effect sizes.

RESULTS

A total of 16 eligible RCTs comprising 2,716 older adults were included. The meta-analysis revealed that exercise significantly improved frailty among older adults [SMD = -0.81, 95 % CI (-1.25, -0.38), P < 0.001]. However, high-intensity exercise did not demonstrate a significant effect on frailty improvement [SMD = -0.45, 95 % CI (-0.96, 0.06), P = 0.3]. The analysis indicated a nonlinear dose-response relationship between exercise and frailty improvement. The predicted values for frailty improvement at the minimum and maximum exercise doses recommended by the World Health Organization (600 MET-minutes/week and 1200 MET-minutes/week, respectively) were -0.79 (95 % CI [-1.17, -0.41]) and -1.39 (95 % CI [-2.62, -0.15]), respectively.

CONCLUSION

Low- to moderate-intensity exercise significantly improves frailty among older adults, while high-intensity exercise programs are not recommended.

摘要

目的

本研究基于《2024年老年人健康指南》，探讨运动处方改善老年人衰弱的剂量反应关系。旨在为制定衰弱干预方案及其临床应用提供循证支持。

方法

从创刊至2024年11月5日，在PubMed、OVID、Cochrane图书馆、科学网和Scopus中进行全面检索。纳入与老年人运动干预相关的随机对照试验（RCT）。选择符合纳入标准的相关研究，并提取数据进行进一步分析。评估纳入研究的质量。使用R进行荟萃分析，采用标准化均数差（SMD）及95%置信区间（95%CI）量化效应量。

结果

共纳入16项合格的RCT，涉及2716名老年人。荟萃分析显示，运动显著改善了老年人的衰弱状况[SMD = -0.81，95%CI（-1.25，-0.38），P < 0.001]。然而，高强度运动对改善衰弱未显示出显著效果[SMD = -0.45，95%CI（-0.96，0.06），P = 0.3]。分析表明运动与衰弱改善之间存在非线性剂量反应关系。世界卫生组织推荐的最低和最高运动剂量（分别为600梅脱-分钟/周和1200梅脱-分钟/周）下，衰弱改善的预测值分别为-0.79（95%CI[-1.17，-0.41]）和-1.39（95%CI[-2.62，-0.15]）。