Yang Linlin, Yuan Zhichao, Peng Chenggen
Hunan International Economics University, Changsha, Hunan, China.
Changsha Normal University, Changsha, Hunan, China
BMJ Open. 2025 Jan 11;15(1):e090623. doi: 10.1136/bmjopen-2024-090623.
Numerous studies have examined the effects of physical activity on cognitive performance and executive function in people with Alzheimer's disease (AD), although the findings are not entirely consistent. There are also insufficient study reviews for specific workout and assessment tool types. Therefore, the purpose of this study was to systematically investigate the effects of aerobic exercise on the quality of life, cognitive performance and depressive symptoms in people with AD.
Risk of bias was assessed using the Cochrane risk of bias tool, systematic reviews and meta-analyses using random-effects modelling, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation tool.
PubMed, Web of Science, Cochrane Library, EMBASE, Scopus, CINAHL and CNKI through 12 March 2024.
The analysis includes all randomised controlled trials (RCTs) that used aerobic exercise as an intervention for individuals with AD.
Two writers selected and searched for data using defined techniques. To investigate possible sources of heterogeneity between studies, meta-regression was carried out using Stata MP V.18.0 and V.14.0 software, standardised mean differences (SMDs) and 95% CIs were computed, and data were reviewed using Review Manager V.5.4 software, which was made available by the Cochrane Collaboration. Sensitivity analyses were employed to ascertain the stability and reliability of the results, and funnel plots and Egger's test were employed to check for publication bias. Correction and assessment of publication bias was done using Duval and Tweedie clipping methods.
Aerobic exercise enhanced cognitive function. For the Minimum Mental State Examination (MMSE) (SMD=0.95, 95% CI 0.58 to 1.32, Z=5.06, p<0.00001), Alzheimer's Disease Assessment Scale-Cognitive Section (ADAS-cog) (SMD=-0.67, 95% CI -1.15 to -0.2, Z=2.77, p=0.006) and quality of life (SMD=0.36, 95% CI 0.08 to 0.64, Z=2.51, p=0.01), but not statistically significant for depressive symptoms (SMD=-0.25, 95% CI -0.63 to 0.13, Z=1.27, p=0.21). Subgroup analysis showed that duration greater than 16 weeks and less than 50 min per intervention improved MMSE Scores. Duration greater than 16 weeks and more than 30 min per intervention improved ADAS-cog Scores in patients with AD. Aerobic exercise greater than 16 weeks, with more than three interventions per week and 30-50 min per intervention improves quality of life in patients with AD.
The study revealed that aerobic exercise was conducive to the improvement of cognitive function and quality of life among patients with AD, yet it did not exert a significant impact on the amelioration of depressive symptoms. Nevertheless, given the high level of heterogeneity and the variations in the quality of the included studies, the conclusions require further verification through more scientifically objective RCTs.
CRD42024526067.
众多研究探讨了体育活动对阿尔茨海默病（AD）患者认知表现和执行功能的影响，尽管研究结果并不完全一致。对于特定的锻炼方式和评估工具类型，也缺乏足够的研究综述。因此，本研究旨在系统地调查有氧运动对AD患者生活质量、认知表现和抑郁症状的影响。
使用Cochrane偏倚风险工具评估偏倚风险，采用随机效应模型进行系统评价和荟萃分析，并使用推荐分级评估、制定和评价工具评估证据的确定性。
截至2024年3月12日的PubMed、科学网、Cochrane图书馆、EMBASE、Scopus、CINAHL和中国知网。
分析包括所有将有氧运动作为AD患者干预措施的随机对照试验（RCT）。
两位作者使用既定技术选择并检索数据。为了调查研究之间可能的异质性来源，使用Stata MP V.18.0和V.14.0软件进行荟萃回归，计算标准化均数差（SMD）和95%置信区间（CI），并使用Cochrane协作网提供的Review Manager V.5.4软件对数据进行审查。采用敏感性分析确定结果的稳定性和可靠性，采用漏斗图和Egger检验检查发表偏倚。使用Duval和Tweedie修剪方法对发表偏倚进行校正和评估。
有氧运动可增强认知功能。对于简易精神状态检查表（MMSE）（SMD = 0.95，95% CI 0.58至1.32，Z = 5.06，p < 0.00001）、阿尔茨海默病评估量表 - 认知部分（ADAS - cog）（SMD = -0.67，95% CI -1.15至 -0.2，Z = 2.77，p = 0.006）和生活质量（SMD = 0.36，95% CI 0.08至0.64，Z = 2.51，p = 0.01）有改善，但对抑郁症状无统计学意义（SMD = -0.25，95% CI -0.63至0.13，Z = 1.27，p = 0.21）。亚组分析表明，每次干预持续时间大于16周且小于50分钟可提高MMSE评分。每次干预持续时间大于16周且大于30分钟可提高AD患者的ADAS - cog评分。有氧运动持续时间大于16周，每周干预次数超过三次且每次干预30 - 50分钟可改善AD患者的生活质量。
该研究表明，有氧运动有利于改善AD患者的认知功能和生活质量，但对改善抑郁症状没有显著影响。然而，鉴于纳入研究的异质性水平较高且质量存在差异，这些结论需要通过更科学客观的RCT进一步验证。
PROSPERO注册号：CRD42024526067。
