The Effect of Exercise Training on Cognitive Function in Older Adults with Mild Cognitive Impairment: A Meta-analysis of Randomized Controlled Trials
The Effect of Exercise Training on Cognitive Function in Older Adults with Mild Cognitive Impairment: A Meta-analysis of Randomized Controlled Trials
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DOI：
10.1016/j.jagp.2013.02.018
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发表时间：
2013-11-01
影响因子：
7.2
通讯作者：
Valenzuela, Michael
中科院分区：
文献类型：
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作者：
Gates, Nicola;Singh, Maria A. Fiatarone;Valenzuela, Michael
目的：运动和认知的研究主要集中在健康或痴呆的老年人，结果在轻度认知障碍（MCI）的个体中是模棱两可的。我们的目的是评估运动对老年MCI患者认知功能的影响。设计：我们进行了一项关于运动对轻度认知障碍成年人认知结果影响的随机对照试验（RCT）的荟萃分析。在Medline、EMBASE、CINAHL、PEDro、SPORTSDICUS、PsychInfo和PubMed中进行了检索。参与者：年龄超过65岁的MCI或简易精神状态检查平均得分24-28（含）的成年人。测量值：使用PEDro量表评估研究质量;提取参与者和干预特征和结局的数据，然后进行荟萃分析。结果：14项RCT（1，695名参与者;年龄65-95岁）符合入选标准。质量是适度的和不足的权力，为小的影响普遍。总体而言，42%的效应量（ES）可能具有临床相关性（ES > 0.20），只有8%的认知结果具有统计学意义。荟萃分析显示，运动对语言流畅性的影响可忽略不计，但具有显著性（ES：0.17 [0.04，0.30]）。没有发现额外的执行措施，记忆或信息处理的显着好处。总体结果与不同运动类型和认知领域的益处不一致。结论：有非常有限的证据表明，运动可以改善MCI患者的认知功能，尽管已发表的研究质量中等，并且由于统计能力低而不确定。关于效益的规模、普遍性、持久性和机制仍存在问题。需要大规模，高质量的随机对照试验来确定运动是否能改善认知或降低MCI患者的痴呆发病率。
Objectives: Investigations of exercise and cognition have primarily focused on healthy or demented older adults, and results have been equivocal in individuals with mild cognitive impairment (MCI). Our aim was to evaluate efficacy of exercise on cognition in older adults with MCI. Design: We conducted a meta-analysis of random controlled trials (RCTs) of exercise effects on cognitive outcomes in adults with MCI. Searches were conducted in Medline, EMBASE, CINAHL, PEDro, SPORTSDICUS, PsychInfo, and PubMed. Participants: Adults aged over 65 years with MCI or Mini-Mental State Exam mean score 24-28 inclusive. Measurements: Study quality was assessed using the PEDro scale; data on participant and intervention characteristics and outcomes were extracted, followed by meta-analysis. Results: Fourteen RCTs (1,695 participants; age 65-95 years) met inclusion criteria. Quality was modest and under-powering for small effects prevalent. Overall, 42% of effect sizes (ESs) were potentially clinically relevant (ES > 0.20) with only 8% of cognitive outcomes statistically significant. Meta-analysis revealed negligible but significant effects of exercise on verbal fluency (ES: 0.17 [0.04, 0.30]). No significant benefit was found for additional executive measures, memory, or information processing. Overall results were inconsistent with benefits varying across exercise types and cognitive domains. Conclusions: There is very limited evidence that exercise improves cognitive function in individuals with MCI, although published research is of moderate quality and inconclusive due to low statistical power. Questions remain regarding the magnitude, generalization, persistence, and mechanisms of benefits. Large-scale, high-quality RCTs are required to determine if exercise improves cognition or reduces dementia incidence in those with MCI.