Effects of physical activity and exercise on the cognitive function of patients with Alzheimer disease: a meta-analysis
Effects of physical activity and exercise on the cognitive function of patients with Alzheimer disease: a meta-analysis
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DOI：
10.1186/s12877-019-1175-2
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发表时间：
2019-07-02
期刊：
影响因子：
4.1
通讯作者：
Wang, Ying-quan
中科院分区：
文献类型：
--
作者：
Jia, Rui-xia;Liang, Jing-hong;Wang, Ying-quan
阿尔茨海默病（alzheimer 's disease， AD）作为痴呆症最常见的病因，给患者和社会卫生保健系统带来了巨大的经济负担，这促使研究者对多种保护因素进行研究，其中体育活动和锻炼已被证明既有效又经济可行。方法系统检索截至2018年11月1日已发表的3个国际数据库（PubMed、Cochrane Library和Embase）和2个中国数据库（万方数据、中国国家知识基础设施）中符合条件的研究。所有分析均使用Stata 14.0进行。由于研究间存在异质性，本meta分析采用随机效应模型。采用meta分析探讨体育活动和运动对老年AD患者认知是否有积极影响，并采用亚组分析研究是否存在剂量反应效应。结果共纳入13项随机对照试验，样本量为673例诊断为AD的受试者。干预组与对照组相比，MMSE评分（SMD=1.12 CI:0.66相似，1.59）测量的被试认知改善有统计学意义。亚组分析显示，不同数量的体育活动和锻炼可以产生不同的效果。结论作为为数不多的meta分析之一，我们的研究详细比较了不同运动量的体育活动和运动干预对AD的影响，表明体育活动和运动可以改善老年AD患者的认知能力。虽然高频干预对认知功能的伴随效应并不大于低频干预，但阈值仍有待确定。然而，需要更多具有严格研究设计的随机对照试验来支持我们的发现。
BackgroundAlzheimer's disease (AD), as the most common cause of dementia, brings huge economic burden for patients and social health care systems, which motivates researchers to study multiple protective factors, among which physical activity and exercise have been proven to be both effective and economically feasible.MethodsA systematic literature search was performed for eligible studies published up to November 1st 2018 on three international databases (PubMed, Cochrane Library, and Embase) and two Chinese databases (Wanfang Data, China National Knowledge Infrastructure). All analyses were conducted using Stata 14.0. Due to heterogeneity between studies, a random-effects model was used for this meta-analysis. Meta-analysis was used to explore if physical activity and exercise can exert positive effects on cognition of elderly with AD and subgroup analyses were conducted to find out if there are dose-response effects.ResultsA total of 13 randomized controlled trials were included with a sample size of 673 subjects diagnosed with AD. Intervention groups showed a statistically significant improvement in cognition of included subjects measured by the MMSE score (SMD=1.12 CI:0.66 similar to 1.59) compared to the control groups. Subgroup analyses showed different amounts of physical activity and exercise can generate different effects.ConclusionsAs one of few meta-analyses comparing different quantities of physical activity and exercise interventions for AD in details, our study suggests that physical activity and exercise can improve cognition of older adults with AD. While the concomitant effects on cognition functions of high frequency interventions was not greater than that of low frequency interventions, the threshold remains to be settled. However, more RCTs with rigorous study design are needed to support our findings.