Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease - A randomized trial
Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease - A randomized trial
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DOI：
10.1001/jama.300.9.1027
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发表时间：
2008-09-03
影响因子：
120.7
通讯作者：
Almeida, Osvaldo P.
中科院分区：
文献类型：
--
作者：
Lautenschlager, Nicola T.;Cox, Kay L.;Almeida, Osvaldo P.
背景：许多观察性研究表明，体育锻炼可以降低认知衰退的风险；然而，来自随机试验的证据还很缺乏。目的确定体育锻炼是否会降低高危老年人的认知衰退比率。设计和设置了2004至2007年间在西澳大利亚州珀斯进行的为期24周的体育锻炼干预随机对照试验。认知功能的评估人员对群体成员身份视而不见。参与者我们招募了报告记忆问题但不符合痴呆症标准的志愿者。311名年龄在50岁或以上的个人接受了资格筛选，89人不符合资格，52人拒绝参加。共有170名参与者被随机分配，138名参与者完成了为期18个月的评估。干预组参与者被随机分配到教育和日常护理组，或参加为期24周的家庭体育活动计划。18个月来，阿尔茨海默病评定量表认知子量表(ADAS-Cog)得分的主要结果变化(可能范围为0-70)。结果在意向治疗分析中，干预组参与者提高了0.26分(95%可信区间，-0.89~0.54)，而常规护理组参与者恶化了1.04分(95%可信区间，0.32至1.82)。干预结束时，干预组和对照组结果测量的绝对差值为-1.3分(95%可信区间，-2.38至-0.22)。在18个月时，干预组参与者在ADAS-Cog上提高了0.73分(95%可信区间，-1.27至0.03)，而常规护理组参与者提高了0.04分(95%可信区间，-0.46至0.88)。词表延迟回忆和临床痴呆症评定盒总和也有小幅改善，而词表总即刻回忆、数字符号编码、语言流利性、Beck抑郁评分和医学结果36项简明身心成分摘要没有显著变化。结论在本研究中，6个月的体力活动计划在18个月的随访期内提供了适度的认知改善。试验登记anzctr.org.au标识：ACTRN12605000136606
Context Many observational studies have shown that physical activity reduces the risk of cognitive decline; however, evidence from randomized trials is lacking.Objective To determine whether physical activity reduces the rate of cognitive decline among older adults at risk.Design and Setting Randomized controlled trial of a 24- week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth, Western Australia. Assessors of cognitive function were blinded to group membership.Participants We recruited volunteers who reported memory problems but did not meet criteria for dementia. Three hundred eleven individuals aged 50 years or older were screened for eligibility, 89 were not eligible, and 52 refused to participate. A total of 170 participants were randomized and 138 participants completed the 18- month assessment.Intervention Participants were randomly allocated to an education and usual care group or to a 24- week home- based program of physical activity.Main Outcome Measure Change in Alzheimer Disease Assessment Scale Cognitive Subscale ( ADAS- Cog) scores ( possible range, 0- 70) over 18 months.Results In an intent- to- treat analysis, participants in the intervention group improved 0.26 points ( 95% confidence interval, - 0.89 to 0.54) and those in the usual care group deteriorated 1.04 points ( 95% confidence interval, 0.32 to 1.82) on the ADAS- Cog at the end of the intervention. The absolute difference of the outcome measure between the intervention and control groups was - 1.3 points ( 95% confidence interval,- 2.38 to - 0.22) at the end of the intervention. At 18 months, participants in the intervention group improved 0.73 points( 95% confidence interval, - 1.27 to 0.03) on the ADAS- Cog, and those in the usual care group improved 0.04 points ( 95% confidence interval, - 0.46 to 0.88). Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well, whereas word list total immediate recall, digit symbol coding, verbal fluency, Beck depression score, and Medical Outcomes 36- Item Short- Form physical and mental component summaries did not change significantly.Conclusions In this study of adults with subjective memory impairment, a 6- month program of physical activity provided a modest improvement in cognition over an 18-month follow- up period.Trial Registration anzctr.org.au Identifier: ACTRN12605000136606.