运动对轻度认知障碍老年人认知功能干预效果的元分析

Meta-analysis of Effect of Exercise Intervention on the Cognitive Function in Elderly with Mild Cognitive Impairment

目的:采用元分析方法检验运动对轻度认知障碍(MCI)老年人认知功能的干预效果及其调节变量,追踪最优防治方案。方法:确定文献纳入与排除标准,检索中英文6个数据库,收集运动对MCI老年人认知功能干预的随机对照实验。运用“Stata12.0”软件对所纳入25篇文献的2400例受试者的结局指标进行分析。结果:1)运动干预能起到延缓MCI老年人认知功能衰退的效果,合并效应量WMD=1.63,95%为CI(1.23,2.02),p<0.01。2)干预效果受到干预时间(I^(2)=95.1%)、干预频率(I^(2)=89.4%)、干预周期(I^(2)=84.6%)的显著调节作用,其中效应量最显著的要素是单次35~50 min、每周4次以上、持续5~7月,p值均<0.05。3)干预内容(I^(2)=65.2%)、文献质量(I^(2)=50.2%)、样本量(I^(2)=57.8%)对干预效果有一定调节作用,其中有氧运动和抗阻运动、A级文献、30例以下样本效应量最显著,p值均<0.05。4)发表年限(I^(2)=17.2%)的调节作用不明显。结论:运动干预能延缓轻度认知障碍老年人的认知功能衰退,干预效果受到多种变量的调节作用。有氧运动或抗阻运动,单次锻炼35~50 min,每周锻炼4次以上,持续锻炼5~7月的干预效果最佳。未来研究需重视样本量的科学估算,并严格遵循实验规范提高研究质量。

Objective:To use meta-analysis to test the effect of exercise intervention on the cognitive function of the elderly with mild cognitive impairment(MCI)and its adjustment variables,and to track the optimal prevention and treatment plan.Methods:Determine the literature inclusion and exclusion criteria,search 6 Chinese and English databases,and collect randomized controlled trials of exercise intervention on the cognitive function of the elderly with MCI.Stata12.0 software was used to analyze the outcome indicators of 2400 subjects included in 25 articles.Results:1)Exercise intervention can delay the decline of cognitive function in the elderly with MCI,the combined effect size WMD=1.63,95%CI is(1.23,2.02),p<0.01.2)The intervention effect is affected by the intervention time(I^(2)=95.1%),intervention frequency(I^(2)=89.4%),and intervention period(I^(2)=84.6%).The most significant factor is a single 35~50 min,more than 4 times a week,and a duration of 5~7months,p<0.05.3)Intervention content(I^(2)=65.2%),literature quality(I^(2)=50.2%),sample size(I^(2)=57.8%)have a certain modulating effect on the intervention effect,among which aerobic exercise And resistance exercise,A-level literature,and samples of less than 30 cases have the most significant effect size,p<0.05.4)The adjustment effect of publication years(I^(2)=17.2%)is not obvious.Conclusion:Exercise intervention can delay the decline of cognitive function in the elderly with MCI,and the intervention effect is regulated by a variety of variables.Aerobic exercise or resistance exercise,a single exercise of 35~50 min,exercise more than 4 times a week,and continuous exercise for 5~7 months have the best prevention and treatment effect.Future research should pay attention to the scientific estimation of sample size,and strictly follow the experimental specifications to improve the quality of research.