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50 岁以上成年人认知功能的运动干预:系统评价与荟萃分析。

Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis.

机构信息

UC Research Institute for Sport and Exercise (UCRISE), University of Canberra, Canberra, Australia.

Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, Australia.

出版信息

Br J Sports Med. 2018 Feb;52(3):154-160. doi: 10.1136/bjsports-2016-096587. Epub 2017 Apr 24.

Abstract

BACKGROUND

Physical exercise is seen as a promising intervention to prevent or delay cognitive decline in individuals aged 50 years and older, yet the evidence from reviews is not conclusive.

OBJECTIVES

To determine if physical exercise is effective in improving cognitive function in this population.

DESIGN

Systematic review with multilevel meta-analysis.

DATA SOURCES

Electronic databases Medline (PubMed), EMBASE (Scopus), PsychINFO and CENTRAL (Cochrane) from inception to November 2016.

ELIGIBILITY CRITERIA

Randomised controlled trials of physical exercise interventions in community-dwelling adults older than 50 years, with an outcome measure of cognitive function.

RESULTS

The search returned 12 820 records, of which 39 studies were included in the systematic review. Analysis of 333 dependent effect sizes from 36 studies showed that physical exercise improved cognitive function (0.29; 95% CI 0.17 to 0.41; p<0.01). Interventions of aerobic exercise, resistance training, multicomponent training and tai chi, all had significant point estimates. When exercise prescription was examined, a duration of 45-60 min per session and at least moderate intensity, were associated with benefits to cognition. The results of the meta-analysis were consistent and independent of the cognitive domain tested or the cognitive status of the participants.

CONCLUSIONS

Physical exercise improved cognitive function in the over 50s, regardless of the cognitive status of participants. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that patients obtain both aerobic and resistance exercise of at least moderate intensity on as many days of the week as feasible, in line with current exercise guidelines.

摘要

背景

体育锻炼被视为预防或延缓 50 岁及以上人群认知能力下降的一种有前途的干预措施,但综述证据尚不确定。

目的

确定体育锻炼是否能有效改善这一年龄段人群的认知功能。

设计

系统评价,包含多层次荟萃分析。

资料来源

电子数据库 Medline(PubMed)、EMBASE(Scopus)、PsychINFO 和 CENTRAL(Cochrane),从建库至 2016 年 11 月。

纳入标准

社区居住的 50 岁以上成年人的体育锻炼干预随机对照试验,以认知功能的结果测量指标。

结果

搜索共返回 12820 条记录,其中 39 项研究纳入系统评价。对 36 项研究的 333 个依赖效应量的分析表明,体育锻炼可改善认知功能(0.29;95%CI 0.17 至 0.41;p<0.01)。有氧运动、抗阻训练、多组分训练和太极等干预措施均有显著的点估计值。当检查运动处方时,每次 45-60 分钟的运动时间和至少中等强度与认知获益相关。荟萃分析的结果是一致的,且与测试的认知域或参与者的认知状态无关。

结论

体育锻炼可改善 50 岁以上人群的认知功能,无论参与者的认知状态如何。为改善认知功能,本荟萃分析为临床医生提供了证据,建议患者每周尽可能多地按照目前的运动指南,进行至少中等强度的有氧运动和抗阻运动。

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