Identifying exercise and cognitive intervention parameters to optimize executive function in older adults with mild cognitive impairment and dementia: a systematic review and meta-analyses of randomized controlled trials.

IF 3.7 1区 医学 Q2 GERIATRICS & GERONTOLOGY
Wenxin Chen, Jessie Leuk Siew-Pin, Yuhang Wu, Ning Huang, Wei-Peng Teo
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Abstract

Physical exercise is recognized for its beneficial effects on brain health and executive function, particularly through the careful manipulation of key exercise parameters, including type, intensity, and duration. The aim of this systematic review and meta-analysis was to delineate the optimal types, intensities, and durations of exercise that improve cognitive functions in older adults with mild cognitive impairment (MCI) or dementia. A comprehensive search was conducted in Scopus, Web of Science, and PubMed from their inception until December 2023. The methodological quality and publication bias of the included studies were assessed using the PEDro scale and Egger's regression test, respectively. Separate meta-analyses were performed to assess the overall impact of exercise on cognitive assessments and to explore the effects of different exercise types (i.e., aerobic, resistance, dual-task, mind-body, and multi-component exercises) and intensities (i.e., low, moderate, and high) on executive function. Results were presented as standardized mean differences (SMD) and 95% confidence intervals (95% CI). A meta-regression analysis was conducted to examine the correlation between exercise duration and mean effects. In total, 15,087 articles were retrieved from three databases, of which 35 studies were included in our final analyses. The results indicated high overall methodological quality (PEDro score = 8) but a potential for publication bias (t = 2.08, p = 0.045). Meta-analyses revealed that all types of exercise (SMD = 0.691, CI [0.498 to 0.885], p < 0.001) and intensities (SMD = 0.694, CI [0.485 to 0.903], p < 0.001) show significant effects favoring exercise. Notably, dual-task exercises (SMD = 1.136, CI [0.236 to 2.035], p < 0.001) and moderate-intensity exercises (SMD = 0.876, CI [0.533 to 1.219], p < 0.001) exhibited the greatest effect. No significant correlation was observed between exercise duration and SMD (R² = 0.038, p = 0.313). Overall, our meta-analyses support the role of physical exercise in enhancing executive function in older adults with MCI or dementia. It is essential to carefully tailor exercise parameters, particularly type and intensity, to meet the specific needs of older adults with MCI or dementia. Such customization is crucial for optimizing executive function outcomes and improving overall brain health.

确定运动和认知干预参数以优化患有轻度认知障碍和痴呆症的老年人的执行功能:随机对照试验的系统回顾和荟萃分析。
体育锻炼因其对大脑健康和执行功能的有益影响而得到认可,特别是通过对关键锻炼参数(包括类型、强度和持续时间)的精心操作。本系统性综述和荟萃分析的目的是确定运动的最佳类型、强度和持续时间,以改善患有轻度认知障碍(MCI)或痴呆症的老年人的认知功能。我们在 Scopus、Web of Science 和 PubMed 上进行了全面搜索,搜索时间从开始到 2023 年 12 月。纳入研究的方法学质量和发表偏倚分别采用 PEDro 量表和 Egger 回归检验进行评估。研究人员分别进行了荟萃分析,以评估运动对认知评估的总体影响,并探讨不同运动类型(即有氧运动、阻力运动、双任务运动、心身运动和多成分运动)和强度(即低强度、中强度和高强度)对执行功能的影响。结果以标准化均值差异(SMD)和 95% 置信区间(95% CI)表示。我们还进行了元回归分析,以研究运动持续时间与平均效果之间的相关性。我们从三个数据库中共检索到 15,087 篇文章,最终分析纳入了其中的 35 项研究。结果表明,这些研究的总体方法学质量较高(PEDro 评分 = 8),但可能存在发表偏倚(t = 2.08,p = 0.045)。元分析表明,所有类型的运动(SMD = 0.691,CI [0.498 to 0.885],p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
8.60
自引率
1.60%
发文量
29
审稿时长
>12 weeks
期刊介绍: European Review of Aging and Physical Activity (EURAPA) disseminates research on the biomedical and behavioural aspects of physical activity and aging. The main issues addressed by EURAPA are the impact of physical activity or exercise on cognitive, physical, and psycho-social functioning of older people, physical activity patterns in advanced age, and the relationship between physical activity and health.
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