各种运动对轻度认知障碍或痴呆老年人神经精神症状的有效性：系统回顾和网络荟萃分析

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-09-01 DOI:10.1016/j.arr.2025.102890

Qinghuan Kong , Kexin Huang , Shuang Li , Xinyun Li , Rui Han , Haiqi Yang , Yuhang Pu , Li Chen , Yong Jia

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引用次数: 0

摘要

目的探讨运动对减轻老年轻度认知障碍（MCI）或痴呆患者神经精神症状（NPS）的比较疗效。方法系统检索自建库至2025年4月29日的10个数据库，最新更新时间为2025年7月13日。包括随机对照试验（rct）和准实验研究，评估运动对MCI或痴呆老年人NPS的有效性。使用随机对照试验的偏倚风险工具（RoB 2）和乔安娜布里格斯研究所（JBI）关键评估清单来评估偏倚风险。采用随机效应网络元分析模型综合所有可用证据。本研究的注册号为CRD420251087869。结果共纳入34项研究，3655名受试者。其中，29项rct为低至高偏倚风险，5项准实验研究为中等偏倚风险。网络meta分析显示，对于NPS，阻力运动（SMD = - 1.70, 95 % CI: - 3.12至- 0.29）以91.8 %排名第一；认知功能方面，多组分运动（SMD = 1.45, 95 % CI: - 0.56 ~ -3.47）以80.2 %排名第一；在日常生活质量（QoL）方面，有氧运动（SMD = 0.37, 95 % CI: - 0.26至-0.99）以77.5 %排名第一；在日常生活活动（ADL）方面，手指运动（SMD = 0.86, 95 % CI: 0.02 ~ -1.71）以89.6% %排名第一。该网络荟萃分析表明，阻力运动最有可能是改善MCI或痴呆老年人NPS的最佳干预措施，而手指运动似乎对提高ADL最有效。然而，由于阻力运动的研究数量有限，这些发现应谨慎解释，需要进一步的高质量研究来证实其有效性。

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Effectiveness of various exercise on neuropsychiatric symptoms among older adults with mild cognitive impairment or dementia: A systematic review and network meta-analysis

Objective

To identify the comparative efficacy of exercise for reducing neuropsychiatric symptoms (NPS) among older adults with mild cognitive impairment (MCI) or dementia.

Methods

Ten databases were systematically searched from their inception to April 29, 2025, with the latest update in July 13, 2025. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of exercise on NPS in older adults with MCI or dementia were included. Risk of bias was assessed using the Risk of Bias tool (RoB 2) tool for RCTs and the Joanna Briggs Institute (JBI) critical appraisal checklists. A random-effects network meta-analysis model was employed to synthesize all available evidence. The registration number of this study is CRD420251087869.

Results

A total of 34 studies involving 3655 participants were included. Among them, 29 RCTs showed a low to high risk of bias, while 5 quasi-experimental studies had moderate risk. A network meta-analysis revealed that for NPS, resistance exercise (SMD = −1.70, 95 % CI: −3.12 to −0.29) ranked first with 91.8 %; for cognition function, multi-component exercise (SMD = 1.45, 95 % CI: −0.56 to –3.47) ranked first with 80.2 %; for quality of daily life (QoL), aerobic exercise (SMD = 0.37, 95 % CI: −0.26 to –0.99) ranked first with 77.5 %; and for activities of daily living (ADL), finger exercise (SMD = 0.86, 95 % CI: 0.02 to –1.71) ranked first with 89.6 %.

Conclusions

This network meta-analysis suggests that resistance exercise is most likely the optimal intervention for improving NPS among older adults with MCI or dementia, while finger exercise appears most effective for enhancing ADL. However, due to the limited number of studies on resistance exercise, these findings should be interpreted with caution, and further high-quality research is needed to confirm its efficacy.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.