Meta-analysis of the effect of aerobic exercise on mild cognitive impairment in the elderly

doi:10.3969/j.issn.2095-4344.1943

Abstract

Abstract:

BACKGROUND: Preliminary study has shown that exercise can improve the cognitive function in senile dementia and patients with mild cognitive impairment.
OBJECTIVE: To understand the effect of aerobic exercise on mild cognitive impairment in elderly people in China by meta-analysis.
METHODS: The search strategies and inclusion and exclusion criteria were developed, and CNKI, CBMdisc, WanFang, VIP, PubMed, EBSCOhost and Cochrane library databases were searched to retrieve the randomized controlled trials concerning aerobic exercise in the elderly patients with mild cognitive impairment. Risk assessment of Cochrane bias was performed, valid information was selected and input, and meta-analysis was performed on RevMan 5.3 software.
RESULTS AND CONCLUSION: Finally, nine articles were obtained, all of which were randomized controlled studies. Meta-analysis results showed that the mini-mental state examination score in the trial group was higher than that in the control group after aerobic exercise intervention [MD=1.51, 95%CI (0.54, 2.48), P < 0.01]. The Montreal Cognitive Assessment score in the trial group was higher than that in the control group [MD=2.90, 95%CI (1.92, 3.88), P < 0.000 01]. After 3 months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.77, 95%CI (0.33, 1.20), P=0.000 6]. After 6 months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.73, 95%CI (0.19, 1.28), P=0.008]. After several months of aerobic exercise intervention, the cognitive score in the trial group was higher than that in the control group [SMD=0.89, 95%CI (0.60, 1.18), P < 0.000 01]. In summary, long-term exercise can improve the cognitive function in the elderly, and this method is safe and feasible, and is easy to carry out in the elderly.

Key words: mild cognitive impairment, meta-analysis, aerobic exercise, elderly, influencing factors, cognitive impairment, exercise intervention, physical exercise

CLC Number:

Liu Dongqi1, Li Rongmei1, Zhang Meiqi1,Chen Yanyan1, Zhang Haiping2 . Meta-analysis of the effect of aerobic exercise on mild cognitive impairment in the elderly[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(35): 5727-5731.

Figures/Tables 3

2.2 质量评价纳入的9篇文献中有6篇描述了随机方法采用的是随机数字表法[8-9，11-14]，其余的仅是描述为“随机分组”，偏向低选择偏倚风险。发现有1篇文献对研究人员设盲[12]，存在潜在的高实施偏倚风险。每一篇文献都对数据进行了如实的记录汇报，在过程中脱离试验的也写明了具体原因和处理办法，所以失访偏倚较低。 2.3 干预后以不同量表为结局指标显示对认知功能的影响 2.3.1 MMSE评分纳入的文献当中，其中有6篇文献中以有氧运动进行3个月干预[7-9，11，13-14]，干预前后均对患者进行了MMSE评分检测。结果显示，这6篇文献研究存在统计学异质性(I2=74%，P=0.002)。选取随机效应模型对结果进行Meta分析。结果显示试验组的MMSE量表评分高于对照组[MD=1.51，95%CI(0.54，2.48)，P < 0.01]，见图2。 2.3.2 MoCA评分以MoCA评分来评价干预3个月后老年人认知状况是否得到改善的文献有5篇[7，11，13-15]。结果显示，纳入的5篇文献之间存在异质性(I2=78%，P=0.001)。选取随机效应模型对结果进行Meta分析。结果显示，试验组MoCA评分明显高于对照组[MD=2.90，95%CI(1.92，3.88)，P < 0.000 01]，见图3。 2.4 有氧运动干预时间不同对认知功能影响 2.4.1 3个月结果对纳入的文献观察发现，大多数研究的试验组干预时间为3个月[7-8，10-11，13-15]。对这7项研究进行数据提取，发现结局指标不完全一致，所以数据处理时采用标准化均数差，得出I2=82%(P < 0.001)，显示各研究之间存在异质性。选取随机效应模型进行Meta分析，结果显示试验组认知功能障碍评分高于对照组[SMD=0.770，95%CI(0.33，1.20)，P=0.000 6]，见图4。 2.4.2 6个月结果有4篇文献研究有氧运动干预的时长为6个月[7，10，12-13]。由于结局指标不同，数据处理时采用标准化均数差。纳入的4篇文献之间存在异质性(I2=81%，P=0.001)。选取随机效应模型进行Meta分析，结果显示试验组认知障碍评分高于对照组[SMD=0.730，95%CI (0.190，1.28)，P=0.008]，见图5。 2.5 有氧运动干预后患者认知情况变化对所纳入的9篇文献数据进行合理提取综合分析[7-15]。对结局指标的选取条件是每篇研究中干预的最长时间后的结果和2种量表评分均存在情况下选MMSE量表评分为主。根据所得数据分析后发现，各研究之间是存在异质性(I2=66%，P=0.003)。据此，选取随机效应模型进行Meta分析，结果显示长时间持续有氧运动干预试验组认知障碍评价评分高于对照组[SMD=0.89，95%CI(0.60，1.18)，P < 0.000 01]，见图6。 2.6 发表偏倚最终纳入文献数量少于10篇，不适用采用漏斗图来评估发表偏倚，所以研究也许存在潜在的发表偏倚。 "

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