手指运动对老年MCI/AD/痴呆患者认知功能的影响:随机对照试验的系统回顾和荟萃分析

Jianghong Liu , Haoer Shi
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摘要

本研究旨在通过随机对照试验(RCTs)的系统回顾和荟萃分析,评估手指锻炼对认知功能和日常生活活动(ADL)的影响。全面检索了4个英文数据库(PubMed、Google Scholar、EMBASE、Cochrane Library)和2个中文数据库(万方、中国国家知识基础设施),检索时间为成立至2023年6月。纳入标准侧重于评估手指运动对认知功能影响的随机对照试验。采用Cochrane Collaboration的偏倚风险工具评估纳入研究的质量。采用随机效应模型进行数据综合,以95%置信区间(ci)计算加权平均差(wmd)或标准化平均差(SMDs)。进行亚组分析和meta回归来探索异质性的潜在来源。本综述纳入了12项研究,其中11项(覆盖1215名参与者)符合meta分析的条件。结果表明,手指运动对一般认知功能和ADL有积极的影响。亚组分析显示,对轻度认知障碍(MCI)患者有显著影响,但对痴呆或阿尔茨海默病(AD)患者的影响不太明显,特别是在中度至重度阶段。人口、锻炼时间和年龄被确定为综合效应的显著调节因子。本系统综述和荟萃分析提供证据支持手指锻炼在改善认知衰退方面的积极作用。然而,大多数被回顾的研究都是在中国人群中进行的,因此需要在不同人群中进行更严格的研究来验证和加强这些发现。对最佳锻炼程序和频率的进一步研究可能会将手指锻炼定位为一种经济有效且方便的干预措施,以防止健康或轻度认知障碍老年人的认知能力下降。
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Finger exercise effects on cognitive functions in older adults with MCI/AD/dementia: A systematic review and meta-analysis of randomized controlled trials

Objective

This study aimed to evaluate the effects of finger exercise on cognitive function and activities of daily living (ADL) through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Methods

A comprehensive search was conducted in four English databases (PubMed, Google Scholar, EMBASE, Cochrane Library) and two Chinese databases (Wanfang, China National Knowledge Infrastructure) from inception to June 2023. The inclusion criteria focused on RCTs evaluating the impact of finger exercise on cognitive function. The quality of the included studies was assessed using the Cochrane Collaboration's risk of bias tool. Data synthesis was performed using random-effects models, calculating weighted mean differences (WMDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses and meta-regression were conducted to explore potential sources of heterogeneity.

Results

Twelve studies were included in the review, with 11 (covering 1215 participants) eligible for meta-analysis. The results demonstrated that a positive effect of finger exercise on general cognitive function and ADL. Subgroup analysis revealed significant effects in individuals with mild cognitive impairment (MCI) but less pronounced effects in patients with dementia or Alzheimer's disease (AD), particularly at moderate to severe stages. Population, exercise hours, and age were identified as significant moderators for the pooled effects.

Conclusions

This systematic review and meta-analysis provide evidence supporting the positive effects of finger exercise in improving cognitive decline. However, the majority of reviewed studies were conducted in the Chinese population, thus warranting more rigorous studies in diverse populations to validate and strengthen these findings. Further investigation into the optimal exercise routines and frequency may position finger exercises as a cost-effective and convenient intervention against cognitive decline in healthy or MCI older adults.

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