Conglin Han, Weishuang Sun, Dan Zhang, Xiaoshuang Xi, Rong Zhang, Weijun Gong
Journal: BMJ open 2023;13(6):e067293
PMID: 37399446
Mild cognitive impairment (MCI) is an intermediate state between normal cognition and dementia. MCI usually refers to cognitive decline beyond that caused by normal ageing, but without significant impairment in activity of daily living. It has been suggested that some non-pharmacological interventions, such as food, exercise, and cognitive stimulation, may be beneficial for the improvement of cognitive function in MCI patients. The aim of this study was to analyse the effect of different types of aerobic exercise on global cognitive function in elderly patients with MCI. This study was a systematic review and meta-analysis of eighteen articles – randomised controlled trials. Result showed that two types of aerobic exercise (including multicomponent aerobic exercise and mind–body exercise) have a positive effect on improving global cognitive function in older patients with MCI. Authors concluded that even though their findings are very promising, additional well-designed randomised controlled trials are needed to provide more evidence.
OBJECTIVES
To summarise the effects of various types of aerobic exercise on the global cognitive function of the elderly with mild cognitive impairment (MCI).
DESIGN
A meta-analysis of randomised controlled trials (RCTs).
DATA SOURCES
PubMed, EMBASE and the Cochrane Library were searched for clinical RCTs from the earliest available records to March 2022.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES
We included RCTs of subjects older than 60 years with MCI. The outcome indicators of cognitive function of interest were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA).
DATA EXTRACTION AND SYNTHESIS
Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies, with disagreements resolved by a third researcher. The was used to assess the risk of bias. Meta-analysis was performed by Review Manager V.5.3 software. Random-effect models were used for meta-analysis.
RESULTS
A total of 1680 patients who participated in 20 RCTs were included in this study. Based on outcomes of MMSE analysis, the aerobic exercise, which was beneficial for global cognitive function in MCI patients, included multicomponent aerobic exercise (MD=1.79, 95% CI (1.41 to 2.17), p<0.01) and mind-body exercise (MD=1.28, 95% CI (0.83 to 1.74), p<0.01). The results of the meta-analysis of conventional aerobic exercise (MD=0.51, 95% CI (0.09 to 0.93), p=0.02) turned out to be statistically insignificant after sensitivity analysis (MD=0.14, 95% CI (-0.47 to 0.75), p=0.65). With the evaluation of MoCA, multicomponent aerobic exercise (MD=5.74, 95% CI (5.02 to 6.46), p<0.01), mind-body exercise (MD=1.29, 95% CI (0.67 to 1.90), p<0.01) and conventional aerobic exercise (MD=2.06, 95% CI (1.46 to 2.65), p<0.01) were showed significant beneficial effects for the patient. However, there was a high degree of heterogeneity between the results of multicomponent aerobic exercise (MMSE) and conventional aerobic exercise (MoCA), which was analysed and explored.
CONCLUSIONS
In general, multicomponent aerobic exercise and mind-body exercise were beneficial in improving global cognitive function in the elderly with MCI. Nevertheless, the improvement effect of mind-body exercise is more reliable compared with multicomponent aerobic exercise and conventional aerobic exercise.
PROSPERO REGISTRATION NUMBER
CRD42022327386.
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.
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