• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry >Drug and Exercise Treatment of Alzheimer Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Effects on Cognition in Randomized Controlled Trials
【24h】

Drug and Exercise Treatment of Alzheimer Disease and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Effects on Cognition in Randomized Controlled Trials

机译：药物和运动疗法治疗阿尔茨海默氏病和轻度认知障碍：随机对照试验中对认知的影响的系统评价和荟萃分析

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objective: Demographic changes are increasing the pressure to improve therapeutic strategies against cognitive decline in Alzheimer disease (AD) and mild cognitive impairment (MCI). Besides drug treatment, physical activity seems to be a promising intervention target as epidemiological and clinical studies suggest beneficial effects of exercise training on cognition. Using comparable inclusion and exclusion criteria, we analyzed the efficacy of drug therapy (cholinesterase inhibitors, memantine, and Ginkgo biloba) and exercise interventions for improving cognition in AD and MCI populations. Methods: We searched The Cochrane Library, EBSCO, OVID, Web of Science, and U.S Food and Drug Administration data from inception through October 30, 2013. Randomized controlled trials in which at least one treatment arm consisted of an exercise or a pharmacological intervention for AD or MCI patients, and which had either a non-exposed control condition or a control condition that received another intervention. Treatment discontinuation rates and Standardized Mean Change score using Raw score standardization (SMCR) of cognitive performance were calculated. Results: Discontinuation rates varied substantially and ranged between 0% and 49% with a median of 18%. Significantly increased discontinuation rates were found for galantamine and rivastigmine as compared to placebo in AD studies. Drug treatments resulted in a small pooled effect on cognition (SMCR: 0.23, 95% CI: 0.20 to 0.25) in AD studies (N = 45, 18,434 patients) and no effect in any of the MCI studies (N = 5, 3,693 patients; SMCR: 0.03, 95% CI: 0.00 to 0.005). Exercise interventions had a moderate to strong pooled effect size (SMCR: 0.83, 95% CI: 0.59 to 1.07) in AD studies (N = 4, 119 patients), and a small effect size (SMCR: 0.20, 95% CI: 0.11 to 0.28) in MCI (N = 6, 443 patients). Conclusions: Drug treatments have a small but significant impact on cognitive functioning in AD and exercise has the potential to improve cognition in AD and MCI. Head-to-head trials with sufficient statistical power are necessary to directly compare efficacy, safety, and acceptability. Combining these two approaches might further increase the efficacy of each individual intervention. Identifier: PROSPERO (2013:CRD42013003910).
机译：目的：人口变化增加了改善针对阿尔茨海默病（AD）和轻度认知障碍（MCI）的认知下降的治疗策略的压力。除了药物治疗以外，体育锻炼似乎是有希望的干预目标，因为流行病学和临床研究表明，运动训练对认知有好处。使用可比较的纳入和排除标准，我们分析了药物治疗（胆碱酯酶抑制剂，美金刚和银杏叶）和运动干预措施的功效，以改善AD和MCI人群的认知。方法：从开始到2013年10月30日，我们搜索了Cochrane图书馆，EBSCO，OVID，Web of Science和美国食品药品监督管理局的数据。 AD或MCI患者，其控制条件未暴露或接受另一项干预的控制条件。使用认知表现的原始评分标准化（SMCR）计算治疗中止率和标准化平均变化评分。结果：停药率差异很大，介于0％和49％之间，中位数为18％。与AD研究中的安慰剂相比，加兰他敏和rivastigmine的停药率显着增加。药物治疗在AD研究（N = 45，18,434例患者）中对认知的综合作用很小（SMCR：0.23，95％CI：0.20至0.25），而在任何MCI研究中（N = 5、3,693例患者）均无影响; SMCR：0.03，95％CI：0.00至0.005）。运动干预在AD研究中（N = 4，119例患者）具有中等至强的合并效应量（SMCR：0.83，95％CI：0.59至1.07），效应量较小（SMCR：0.20，95％CI：0.11）至MCI（N = 6，443例）中的0.28）。结论：药物治疗对AD的认知功能影响很小，但影响显着，运动有可能改善AD和MCI的认知。直接比较疗效，安全性和可接受性的具有足够统计能力的面对面试验是必要的。将这两种方法结合起来可以进一步提高每种干预措施的功效。标识符：PROSPERO（2013：CRD42013003910）。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号