Background and Objective

Exercise is a promising non-pharmacological therapy for subjective cognitive decline, but it is unclear which type of exercise is most effective. The objective was to assess the comparative effects and ranks of all exercise-based interventions on cognitive function in patients with subjective cognitive decline (SCD).

Method

In this network meta-analysis, Online databases for Web of Science, PubMed, Embase, Medline, Cochrane Library and PsycINFO were searched from inception to April 30, 2023. The included studies are randomized controlled trials assessing the efficacy of exercise interventions for individuals with SCD. The primary outcome measure is memory, while secondary outcome measures encompass executive function, attention, verbal fluency, and global cognitive function. Represented using Standardized Mean Differences (SMDs) along with their 95% Confidence Intervals (CIs). Bias assessment was conducted in accordance with the ‘Cochrane Risk of Bias Assessment Tool, 2nd Edition’ (RoB 2). Pairwise meta-analysis was carried out using the ‘meta-analysis’ module within STATA 14.0, and network meta-analysis was performed using the ‘mvmeta’ and ‘network’ packages available in STATA 14.0. Registration number CRD42023289687.

Result

This study included a total of 11 randomized controlled trials, encompassing 1,166 patients. Mind-body exercise was found to be efficacious in enhancing or sustaining memory (SMD: 0.58, 95%CI: 0.06 ∼ 1.10) and executive function (SMD: 0.41, 95%CI: 0.09 ∼ 0.73) in individuals with subjective cognitive decline. Furthermore, mind-body exercise exhibited the highest probability of being the most effective measures for improving or preventing the decline in memory (surface under cumulative ranking curve (SUCRA) value: 90.4) and executive function (SUCRA value: 91.8). The second-ranked moderate-intensity aerobic exercise has also shown a positive effect on the improvement of executive function in patients with subjective cognitive decline (SMD: 0.23, 95%CI: 0.03 ∼ 0.43, SUCRA value: 68.2). However, we did not observe a significant effectiveness of exercise interventions on verbal fluency, attention, and overall cognitive function in subjective cognitive decline.

Conclusion

Mind-body exercise may potentially be the optimal strategies for enhancing memory and executive function in individuals with subjective cognitive decline. Additionally, moderate-intensity aerobic exercise has shown a modest positive effect on executive function in subjective cognitive decline. When resources permit, practical application of these findings may be considered. Nevertheless, further support for the conclusions of this study is warranted through larger sample sizes and well-designed multicenter trials.

中文翻译：

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不同运动干预对主观认知下降患者的影响：系统评价和网络荟萃分析

背景和目的

运动是治疗主观认知能力下降的一种有前途的非药物疗法，但目前尚不清楚哪种类型的运动最有效。目的是评估所有基于运动的干预措施对主观认知衰退（SCD）患者认知功能的比较效果和排名。

方法

在这项网络荟萃分析中，检索了 Web of Science、PubMed、Embase、Medline、Cochrane Library 和 PsycINFO 的在线数据库，搜索时间从开始到 2023 年 4 月 30 日。纳入的研究是随机对照试验，评估运动干预对患有以下疾病的个体的功效： SCD。主要结果指标是记忆力，次要结果指标包括执行功能、注意力、语言流畅性和整体认知功能。使用标准化均值差 (SMD) 及其 95% 置信区间 (CI) 表示。偏差评估按照“Cochrane 偏差风险评估工具，第二版”(RoB 2) 进行。成对荟萃分析是使用 STATA 14.0 中的“荟萃分析”模块进行的，网络荟萃分析是使用 STATA 14.0 中提供的“mvmeta”和“网络”软件包进行的。注册号 CRD42023289687。

结果

这项研究总共包括 11 项随机对照试验，涉及 1,166 名患者。研究发现，身心锻炼可有效增强或维持主观认知能力下降的个体的记忆力（SMD：0.58，95%CI：0.06 ∼ 1.10）和执行功能（SMD：0.41，95%CI：0.09 ∼ 0.73）。此外，身心锻炼最有可能成为改善或预防记忆力下降（累积排序曲线下表面（SUCRA）值：90.4）和执行功能（SUCRA 值：91.8）下降的最有效措施。位居第二的中等强度有氧运动对主观认知下降患者执行功能的改善也显示出积极作用（SMD：0.23，95%CI：0.03∼0.43，SUCRA值：68.2）。然而，我们没有观察到运动干预对主观认知下降中的言语流畅性、注意力和整体认知功能有显着效果。

结论

身心锻炼可能是增强主观认知能力下降个体记忆和执行功能的最佳策略。此外，中等强度的有氧运动对主观认知能力下降的执行功能显示出适度的积极影响。如果资源允许，可以考虑这些发现的实际应用。尽管如此，通过更大的样本量和精心设计的多中心试验有必要进一步支持这项研究的结论。