有氧運動對阿茲海默症病人日常生活功能之成效──系統性文獻回顧

The Effects of Aerobic Exercise on Daily Function of Patients with Alzheimer's Disease- A Systematic Review

"背景：隨著社會高齡化，因失智症相關疾病就醫者由17.4% 提高至24.4%。阿茲海默症為最常見之退化型失智症，常見記憶力減退、言語表達困難、認知功能下降、缺乏定向感，甚至喪失基本和工具性活動的獨立性，其所延伸的長期照護需求往往形成個人、家庭及社會經濟負擔。有氧運動似乎可以改善阿茲海默症認知及情緒症狀，但目前國內缺乏影響個案日常活動獨立性之系統性文獻探討。 目的：探討有氧運動之介入措施，對於改善輕至中度阿茲海默症者的日常活動功能之成效。 方法：本文採系統性文獻回顧，搜尋2002 年到2020 年11 月PubMed、Cochrane Library、Embase 等資料庫，使用阿茲海默症、老年痴呆、有氧運動、日常生活活動、Alzheimer、Dementia、Aerobic exercise、Daily living activities 等關鍵詞搜尋，改善日常生活活動功能之有氧運動為介入措施之隨機分派臨床試驗研究文章。 結果：本系統文獻共回顧 9 篇研究，共1237 位輕至中度阿茲海默症病人，結果發現，雖介入之運動量、頻率、強度、場所及執行方式不同，無論是單獨有氧運動（如：以跑步機、騎自行車、快步行走等）或合併力量訓練、平衡訓練，以團體或個別運動介入達4 個月，即可改善病人基本活動功能及認知功能。為了更能有效轉譯有氧運動之臨床應用，建議增加樣本數、延長介入時間及評估時間點、建構相同運動類型、劑量及強度之介入方案。 結論：臨床上，醫護人員可透過有氧運動介入設計，改善輕度至中度阿茲海默症病人日常生活活動及認知功能，進而提升其照護及生活品質。"

"Background: Due to the phenomenon of the aging society, patients suffering from senility dementia and related diseases increased from 17.4% to 24.4%. Alzheimer’s disease (AD) is the most frequently diagnosed degenerative dementias, which manifests itself with the typical symptoms, including memory loss, expressive language difficulty, cognitive function decline, disorientation, and even loss of independence in instrumental activities of daily life living. The extended long-term care needs of AD may lead to individuals, families, social and economic burdens. AD patients seem to be beneficial from aerobic exercise on cognitive and emotional symptoms; nevertheless, there is still lacking domestic systematic review examining the effectiveness of aerobic exercise on daily life activities of AD patients. Purpose: To examine the effects of aerobic exercise on improving the instrumental activities of daily life living of AD patients. Method: This paper employed a systematic review method by applying the keywords of Alzheimer’s disease, senile dementia, aerobic exercise, and instrumental activities of daily life via PubMed, Cochrane Library, Embase and other databases. The authors searched for articles with a randomized controlled trial published from 2002 to November 2020. Results: There were nine articles included in this review, with a total of 1237 mild to moderate Alzheimer’s disease patients. The results showed that either a single form of aerobic exercise (i.e. treadmill, bicycle, brisk walking, etc.) or combined weight training/balance training with aerobic exercise and any diverse intensity, frequency, intensity, location and execution method of exercise, intervene in groups or individual exercise for up to 4 months, had potential benefits on patients’ instrumental activities of daily life and cognitive functions. To translate the aerobic exercise into clinical practice efficiently, the authors suggest increasing the numbers of samples, extending the duration of exercise interventions and evaluation, and structuralizing the forms, dosages and intensity of exercises. Conclusion: The health care providers could employ the aerobic exercises to improve the instrumental activities of daily life and cognitive function of patients with mild to moderate Alzheimer’s disease, enhancing their quality of care and quality of life."