急性健身運動對阿茲海默症與輕度認知障礙患者執行功能之影響：文獻回顧

The effect of acute exercise on executive functions in people with Alzheimer’s disease or mild cognitive impairment: A review

阿茲海默症與輕度認知障礙是一種精神障礙，它不僅會使患者的執行功能下降，且對其生活品質有負面影響。雖然目前藥物對兩種族群都能有效改善其症狀，但是也附帶著一些副作用，因此非藥物治療方法（例如：急性健身運動）在阿茲海默症與輕微認知障礙的治療中發揮重要的作用，且其對執行功能有著長期和短期的正向效益。為此，本回顧的目的將以急性健身運動之視角，探討其對不同執行功能之影響，且將討論其可能機制。本文經PubMed、Scopus及Google Scholar等資料庫進行搜尋後，發現共有四篇研究進行探討。回顧顯示，急性有氧運動對阿茲海默症與輕微認知損傷參與者的抑制控制、工作記憶，及計畫均有正面影響。此外，相較於單一有氧運動急性運動介入，健身運動結合認知訓練對阿茲海默症執行功能之效應更佳。而在輕微認知損傷族群中，中等強度急性有氧與阻力運動皆可增強抑制控制，而高強度健身運動則會降低了其表現。另外，本文回顧指出，腦源性神經營養因子與第一類型胰島素樣生長因子係影響執行功能之可能機制。未來仍需更多研究針對急性健身運動對特定類別之執行功能（例如：轉換）進行探究，並建立最適改善執行功能之健身運動處方，進一步釐清急性健身運動改善阿茲海默症與輕微認知障礙執行功能之其他可能機制。

Alzheimer’s disease (AD) and Mild cognitive impairment (MCI) are the mental disorders that worsen executive functions (EF) and negatively affect quality of life. Medical treatments for AD and MCI are effective but have unpleasant side effects. Non-medical approaches, like exercise, play an important role in the treatment of AD and MCI, as acute exercise has benefits on EF. In this context, the purpose of this review was to differentiate the acute exercise effects on different domains of EF, and to recognize the potential affecting mechanisms. After reviewing, we found 4 studies via researching on PubMed, Scopus, and Google Scholar. The results showed that acute aerobic exercise has positive impacts on multi aspects of EF across a range of AD and MCI subjects, including inhibitory control (IC), working memory (WM), and planning. Furthermore, acute exercise, combined with cognitive trainings, generated more benefits to EF than aerobic exercise alone in AD populations. As for the MCI populations, acute aerobic exercise and resistant exercise with moderate intensity enhanced IC, but high intensity acute exercise impaired IC. Additionally, brain-derived neurotrophic factor (BDNF) and insulin-like growth factor 1 (IGF-1) are potential mechanisms known to mediate the effects of acute exercise on EF in people with AD and MCI. More studies are needed in order to properly investigate the remaining aspects of EF (e.g., shifting), and to find the most suitable exercise protocol for maximizing the beneficial effects, as well as for clarifying whether the acute exercise-induced IGF-1 can benefit the EF in AD and MCI populations.