体力活动对健康老年女性认知功能的影响：一项系统综述与荟萃分析。
完整摘要 · 中文译文
背景：年龄相关认知衰退是一个重大公共卫生挑战，尤其是在面临痴呆风险不成比例升高的老年女性中。体力活动已被提出作为一种可改变的生活方式因素，具有潜在的神经保护益处；然而，针对认知健康老年女性的特异性证据仍然有限。 方法：按照系统评价和荟萃分析优先报告条目（PRISMA）指南，对随机对照试验（RCT）进行了系统评价和荟萃分析。检索PubMed、Cochrane Library、Web of Science和Embase，检索时间从数据库建库至2026年9月26日。若研究纳入年龄>60岁的健康女性并比较体力活动干预与对照条件，则符合纳入标准。主要结局为使用简易精神状态检查（MMSE）或蒙特利尔认知评估（MoCA）评估的总体认知功能。次要结局包括脑源性神经营养因子（BDNF）和体重指数（BMI）。根据情况使用随机效应模型或固定效应模型计算合并效应量。进行亚组分析和荟萃回归以探索潜在调节因素。使用推荐分级的评估、制定与评价（GRADE）方法评价证据确定性。 结果：共纳入10项RCT，包含446名参与者。体力活动与更高的总体认知功能评分相关（Hedges' g = 0.63，95% CI：0.12-1.13，p = 0.02），并与BDNF水平升高相关 （MD = 2.43，95% CI：0.57-4.28，p = 0.01）。未观察到对BMI有统计学显著影响（MD = 0.63，95% CI：-1.12-2.37，p = 0.48）。整体认知功能方面观察到显著的 studie 间异质性（I2 = 77.82%）。对干预时长（p = 0.82）或干预频率（p = 0.12）的亚组差异正式检验均无统计学显著性。 结论：合并证据提示，身体活动对健康老年女性的整体认知功能和BDNF水平可能具有有益影响；然而，证据确定性极低。未观察到对BMI有统计学显著影响，亚组分析未提供充分证据表明干预频率显著改变了其对认知功能的影响。需要进一步开展设计良好、样本量更大且结局指标标准化的随机对照试验（RCT）以证实这些发现。 系统综述注册：PROSPERO，注册号CRD420251249052，https://www.crd.york.ac.uk/PROSPERO/view/CRD420251249052。
完整摘要 · 英文原文
BACKGROUND: Age-related cognitive decline represents a major public health challenge, particularly among older women who face a disproportionately elevated risk of dementia. Physical activity has been proposed as a modifiable lifestyle factor with potential neuroprotective benefits; however, evidence specific to cognitively healthy older women remains limited. METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, the Cochrane Library, Web of Science, and Embase were searched from database inception to 26 September 2026. Studies were eligible if they enrolled healthy women aged >60 years and compared physical activity interventions with control conditions. The primary outcome was global cognitive function assessed using the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA). Secondary outcomes included brain-derived neurotrophic factor (BDNF) and body mass index (BMI). Pooled effect sizes were calculated using random-effects or fixed-effect models as appropriate. Subgroup analyses and meta-regression were performed to explore potential moderators. The certainty of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. RESULTS: Ten RCTs encompassing 446 participants were included. Physical activity was associated with higher global cognitive function scores (Hedges' g = 0.63, 95% CI: 0.12-1.13, p = 0.02) and increased BDNF levels (MD = 2.43, 95% CI: 0.57-4.28, p = 0.01). No statistically significant effect on BMI was observed (MD = 0.63, 95% CI: -1.12-2.37, p = 0.48). Substantial between-study heterogeneity was observed for global cognitive function (I2 = 77.82%). Formal tests for subgroup differences were not statistically significant for either intervention duration (p = 0.82) or intervention frequency (p = 0.12). CONCLUSION: The pooled evidence suggests potential beneficial effects of physical activity on global cognitive function and BDNF levels in healthy older women; however, the certainty of evidence was very low. No statistically significant effect on BMI was observed, and subgroup analyses did not provide sufficient evidence that intervention frequency significantly modified the effect on cognitive function. Further well-designed RCTs with larger samples and standardized outcome measures are needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: PROSPERO under registration number CRD420251249052, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251249052.