身心运动对轻度认知障碍老年人认知功能和外周血脑源性神经营养因子的影响：系统综述与荟萃分析。
完整摘要 · 中文译文
目的：系统评价身心运动（MBE）对轻度认知障碍（MCI）老年人认知功能及外周血脑源性神经营养因子（BDNF）水平的影响，并探讨其干预效果及潜在生物学机制。 方法：检索PubMed、Web of Science、EMBASE和Cochrane Library数据库自建库至2026年3月的随机对照试验（RCT），研究对象为接受各种身心运动干预（包括太极拳、八段锦、瑜伽和正念/冥想）的MCI老年人。主要结局指标包括认知功能（整体认知功能、言语流畅性、执行功能、情景记忆、短期记忆、工作记忆以及处理速度和注意力）和外周血BDNF水平。效应量以标准化均数差（SMD）及95%置信区间（CI）表示，并根据异质性采用固定效应或随机效应模型进行合并。采用敏感性分析和漏斗图评估结果的稳健性和发表偏倚。 结果：共纳入17项随机对照试验，涉及1251名参与者。身心运动显著改善了MCI老年人的整体认知功能（SMD = 0.82，95% CI：0.55至1.09，p < 0.001）、言语流畅性（SMD = 0.58，95% CI：0.25至0.91，p = 0.001）、执行功能（SMD = 0.39，95% CI：0.12至0.67，p = 0.005）、情景记忆（SMD = 0.59，95% CI：0.26至0.92，p < 0.001）和短期记忆（SMD = 0.54，95% CI：0.27至0.81，p < 0.001）。工作记忆显示出潜在 提示性改善，但结果在敏感性分析中并不稳健。在处理速度/注意力（SMD = 0.12；95% CI：-0.04至0.28；p = 0.131）或外周血BDNF（SMD = 0.89；95% CI：-0.12至1.89；p = 0.085）方面未观察到显著效应。亚组分析提示，当干预持续时间超过12周时，基于太极拳的干预和词语流畅性可获得更大获益。 结论：身心运动有助于改善患有轻度认知障碍（MCI）的老年人的整体认知功能、词语流畅性、执行功能、情景记忆和短期记忆；然而，关于其对处理速度和注意力以及外周血BDNF水平影响的证据仍不充分。基于太极拳的身心运动和更长的干预持续时间可能产生更大获益。这些发现支持将身心运动作为MCI老年人综合干预的重要辅助策略，并为在临床和实践环境中优化基于运动的干预方案提供了参考。
完整摘要 · 英文原文
OBJECTIVE: To systematically evaluate the effects of mind-body exercise (MBE) on cognitive function and peripheral blood brain-derived neurotrophic factor (BDNF) levels in older adults with mild cognitive impairment (MCI), and to explore its intervention effects and potential biological mechanisms. METHODS: PubMed, Web of Science, EMBASE, and the Cochrane Library were searched from database inception to March 2026 for randomized controlled trials (RCTs) investigating various MBE interventions, including Tai Chi, Baduanjin, yoga, and mindfulness/meditation, in older adults with MCI. The primary outcomes included cognitive function (global cognitive function, verbal fluency, executive function, episodic memory, short-term memory, working memory, and processing speed and attention) and peripheral blood BDNF levels. Effect sizes were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs) and pooled using fixed- or random-effects models according to heterogeneity. Sensitivity analyses and funnel plots were used to assess robustness and publication bias. RESULTS: Seventeen randomized controlled trials involving 1251 participants were included. MBE significantly improved global cognitive function (SMD = 0.82, 95% CI: 0.55 to 1.09, p < 0.001), verbal fluency (SMD = 0.58, 95% CI: 0.25 to 0.91, p = 0.001), executive function (SMD = 0.39, 95% CI: 0.12 to 0.67, p = 0.005), episodic memory (SMD = 0.59, 95% CI: 0.26 to 0.92, p < 0.001), and short-term memory (SMD = 0.54, 95% CI: 0.27 to 0.81, p < 0.001) in older adults with MCI. Working memory showed a potential improvement, but the result was not robust in sensitivity analysis. No significant effects were observed for processing speed/attention (SMD = 0.12; 95% CI: -0.04 to 0.28; p = 0.131) or peripheral blood BDNF (SMD = 0.89; 95% CI: -0.12 to 1.89; p = 0.085). Subgroup analyses suggested greater benefits for Tai Chi-based interventions and for verbal fluency when intervention duration exceeded 12 weeks. CONCLUSIONS: Mind-body exercise is beneficial for improving global cognitive function, verbal fluency, executive function, episodic memory, and short-term memory in older adults with MCI; however, evidence remains insufficient regarding its effects on processing speed and attention and peripheral blood BDNF levels. Tai Chi-based mind-body exercise and longer intervention durations may yield greater benefits. These findings support the use of mind-body exercise as an important adjunctive strategy for comprehensive intervention in older adults with MCI and provide a reference for optimizing exercise-based intervention programs in clinical and practical settings.