To determine the effects of simultaneous dual-task training on cognitive function, physical function, and depression in older adults with mild cognitive impairment or dementia. Comprehensive database searches were conducted in PubMed, Embase, the Cochrane Library, CINAHL, Ovid-Medline, Web of Science, and Scopus up to December 2022. Randomized controlled trials were included to assess the efficacy of simultaneous dual-task training for older adults with mild cognitive impairment or dementia. The analysis utilized Comprehensive Meta-Analysis version 3.0, presenting Hedges' g and the corresponding 95 % confidence interval (CI) for the pooled effect size and, applying a random-effects model. The and Cochran's Q tests were employed to evaluate heterogeneity. The Cochrane Risk of Bias 2.0 tool was employed to assess study quality. The Copenhagen Trial Unit (version 0.9.5.10 Beta) was employed for trial sequential analysis, providing a rigorous methodology for evaluating cumulative evidence from multiple studies. Of the 1676 studies identified, 20 studies involving 1477 older adults with cognitive impairment were included. Dual-task training significantly enhanced global cognition (0.477, 95 % CI: 0.282 to 0.671), executive function (−0.310, 95 % CI: −0.586 to −0.035), working memory (0.714, 95 % CI: 0.072 to 1.355), gait (0.418, 95 % CI: 0.252 to 0.583), physical activity (0.586, 95 % CI: 0.012 to 1.16), and depression (−0.703, 95 % CI: −1.253 to −0.153). Trial sequential analyses revealed the robustness of this meta-analysis, which was based on a sufficient sample size from the included studies. Moreover, dual-task training demonstrated beneficial effects on global cognition, executive function, working memory, and gait. Dual-task training improved cognition, physical function, and depression among older adults with cognitive impairment. Accordingly, dual-task training should be considered a clinical nonpharmacological intervention for older adults with mild cognitive impairment or dementia. Nevertheless, the trial sequential analysis results were consistent with those of the pairwise meta-analysis but only global cognition reached significance by crossing the trial sequential analysis boundary. Future studies with higher-quality designs and larger sample sizes are required to obtain more conclusive results regarding other outcomes. PROSPERO CRD42023418598.

中文翻译：

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患有认知障碍的老年人的双任务训练：随机对照试验的荟萃分析和试验序贯分析

旨在确定同时双任务训练对患有轻度认知障碍或痴呆的老年人的认知功能、身体功能和抑郁的影响。截至 2022 年 12 月，我们在 PubMed、Embase、Cochrane 图书馆、CINAHL、Ovid-Medline、Web of Science 和 Scopus 中进行了全面的数据库检索。其中纳入了随机对照试验，以评估同步双任务训练对患有老年痴呆症的老年人的有效性。轻度认知障碍或痴呆。该分析利用综合荟萃分析 3.0 版，呈现 Hedges g 和汇总效应大小的相应 95% 置信区间 (CI)，并应用随机效应模型。采用 和 Cochran's Q 检验来评估异质性。使用 Cochrane 偏差风险 2.0 工具来评估研究质量。采用哥本哈根试验装置（版本 0.9.5.10 Beta）进行试验序贯分析，为评估多项研究的累积证据提供严格的方法。在确定的 1676 项研究中，有 20 项研究涉及 1477 名患有认知障碍的老年人。双任务训练显着增强了整体认知（0.477，95％CI：0.282至0.671）、执行功能（−0.310，95％CI：−0.586至−0.035）、工作记忆（0.714，95％CI：0.072至1.355） 、步态（0.418，95% CI：0.252至0.583）、体力活动（0.586，95% CI：0.012至1.16）和抑郁（-0.703，95% CI：-1.253至-0.153）。试验序贯分析揭示了该荟萃分析的稳健性，该分析基于纳入研究的足够样本量。此外，双任务训练对整体认知、执行功能、工作记忆和步态具有有益的影响。双任务训练改善了患有认知障碍的老年人的认知、身体功能和抑郁。因此，双任务训练应被视为对患有轻度认知障碍或痴呆的老年人的临床非药物干预。尽管如此，试验序贯分析结果与配对荟萃分析的结果一致，但只有全局认知通过跨越试验序贯分析边界而达到显着性。未来的研究需要更高质量的设计和更大的样本量，以获得关于其他结果的更结论性的结果。普洛斯彼罗 CRD42023418598。