Background

Vascular cognitive impairment (VCI) is the second most common cause of cognitive impairment worldwide and includes a spectrum from vascular cognitive impairment no dementia (VCIND) to vascular dementia (VaD). There is no specific pharmacological treatment approved for VCI. Physical activity has been indicated to be a promising preventive measure for cognition, with direct as indirectly benefits, while improving several modifiable vascular risk factors, so potentially effective when considering VCI. Our aim was to conduct a systematic review with a meta-analysis approaching the potential preventive role of physical activity on VCI.

Methods

A systematic search was conducted in 7 databases. A total of 6786 studies were screened and assessed for eligibility, culminating in the inclusion of 9 observational prospective studies assessing physical activity impact irrespectively the type for quality assessment and qualitative and quantitative synthesis. Quantitative synthesis was performed using the reported adjusted HRs. Physical activity was handled as a dichotomous variable, with two groups created (high versus low physical activity). Subgroup analyses were done for risk of bias, VaD and length of follow-up.

Results

There was considerable methodological heterogeneity across studies. Only three studies reported significant associations. The overall effect was statistically significant (HR 0.68, 95%CI 0.54-0.86, I² 6.8%), with higher levels of physical activity associated with a smaller risk of VCI overtime, particularly VaD.

Conclusions

These findings suggest that physical activity is a potential preventive factor for vascular dementia. Insufficient data is available on VCIND. Randomized studies are desired to confirm these results.

中文翻译：

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血管性认知障碍中的体力活动：系统评价与荟萃分析

背景

血管性认知障碍（VCI）是全球第二大常见的认知障碍原因，包括从血管性认知障碍非痴呆（VCIND）到血管性痴呆（VaD）等一系列疾病。目前尚无批准用于 VCI 的特定药物治疗。身体活动已被证明是一种很有前途的认知预防措施，具有直接和间接益处，同时改善了一些可改变的血管危险因素，因此在考虑 VCI 时可能有效。我们的目的是通过荟萃分析进行系统评价，探讨体力活动对 VCI 的潜在预防作用。

方法

在 7 个数据库中进行了系统检索。总共筛选和评估了 6786 项研究的资格，最终纳入了 9 项观察性前瞻性研究，评估身体活动的影响，无论质量评估和定性和定量综合的类型如何。使用报告的调整后的 HR 进行定量合成。体力活动被处理为二分变量，创建了两组（高体力活动与低体力活动）。对偏倚风险、VaD 和随访时间进行了亚组分析。

结果

各项研究之间存在相当大的方法学异质性。只有三项研究报告了显着的关联。总体效果具有统计学显着性（HR 0.68，95%CI 0.54-0.86，I ² 6.8%），体力活动水平越高，VCI 超时风险越小，尤其是 VaD。

结论

这些发现表明体力活动是血管性痴呆的潜在预防因素。VCIND 上的可用数据不足。需要随机研究来证实这些结果。