Publicação
Physical activity for the prevention of vascular cognitive impairment : a systematic review with meta-analysis
| Resumo: | Background: As people live longer, the number of people living with cognitive impairment is forecast to increase and, in the absence of effective treatments to halt its natural history, a shift is being seen towards prevention through action on modifiable risk factors, namely physical activity due to its pleiotropic health benefits. Vascular Cognitive Impairment (VCI) refers to an umbrella term ranging from Vascular Cognitive Impairment, Not Dementia (VCIND) to overt Vascular Dementia (VaD), and is thought of as the second most common cause of cognitive impairment in the western world. The aim of this systematic review with meta-analysis is to summarize the existing evidence on the potential preventive role of physical activity on VCI. Methods: A systematic search was conducted in 7 databases. A total of 5767 studies were screened and assessed for eligibility, culminating in the inclusion of 9 observational prospective studies for quality assessment and qualitative and quantitative synthesis, but no RCTs were available. Quantitative synthesis was performed using calculated ORs and the reported adjusted HRs. Subgroup analyses were done for risk of bias, vascular dementia and length of follow-up. Results: There is considerable methodological heterogeneity across studies. Only three studies report significant associations. The overall effect was statistically significant (OR 0.60, 95%CI 0.47-0.76, I2 39%; 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. These results are only applicable to vascular dementia. Higher lengths of follow-up tend to lose the strength of associations and studies with higher risk of bias lose their significance. Conclusions: These results suggest a preventive role of physical activity on VaD. Insufficient data is available on VCIND. Further studies of sounder designs, namely RCTs, are needed to confirm these results. |
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| Autores principais: | Melita, Catarina Anaísa Gonçalves |
| Assunto: | Defeito cognitivo vascular Demência vascular Prevenção Actividade física Neurologia |
| Ano: | 2017 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Background: As people live longer, the number of people living with cognitive impairment is forecast to increase and, in the absence of effective treatments to halt its natural history, a shift is being seen towards prevention through action on modifiable risk factors, namely physical activity due to its pleiotropic health benefits. Vascular Cognitive Impairment (VCI) refers to an umbrella term ranging from Vascular Cognitive Impairment, Not Dementia (VCIND) to overt Vascular Dementia (VaD), and is thought of as the second most common cause of cognitive impairment in the western world. The aim of this systematic review with meta-analysis is to summarize the existing evidence on the potential preventive role of physical activity on VCI. Methods: A systematic search was conducted in 7 databases. A total of 5767 studies were screened and assessed for eligibility, culminating in the inclusion of 9 observational prospective studies for quality assessment and qualitative and quantitative synthesis, but no RCTs were available. Quantitative synthesis was performed using calculated ORs and the reported adjusted HRs. Subgroup analyses were done for risk of bias, vascular dementia and length of follow-up. Results: There is considerable methodological heterogeneity across studies. Only three studies report significant associations. The overall effect was statistically significant (OR 0.60, 95%CI 0.47-0.76, I2 39%; 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. These results are only applicable to vascular dementia. Higher lengths of follow-up tend to lose the strength of associations and studies with higher risk of bias lose their significance. Conclusions: These results suggest a preventive role of physical activity on VaD. Insufficient data is available on VCIND. Further studies of sounder designs, namely RCTs, are needed to confirm these results. |
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