Abstract：
OBJECTIVE: To evaluate the effectiveness of combined aerobic and resistance exercise on cognition, metabolic health, physical function, and health-related quality of life (HRQoL) in middle-aged and older adults with type 2 diabetes mellitus (T2DM).
METHODS: Systematic search of CINAHL, Cochrane, EMBASE, Scopus, PubMed, ProQuest Dissertation and Thesis, PsycINFO, Web of Science databases, and gray literature from Google Scholar. Pertinent randomized controlled trials (RCTs) were selected. The Protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42023387336).
METHODS: The risk of bias was evaluated using the Cochrane Risk of Bias tool by 2 reviewers independently. Outcome data were extracted in a fixed-effect model if heterogeneity test were not significant and I2≤50%; otherwise, the random-effects model was used.
RESULTS: Sixteen studies with 2426 participants were included in this review. Combined aerobic and resistance exercise had significant positive effects on cognition (SMD=0.34, 95% CI: 0.13 to 0.55), metabolic health on HbA1c (SMD=-0.35, 95% CI: -0.48 to -0.22) and lipid profile (total cholesterol SMD=-0.20, 95% CI: -0.34 to -0.07; low-density lipoprotein SMD=-0.19, 95% CI: -0.33 to -0.05; high-density lipoprotein SMD=0.25, 95% CI: 0.12 to 0.39; and triglycerides SMD=-0.18, 95% CI: -0.31 to -0.04), physical function on aerobic oxygen uptake (SMD=0.58, 95% CI: 0.21 to 0.95) and body mass index (MD=-1.33, 95% CI: -1.84 to -0.82), and physical HRQoL (MD=4.17, 95% CI: 0.86 to 7.48). Our results showed that clinically important effects on cognition may occur in combining the low-moderate intensity of aerobic exercise and progressive intensity of resistance training, the total duration of the exercise needs to be at least 135 minutes per week, among which, resistance training should be at least 60 minutes.
CONCLUSIONS: Combined aerobic and resistance exercise effectively improves cognition, ameliorates metabolic health, enhances physical function, and increases physical HRQoL in middle-aged and older adults with T2DM. More RCTs and longitudinal follow-ups are required to provide future evidence of structured combined aerobic and resistance exercise on other domains of cognition.
METHODS: Systematic search of CINAHL, Cochrane, EMBASE, Scopus, PubMed, ProQuest Dissertation and Thesis, PsycINFO, Web of Science databases, and gray literature from Google Scholar. Pertinent randomized controlled trials (RCTs) were selected. The Protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42023387336).
METHODS: The risk of bias was evaluated using the Cochrane Risk of Bias tool by 2 reviewers independently. Outcome data were extracted in a fixed-effect model if heterogeneity test were not significant and I2≤50%; otherwise, the random-effects model was used.
RESULTS: Sixteen studies with 2426 participants were included in this review. Combined aerobic and resistance exercise had significant positive effects on cognition (SMD=0.34, 95% CI: 0.13 to 0.55), metabolic health on HbA1c (SMD=-0.35, 95% CI: -0.48 to -0.22) and lipid profile (total cholesterol SMD=-0.20, 95% CI: -0.34 to -0.07; low-density lipoprotein SMD=-0.19, 95% CI: -0.33 to -0.05; high-density lipoprotein SMD=0.25, 95% CI: 0.12 to 0.39; and triglycerides SMD=-0.18, 95% CI: -0.31 to -0.04), physical function on aerobic oxygen uptake (SMD=0.58, 95% CI: 0.21 to 0.95) and body mass index (MD=-1.33, 95% CI: -1.84 to -0.82), and physical HRQoL (MD=4.17, 95% CI: 0.86 to 7.48). Our results showed that clinically important effects on cognition may occur in combining the low-moderate intensity of aerobic exercise and progressive intensity of resistance training, the total duration of the exercise needs to be at least 135 minutes per week, among which, resistance training should be at least 60 minutes.
CONCLUSIONS: Combined aerobic and resistance exercise effectively improves cognition, ameliorates metabolic health, enhances physical function, and increases physical HRQoL in middle-aged and older adults with T2DM. More RCTs and longitudinal follow-ups are required to provide future evidence of structured combined aerobic and resistance exercise on other domains of cognition.
摘要：
目的：评价有氧和抗阻联合运动对认知功能的影响。代谢健康，物理功能，中老年人2型糖尿病（T2DM）患者的健康相关生活质量。
方法：CINAHL的系统搜索，科克伦,EMBASE,Scopus,PubMed,ProQuest论文和论文，PsycINFO,WebofScience数据库,以及谷歌学者的灰色文献。选择相关的随机对照试验(RCTs)。该议定书已在国际系统审查前瞻性登记册（PROSPEROCRD42023387336）中注册。
方法：由两名评审员独立使用Cochrane偏差风险工具评估偏差风险。结果数据在固定效应模型中提取，如果异质性检验不显著，I2≤50%；否则，使用随机效应模型。
结果：本综述包括16项研究，2,426名参与者。有氧运动和抗阻运动对认知有显著的正向影响(SMD=0.34,95CI:0.13~0.55),代谢健康对HbA1c（SMD=-0.35，95CI：-0.48至-0.22）和血脂状况（总胆固醇SMD=-0.20，95CI：-0.34至-0.07；低密度脂蛋白SMD=-0.19，95CI：-0.33至-0.05；高密度脂蛋白SMD=0.25，95CI：0.12至0.39；甘油三酯=-0.18，95CI-0.31，有氧摄氧量的身体功能（SMD=0.58，95CI：0.21至0.95）和体重指数（MD=-1.33，95CI：-1.84至-0.82），与身体健康相关的生活质量（MD=4.17，95CI：0.86至7.48）。我们的结果表明，低-中等强度的有氧运动和渐进性强度的抗阻训练相结合可能会对认知产生临床上重要的影响，锻炼的总持续时间需要每周至少135分钟，其中阻力训练应至少60分钟。
结论：有氧和抗阻联合运动可有效改善认知，改善代谢健康，增强身体功能，并提高2型糖尿病中老年人的身体健康相关生活质量。需要更多的随机对照试验和纵向随访，以提供在其他认知领域进行结构化的有氧和抵抗运动的未来证据。
方法：CINAHL的系统搜索，科克伦,EMBASE,Scopus,PubMed,ProQuest论文和论文，PsycINFO,WebofScience数据库,以及谷歌学者的灰色文献。选择相关的随机对照试验(RCTs)。该议定书已在国际系统审查前瞻性登记册（PROSPEROCRD42023387336）中注册。
方法：由两名评审员独立使用Cochrane偏差风险工具评估偏差风险。结果数据在固定效应模型中提取，如果异质性检验不显著，I2≤50%；否则，使用随机效应模型。
结果：本综述包括16项研究，2,426名参与者。有氧运动和抗阻运动对认知有显著的正向影响(SMD=0.34,95CI:0.13~0.55),代谢健康对HbA1c（SMD=-0.35，95CI：-0.48至-0.22）和血脂状况（总胆固醇SMD=-0.20，95CI：-0.34至-0.07；低密度脂蛋白SMD=-0.19，95CI：-0.33至-0.05；高密度脂蛋白SMD=0.25，95CI：0.12至0.39；甘油三酯=-0.18，95CI-0.31，有氧摄氧量的身体功能（SMD=0.58，95CI：0.21至0.95）和体重指数（MD=-1.33，95CI：-1.84至-0.82），与身体健康相关的生活质量（MD=4.17，95CI：0.86至7.48）。我们的结果表明，低-中等强度的有氧运动和渐进性强度的抗阻训练相结合可能会对认知产生临床上重要的影响，锻炼的总持续时间需要每周至少135分钟，其中阻力训练应至少60分钟。
结论：有氧和抗阻联合运动可有效改善认知，改善代谢健康，增强身体功能，并提高2型糖尿病中老年人的身体健康相关生活质量。需要更多的随机对照试验和纵向随访，以提供在其他认知领域进行结构化的有氧和抵抗运动的未来证据。
