Abstract：
UNASSIGNED: To evaluate and rank the effectiveness of specific non-pharmacological treatments (NPTs) in improving the global cognitive function in individuals with Alzheimer\'s disease (AD) and to examine the dose-response relationship.
UNASSIGNED: We conducted a systematic search in PubMed, MEDLINE, Embase, PsycINFO, CENTRAL, WOS, and CNKI from their inception to 15 February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes using random effects models.
UNASSIGNED: We included 68 studies involving 5053 participants in this meta-analysis. The treatments with the highest cumulative probabilities for improving global cognitive function were transcranial direct current stimulation (tDCS), followed by physical exercise (PE), and repetitive transcranial magnetic stimulation (rTMS). Additionally, cognitive stimulation (CS), cognitive training CT), multidisciplinary program (MD), and reminiscence treatment (RT) also significantly improve the global cognitive function of people with AD. A non-linear dose-response association was observed for tDCS, PE, rTMS, CS, and CT with global cognitive improvement. Notably, no minimal threshold was identified for the beneficial effects of PE on cognition. The estimated minimal doses for clinically relevant changes in cognition were 33 min per week for tDCS, 330 MET-min per week for PE, and 8000 pulses per week for rTMS.
UNASSIGNED: tDCS, PE, and rTMS are the better effective NPTs for enhancing global cognitive function in individuals with AD. Properly dosing these treatments can yield significant clinical benefits. Our findings support the clinical utility of low-dose exercise in improving cognition in people with AD.
UNASSIGNED: We conducted a systematic search in PubMed, MEDLINE, Embase, PsycINFO, CENTRAL, WOS, and CNKI from their inception to 15 February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes using random effects models.
UNASSIGNED: We included 68 studies involving 5053 participants in this meta-analysis. The treatments with the highest cumulative probabilities for improving global cognitive function were transcranial direct current stimulation (tDCS), followed by physical exercise (PE), and repetitive transcranial magnetic stimulation (rTMS). Additionally, cognitive stimulation (CS), cognitive training CT), multidisciplinary program (MD), and reminiscence treatment (RT) also significantly improve the global cognitive function of people with AD. A non-linear dose-response association was observed for tDCS, PE, rTMS, CS, and CT with global cognitive improvement. Notably, no minimal threshold was identified for the beneficial effects of PE on cognition. The estimated minimal doses for clinically relevant changes in cognition were 33 min per week for tDCS, 330 MET-min per week for PE, and 8000 pulses per week for rTMS.
UNASSIGNED: tDCS, PE, and rTMS are the better effective NPTs for enhancing global cognitive function in individuals with AD. Properly dosing these treatments can yield significant clinical benefits. Our findings support the clinical utility of low-dose exercise in improving cognition in people with AD.
摘要：
■评估特定非药物治疗（NPT）在改善阿尔茨海默病（AD）患者整体认知功能方面的有效性并进行排名，并检查剂量-反应关系。
■我们在PubMed中进行了系统搜索，MEDLINE,Embase,PsycINFO,中部,WOS,和CNKI从成立到2023年2月15日。使用随机效应模型计算结果的标准化平均差异（SMD）和95％置信区间（CI）。
■在这项荟萃分析中，我们纳入了68项研究，涉及5053名参与者。改善整体认知功能的累积概率最高的治疗方法是经颅直流电刺激（tDCS）。其次是体育锻炼（PE），和重复经颅磁刺激（rTMS）。此外,认知刺激（CS），认知训练CT)，多学科计划（MD），和回忆治疗（RT）也显着改善了AD患者的整体认知功能。观察到tDCS的非线性剂量反应关联，PE,rTMS,CS,和CT与整体认知改善。值得注意的是,未发现PE对认知有益影响的最小阈值.对于tDCS，临床相关认知变化的估计最小剂量为每周33分钟，PE每周330MET-min，rTMS每周8000次脉冲。
■tDCS,PE,rTMS和rTMS是增强AD患者整体认知功能的更有效的NPT。适当地给药这些治疗可以产生显著的临床益处。我们的发现支持低剂量运动在改善AD患者认知方面的临床应用。
■我们在PubMed中进行了系统搜索，MEDLINE,Embase,PsycINFO,中部,WOS,和CNKI从成立到2023年2月15日。使用随机效应模型计算结果的标准化平均差异（SMD）和95％置信区间（CI）。
■在这项荟萃分析中，我们纳入了68项研究，涉及5053名参与者。改善整体认知功能的累积概率最高的治疗方法是经颅直流电刺激（tDCS）。其次是体育锻炼（PE），和重复经颅磁刺激（rTMS）。此外,认知刺激（CS），认知训练CT)，多学科计划（MD），和回忆治疗（RT）也显着改善了AD患者的整体认知功能。观察到tDCS的非线性剂量反应关联，PE,rTMS,CS,和CT与整体认知改善。值得注意的是,未发现PE对认知有益影响的最小阈值.对于tDCS，临床相关认知变化的估计最小剂量为每周33分钟，PE每周330MET-min，rTMS每周8000次脉冲。
■tDCS,PE,rTMS和rTMS是增强AD患者整体认知功能的更有效的NPT。适当地给药这些治疗可以产生显著的临床益处。我们的发现支持低剂量运动在改善AD患者认知方面的临床应用。
