隨著老年人口的快速增長,認知衰退已成為一項重大公共健康挑戰,特別是在輕度認知障礙(MCI)人群中。八段錦,一種歷史悠久的中國傳統氣功,被認為可以通過影響腸道健康促進認知改善。本研究探討八段錦練習對老年人認知功能的影響,並揭示腸道微生物如何在其中發揮重要作用。
輕度認知障礙(MCI)是介於正常老化與癡呆之間的過渡狀態,在中國60歲以上老年人中,MCI的患病率超過20%。MCI患者的日常生活能力尚可,但其認知功能下降可能發展為阿茲海默症,嚴重影響生活品質。
研究顯示,腸道微生物與認知功能密切相關,這使腸-腦軸成為研究認知改善的重要方向。非藥物干預,如八段錦鍛煉,因其對腸道健康的潛在影響,成為當前的研究熱點。
這項隨機對照試驗的主要目的是評估八段錦鍛煉對輕度認知障礙老年人認知功能的影響,以及腸道微生物在這一過程中的調節作用。研究假設24週的八段錦鍛煉能改善記憶與執行功能,並通過調節腸道微生物代謝物,增強整體認知能力。
此研究將為未來公共衛生策略提供支持,尤其是在老年人健康老齡化的倡議中。
本研究採用雙臂隨機對照設計,從上海四個社區中招募64名MCI老年人,隨機分配至八段錦組和對照組:
八段錦組:每週四次,每次60分鐘,持續24週的八段錦練習。
對照組:維持原有生活方式,接受基本健康教育。
選擇參與者時,確保其符合MCI診斷標準,並排除具有重大健康問題或腸胃疾病的個體。
使用蒙特利爾認知評估量表(MoCA)作為主要工具,測試參與者的整體認知能力,包括記憶、執行功能和語言。輔助測試如連線測試與畫鐘測試,進一步細化認知功能改善的領域。
採集參與者的糞便樣本,進行16S rRNA測序與代謝物分析,研究腸道微生物群的多樣性及其代謝產物的變化,特別是短鏈脂肪酸和其他神經活性化合物的作用。
八段錦結合溫和的動作、呼吸控制與冥想,適合行動受限的老年人。作為一種經過數百年驗證的中國傳統鍛煉,八段錦強調氣的平衡,對整體健康和身心協調具有廣泛益處。
本研究結果將為非藥物性認知改善策略提供新證據,並進一步推動八段錦作為公共健康干預的一部分。如果證實假設,八段錦將可能成為改善認知健康和腸道健康的雙重解決方案,為老年人提供更全面的健康老齡化模式。
研究成果將發表於同行評審期刊,如 BMJ Open,並通過社區和醫療教育活動廣泛傳播。
這項研究是認識腸道健康與認知功能聯繫的重要一步,揭示八段錦的多重益處,為健康老齡化開啟新篇章。
BMJ Open
. 2024 Nov 21;14(11):e087684. doi: 10.1136/bmjopen-2024-087684.
Mediating role of gut microbiota on Baduanjin for cognitive function in community-dwelling older adults with mild cognitive impairment: a study protocol for a cluster randomised controlled trial
Liwei Sun 1 2, Qian Geng 1 2, Guohua Zheng 3
Affiliations Expand
PMID: 39578030
Free article
Abstract
Introduction: The gut microbiome plays an important role in maintaining both cognitive and physical functions in older adults, and gut dysbiosis is an important pathophysiological mechanism of mild cognitive impairment (MCI) in older adults. As a typical traditional Chinese mind-body exercise, regular Baduanjin training has been shown to improve cognitive function and modulate the gut microbiome in community-dwelling older adults. However, the potential role of the gut microbiome in the benefits of Baduanjin on cognitive function remains unclear. The aim of this study is to investigate the mediating effect of gut microbiome between regular Baduanjin training and improvement in cognitive function in community-dwelling older adults with MCI.
Methods and analysis: This is a two-arm, randomised, parallel-controlled, single-blinded trial. Four residential communities (clusters) with a total of 64 eligible participants (16 participants in each residential community) will be randomised 1:1 to either the 24-week Baduanjin exercise intervention group (60 min per session, four sessions per week) or the no specific exercise intervention control group. Global cognitive function and the subdimensions of cognition including executive function, visuospatial function, language function and memory function will be assessed using the Montreal Cognitive Assessment Scale, Trail Making Test, Auditory Verbal Learning Test, Boston Naming Test-30 and Clock-Drawing Test, while the gut microbiome and its metabolomics will be detected using 16S rRNA and ultra-high-performance liquid chromatography-tandem mass spectrometry at baseline and at the end of 24-week intervention. The intervention effect of Baduanjin exercise and mediating role of gut microbiota will be analysed using linear mixed models and the bootstrapping method in the Hayes process.
Ethics and dissemination: This study conforms to Declaration of Helsinki principles and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of the Shanghai University of Medicine and Health Sciences (approval number: 2023-GZR-011). Written informed consent will be obtained from all participants. Results will be disseminated to relevant groups in peer-reviewed journal(s), and at relevant international or national scientific conferences. Key findings will also be shared with social media, healthcare providers, participants or community-dwelling older adults to support access for non-research audiences.
Trial registration number: ChiCTR2300078147.
Keywords: Cognition; GERIATRIC MEDICINE; MICROBIOLOGY; Protocols & guidelines; Randomized Controlled Trial.