有氧运动对老年恢复期双相情感障碍患者认知功能的影响

Effects of Aerobic Exercise on Cognitive Function in Elderly Patients with Bipolar Disorder During Recovery Phase

中文关键词:  老年患者  双相情感障碍  有氧运动  认知功能  复发次数

英文关键词:Elderly patients  Bipolar disorder  Aerobic exercise  Cognitive function  Relapse frequency

中文摘要:

      背景 双相情感障碍是一种以情绪极端波动为特征的重性精神疾病，老年双相情感障碍患者由于年龄相关的神经退行性改变，更易出现认知功能损害，严重影响其社会功能和生活质量。其治疗主要依赖药物治疗，但药物对认知功能的改善作用有限，甚至部分药物可能加剧认知障碍。在抑郁症、精神分裂症、阿尔兹海默病等神经精神疾病中，规律有氧运动已被证明可显著改善认知功能。然而，关于有氧运动对老年恢复期双相情感障碍患者认知功能的影响研究有限。 目的 研究有氧运动对老年恢复期双相情感障碍患者认知功能的影响，为改善老年恢复期双相情感障碍认知功能提供参考。方法 选择老年恢复期双相情感障碍患者60例，按照随机数字表法分为研究组和对照组各30例，两组均给予富马酸喹硫平片和丙戊酸镁缓释片，研究组在此基础上予以规律有氧运动训练（慢走、做操、跑步机上跑步），每次30分钟，每周3次治疗，系统自动监测患者心率，指夹式脉氧仪监测血氧，于干预前及治疗后3W、6W、9W、12W对两组患者进行蒙特利尔认知评估量表（Montreal Cognitive Assessment，MoCA）、汉密尔顿抑郁量表（Hamilton Depression Rating Scale，HAMD）24项、韦氏记忆量表（Wechsler Memory Scale，WMS）记忆商数、杨氏躁狂评定量表（Young Mania Rating Scale，YMRS）测评，比较２组患者的认知功能改善情况。结果 治疗后，对比两组之间HAMD-24评分、YMRS评分、MoCA评分、WMS记忆商数均具有统计学意义。将2组患者的复发次数和MoCA评分、WMS记忆商数之间进行相关性分析，发现复发次数和MoCA评分、WMS记忆商数之间有着显著的负相关关系；将复发次数作为自变量，MoCA评分、WMS记忆商数作为因变量进行线性回归分析，发现复发次数会对MoCA评分、WMS记忆商数产生显著的负向影响关系。结论 1.有氧运动可能有助于改善老年恢复期双相情感障碍患者的认知功能；2.有氧运动对老年恢复期双相情感障碍患者的情绪稳定性和整体症状缓解具有促进作用；3.老年恢复期双相情感障碍患者的认知功能损害程度与其疾病复发次数呈显著正相关，复发次数越多，认知功能下降越明显。

英文摘要:

      Background Bipolar disorder (BD) is a severe mental illness characterized by extreme mood fluctuations. Elderly BD patients are more prone to cognitive impairment due to age-related neurodegenerative changes, which significantly affect their social functioning and quality of life. Pharmacotherapy remains the primary treatment, but its effects on cognitive function are limited, and some medications may even exacerbate cognitive deficits. Regular aerobic exercise has been shown to significantly improve cognitive function in neuropsychiatric disorders such as depression, schizophrenia, and Alzheimer"s disease. However, research on the effects of aerobic exercise on cognitive function in elderly BD patients during the recovery phase is limited. Objective To investigate the effects of aerobic exercise on cognitive function in elderly BD patients during the recovery phase, providing a reference for improving cognitive function in this population. Methods Sixty elderly BD patients in the recovery phase were randomly divided into a study group (n=30) and a control group (n=30). Both groups received quetiapine fumarate tablets and magnesium valproate sustained-release tablets, while the study group additionally underwent structured aerobic exercise training (brisk walking, calisthenics, treadmill running) for 30 minutes per session, three times weekly. Heart rate and blood oxygen levels were monitored using a fingertip pulse oximeter. Cognitive function was assessed before intervention and at 3, 6, 9, and 12 weeks post-intervention using the Montreal Cognitive Assessment (MoCA), Hamilton Depression Rating Scale (HAMD-24), Wechsler Memory Scale (WMS) Memory Quotient, and Young Mania Rating Scale (YMRS). Results After treatment, significant differences were observed between the two groups in HAMD-24 scores, YMRS scores, MoCA scores, and WMS Memory Quotient. Correlation analysis revealed a significant negative relationship between relapse frequency and both MoCA scores and WMS Memory Quotient. Linear regression analysis indicated that relapse frequency significantly and negatively influenced MoCA scores and WMS Memory Quotient. Conclusions 1. Aerobic exercise may help improve cognitive function in elderly BD patients during the recovery phase. 2. Aerobic exercise promotes emotional stability and overall symptom alleviation in elderly BD patients during recovery. 3. The severity of cognitive impairment in elderly BD patients is significantly positively correlated with relapse frequency, with more relapses associated with greater cognitive decline.