第六章 結論與建議
第二節 建議
綜合文獻分析及研究結果,對未來研究及實務設計部分提出建議如下:
一、 研究對象:本研究所蒐集到的文獻多以高齡之失智症患者為研究對象,結 論無法推論對於較年輕的失智症患者是否有顯著影響。建議未來研究者 可拓展研究母體,對於較年輕之失智症患者族群進行介入與分析,其研究 結果可能更具有外推性。
二、研究方法:本次納入的台灣文獻,研究方法並無隨機分配,建議未來之研 究者可進行隨機分配之實驗設計,以增加研究之內在效度。
參考文獻
中文文獻
王俊智、劉人豪、張育愷(2019)。 健身運動,阿茲海默症與認知功能之關聯:
APOE ε4 之角色。中華體育季刊,33(2),91-99。
台灣失智症協會(2022)。台灣失智症人口推估。台灣失智症協會。Retrieved Januanry 14 from http://www.tada2002.org.tw/About/IsntDementia
朱育秀、陳綉儀、林宜錚(2015)。Wii 虛擬實境遊戲於失智症患者認知與平衡 及步態之療效: 系統性回顧。物理治療,40(3),129-135。
江秀玲、羅方妤、李世代、馬漢光、胡名霞(2011)。機構失智症老人計時起走 測驗能力的相關因子及預測因子之先驅研究。物理治療,36(1),29-35。
吳治翰、齊璘、張育愷(2015)。以磁共振成像回顧健身運動與大腦結構之關 聯。中華體育季刊,29(2),153-160。
周世珍(2006)。荷蘭健康照護法制新趨勢。長期照護雜誌,10(2),136-153。
林佩欣(2017)。運動護智-如何有效運動以預防及延緩失智。長期照護雜誌, 21
(3),211-223。
林宗輝、賴宜君(2019)。民眾對於失智症的認知及預防之研究。休閒保健期刊
(22),113-132。
林詩淳、蔡坤維、陳妙文、辜美安(2015)。老年人肌少症之預防與照護。志為 護理-慈濟護理雜誌,14(2),62-68。
邱銘章、湯麗玉(2009)。失智症照護指南。原水。
洪彰岑、黃錦源、葉清華、許昭興、甘能斌(2017)。失智症與代謝症候群的關 連性及其防治策略。輔仁大學體育學刊(16),242-256。
胡文郁(2003)。實證護理之系統性文獻查證。護理雜誌,50(1),34-43。
國家發展委員會(2023)。高齡人口占比趨勢。國家發展委員會。Retrieved
Janunary 14 from https://pop-proj.ndc.gov.tw/chart.aspx?c=10&uid=66&pid=60 張凱茗(2018)。運動對於失智症之預防-國際治療準則之建議。血管醫學防治季
刊(31),37-39。
郭嘉琪、王秀紅(2012)。系統性文獻回顧自我管理在國內慢性病介入研究之應 用。護理暨健康照護研究,8(1),50-60。
陳秀惠、林品瑄、楊尚育、李雅珍(2018)。體能活動介入對日間照顧中心失智 症高齡者體適能之成效。臺灣職能治療研究與實務雜誌,14(2),101-110。
陳俊民、王秀華、李淑芳(2016)。阿茲海默症患者之運動處方。大專體育
(137),37-44。
陳俐蓉、古博文、林志遠(2015)。老年人身體活動與認知功能之中介分析。 中 華體育季刊,29(1),67-71。
陳昱合、張素嫺、方妙君、蔡美利(2009)。運用運動訓練維持失智老人如廁功 能之探討。護理暨健康照護研究,5(4),265-272。
陳錫晚、陳瑛治(2019)。認知運動操對失智症預防之應用。長期照護雜誌, 23
(1),61-74。
陳豐慈、祝堅恆、齊璘、吳治翰、張育愷(2017)。運動介入對輕度認知損傷老 年人認知功能之影響: 文獻回顧與未來展望。臺灣運動心理學報,17
(1),131-153。
陳豐慈、詹貴惠、馮勝賢、吳聰義、高士竣、張育愷(2019)。新觀點: 健身運動 與營養補充劑對認知老化之影響。體育學報,52(第 S),1-15。
黃千盈、徐文俊、李佳琳、邱逸榛(2011)。身體活動介入措施於失智症患者之 應用文獻回顧。長期照護雜誌,15(2),157-167。
黃森芳、陳聰毅、何采容、黃國欽(2013)。身體活動對預防老年失智症之成效
及其可能機制。臺灣體育論壇(6),39-48。
黃韻潔、潘正宸(2020)。運動處方與運動介入對智能障礙者健康體適能的影 響。大專體育(153),24-36。
楊文中、陳豐慈、吳聰義、陳麗華、張育愷(2016)。健身運動對記憶相關認知 功能之影響。臺灣運動心理學報,16(2),57-83。
楊惠娟(2009)。失智症的介紹及治療。秀傳季刊,24(3),6-7。
楊榮真、許瑞祈、蔡曉婷、蔡逸蓁、陳怡君、朱育瑩、蔡孟儒、呂怡慧、羅靜 斐、賴彥廷(2017)。團體運動班介入於社區輕度認知障礙和輕度失智長 者之成效。臨床醫學月刊,80(5),662-666。
穆佩芬(2014)。質性系統性文獻回顧研究法。源遠護理,8(3),5-11。
龍裔夫、黃崇儒、洪聰敏(2010)。運動介入與前額腦波側化,情緒狀態之關 係。中華體育季刊,24(3),1-15。
衛生福利部(2020)。2025 年達成失智友善台灣。衛生福利部。
謝明玲(2014)。做對 3 件事治好健忘症。天下雜誌。Retrieved Januanry 14 from https://www.cw.com.tw/article/5055181
謝瓊儀、王秀華(2017)。多元運動課程介入對輕度認知功能障礙高齡者之成效 研究。嘉大體育健康休閒期刊,16(2),13-32。
豐東洋、黃耀宗、郭正煜、高士竣(2016)。身體活動量對老年人執行控制功能 影響之探討。體育學報,49(S),17-31。
英文文獻
Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R., & Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo clinic proceedings,
Ando, S., Kokubu, M., Yamada, Y., & Kimura, M. (2011). Does cerebral oxygenation affect cognitive function during exercise? European journal of applied
physiology, 111(9), 1973-1982.
Biddle, S., Fox, K. R., & Boutcher, S. H. (2000). Physical activity and psychological well-being (Vol. 552). Routledge London.
Brett, L., Stapley, P., Meedya, S., & Traynor, V. (2019). Effect of physical exercise on physical performance and fall incidents of individuals living with dementia in nursing homes: a randomized controlled trial. Physiotherapy theory and practice.
Chang, Y.-K., Labban, J. D., Gapin, J. I., & Etnier, J. L. (2012). The effects of acute exercise on cognitive performance: a meta-analysis. Brain Research, 1453, 87-101.
Coan, J. A., & Allen, J. J. (2004). Frontal EEG asymmetry as a moderator and mediator of emotion. Biological psychology, 67(1-2), 7-50.
Colcombe, S., & Kramer, A. F. (2003). Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychological science, 14(2), 125-130.
D'Amico, F., Rehill, A., Knapp, M., Lowery, D., Cerga‐Pashoja, A., Griffin, M., Iliffe, S., & Warner, J. (2016). Cost‐effectiveness of exercise as a therapy for
behavioural and psychological symptoms of dementia within the EVIDEM‐E randomised controlled trial. International journal of geriatric psychiatry, 31(6), 656-665.
Daviglus, M. L., Plassman, B. L., Pirzada, A., Bell, C. C., Bowen, P. E., Burke, J. R., Connolly, E. S., Dunbar-Jacob, J. M., Granieri, E. C., & McGarry, K. (2011).
Risk factors and preventive interventions for Alzheimer disease: state of the science. Archives of neurology, 68(9), 1185-1190.
Dawson, N., Judge, K. S., & Gerhart, H. (2019). Improved functional performance in individuals with dementia after a moderate-intensity home-based exercise program: a randomized controlled trial. Journal of geriatric physical therapy, 42(1), 18-27.
Fratiglioni, L., De Ronchi, D., & Agüero-Torres, H. (1999). Worldwide prevalence and incidence of dementia. Drugs & aging, 15(5), 365-375.
Haeger, A., Costa, A. S., Romanzetti, S., Kilders, A., Trautwein, C., Haberl, L., Beulertz, M., Hildebrand, F., Schulz, J. B., & Reetz, K. (2020). Effect of a multicomponent exercise intervention on brain metabolism: A randomized controlled trial on Alzheimer's pathology (Dementia‐MOVE). Alzheimer's &
Dementia: Translational Research & Clinical Interventions, 6(1), e12032.
Henskens, M., Nauta, I. M., Drost, K. T., & Scherder, E. J. (2018). The effects of movement stimulation on activities of daily living performance and quality of life in nursing home residents with dementia: a randomized controlled trial.
Clinical interventions in aging, 13, 805.
Hillman, C. H., Kamijo, K., & Pontifex, M. B. (2012). The relation of ERP indices of exercise to brain health and cognition. In Functional neuroimaging in exercise and sport sciences (pp. 419-446). Springer.
Ho, R. T., Fong, T. C., Chan, W. C., Kwan, J. S., Chiu, P. K., Yau, J. C., & Lam, L. C.
(2020). Psychophysiological effects of dance movement therapy and physical exercise on older adults with mild dementia: a randomized controlled trial. The
Journals of Gerontology: Series B, 75(3), 560-570.
Kesaniemi, Y. A., DANFORTH, E. J., Jensen, M. D., Kopelman, P. G., Lefèbvre, P., &
Reeder, B. A. (2001). Dose-response issues concerning physical activity and health: an evidence-based symposium. Medicine and science in sports and exercise, 33(6), S351-S358.
Khan, M., Akhter, S., Soomro, R. R., & Ali, S. S. (2014). The effectiveness of Cognitive Behavioral Therapy (CBT) with general exercises versus general exercises alone in the management of chronic low back pain. Pakistan journal of
pharmaceutical sciences, 27(4 SI), 1113-1117.
Khan, N. A., & Hillman, C. H. (2014). The relation of childhood physical activity and aerobic fitness to brain function and cognition: a review. Pediatric exercise science, 26(2), 138-146.
Lambourne, K., & Tomporowski, P. (2010). The effect of exercise-induced arousal on cognitive task performance: a meta-regression analysis. Brain Research, 1341, 12-24.
Landers, D. M., & Petruzzello, S. J. (1994). Physical activity, fitness, and anxiety.
Loprinzi, P. D., Herod, S. M., Cardinal, B. J., & Noakes, T. D. (2013). Physical activity and the brain: a review of this dynamic, bi-directional relationship. Brain Research, 1539, 95-104.
Maltais, M., Rolland, Y., Haÿ, P.-E., Armaingaud, D., Vellas, B., & de Souto Barreto, P.
(2019). Six-month observational follow-up on activities of daily living in people with dementia living in nursing homes after a 6-month group based on either exercise or social activities. Aging Clinical and Experimental Research, 31(3), 361-366.
Maltais, M., Rolland, Y., Haÿ, P.-E., Armaingaud, D., Cestac, P., Rouch, L., & de Souto
Barreto, P. (2018). The effect of exercise and social activity interventions on nutritional status in older adults with dementia living in nursing homes: a
randomised controlled trial. The journal of nutrition, health & aging, 22(7), 824-828.
Martinsen, E. W. (1990). Benefits of exercise for the treatment of depression. Sports Medicine, 9(6), 380-389.
McAuley, E. (1994). Physical activity and psychosocial outcomes.
McCurry, S. M., Pike, K. C., Logsdon, R. G., Vitiello, M. V., Larson, E. B., & Teri, L.
(2010). Predictors of short-and long-term adherence to a daily walking program in persons with Alzheimer’s disease. American Journal of Alzheimer's Disease
& Other Dementias®, 25(6), 505-512.
McGough, E. L., Kelly, V. E., Logsdon, R. G., McCurry, S. M., Cochrane, B. B., Engel, J. M., & Teri, L. (2011). Associations between physical performance and
executive function in older adults with mild cognitive impairment: gait speed and the timed “up & go” test. Physical therapy, 91(8), 1198-1207.
Morgan, W. P. (1985). Affective beneficence of vigorous physical activity. Medicine &
Science in Sports & Exercise.
Morgan, W. P., Roberts, J. A., Brand, F. R., & Feinerman, A. D. (1970). Psychological effect of chronic physical activity. Medicine and Science in Sports, 2(4), 213-217.
Morris, J. C. (1997). Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International psychogeriatrics, 9(S1), 173-176.
Norton, S., Matthews, F. E., Barnes, D. E., Yaffe, K., & Brayne, C. (2014). Potential for primary prevention of Alzheimer's disease: an analysis of population-based data.
The Lancet Neurology, 13(8), 788-794.
Olazarán, J., Reisberg, B., Clare, L., Cruz, I., Peña-Casanova, J., Del Ser, T., Woods, B., Beck, C., Auer, S., & Lai, C. (2010). Nonpharmacological therapies in
Alzheimer’s disease: a systematic review of efficacy. Dementia and geriatric cognitive disorders, 30(2), 161-178.
Oremus, M., Wolfson, C., Perrault, A., Demers, L., Momoli, F., & Moride, Y. (2001).
Interrater reliability of the modified Jadad quality scale for systematic reviews of Alzheimer’s disease drug trials. Dementia and geriatric cognitive disorders, 12(3), 232-236.
Park, H., Park, J. H., Na, H. R., Hiroyuki, S., Kim, G. M., Jung, M. K., Kim, W. K., &
Park, K. W. (2019). Combined intervention of physical activity, aerobic exercise, and cognitive exercise intervention to prevent cognitive decline for patients with mild cognitive impairment: A randomized controlled clinical study. Journal of clinical medicine, 8(7), 940.
Paterson, B. L., Thorne, S. E., Canam, C., & Jillings, C. (2001). Meta-study of qualitative health research: A practical guide to analysis and meta-synthesis (Vol. 3). Sage.
Petruzzello, S. J., Landers, D. M., Hatfield, B. D., Kubitz, K. A., & Salazar, W. (1991).
A meta-analysis on the anxiety-reducing effects of acute and chronic exercise.
Sports Medicine, 11(3), 143-182.
Plante, T. G., & Rodin, J. (1990). Physical fitness and enhanced psychological health.
Current psychology, 9(1), 3-24.
Qiu, C., De Ronchi, D., & Fratiglioni, L. (2007). The epidemiology of the dementias: an update. Current opinion in psychiatry, 20(4), 380-385.
Raglin, J. S. (1990). Exercise and mental health. Sports Medicine, 9(6), 323-329.
Sampaio, A., Marques-Aleixo, I., Seabra, A., Mota, J., & Carvalho, J. (2021). Physical exercise for individuals with dementia: potential benefits perceived by formal caregivers. BMC geriatrics, 21(1), 1-14.
Sandelowski, M., & Barroso, J. (2003). Toward a metasynthesis of qualitative findings on motherhood in HIV‐positive women. Research in nursing & health, 26(2), 153-170.
Sandelowski, M., Barroso, J., & Voils, C. I. (2007). Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Research in nursing
& health, 30(1), 99-111.
Serrano-Pozo, A., Frosch, M. P., Masliah, E., & Hyman, B. T. (2011).
Neuropathological alterations in Alzheimer disease. Cold Spring Harbor perspectives in medicine, 1(1), a006189.
Stevens, J., & Killeen, M. (2006). A randomised controlled trial testing the impact of exercise on cognitive symptoms and disability of residents with dementia.
Contemporary nurse, 21(1), 32-40.
Teixeira, P. J., Carraça, E. V., Markland, D., Silva, M. N., & Ryan, R. M. (2012).
Exercise, physical activity, and self-determination theory: a systematic review.
International Journal of Behavioral Nutrition and Physical Activity, 9(1), 1-30.
Tomporowski, P. D. (2003). Effects of acute bouts of exercise on cognition. Acta psychologica, 112(3), 297-324.
Tomporowski, P. D., Lambourne, K., & Okumura, M. S. (2011). Physical activity interventions and children's mental function: an introduction and overview.
Preventive medicine, 52, S3-S9.
Tsugawa, A., Shimizu, S., Hirose, D., Sato, T., Hatanaka, H., Takenoshita, N., Kaneko, Y., Ogawa, Y., Sakurai, H., & Hanyu, H. (2020). Effects of 12‐month exercise
intervention on physical and cognitive functions of nursing home residents requiring long‐term care: a non‐randomised pilot study. Psychogeriatrics, 20(4), 419-426.
WHO. (2022). Dementia. World Health Organization. Retrieved Januanry 14 from https://www.who.int/news-room/fact-sheets/detail/dementia
Williams, C., & Tappen, R. (2008). Exercise training for depressed older adults with Alzheimer's disease. Aging and Mental Health, 12(1), 72-80.
附錄一 文獻品質評定
評分標準 1 2 3 4 5 6 7 8
編 號
題目 Modified Jadad Scale(文獻 品質評定) 評分標準/
總分
有無描 述隨機 化(有 為1 分,無 為0 分)
隨機化 是否適 當(適 當1 分,未 描述0 分,不 適當得 扣1 分)
描述盲 化(雙 盲1 分、單 盲0.5 分,未 描述0 分)
盲化是 否適當
(適當 1 分,
未描述 0 分,
不適當 得扣1 分)
描述退 出人數 及理由
(有描 述為1 分,無 描述為 0 分)
描述納 入或排 除標準
(有描 述為1 分,無 描述為 0 分)
描述評 估不良 反應
(有描 述為1 分,無 描述為 0 分)
描述統 計分析 方法
(有描 述為1 分,無 描述為 0 分)
1 運用運動訓練
維持失智老人 如廁功能之探 討
3 0 0 0 0 1 1 0 1
2
Cost-effectiveness of exercise as a therapy for behavioural and
psychological symptoms of dementia within the
EVIDEM-E randomised controlled trial
5.5 1 1 0.5 1 0 1 0 1
3 團體運動班介
入於社區輕度 認知障礙和輕 度 失智長者之 成效
2 0 0 0 0 0 1 0 1
4 多元運動課程
介入對輕度認 知功能障礙高 齡者之成效研 究
2 0 0 0 0 0 1 0 1
5 Improved Functional Performance in Individuals With Dementia After a Moderate- Intensity Home-Based Exercise Program:
A Randomized Controlled Trial
6 1 1 0 0 1 1 1 1
6 體能活動介入
對日間照顧中 心失智症高齡 者體適能之成 效
3 0 0 0 0 1 1 0 1
7 The effects of movement stimulation on activities of daily living performance and quality of life in nursing home residents with dementia: a randomized controlled trial
5.5 1 1 0.5 1 0 1 0 1
8 Psychophysiolo gical Effects of Dance
Movement Therapy and Physical Exercise on Older Adults With Mild Dementia:
A Randomized Controlled Trial
6.5 1 1 0.5 1 1 1 0 1
9 The effect of exercise and social activity interventions on nutritional status in older adults with dementia living in nursing homes: A randomized controlled trail
6.5 1 1 0.5 1 1 1 0 1
10 Six-month observational follow-up on activities of daily living in people with dementia living in nursing homes after a 6-month group based
on either exercis e or social activities
5 1 1 0 0 1 1 0 1
11 Effect of physical exercise on physical performance and fall incidents of individuals living with dementia in nursing homes:
a randomized controlled trial
7 1 1 1 1 1 1 0 1
12 Combined Intervention of Physical Activity, Aerobic Exercise, and Cognitive
5 1 1 1 0 0 1 0 1