(18)体育锻炼和认知健康-Physical Activity and Cognitive Health-公开课-关爱惟士
(18)体育锻炼和认知健康-Physical Activity and Cognitive Health

课程视频:http://player.youku.com/embed/XMjY3ODM2MzM4OA




Professor Nicola Lautenschlager

Nicola Lautenschlager教授


A definition of physical activity would be any use of your skeletal muscles which needs energy. Research into the link between physical activity and cognition, in later life, is actually quite a new field. So we really only have increasing evidence in the last 20 to 30 years. However, the evidence we have so far is very promising. There are observational and longitudinal studies which have shown for quite a while that people who adhere to physical activity throughout their lifetime have a lower risk of developing cognitive decline when they get older. And more recently, there has also been an increasing number of randomised control trials with either healthy individuals or people in the community who are at higher risk. Especially for the randomised control trials, the evidence is not consistent. So some of the trials were negative but many were also positive. There is a clear indication we need more research done in this field to understand it better.

体育运动的定义是任何使用你的肌肉消耗能量的活动。关于体育运动和认知之间关系的研究,实际上是一个非常新的领域。所以我们在过去二三十年间仅仅获得一些增加的证据。然而我们迄今获得的证据是非常有希望的。纵向研究和观察已经表明一生坚持体育锻炼的人,当他们变老时,他们拥有很低的认知下降的风险。最近,还有越来越多的用健康个体或在社区中处于较高风险的人做的随机对照试验。特别是这些随机对照试验的证据不一致。有些试验是阴性结果,但很多试验是阳性结果。这清楚的表明我们在这个领域需要做更多的研究,以便更好地了解它。


The positive studies have shown that regular physical activities are associated with improved cognitive performance. Interestingly, there seems to be evidence pointing towards not every type of cognitive performance benefiting in the same way. Currently, most positive studies show that the evidence is especially for executive function or frontal lobe functions, and anything having to do with speed, so for example, processing speed. Whereas for other cognitive areas such as memory, the findings are much more diverse and controversial.

阳性结果的研究表明经常性的体育锻炼与改善认知表现相关。有趣的是,似乎有证据指向并不是每项认知表现都以同一方式受益。目前,很多阳性结果的研究证据往往专门是关于执行功能或额叶功能,和任何与速度有关的功能,例如速度处理过程。而对于像记忆之类的其它认知领域,结果往往是多样和矛盾的。


The other interesting finding so far is that it is important to decide what type of physical activity or exercise is most beneficial when you want to maintain your cognitive health, and again the current evidence of the literature points towards aerobic exercise. Meaning it has to be a type of physical activity where there is enough expenditure of energy to have an increased heartbeat, have more intense breathing, basically an activity where the person can’t keep talking, for example, because they need their breath to do the exercise. To give you a practical idea, if you talk about walking which is the most commonly performed type of aerobic exercise, it has to be of a speed and intensity that is reached, that the person develops more laboured breathing and works up a sweat.

迄今为止,另一个有趣的发现是,当你想维持你的认知健康时,决定进行哪种类型的体育运动或锻炼是最有效的,是非常重要的。目前的文献资料证据再次指向有氧运动。这意味着是一种充分消耗能量,使心跳加快,呼吸增加的运动。例如,这种运动基本上是一种人们无法保持交谈的运动,因为人们需要呼吸来做运动。给你一个实际例子,如果你谈论走路的话,这是一种最常见的有氧运动,它需要达到一定的速度和强度,需要更多的呼吸和出汗。


It also has been shown more recently that strength training, so specific training where you use, for example, weights to strengthen your muscles, is also beneficial for cognition, and it looks like a combination of both, physical activity with aerobic focus plus strength training, is probably the best combination, rather than doing only one of these types. Where the evidence is more limited is for exercise which is rather focusing on balance or relaxation, like yoga. We know there are lots of benefits for older people, like the reduction of risk for falls and having a better balance, but whether these more low-impact exercises also can help to contribute to cognitive health is not quite clear.

另外,最近更多的研究表明你所使用的十分特殊的训练--力量训练, 例如,加强你肌肉的重量训练,对认知也有好处,它似乎是一种有氧运动和力量训练结合的体育锻炼,它或许是最好的组合,而不是仅做这些运动类型其中的一种。然而关于像瑜伽这类平衡和放松的运动有关的研究证据更加有限。我们知道此类运动对老人有很多好处,例如可以降低摔跤的风险和有更好的平衡能力,但我们尚不清楚这些低冲击运动是否也能帮助和有利于认知健康。


What is still unknown, and needs much more research in the future, is the question, “What is the right dose?” So how much physical activity do you have to do per week, at what level of intensity, to have the best benefits for your cognitive health? There seems to be emerging evidence that a combination of different types, as I mentioned, might be better than just doing one type, and there is also an emerging field which investigates whether combining physical activity with some cognitive tasks might have additional benefit. For example, it has been shown if you have a physical activity type, like dancing, where you also have to remember steps, or Tai Chi where you have to remember movements, this might give you additional benefit. Another area they’re investigating is what we call dual task exercise. That means someone is, for example, in the gym and does aerobic exercise and then in intervals between the physical activity, they try to do a cognitive task like solving a crossword puzzle or doing some arithmetic. So that’s also an interesting area of research.

究竟多大的运动量合适呢?即每周需要你做多少运动以及运动强度如何?这个尚未解决的问题需要将来做更多的研究。新出现的证据似乎表明不同类型的运动组合似乎比只做一种运动好。而且新出现的研究领域正在调查体育运动和认知任务相结合是否有更多的好处。例如有证据表明如果你有像跳舞这样的需要记住舞步的运动类型,或太极这样的需要记住动作的运动类型,你会受益更多。他们调查的另一个领域是我们所说的双重任务锻炼。例如有人先在健身馆进行有氧锻炼,然后在体育锻炼的空隙来完成像填字游戏和算数之类的认知任务。所以那也是一个有趣的研究领域。


Australia, like many other western countries, has official physical activity guidelines and we are also fortunate in our country that we have specific guidelines for older Australians. The recommendations for older people are actually very similar to the recommendations for younger people. So there is quite global agreement that the recommended physical activity level we all should try to adhere to is approximately 150 minutes per week. Now how these 150 minutes are spent across the week is very variable. The recommendation is that it shouldn’t be shorter than 10 minutes at a given time. Very often you read a recommendation that trying to do 30 minutes, most days of the week, is a good way to go about it. The recommendations further say the type of physical activity should be mainly moderate aerobic exercise. So that could be either fast walking, or it could be going into a gym program, or it could be bike riding, for example. So there are lots of options. It could be swimming. And then ideally that should be combined with, at least twice a week, some strength training, and obviously outside the benefit for cognition, some balance training to reduce the risk of falls in older people.

像很多其它西方国家,在澳大利亚有体育锻炼的官方指南,幸运的是我们有针对澳大利亚老年人的特殊指南。对老人的建议,实际上和对年轻人的建议相类似。所以全球性协议指南建议我们坚持每周150分钟的体育锻炼。现在如何在一周花150分钟是非常不同的。指南建议每次运动不要少于10分钟。最好方式是在每周的大多数日子,每天活动半小时。另外,指南还建议体育锻炼类型应该主要是中度有氧运动。所以这些运动可以是快走,某个健身项目,或像骑自行车运动。所以可以有很多选择,游泳也行。最理想的是与每周两次的对认知明显有好处的力量训练和降低老年人跌倒的风险的平衡训练相结合。


So the question, “[Does] it makes a difference if you have done lots of physical activity as a child or a younger person, in terms of the benefits to your cognitive health when you are older?” is a very interesting question. There are studies which have exactly shown that there is, sort of, a lifelong accumulation of your physical activity efforts throughout your lifespan, and the more you have done throughout your life, the better the chances that you have good cognitive health when you’re older. However, there is also research showing that it’s never too late to get started. Looking, for example, at older participants or people who never have done physical activity in their life, who have had a more or less sedentary life and then only started doing physical activity at an older age, even that group can experience some quite impressive benefit with regards to their cognitive health.

因此这个问题“你在小时候或年轻的时候进行了大量的体育活动是否会有利于你老年时的认知健康?”是一个非常有趣的问题。一些研究已经确切表明了你在一生中的体育锻炼的努力的积累,你在一生中做的越多,你在年老时就越可能有好的认知健康。但是也有研究表明何时开始都为时不晚。例如,从未参加过体育运动,或多或少的拥有久坐生活的老年参加者仅仅在较大的年纪开始做运动,就可以获得对他们认知健康的令人印象相当深刻的好处。


The largest amount of evidence in this field we do have for cognitively healthy people, when it comes, for example, to randomise control trials, there is a small but increasing number of studies which focused on people who already experience some cognitive impairment. A classic example would be studies with either older people who have subjective memory decline or, what we call, mild cognitive impairment. Both of these clinical groups have been identified as being at increased risk of later on developing some more pronounced cognitive decline, such as dementia. The study results are less clear in those clinical groups, compared to healthy participants, but there have been a number of trials now which have shown that, also in these clinical groups, there is benefit to cognitive performance, and a few of these studies even have shown that the right type of physical activity program might help to delay the progression of the cognitive impairment.

我们在这个领域中确实有最大量关于认知健康的人群的证据。但对于随机对照试验,有少量但数量在不断增长的的研究集中在已有认知缺陷的人群。一个经典的例子是关于主观记忆下降的老人或轻度认知障碍的老人的研究。这两个临床组的人以后发展为像痴呆症这样的显著的认知下降的风险都会增加。和健康的参与者相比,在这些临床组的研究结果不太清楚,但是目前一些试验表明即使在这些临床组中,正确类型的体育运动或许可以帮助延缓认知障碍的进程。


翻译:关爱惟士-未经允许不得转载,违者必追究法律责任

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