Background Alzheimer’s disease (AD), as the most common cause of dementia, brings huge economic burden for patients and social health care systems, which motivates researchers to study multiple protective factors, among which physical activity and exercise have been proven to be both effective and economically feasible. Methods A systematic literature search was performed for eligible studies published up to November 1st 2018 on three international databases (PubMed, Cochrane Library, and Embase) and two Chinese databases (Wanfang Data, China National Knowledge Infrastructure). All analyses were conducted using Stata 14.0. Due to heterogeneity between studies, a random-effects model was used for this meta-analysis. Meta-analysis was used to explore if physical activity and exercise can exert positive effects on cognition of elderly with AD and subgroup analyses were conducted to find out if there are dose-response effects. Results A total of 13 randomized controlled trials were included with a sample size of 673 subjects diagnosed with AD. Intervention groups showed a statistically significant improvement in cognition of included subjects measured by the MMSE score (SMD = 1.12 CI:0.66~1.59) compared to the control groups. Subgroup analyses showed different amounts of physical activity and exercise can generate different effects. Conclusions As one of few meta-analyses comparing different quantities of physical activity and exercise interventions for AD in details, our study suggests that physical activity and exercise can improve cognition of older adults with AD. While the concomitant effects on cognition functions of high frequency interventions was not greater than that of low frequency interventions, the threshold remains to be settled. However, more RCTs with rigorous study design are needed to support our findings. Electronic supplementary material The online version of this article (10.1186/s12877-019-1175-2) contains supplementary material, which is available to authorized users.

Background:The increasing prevalence of Alzheimer disease (AD) emphasizes the need for effective treatments. Both pharmacological therapies such as nutrition therapy (NT) and nonpharmacologic therapies including traditional treatment or personalized treatment (e.g., physical exercise, music therapy, computerized cognitive training) have been approved for the treatment of AD or mild cognitive impairment (MCI) in numerous areas.Methods:The aim of this study was to compare 4 types of interventions, physical exercise (PE), music therapy (MT), computerized cognitive training (CCT), and NT, in older adults with mild to moderate AD or MCI and identify the most effective intervention for their cognitive function. We used a system of search strategies to identify relevant studies and include randomized controlled trials (RCTs), placebo-controlled trials evaluating the efficacy and safety of 4 interventions in patients with AD or MCI. We updated the relevant studies which were published before March 2017 as a full-text article. Using Bayesian network meta-analysis (NMA), we ranked cognitive ability based objectively on Mini-Mental State Examination (MMSE), and assessed neuropsychiatric symptoms based on Neuropsychiatric Inventory (NPI). Pairwise and network meta-analyses were sequentially performed for efficacy and safety of intervention compared to control group through RCTs included.Results:We included 17 RCTs. Fifteen trials (n = 1747) were pooled for cognition and no obvious heterogeneity was found (I2 = 21.7%, P = .212) in NMA, the mean difference (MD) of PE (MD = 2.1, confidence interval [CI]: 0.44–3.8) revealed that PE was significantly efficacious in the treatment group in terms of MMSE. Five trials (n = 660) assessed neuropsychiatric symptoms with an obvious heterogeneity (I2 = 61.6%, P = .034), the MD of CCT (MD = −7.7, CI: −14 to −2.4), revealing that CCT was significantly efficacious in NPI.Conclusions:As the first NMA comparing different interventions for AD and MCI, our study suggests that PE and CCT might have a significant improvement in cognition and neuropsychiatric symptoms respectively. Moreover, nonpharmacological therapies might be better than pharmacological therapies.

BackgroundDepressive symptoms are a pervasive mental health problem in Chinese adolescents. The aim of this article was to systematically assess the trend of depressive symptoms in China among adolescents (1988 to 2018).Material/MethodsA systematic and comprehensive literature search was conducted in both English and Chinese databases, including PubMed, EMBASE, Cochrane CENTRAL, CNKI, and Wan Fang Database, to identify relevant studies published between 1988 and 2018. Batteries of analyses in this meta-analysis were undertaken using Stata version 12.0 statistical software.ResultsSixty-two related reports involving 232 586 participants finally met our inclusion and exclusion criteria. The results suggest the prevalence of depressive symptoms has generally increased over time. The prevalence estimates before 2000 were 18.4% (95% CI, 14.5–22.3%), and were 26.3% (95% CI, 21.9–30.8%) after 2016. The pooled prevalence of depressive symptoms among children and adolescents was 22.2% (95% CI: 19.9–24.6%, I2=99.6%, p<0.001). More subgroup analyses classified by screening instrument, gender, and region were carried out in this meta-analysis.ConclusionsResults of our meta-analysis suggest that depressive symptoms have become more prevalent among Chinese adolescents. This trend emphasizes the need for effective prevention strategies and greater availability of screening tools for this vulnerable population.

Background: During adolescence, middle school students facing psychophysical changes are vulnerable to psychological problems. The present study aimed to investigate mental health status and associated school interpersonal relationships among adolescents in China, which may help to inform effective prevention strategies to reduce the prevalence of mental health problems. Methods: In the cross-sectional study, a total of 10,131 middle school students were selected from three cities in eastern China by stratified random sampling. The Symptom Checklist-90 (SCL-90), Teacher-Student Relationship Questionnaire (TSRQ) and Peer Relationship Scale (PRS) were used to evaluate psychological symptoms, the quality of relationship with teachers and the quality of relationship with peers, respectively. Multivariable logistic regression analysis was conducted to explore the association between school interpersonal relationships and mental health problems in adolescents. Results: 36% of the middle school students reported positive in mental health problems assessed by the SCL-90. The most prevalent dimensional symptom was obsessive-compulsive (43.3%). The risk of all types of psychological symptoms was significantly associated with school interpersonal relationships. Moreover, a higher risk of mental health problems was associated with poorer school interpersonal relationships. Conclusions: Mental health problems were prevalent among adolescents and highly associated with school interpersonal relationships. Our findings underscore the pressing need for school administrators to make efforts to improve school interpersonal relationships among adolescents.

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