Abstract: Background　Cognitive frailty is associated with an evidently high risk of disability and all-cause mortality. Detecting and managing cognitive frailty at early stages may reverse adverse outcomes and poor quality of life. Objective　To study the effect of a multicomponent exercise prescription on frailty phenotype，cognitive function，dietary intakes，and nutritional parameters in elderly patients with cognitive frailty. Methods　From January 2017 to December 2018，ninety elderly patients with cognitive frailty were randomly divided into multicomponent exercise group（n=45） and control group（n=45）and received corresponding interventions. Their frailty indicators（6-meter timed walk，grip strength，Fried frailty phenotype score），Mo-CA scores，dietary intakes，and nutritional parameters〔albumin，prealbumin，transferrin，lymphocyte count，and Mini Nutritional Assessment（MNA） score〕 were recorded at baseline，at 3 and 6 months after intervention. Results　The frailty indicators，Mo-CA score，dietary（vegetables，fruits，fish/shrimp，poultry/meat，eggs，liquid milk，nuts） intakes，and nutritional indices were significantly different in two groups（P<0.05）. The frailty indicators，Mo-CA score，dietary （vegetables，fruits，fish/shrimp，poultry /meat，eggs，liquid milk，nuts） intakes，and nutritional indices were significantly different in two groups at different measurement times（P<0.05）. Intervention contents and duration had substantial interaction on time taken for frailty indicators，dietary（vegetables，fruits，fish/shrimp，poultry /meat，eggs，liquid milk，nuts） intakes，and nutritional indices（P<0.05）. Compared with the control group，the exercise group took less time to complete the 6-meter timed walk and had lower frailty phenotype score，and higher grip strength，Mo-CA score，albumin，prealbumin，transferrin，the number of lymphocytes，and MNA score at the end of 3-month or 6-month intervention（P<0.05）. After 3-month intervention，the intake of vegetables，fruits，fish/shrimp，eggs，liquid milk increased in the exercise group compared with control group（P<0.05）. After 6-month intervention，the intake of vegetables，fruits，fish/shrimp，poultry /meat，eggs，liquid milk and nuts improved in the exercise group compared with control group（P<0.05）. Self-controlled comparisons showed that in the exercise group，the time required to complete the 6-meter timed walk and fraity phenotype score decreased，while the grip strength，Mo-CA score，the intake of vegetables，fruits，fish/shrimp，poultry /meat，eggs，liquid milk and nuts，albumin，pre albumin，transferrin，the number of lymphocytes，and MNA score increased at the end of 3-month or 6-month intervention，compared with at pre-intervention（P<0.05）. Conclusion　The multicomponent exercise prescription can improve the frailty phenotype，cognitive function，dietary intakes，and nutrition in elderly patients with cognitive frailty.

Key words: Cognition disorders, Frailty, Exercise prescription, Nutrition

摘要： 背景　认知衰弱与老年人残疾率和全因死亡率密切相关，早期识别及干预认知衰弱，可能逆转病程，改善老年人的功能状态。目的　研究多组分运动处方对老年认知衰弱患者的衰弱表型、认知功能、膳食摄入量及营养状况的影响。方法　2017年1月—2018年12月将90例老年认知衰弱患者随机分为对照组和多组分运动处方组（运动组），每组45例。分别评定基线期、干预3个月及6个月的衰弱指标（6 m步行时间、握力、Fried衰弱表型评分）、蒙特利尔认知评定量表（Mo-CA）评分、膳食摄入量、营养指标〔清蛋白、前清蛋白、转铁蛋白、淋巴细胞计数、简易营养评估评分（MNA）〕。结果　两组衰弱指标、Mo-CA评分、膳食（蔬菜、水果、鱼虾、禽肉/畜肉、蛋、液态奶、坚果类）摄入量、各营养指标比较，差异有统计学意义（P<0.05）；不同时间点衰弱指标、Mo-CA评分、膳食（蔬菜、水果、鱼虾、禽肉/畜肉、蛋、液态奶、坚果类）摄入量、各营养指标比较，差异有统计学意义（P<0.05）；且组别和时间在衰弱指标、膳食（蔬菜、水果、鱼虾、禽肉/畜肉、蛋、液态奶、坚果类）摄入量、各营养指标上存在交互作用（P<0.05）。干预3个月、6个月，运动组的6 m步行时间、Fried衰弱表型评分低于对照组（P<0.05），握力、Mo-CA评分、清蛋白、前清蛋白、转铁蛋白、淋巴细胞计数、MNA评分高于对照组（P<0.05）；干预3个月，运动组的蔬菜、水果、鱼虾、蛋、液态奶摄入量高于对照组（P<0.05）；干预6个月，运动组蔬菜、水果、鱼虾、禽肉/畜肉、蛋、液态奶、坚果类的摄入量高于对照组（P<0.05）。干预3个月、6个月，运动组的6 m步行时间、Fried衰弱表型评分低于基线期（P<0.05），握力、Mo-CA评分、膳食（蔬菜、水果、鱼虾、禽肉/畜肉、蛋、液态奶、坚果类）摄入量、清蛋白、前清蛋白、转铁蛋白、淋巴细胞计数、MNA评分高于基线期（P<0.05）。结论　多组分运动处方对改善认知衰弱患者的衰弱表型、轻度认知障碍、膳食摄入量、营养状况有一定作用。

关键词: 认知障碍, 衰弱, 运动处方, 营养