Park Helen L, O'Connell Janice E, Thomson Richard G
University of Newcastle Department of Geriatric Medicine, Sunderland Royal Hospital, UK.
Int J Geriatr Psychiatry. 2003 Dec;18(12):1121-34. doi: 10.1002/gps.1023.
The public health impact of cognitive decline and dementia is increasing as the population ages. Studies exploring therapies or risk factors for cognitive impairment require understanding of expected age-related decline.
To establish the rate of age-related cognitive decline in the general elderly population.
Systematic review of studies of cognitive decline in the general elderly population. Medline, Embase and PsycINFO databases were searched using an adapted version of McMaster's aetiology, causation and harm strategies and the Cochrane Dementia and Cognitive Impairment Group strategy. Grey literature was explored and experts contacted. A second observer was involved at all stages and quality appraisal of included studies was performed. Included studies were representative, community-based, cohort studies of people aged over 60, incorporating individuals with dementia.
Identification of 5990 abstracts and retrieval of 163 full texts led to inclusion of 19 papers. Heterogeneity made narrative review the appropriate method of data synthesis. Some degree of cognitive impairment with increasing age was found in all studies, although the extent varied. The prevalence of cognitive impairment and the rate of decline increased with age. Studies were of variable quality.
Cognitive decline is almost universal in the general elderly population and increases with age. Improved communication between researchers and between clinicians to identify a core minimum data set of neuropsychological tests that could be used in different populations would support consistent study design and meta-analysis, helping to quantify the true rate of cognitive decline in the elderly and assisting diagnosis in clinical practice.
随着人口老龄化，认知功能减退和痴呆对公共卫生的影响日益增加。探索认知功能损害的治疗方法或危险因素的研究需要了解预期的与年龄相关的衰退情况。
确定一般老年人群中与年龄相关的认知衰退率。
对一般老年人群认知衰退研究的系统评价。使用麦克马斯特病因学、因果关系和危害策略的改编版本以及Cochrane痴呆与认知障碍小组策略对Medline、Embase和PsycINFO数据库进行检索。探索灰色文献并联系专家。在所有阶段都有第二名观察者参与，并对纳入研究进行质量评估。纳入研究为具有代表性的、基于社区的、针对60岁以上人群的队列研究，纳入了患有痴呆症的个体。
识别出5990篇摘要并检索到163篇全文，最终纳入19篇论文。异质性使得叙述性综述成为合适的数据合成方法。所有研究均发现随着年龄增长存在一定程度的认知损害，尽管程度有所不同。认知损害的患病率和衰退率随年龄增加而上升。研究质量参差不齐。
认知衰退在一般老年人群中几乎普遍存在，且随年龄增长而加剧。研究人员与临床医生之间加强沟通，以确定可用于不同人群的核心最小神经心理测试数据集，将有助于支持一致的研究设计和荟萃分析，有助于量化老年人认知衰退的真实发生率，并协助临床实践中的诊断。
