Department of Anthropology, University of Washington, Seattle, Washington 98195, USA.
J Am Geriatr Soc. 2012 Mar;60(3):413-9. doi: 10.1111/j.1532-5415.2011.03847.x. Epub 2012 Jan 30.
To evaluate exclusion of persons with cognitive impairment from research in geriatrics by determining its frequency, method, and rationale and treatment in the resulting publications.
All original research articles published in 2008 and 2009 in the Journal of the American Geriatrics Society (n = 434) were reviewed using a structured data collection tool.
The Journal of the American Geriatrics Society.
There were no participants in this study.
Data captured included recruitment method, explicit criterion for exclusion of persons with cognitive impairment, justification of exclusion criterion, reason given for exclusion, percentage of individuals excluded, and mention of exclusion as a possible limitation.
Of 434 articles examined, 16% used recruitment methods likely to reduce participation by persons with cognitive impairment. At least 29% of studies (n = 127) employed explicit exclusion criteria. Half used the Folstein Mini-Mental State Examination (MMSE), with variable cut points (10, 12, 17, 18, 23, 26), and 19% excluded individuals for "having dementia" without specifying how this was determined. Few (6%) provided any justification for exclusion criteria used, only 43% gave any reason for exclusion, and only 14% discussed exclusion as a possible limitation.
Persons with cognitive impairment are frequently excluded from research, often without rationale or mention of exclusion as a limitation or any discussion of its potential effect on the evidence base in geriatrics. When necessary, exclusion should be done thoughtfully and with awareness that this may reduce the clinical utility of study findings.
通过确定 2008 年和 2009 年《美国老年医学会杂志》（JAGS）中发表的所有原始研究文章中认知障碍患者被排除在老年医学研究之外的频率、方法和理由以及处理方法，来评估这种情况。
使用结构化数据收集工具对 2008 年和 2009 年《美国老年医学会杂志》（JAGS）中发表的所有原始研究文章进行了回顾。
《美国老年医学会杂志》。
本研究无参与者。
捕获的数据包括招募方法、明确排除认知障碍患者的标准、排除标准的理由、排除的理由、排除的人数百分比以及将排除作为可能的限制提及。
在检查的 434 篇文章中，有 16%的文章使用了可能减少认知障碍患者参与的招募方法。至少 29%的研究（n=127）采用了明确的排除标准。一半使用了 Folstein 简易精神状态检查（MMSE），其切点值不同（10、12、17、18、23、26），19%的人因“患有痴呆症”而排除在外，而没有具体说明如何确定这一点。很少有（6%）对使用的排除标准提供任何理由，只有 43%给出了排除的理由，只有 14%讨论了排除作为一种可能的局限性。
认知障碍患者经常被排除在研究之外，通常没有理由或没有提及将其排除作为一种局限性，也没有讨论其对老年医学证据基础的潜在影响。在必要时，应慎重考虑排除，因为这可能会降低研究结果的临床实用性。
