van de Vorst Irene E, Koek Huiberdina L, de Vries Rehana, Bots Michiel L, Reitsma Johannes B, Vaartjes Ilonca
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Geriatrics, University Medical Center Utrecht, Utrecht, the Netherlands.
J Am Geriatr Soc. 2016 Jan;64(1):37-46. doi: 10.1111/jgs.13835. Epub 2015 Dec 21.
To assess the effect of cardiovascular diseases and risk factors on mortality in individuals with dementia.
Systematic review and meta-analysis. English- and Dutch-language studies in PubMed, EMBASE, and PsycINFO databases were searched in April 2014 with hand-searching of in-text citations and no publication limitations. Inclusion criteria were original studies reporting on cardiovascular risk factors or diseases and their relationship with survival in individuals with dementia. The Quality In Prognosis Studies tool was used to appraise all included articles.
Population-, hospital-, and nursing home-based.
Community-dwelling, hospitalized individuals and nursing home residents with dementia.
A random-effects meta-analysis was performed to investigate the effect of several cardiovascular diseases and risk factors on overall mortality.
Twelve studies with 235,865 participants were included. In pooled analyses, male sex (hazard ratio (HR)=1.67, 95% confidence interval (CI)=1.56-1.78), diabetes mellitus (DM) (HR=1.49, 95% CI=1.33-1.68), smoking (ever vs never) (HR=1.37, 95% CI=1.17-1.61), coronary heart disease (CHD) (HR=1.21, 95% CI=1.02-1.44) and congestive heart failure (CHF) (HR=1.37, 95% CI=1.18-1.59) were associated with mortality. Stroke, high blood pressure, being overweight, and hypercholesterolemia were not statistically significantly related to mortality.
Individuals with dementia and DM, smoking, CHD, and CHF have a greater risk of death than individuals with dementia without these risk factors or diseases.
评估心血管疾病及危险因素对痴呆患者死亡率的影响。
系统评价与荟萃分析。2014年4月检索了PubMed、EMBASE和PsycINFO数据库中的英文和荷兰语文献，并对文中引用进行手工检索，无发表限制。纳入标准为报告心血管危险因素或疾病及其与痴呆患者生存关系的原始研究。使用预后研究质量工具对所有纳入文章进行评估。
基于人群、医院和养老院。
社区居住、住院的痴呆患者以及养老院居民。
进行随机效应荟萃分析，以研究几种心血管疾病和危险因素对总死亡率的影响。
纳入12项研究，共235865名参与者。在汇总分析中，男性（风险比（HR）=1.67，95%置信区间（CI）=1.56 - 1.78）、糖尿病（DM）（HR = 1.49，95% CI = 1.33 - 1.68）、吸烟（曾经吸烟与从不吸烟）（HR = 1.37，95% CI = 1.17 - 1.61）、冠心病（CHD）（HR = 1.21，95% CI = 1.02 - 1.44）和充血性心力衰竭（CHF）（HR = 1.37，95% CI = 1.18 - 1.59）与死亡率相关。中风、高血压、超重和高胆固醇血症与死亡率无统计学显著相关性。
患有痴呆且伴有糖尿病、吸烟、冠心病和充血性心力衰竭的患者比没有这些危险因素或疾病的痴呆患者死亡风险更高。
