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临床和社区人群中轻度认知障碍的患病率和进展:系统评价和荟萃分析。

The prevalence and progression of mild cognitive impairment among clinic and community populations: a systematic review and meta-analysis.

机构信息

Pudong New District Mental Health Center,Shanghai,China.

Pudong New District Health Bureau,Shanghai,China.

出版信息

Int Psychogeriatr. 2017 Oct;29(10):1595-1608. doi: 10.1017/S1041610217000473.

Abstract

BACKGROUND

It has been reported that up to 42% of the population aged over 60 are affected by mild cognitive impairment (MCI) worldwide. This study aims to investigate the prevalence and progression of MCI through a meta-analysis.

METHODS

We searched Embase and PubMed for relevant literature. Stable disease rate (SR), reversion rate (RR), dementia rate (DR), and Alzheimer's disease rate (AR) were used to evaluate the progression of MCI. The prevalence and progression rates were both obtained by reported percentile and indirect data analysis. Additionally, we carried out sensitivity analysis of each index by excluding some studies due to influence analysis with the most publication bias.

RESULTS

Effect size (ES) was used to present adjusted overall prevalence (16%) and progression rates including SR (45%), RR (15%), DR (34%), and AR (28%) of MCI. Compared with clinic-based outcomes, MCI prevalence, SR, and RR are significantly higher in community, while DR and AR are lower. Despite significant heterogeneity found among the studies, no publication bias was observed.

CONCLUSIONS

Age and gender were observed to be associated with MCI, in which age was considered as an impact factor for DR. The strong heterogeneity may result from variations in study design and baselines. Standardized MCI criteria were suggested to systematically evaluate MCI in the future.

摘要

背景

据报道,全球 60 岁以上人群中有高达 42%的人患有轻度认知障碍(MCI)。本研究旨在通过荟萃分析来研究 MCI 的患病率和进展情况。

方法

我们在 Embase 和 PubMed 中搜索相关文献。采用稳定疾病率(SR)、逆转率(RR)、痴呆率(DR)和阿尔茨海默病率(AR)来评估 MCI 的进展情况。患病率和进展率均通过报告百分位数和间接数据分析获得。此外,我们还通过排除一些因影响分析而存在最大发表偏倚的研究来对每个指标进行敏感性分析。

结果

采用效应量(ES)来表示 MCI 的调整后总体患病率(16%)和进展率,包括 SR(45%)、RR(15%)、DR(34%)和 AR(28%)。与基于诊所的结果相比,社区中 MCI 的患病率、SR 和 RR 明显更高,而 DR 和 AR 则较低。尽管研究之间存在显著的异质性,但未发现发表偏倚。

结论

年龄和性别与 MCI 有关,其中年龄被认为是 DR 的影响因素。强烈的异质性可能是由于研究设计和基线的差异所致。建议未来采用标准化的 MCI 标准来系统地评估 MCI。

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