诊断后路易体痴呆和阿尔茨海默病的生存时间和差异：纵向研究的荟萃分析。

Survival time and differences between dementia with Lewy bodies and Alzheimer's disease following diagnosis: A meta-analysis of longitudinal studies.

机构信息

King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; South London and Maudsley NHS Foundation Trust, London, UK.

King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.

出版信息

Ageing Res Rev. 2019 Mar;50:72-80. doi: 10.1016/j.arr.2019.01.005. Epub 2019 Jan 6.

DOI:10.1016/j.arr.2019.01.005

PMID:30625375

Abstract

OBJECTIVE

To synthesize the evidence across longitudinal studies comparing survival in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).

METHODS

We conducted a systematic review and meta-analysis of studies comparing survival in clinically diagnosed DLB to AD. Longitudinal cohort studies were identified through a systematic search of major electronic databases from inception to May 2018. A random effects meta-analysis was performed to calculate survival time and relative risk of death.

RESULTS

Overall, 11 studies were identified including 22,952 patients with dementia: 2029 with DLB (mean diagnosis age 76.3; 47% female) compared with 20,923 with AD (mean diagnosis age 77.2; 65.1% female). Average survival time in DLB from diagnosis was 4.11 years (SD ± 4.10) and in AD 5.66 (SD ± 5.32) years, equating to a 1.60 (95% CI: -2.44 to -0.77) years shorter survival in DLB (p < 0.01). Relative risk of death was increased by 1.35 (95%CI: 1.17-1.55) in DLB compared to AD (p < 0.01). Differences in survival were not explained by follow-up time, age at diagnosis, gender, or cognitive score.

CONCLUSIONS

There is consistent evidence for higher and earlier mortality in DLB compared to AD. This is important for all stakeholders and underlines the importance of expanding research into DLB.

摘要

目的

综合比较路易体痴呆症 (DLB) 和阿尔茨海默病 (AD) 患者生存情况的纵向研究证据。

方法

我们系统地检索了从建立到 2018 年 5 月的主要电子数据库，以确定比较临床诊断的 DLB 与 AD 患者生存情况的纵向队列研究。采用随机效应荟萃分析计算生存时间和死亡相对风险。

结果

共确定了 11 项研究，包括 22952 例痴呆症患者：2029 例 DLB（平均诊断年龄 76.3 岁；47%为女性）与 20923 例 AD（平均诊断年龄 77.2 岁；65.1%为女性）相比。DLB 从诊断到平均生存时间为 4.11 年（标准差±4.10），AD 为 5.66 年（标准差±5.32），相当于 DLB 患者的生存时间缩短了 1.60 年（95%CI：-2.44 至-0.77）（p<0.01）。与 AD 相比，DLB 死亡的相对风险增加了 1.35（95%CI：1.17-1.55）（p<0.01）。生存差异不能用随访时间、诊断时的年龄、性别或认知评分来解释。