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老年人高胆固醇血症的管理:近期证据的范围综述

Hypercholesterolemia Management in Older Adults: A Scoping Review of Recent Evidence.

作者信息

Buck Harleah G, Mcghee Stephen, Polo Randall L, Zambroski Cheryl

出版信息

J Gerontol Nurs. 2019 Mar 1;45(3):31-42. doi: 10.3928/00989134-20190211-04.

Abstract

Given the high co-occurrence of age and hypercholesterolemia, there is a critical need for age-appropriate evidence for achieving normal cholesterol levels. The purpose of the current review was to map recent evidence (i.e., past 5 years) on hypercholesterolemia management in older adults and identify gaps in the evidence. Electronic searches in PubMed, CINAHL, and Scopus were conducted. Inclusion criteria were age 65 or older and lipid panel outcome. Exclusion criteria were a mixed age sample and familial hypercholesterolemia. An initial pool of 3,176 unique records resulted in 26 articles that met inclusion criteria. Arksey and O'Malley's scoping study framework was used. Sample sizes ranged from 12 to 1,010 (N = 8,509) adults ages 65 to 96. Evidence supports the use of exercise, diet, and statins in older adults. Laboratory, intervention, and methodological gaps were identified. Much remains to be examined in safely managing older adults with hypercholesterolemia, including determining time to behavior change in nonpharmacological interventions and contextual factors influencing adherence. [Journal of Gerontological Nursing, 45(3), 31-42.].

摘要

鉴于年龄与高胆固醇血症的高共现率,迫切需要有适合不同年龄段的证据来实现正常的胆固醇水平。本综述的目的是梳理近期(即过去5年)关于老年人高胆固醇血症管理的证据,并找出证据中的空白。我们在PubMed、CINAHL和Scopus数据库中进行了电子检索。纳入标准为年龄65岁及以上且有血脂检查结果。排除标准为年龄混合样本和家族性高胆固醇血症。初步筛选出的3176条独特记录最终得到26篇符合纳入标准的文章。我们采用了阿克西和奥马利的范围界定研究框架。样本量从12人到1010人不等(N = 8509),年龄在65岁至96岁之间。有证据支持在老年人中使用运动、饮食和他汀类药物。我们还发现了实验室、干预措施和方法学方面的空白。在安全管理高胆固醇血症老年人方面仍有许多问题有待研究,包括确定非药物干预中行为改变的时间以及影响依从性的背景因素。[《老年护理杂志》,45(3),31 - 42。]

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