Borges Marcus Kiiti, Canevelli Marco, Cesari Matteo, Aprahamian Ivan
Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Department of Human Neuroscience, Sapienza University, Rome, Italy.
Front Med (Lausanne). 2019 Feb 19;6:26. doi: 10.3389/fmed.2019.00026. eCollection 2019.
Current evidence in the literature supports associations between frailty, cognitive impairment, and dementia. The study aim was to describe the risk of cognitive disorders associated with physical frailty in older adults from community-based studies. We performed a systematic review and meta-analysis, using MEDLINE, PsycINFO, Scopus, and Web of Science as databases for the search. Cohort and longitudinal studies were included in qualitative analysis and quantitative synthesis. For inclusion, studies had to assess dementia and cognitive impairment as a primary or secondary outcome, and describe the prevalence of frailty among participants at baseline and follow-up. Of the 2,210 studies retrieved by the systematic review, 6 relevant studies were included in a meta-analysis. Baseline frailty was significantly associated with an increased risk of geriatric cognitive disorders (pooled OR = 1.80, 95% CI = 1.11-2.92; = 0.02). Heterogeneity across the studies was significant ( = 79%). The analyses confirmed that frail older adults were at higher risk of incident cognitive disorders than non-frail elders. Frailty status seems to be most associated with the risk of incident dementia. Frailty may represent a risk factor for dementia and could constitute a novel modifiable target in early cognitive impairment.
文献中的现有证据支持衰弱、认知障碍和痴呆之间的关联。本研究的目的是通过基于社区的研究来描述老年人身体衰弱与认知障碍相关的风险。我们进行了一项系统综述和荟萃分析，使用MEDLINE、PsycINFO、Scopus和Web of Science作为检索数据库。队列研究和纵向研究纳入定性分析和定量综合分析。纳入的研究必须将痴呆和认知障碍作为主要或次要结局进行评估，并描述基线和随访时参与者中衰弱的患病率。在系统综述检索到的2210项研究中，有6项相关研究纳入了荟萃分析。基线衰弱与老年认知障碍风险增加显著相关（合并OR = 1.80，95%CI = 1.11 - 2.92；P = 0.02）。各研究间的异质性显著（I² = 79%）。分析证实，衰弱的老年人比非衰弱的老年人发生认知障碍的风险更高。衰弱状态似乎与新发痴呆风险最为相关。衰弱可能是痴呆的一个风险因素，并且可能构成早期认知障碍中一个新的可改变的靶点。
