Gillis Cai, Mirzaei Fariba, Potashman Michele, Ikram M Arfan, Maserejian Nancy
Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Biogen, Cambridge, MA, USA.
Alzheimers Dement (Amst). 2019 Mar 8;11:248-256. doi: 10.1016/j.dadm.2019.01.004. eCollection 2019 Dec.
Incidence estimates of mild cognitive impairment (MCI) range widely. We obtained contemporary age-specific MCI incidence rates and examined sources of heterogeneity.
We conducted a systematic review of population-based studies from the Americas, Europe, and Australia using restrictive inclusion criteria to limit heterogeneity. Incidence was examined using 5-year age categories for MCI and amnestic/nonamnestic subtypes. Data were synthesized using quantitative and qualitative descriptive analyses and quantitative meta-analyses.
Meta-analysis estimates (95% CI) of MCI incidence per 1000 person-years were 22.5 (5.1-51.4) for ages 75-79y, 40.9 (7.7-97.5) for ages 80-84y, and 60.1 (6.7-159.0) for ages 85+y. Despite restrictive inclusion criteria, considerable heterogeneity (measured by I) remained. Meta-analysis findings and simple descriptive statistics were consistent and supported by qualitative review.
Heterogeneity in MCI incidence estimates persisted across age-specific estimates from population samples, likely reflecting differences in populations and methods. Incidence rate ranges are important to consider with summary point estimates.
轻度认知障碍(MCI)的发病率估计范围广泛。我们获取了当代特定年龄的MCI发病率,并研究了异质性来源。
我们对来自美洲、欧洲和澳大利亚的基于人群的研究进行了系统评价,使用严格的纳入标准来限制异质性。使用5岁年龄组对MCI及其遗忘型/非遗忘型亚型的发病率进行研究。数据采用定量和定性描述性分析以及定量荟萃分析进行综合。
每1000人年的MCI发病率的荟萃分析估计值(95%CI),75 - 79岁为22.5(5.1 - 51.4),80 - 84岁为40.9(7.7 - 97.5),85岁及以上为60.1(6.7 - 159.0)。尽管纳入标准严格,但仍存在相当大的异质性(用I衡量)。荟萃分析结果和简单描述性统计结果一致,并得到定性评价的支持。
在人群样本中,MCI发病率估计的异质性在各特定年龄估计中持续存在,这可能反映了人群和方法的差异。在考虑汇总点估计值时,发病率范围很重要。