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认知衰弱作为老年人痴呆症的预测指标:一项系统评价与荟萃分析。

Cognitive frailty as a predictor of dementia among older adults: A systematic review and meta-analysis.

作者信息

Zheng Lufang, Li Guichen, Gao Dawei, Wang Shuo, Meng Xiangfei, Wang Cong, Yuan Haibo, Chen Li

机构信息

School of Nursing, Jilin University, Changchun, China.

School of Mechanical and Aerospace Engineering, Jilin University, Changchun, China.

出版信息

Arch Gerontol Geriatr. 2020 Mar-Apr;87:103997. doi: 10.1016/j.archger.2019.103997. Epub 2019 Dec 10.

Abstract

OBJECTIVE

The aim of this systematic review and meta-analysis was to synthesize the pooled risk effect and to determine whether cognitive frailty is a predictor of dementia among older adults.

DESIGN

Systematic review and meta-analysis.

SETTING AND PARTICIPANTS

PubMed, EMBASE, Web of Science, and the Cochrane Library were systematically searched until June 5, 2019. Only cohort studies and population-based longitudinal studies published in English were eligible. Study selection, data extraction and quality assessment of including studies were independently completed by two researchers. A fixed-effects model was used to synthesize the risk of baseline cognitive frailty on dementia in the older adults compared with older adults without cognitive frailty.

MEASUREMENTS

The risk of cognitive frailty on incident dementia.

RESULTS

Of the 1566 identified records, 7 studies met the inclusion criteria and were included in the review. And 4 studies reporting hazard ratio (HR) of incident dementia for cognitive frailty were included in the meta-analysis. Synthesized results showed that baseline cognitive frailty in the elderly was significantly associated with an increased risk of developing dementia as compared with those without cognitive frailty (prefrailty + CI model: pooled HR = 3.99, 95 %CI = 2.94-5.43, p < 0.00001, I = 31 %; frailty + CI model: pooled HR = 5.58, 95 %CI = 3.17-9.85, p < 0.00001, I = 0 %). Heterogeneity across the studies was low.

CONCLUSION

Cognitive frailty is a significant predictor of dementia. Cognitive frailty status may be a novel modifiable target in identification of early signs before dementia.

摘要

目的

本系统评价和荟萃分析旨在综合汇总风险效应,并确定认知衰弱是否为老年人痴呆症的预测指标。

设计

系统评价和荟萃分析。

设置与参与者

系统检索了PubMed、EMBASE、科学网和考克兰图书馆,检索截至2019年6月5日。仅纳入以英文发表的队列研究和基于人群的纵向研究。两名研究人员独立完成纳入研究的筛选、数据提取和质量评估。采用固定效应模型综合分析老年人中基线认知衰弱与无认知衰弱老年人相比患痴呆症的风险。

测量指标

认知衰弱对新发痴呆症的风险。

结果

在1566条检索到的记录中,7项研究符合纳入标准并被纳入本评价。荟萃分析纳入了4项报告认知衰弱对新发痴呆症风险比(HR)的研究。综合结果显示,与无认知衰弱的老年人相比,老年人的基线认知衰弱与患痴呆症风险增加显著相关(pre衰弱+CI模型:合并HR =3.99,95%CI =2.94-5.43, p<0.00001, I=31%;衰弱+CI模型:合并HR =5.58,95%CI =3.17-9.85, p<0.00001, I=0%)。各研究间异质性较低。

结论

认知衰弱是痴呆症显著的预测指标。认知衰弱状态可能是痴呆症早期体征识别中的一个新的可改变的靶点。

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