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营养补充剂对痴呆患者神经精神症状的影响:系统评价和荟萃分析。

Nutritional supplements for neuropsychiatric symptoms in people with dementia: A systematic review and meta-analysis.

机构信息

Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.

Neurologisches Rehabilitationszentrum Rosenhügel, Vienna, Austria.

出版信息

Int J Geriatr Psychiatry. 2020 Nov;35(11):1285-1291. doi: 10.1002/gps.5407. Epub 2020 Aug 28.

Abstract

UNLABELLED

The aim of the present study was to assess the effects of nutritional supplementation on neuropsychiatric symptoms among people with dementia.

METHODS/DESIGN: Randomized controlled trials (RCTs) were searched in the Databases PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov from inception until January 31, 2020. Studies of RCTs carried out on people with any type of dementia who were taking nutritional supplements and had neuropsychiatric symptoms were included in this systematic review and meta-analysis. Neuropsychiatric symptoms were assessed with the validated Neuropsychiatric Inventory (NPI). Effect sizes were calculated with standardized mean differences (SMD) and 95% confidence intervals (95%CI), applying a random effect model.

RESULTS

The search yielded 1034 studies with four studies being included in the meta-analysis with a total of 377 people with dementia (mean age 69.3 [SD: 7.7] years). The diagnoses comprised mild to late Alzheimer's disease and frontotemporal dementia. Two studies included a multicomponent supplementation, one an omega-3, and one a special supplement tailored for cognitive impairment. The median follow-up was 18 weeks, with a range from 12 to 24 weeks. Pooled data showed that nutritional supplementation did not improve NPI (SMD = -0.33; [95%CI: -0.74 to 0.08]; P = 0.11; I = 45%).

CONCLUSIONS

The findings of this meta-analysis demonstrated no significant impact on NPI through nutritional supplementation. However, the generalization of the results is limited, as different supplements were used in different stages of dementia with a short follow-up time.

摘要

目的

本研究旨在评估营养补充对痴呆患者神经精神症状的影响。

方法/设计:从建库起至 2020 年 1 月 31 日,我们在数据库 PubMed、EMBASE、SCOPUS、Cochrane 对照试验中心注册库和 Clinicaltrials.gov 中搜索了随机对照试验(RCT)。本系统评价和荟萃分析纳入了针对任何类型痴呆患者、服用营养补充剂且有神经精神症状的 RCT 研究。神经精神症状采用经验证的神经精神问卷(NPI)进行评估。采用标准化均数差(SMD)和 95%置信区间(95%CI)计算效应量,应用随机效应模型。

结果

检索得到 1034 项研究,其中 4 项研究纳入荟萃分析,共纳入 377 例痴呆患者(平均年龄 69.3[SD:7.7]岁)。诊断包括轻度至晚期阿尔茨海默病和额颞叶痴呆。两项研究包含多种成分的补充剂,一项研究包含欧米伽 3,一项研究包含针对认知障碍的特殊补充剂。中位随访时间为 18 周,范围为 12 至 24 周。汇总数据显示,营养补充并未改善 NPI(SMD=-0.33;95%CI:-0.74 至 0.08;P=0.11;I=45%)。

结论

本荟萃分析的结果表明,营养补充对 NPI 没有显著影响。然而,由于在痴呆的不同阶段使用了不同的补充剂且随访时间较短,因此结果的推广受到限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7136/7692950/cb1673225bd0/GPS-35-1285-g001.jpg

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