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55 岁及以上社区居住的中国人中轻度认知障碍的患病率:荟萃分析和系统评价。

Prevalence of mild cognitive impairment in community-dwelling Chinese populations aged over 55 years: a meta-analysis and systematic review.

机构信息

Department of General Practice, Yangpu hospital, Tongji University School of Medicine, Shanghai, 200090, China.

School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia.

出版信息

BMC Geriatr. 2021 Jan 6;21(1):10. doi: 10.1186/s12877-020-01948-3.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review.

METHODS

The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses.

RESULTS

A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6, 14.2%] for MCI and 10.9% [95% CI, 7.7, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association's Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer's Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others.

CONCLUSION

Higher MCI prevalence was identified in community-dwelling older adult populations in China compared with some other countries, possibly due to more broadened criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019134686.

摘要

背景

轻度认知障碍(MCI)是正常认知老化和明显痴呆之间的中间阶段,其中以遗忘型 MCI(aMCI)为主要亚型。本研究旨在通过荟萃分析和系统评价综合中国社区人群 MCI 和 aMCI 的患病率结果。

方法

本研究遵循系统评价和荟萃分析的 Preferred Reporting Items(PRISMA)协议。从 10 个电子文献数据库中检索了 2020 年 3 月 1 日前发表的英文和中文研究。两位审查员根据预先确定的纳入和排除标准筛选研究的相关性,并独立使用风险偏倚工具评估纳入研究的质量。采用随机效应模型估计 MCI 和 aMCI 的患病率,然后进行亚组分析和荟萃回归。进行敏感性和发表偏倚检验以验证荟萃分析的稳健性。

结果

共有 41 项研究,涉及 112632 名参与者被纳入荟萃分析。中国 55 岁以上的社区人群 MCI 的总患病率为 12.2%(95%置信区间:10.6%,14.2%),aMCI 的患病率为 10.9%(95%置信区间:7.7%,15.4%)。MCI 的患病率随年龄增长而增加。美国精神病学会的诊断工具(DSM-IV)产生的 MCI 患病率最高(13.5%),其次是彼森标准(12.9%)和美国国立老化研究所-阿尔茨海默病协会(NIA-AA)标准(10.3%)。女性、农村居民、独居者和受教育程度较低者的 MCI 患病率高于其他人群。

结论

与其他一些国家相比,中国社区老年人的 MCI 患病率较高,这可能是由于采用了更广泛的标准来确认诊断。该研究表明,aMCI 占 MCI 的 66.5%,与其他地方的研究结果一致。

系统评价注册编号

PROSPERO CRD42019134686。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c336/7789349/f4080fa80c30/12877_2020_1948_Fig1_HTML.jpg

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