School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; Monash University, Centre for Medicine Use and Safety, Victoria, Australia.
J Am Med Dir Assoc. 2022 Nov;23(11):1807-1814. doi: 10.1016/j.jamda.2022.01.084. Epub 2022 Mar 10.
To investigate the prevalence of frailty in older adults living with dementia and explore the differences in medication use according to frailty status.
Systematic review of published literature from inception to August 20, 2020.
Adults age ≥65 years living with dementia in acute-care, community and residential care settings.
A systematic search was performed in Embase, Medline, International Pharmaceutical Abstracts, APA PscyInfo, CINAHL, Scopus, and Web of Science. Two reviewers independently screened records and conducted quality assessment using the Newcastle-Ottawa Scale.
Sixteen articles met the inclusion criteria, with 7 studies conducted in acute care setting and 9 studies in community-dwelling adults. Five studies recruited people with dementia exclusively, and 11 studies were conducted in older populations that included individuals with dementia diagnosis. Among studies conducted in acute care setting, the prevalence of frailty ranged from 50.8% to 91.8% compared with studies in community-dwelling setting, which reported a prevalence of 24.3% to 98.9%. With respect to medication exposure, 3 studies documented medication use according to frailty status but not dementia status. Higher medications use, measured as total number of medications was reported in frail [7.0 ± 4.0 (SD) -12.0 ± 9.0 (SD)] compared with nonfrail participants [6.1 ± 3.1(SD) -10.4 ± 3.8 (SD)].
Current data suggests a wide range of frailty prevalence in individuals with dementia. Future studies should systematically document frailty in adults living with dementia and its impact on medication use.
调查患有痴呆症的老年人中衰弱的流行情况，并探讨根据衰弱状况药物使用的差异。
对 2020 年 8 月 20 日前发表的文献进行系统综述。
年龄≥65 岁、居住在急性护理、社区和居住护理环境中的痴呆症成年人。
在 Embase、Medline、国际药学文摘、APA PscyInfo、CINAHL、Scopus 和 Web of Science 中进行系统检索。两名审查员独立筛选记录，并使用纽卡斯尔-渥太华量表进行质量评估。
16 篇文章符合纳入标准，其中 7 项研究在急性护理环境中进行，9 项研究在社区居住的成年人中进行。5 项研究专门招募了痴呆症患者，11 项研究在包括痴呆症诊断在内的老年人群中进行。在急性护理环境中进行的研究中，衰弱的患病率从 50.8%到 91.8%不等，而在社区居住环境中进行的研究报告的患病率从 24.3%到 98.9%不等。关于药物暴露，有 3 项研究根据衰弱状况而不是痴呆症状况记录了药物使用情况。在虚弱组中，药物使用量（以服用药物的总数衡量）较高[7.0±4.0（SD）-12.0±9.0（SD）]，而非虚弱组中，药物使用量（以服用药物的总数衡量）较低[6.1±3.1（SD）-10.4±3.8（SD）]。
目前的数据表明，痴呆症患者的衰弱患病率差异很大。未来的研究应系统地记录患有痴呆症的成年人的衰弱情况及其对药物使用的影响。
