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精神障碍与痴呆症之间关联的系统评价:系统评价与荟萃分析的伞状综述

Systematic evaluation of the associations between mental disorders and dementia: An umbrella review of systematic reviews and meta-analyses.

作者信息

Zhao Qin, Xiang Hongyu, Cai Yan, Meng Steven Siyao, Zhang Yunyang, Qiu Peiyuan

机构信息

West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

School of Public Health, Sun Yat-sen University, Guangzhou, China.

出版信息

J Affect Disord. 2022 Jun 15;307:301-309. doi: 10.1016/j.jad.2022.03.010. Epub 2022 Mar 10.

Abstract

BACKGROUND

Increasing evidence support the correlation between mental disorders and the likelihood of developing dementia. We aim to conduct an umbrella review to assess the risk of dementia in patients with eight mental disorders.

METHODS

We searched PubMed, Embase, Web of science, CNKI, VIP, and Wanfang databases from inception to October 29, 2021. For each included meta-analysis, the effect size with a 95% confidence interval was estimated using either a random effect model or a fixed effect model, and between-study heterogeneity was expressed by I and Cochran's Q test. The ROBIS tool was used to assess the risk of bias.

RESULTS

A total of ten systematic reviews were included. Among these studies, we identified seven risk factors, including anxiety disorder, bipolar disorder, depression, late-life depression, post-traumatic stress disorder, schizophrenia, and sleep disorder. Light to moderate alcohol drinking was identified as a protective factor. The evaluation results of the ROBIS tool showed that nine systematic reviews had high risk of bias and one had low risk of bias. The strength of evidence supporting the associations between late-life depression and all-cause dementia, Alzheimer's disease, and vascular dementia was high; the strength of evidence supporting the association between depression and all-cause dementia was moderate.

LIMITATIONS

Most associations had low strength of evidence and high risk of bias.

CONCLUSIONS

This umbrella review shows that high and moderate evidence supports the associations between some mental disorders and dementia. More cohort studies are needed to support the associations between mental disorders and dementia.

摘要

背景

越来越多的证据支持精神障碍与患痴呆症可能性之间的关联。我们旨在进行一项综合综述,以评估八种精神障碍患者患痴呆症的风险。

方法

我们检索了从数据库建立至2021年10月29日的PubMed、Embase、Web of science、中国知网、维普和万方数据库。对于每项纳入的荟萃分析,使用随机效应模型或固定效应模型估计效应量及95%置信区间,并通过I²和 Cochr an Q检验表示研究间异质性。使用ROBIS工具评估偏倚风险。

结果

共纳入十项系统评价。在这些研究中,我们确定了七个风险因素,包括焦虑症、双相情感障碍、抑郁症、老年期抑郁症、创伤后应激障碍、精神分裂症和睡眠障碍。轻度至中度饮酒被确定为保护因素。ROBIS工具的评估结果显示,九项系统评价存在高偏倚风险,一项存在低偏倚风险。支持老年期抑郁症与全因性痴呆、阿尔茨海默病和血管性痴呆之间关联的证据强度高;支持抑郁症与全因性痴呆之间关联的证据强度为中等。

局限性

大多数关联的证据强度低且偏倚风险高。

结论

这项综合综述表明,高和中等强度的证据支持某些精神障碍与痴呆症之间的关联。需要更多队列研究来支持精神障碍与痴呆症之间的关联。

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