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慢性阻塞性肺疾病与轻度认知障碍及痴呆风险的关联:一项系统综述和荟萃分析。

Association of chronic obstructive pulmonary disease with mild cognitive impairment and dementia risk: A systematic review and meta-analysis.

作者信息

Zhao Li-Ying, Zhou Xue-Lai

机构信息

Department of Geriatrics, Traditional Chinese Medical Hospital of Zhuji, Zhuji 311800, Zhejiang Province, China.

Department of Respiratory Medicine, Traditional Chinese Medical Hospital of Zhuji, Zhuji 311800, Zhejiang Province, China.

出版信息

World J Clin Cases. 2022 Apr 16;10(11):3449-3460. doi: 10.12998/wjcc.v10.i11.3449.

Abstract

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a common public health issue that has been linked to cognitive dysfunction.

AIM

To investigate the relationship between COPD and a risk of mild cognitive impairment (MCI) and dementia.

METHODS

A comprehensive literature search of the PubMed, Embase, Google Scholar, and Cochrane Library electronic databases was conducted. Pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CIs) were calculated using a random or fixed effects model. Studies that met the inclusion criteria were assessed for quality using the Newcastle Ottawa Scale.

RESULTS

Twenty-seven studies met all the inclusion criteria. Meta-analysis yielded a strong association between COPD and increased risk of MCI incidence (OR = 2.11, 95%CI: 1.32-3.38). It also revealed a borderline trend for an increased dementia risk in COPD patients (OR = 1.16, 95%CI: 0.98-1.37). Pooled hazard ratios (HR) using adjusted confounders also showed a higher incidence of MCI (HR = 1.22, 95%CI: -1.18 to -1.27) and dementia (HR = 1.32, 95%CI: -1.22 to -1.43) in COPD patients. A significant lower mini-mental state examination score in COPD patients was noted (MD = -1.68, 95%CI: -2.66 to -0.71).

CONCLUSION

Our findings revealed an elevated risk for the occurrence of MCI and dementia in COPD patients. Proper clinical management and attention are required to prevent and control MCI and dementia incidence in COPD patients.

摘要

背景

慢性阻塞性肺疾病(COPD)是一个常见的公共卫生问题,已被证实与认知功能障碍有关。

目的

探讨慢性阻塞性肺疾病(COPD)与轻度认知障碍(MCI)及痴呆风险之间的关系。

方法

对PubMed、Embase、谷歌学术和考克兰图书馆电子数据库进行全面的文献检索。采用随机或固定效应模型计算合并比值比(OR)和平均差(MD)及其95%置信区间(CI)。使用纽卡斯尔渥太华量表对符合纳入标准的研究进行质量评估。

结果

27项研究符合所有纳入标准。荟萃分析显示,慢性阻塞性肺疾病(COPD)与轻度认知障碍(MCI)发病率增加之间存在强关联(OR = 2.11,95%CI:1.32 - 3.38)。分析还显示,慢性阻塞性肺疾病(COPD)患者患痴呆症的风险有边缘性增加趋势(OR = 1.16,95%CI:0.98 - 1.37)。使用调整混杂因素后的合并风险比(HR)也显示,慢性阻塞性肺疾病(COPD)患者中轻度认知障碍(MCI)(HR = 1.22,95%CI:-1.18至-1.27)和痴呆症(HR = 1.32,95%CI:-1.22至-1.43)的发病率更高。慢性阻塞性肺疾病(COPD)患者的简易精神状态检查表得分显著较低(MD = -1.68,95%CI:-2.66至-0.71)。

结论

我们的研究结果显示,慢性阻塞性肺疾病(COPD)患者发生轻度认知障碍(MCI)和痴呆症的风险升高。需要采取适当的临床管理和关注措施,以预防和控制慢性阻塞性肺疾病(COPD)患者中轻度认知障碍(MCI)和痴呆症的发病率。

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