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视力障碍是否是老年人脆弱的危险因素?10 年临床研究的系统回顾和荟萃分析。

Is the visual impairment a risk factor for frailty in older adults? A systematic review and meta-analysis of 10-year clinical studies.

机构信息

Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy.

Catholic University "Sacro Cuore", Rome, Italy.

出版信息

Aging Clin Exp Res. 2023 Feb;35(2):227-244. doi: 10.1007/s40520-022-02296-5. Epub 2022 Nov 11.

Abstract

BACKGROUND

Frailty is linked to poor health outcomes later in life. Recent research suggests that visual loss is a possible modifiable risk factor for frailty.

AIMS

To analyze the relationship between visual impairment (VI) and frailty and investigate whether it can increase the risk of frailty in older adults.

METHODS

We performed a systematic review and meta-analysis of cohort studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We systematically searched PubMed, Embase, and Scopus databases for relevant studies published between 2012 and 2022 that clearly described VI and frailty measurement methods. Cross-sectional and longitudinal studies that examined the associations between VI and the existence of frailty in adults aged 65 years or older were synthesized. Meta-analyses were conducted using the measurement of risk and a 95% confidence interval for each study. Quality assessment using the Newcastle-Ottawa Scale (NOS), risk of bias, heterogeneity, and sensitivity analyses were also conducted.

RESULTS

Our search identified 1074 manuscripts published in the English language between 1 January 2012 and 9 June 2022. After studies screening, seventeen articles, including 22,192 participants and 3624 cases of frailty, were selected. A random-effect meta-analysis demonstrated a significant association between visual impairment and the risk of frailty (OR 2.13; 95% CI 1.67-2.72). The quality rating of the cross-sectional studies averaged 8.33 (95% CI 7.77-8.89) of the maximum score on the NOS.

CONCLUSIONS

Visual impairment increases the risk of frailty in later life and should be accurately assessed in frail older adults.

摘要

背景

虚弱与晚年健康状况不佳有关。最近的研究表明,视力丧失可能是导致虚弱的一个可改变的危险因素。

目的

分析视力障碍(VI)与虚弱之间的关系,并探讨其是否会增加老年人虚弱的风险。

方法

我们按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行了系统的文献回顾和荟萃分析。我们系统地检索了 PubMed、Embase 和 Scopus 数据库,以获取 2012 年至 2022 年期间发表的明确描述 VI 和虚弱测量方法的相关研究。综合了横断面和纵向研究,这些研究检查了 VI 与 65 岁或以上成年人虚弱状态之间的关联。使用每项研究的风险测量和 95%置信区间进行荟萃分析。还进行了质量评估,使用纽卡斯尔-渥太华量表(NOS)、偏倚风险、异质性和敏感性分析。

结果

我们的搜索共确定了 2012 年 1 月 1 日至 2022 年 6 月 9 日期间以英文发表的 1074 篇手稿。经过研究筛选,有 17 篇文章,包括 22192 名参与者和 3624 例虚弱病例,被选中。一项随机效应荟萃分析表明,视力障碍与虚弱风险之间存在显著关联(OR 2.13;95%CI 1.67-2.72)。横断面研究的质量评分平均为 NOS 最高得分的 8.33(95%CI 7.77-8.89)。

结论

视力障碍会增加晚年虚弱的风险,因此应在虚弱的老年患者中准确评估视力。

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