COVID-19 大流行对无 COVID-19 的痴呆症患者死亡率的影响:系统评价和荟萃分析。
The impact of the COVID-19 pandemic on mortality in people with dementia without COVID-19: a systematic review and meta-analysis.
机构信息
Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
Theme Inflammation and Aging, Karolinska University hospital, Huddinge, Sweden.
出版信息
BMC Geriatr. 2022 Nov 19;22(1):878. doi: 10.1186/s12877-022-03602-6.
INTRODUCTION
Significant mortality amongst vulnerable populations, such as people living with dementia, might go undetected during pandemic conditions due to refocus of care efforts. There is an urgent need to fully evaluate the pandemic impact on mortality amongst people living with dementia in order to facilitate future healthcare reforms and prevent deaths. The purpose of this study was to determine whether there was any significant difference in mortality amongst people with dementia without COVID-19 during the COVID-19 pandemic compared to previous years.
METHODS
A literature search was conducted in 5 databases. The relative risk ratio and confidence interval was used to estimate the change in mortality rates amongst people with dementia during the COVID-19 pandemic. The I value was used to assess heterogeneity, publication bias, and sensitivity analyses were performed.
RESULTS
Pooled analysis of 11 studies showed that mortality amongst people living with dementia was significantly increased during the COVID-19 pandemic for people with dementia without COVID-19. Mortality risk increased by 25% during the time period studied. Subgroup analysis was not performed due the low number of included studies.
CONCLUSIONS
The results of this study suggest that people with dementia had a significant increased mortality during the pandemic even if they did not have COVID-19. People with dementia should participate in efforts that reduce general social spread and pandemic impact on healthcare system such as vaccinations, mask mandates, and testing. These results have clinical implications as preventing direct COVID-19 infection is not enough to adequately protect people living with dementia from increased mortality. Measures to limit social spread of infections and help support patients should also be a focus for clinicians. Further research should focus on the identification of mechanisms and other explanations for increased mortality as well as contributing factors such as living in care homes and differences between countries with various pandemic strategies.
简介
在大流行期间,由于护理工作重点的转移,脆弱人群(如痴呆症患者)的大量死亡可能未被发现。为了促进未来的医疗保健改革和防止死亡,迫切需要全面评估大流行对痴呆症患者死亡率的影响。本研究的目的是确定在 COVID-19 大流行期间,与前几年相比,患有痴呆症但无 COVID-19 的患者的死亡率是否有任何显著差异。
方法
在 5 个数据库中进行了文献检索。使用相对风险比和置信区间来估计 COVID-19 大流行期间痴呆症患者死亡率的变化。使用 I ² 值评估异质性、发表偏倚,并进行敏感性分析。
结果
对 11 项研究的汇总分析表明,在 COVID-19 大流行期间,即使患有痴呆症的人没有 COVID-19,痴呆症患者的死亡率也显著增加。在研究期间,死亡率风险增加了 25%。由于纳入的研究数量较少,因此未进行亚组分析。
结论
这项研究的结果表明,即使没有 COVID-19,痴呆症患者在大流行期间的死亡率也显著增加。痴呆症患者应参与减少一般社会传播和大流行对医疗保健系统的影响的努力,例如接种疫苗、戴口罩和检测。这些结果具有临床意义,因为预防直接的 COVID-19 感染不足以充分保护痴呆症患者免受死亡率增加的影响。限制感染的社会传播并帮助支持患者的措施也应成为临床医生的关注焦点。进一步的研究应集中在确定机制和其他导致死亡率增加的解释以及居住在护理院和各国大流行策略差异等因素上。
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