Kruse Clemens Scott, Mileski Michael E, Wilkinson Reagan, Hock Britney, Samson Roger, Castillo Taylor
School of Health Administration, Texas State University, San Marcos, TX 78666, USA.
Healthcare (Basel). 2023 Nov 21;11(23):3013. doi: 10.3390/healthcare11233013.
About 50 million people worldwide suffered from dementia in 2018-two-thirds of those with Alzheimer's disease (AD). By 2050, this number is expected to rise to 152 million-which is slightly larger than the country of Russia. About 90% of these people are over the age of 65, but early-onset dementia can occur at younger ages. Early detection is imperative to expedient treatment, which can improve outcomes over the span of diagnosis.
To conduct a meta-analysis of similar studies along with a systematic literature review to hasten the development of clinical practice guidelines to assist clinicians in the diagnosis of AD. We analyzed data points in each article published over the last 10 years to meet this objective: cost, efficiency, accuracy, acceptability (by physician and patient), patient satisfaction, and barriers to adoption.
Four research databases were queried (PubMed, CINAHL Ultimate, Web of Science, and ScienceDirect). The review was conducted in accordance with a published protocol, the Kruse Protocol, and reported in accordance with PRISMA (2020).
Ten interventions were identified to help diagnose AD among older patients, and some involved a combination of methods (such as MRI and PET). The average sample size was 320.32 (SD = 437.51). These 10 interventions were identified as accurate, non-invasive, non-stressful, inexpensive, convenient, and rapid. Only one intervention was identified as statistically ineffective, and this same intervention was used effectively in other studies. The barriers identified were cost, training, expense of travel, and required physical presence of patient. The weighted average sensitivity was 85.16%, specificity was 88.53, and the weighted average effect size was 0.7339 (medium).
Innovation can accurately diagnose AD, but not all methods are successful. Providers must ensure they have the proper training and familiarity with these interventions to ensure accuracy in diagnosis. While the physical presence of the patient is often required, many interventions are non-invasive, non-stressful, and relatively inexpensive.
2018年，全球约有5000万人患有痴呆症，其中三分之二为阿尔茨海默病（AD）患者。到2050年，这一数字预计将增至1.52亿，略大于俄罗斯的人口数量。这些患者中约90%年龄在65岁以上，但早发性痴呆也可能在较年轻的年龄段出现。早期检测对于及时治疗至关重要，这可以在诊断期间改善治疗效果。
对类似研究进行荟萃分析，并进行系统的文献综述，以加速临床实践指南的制定，帮助临床医生诊断AD。为实现这一目标，我们分析了过去10年发表的每篇文章中的数据点：成本、效率、准确性、可接受性（医生和患者的接受程度）、患者满意度以及采用的障碍。
查询了四个研究数据库（PubMed、CINAHL Ultimate、Web of Science和ScienceDirect）。该综述按照已发表的方案——克鲁斯方案进行，并根据PRISMA（2020）进行报告。
确定了10种有助于诊断老年患者AD的干预措施，其中一些涉及多种方法的组合（如MRI和PET）。平均样本量为320.32（标准差=437.51）。这10种干预措施被确定为准确、无创、无压力、廉价、方便且快速。仅有一种干预措施被确定为在统计学上无效，而该干预措施在其他研究中却有效使用。确定的障碍包括成本、培训、差旅费以及患者需要亲自到场。加权平均敏感度为85.16%，特异度为88.53，加权平均效应量为0.7339（中等）。
创新方法能够准确诊断AD，但并非所有方法都成功。医疗服务提供者必须确保他们接受了适当的培训并熟悉这些干预措施，以确保诊断的准确性。虽然通常需要患者亲自到场，但许多干预措施是无创、无压力且相对廉价的。
