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孤独感与老年人轻度认知障碍的关系:一项纵向研究的荟萃分析。

Association between loneliness and mild cognitive impairment in older adults: a meta-analysis of longitudinal studies.

机构信息

School of Nursing, Qingdao University, Qingdao, Shandong, P.R. China.

Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

出版信息

Aging Ment Health. 2024 Dec;28(12):1650-1658. doi: 10.1080/13607863.2024.2358079. Epub 2024 Jun 2.

Abstract

OBJECTIVES

Prior studies reporting the effects of loneliness on mild impairment cognitive (MCI) have generated inconsistent results. This meta-analysis aimed to investigate the longitudinal association between loneliness and risk of MCI among community-dwelling middle-aged and older adults.

METHOD

Five electronic databases were searched from inception to 9 May 2023. Eligible studies examined the longitudinal association between loneliness and cognitive outcomes, including incident MCI, cognitive impairment, and cognitive decline. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects meta-analysis. Sensitivity analysis and subgroup analysis were conducted. Publication bias was examined using Egger's and Begg tests.

RESULTS

Eight studies were included. Among the 45,032 participants, 10,570 were diagnosed with MCI/cognitive decline. Loneliness was positively associated with an increased risk of MCI (overall OR = 1.14; 95% CI = 1.05, 1.23), with moderate heterogeneity (I = 44.2%). Sensitivity analysis have minimal influence on the aforementioned pooled effect. Subgroup analyses indicated stronger associations in studies which employed incident MCI as cognitive outcome (OR = 2.55, 95%CI = 1.31, 1.83), were conducted in non-Asia countries (OR = 1.52, 95%CI = 0.95, 1.20), and reported no depression adjustment (OR = 1.51, 95%CI = 1.04, 1.25). The association between loneliness and MCI was stronger among males compare to females. The Egger test and Begg test showed no evidence of significant publication bias ( = .493;  = .474).

CONCLUSION

The findings indicated that loneliness was associated with an increased risk of MCI. Future longitudinal studies should evaluate potential cases of MCI through comprehensive clinical assessments by practitioners to draw robust findings on the association of loneliness with MCI.

摘要

目的

先前报告孤独感对轻度认知障碍(MCI)影响的研究结果并不一致。本荟萃分析旨在调查社区中老年人群孤独感与 MCI 风险之间的纵向关联。

方法

从建库至 2023 年 5 月 9 日,我们检索了 5 个电子数据库。纳入研究考察了孤独感与认知结局(包括新发 MCI、认知障碍和认知衰退)之间的纵向关联。使用随机效应或固定效应荟萃分析计算比值比(OR)和 95%置信区间(CI)。进行敏感性分析和亚组分析。采用 Egger 检验和 Begg 检验评估发表偏倚。

结果

共纳入 8 项研究,45032 名参与者中 10570 人被诊断为 MCI/认知衰退。孤独感与 MCI 风险增加呈正相关(总体 OR=1.14,95%CI=1.05,1.23),存在中度异质性(I²=44.2%)。敏感性分析对上述汇总效应影响较小。亚组分析表明,将新发 MCI 作为认知结局的研究(OR=2.55,95%CI=1.31,1.83)、在非亚洲国家开展的研究(OR=1.52,95%CI=0.95,1.20)和未调整抑郁状态的研究(OR=1.51,95%CI=1.04,1.25)中关联更强。与女性相比,男性孤独感与 MCI 的关联更强。Egger 检验和 Begg 检验均未显示出显著的发表偏倚( = .493;  = .474)。

结论

研究结果表明,孤独感与 MCI 风险增加相关。未来的纵向研究应通过临床医生进行全面的临床评估来评估潜在的 MCI 病例,以得出关于孤独感与 MCI 关联的可靠结论。

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