老年人药物治疗与认知障碍的关系：系统评价和荟萃分析。
Association between polypharmacy and cognitive impairment in older adults: A systematic review and meta-analysis.
机构信息
School of Nursing, Hangzhou Normal University, Hangzhou, PR China.
School of Nursing, Hangzhou Normal University, Hangzhou, PR China.
出版信息
Geriatr Nurs. 2024 Sep-Oct;59:330-337. doi: 10.1016/j.gerinurse.2024.07.005. Epub 2024 Aug 6.
OBJECTIVE
This meta-analysis explored the relationship between polypharmacy and cognitive impairment in older adults.
METHODS
We systematically searched for observational studies on polypharmacy and cognitive impairment in the Cochrane Library, PubMed, Web of Science, Embase, and CINAHL databases and performed meta-analysis to pool the study results using fixed- or random-effects models. The quality of evidence was assessed using the Grading of Recommendations, Assessment Development, and Evaluation system.
RESULTS
Twenty-seven studies involving 124,452,121 older adults aged >60 years were included. These studies showed that the risk of cognitive impairment was significantly increased in older adults with polypharmacy (≥5 medications) (OR = 1.39, 95% CI: 1.23-1.58, P < 0.001) and in those with excessive polypharmacy (≥10 medications) (OR = 1.51, 95% CI: 1.01-2.25, P = 0.042).
CONCLUSION
This study suggests a potential association between polypharmacy and cognitive impairment in older adults. However, the causal relationship requires further verification.
目的
本荟萃分析探讨了老年人中多种药物治疗与认知障碍之间的关系。
方法
我们系统地检索了 Cochrane 图书馆、PubMed、Web of Science、Embase 和 CINAHL 数据库中关于多种药物治疗与认知障碍的观察性研究，并使用固定效应或随机效应模型对研究结果进行荟萃分析。使用推荐评估、制定与评价系统（Grading of Recommendations, Assessment, Development, and Evaluation system）评估证据质量。
结果
共纳入 27 项研究，涉及 124452121 名年龄大于 60 岁的老年人。这些研究表明，与使用 5 种及以上药物的老年人（OR=1.39，95%CI：1.23-1.58，P<0.001）和使用 10 种及以上药物的老年人（OR=1.51，95%CI：1.01-2.25，P=0.042）相比，认知障碍的风险显著增加。
结论
本研究提示老年人中多种药物治疗与认知障碍之间可能存在关联，但因果关系尚需进一步验证。
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