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老年人综合照护(ICOPE)对提高老年人内在能力的有效性:一项系统评价和荟萃分析

Effectiveness of Integrated Care for Older Pepole (ICOPE) in Improving Intrinsic Capacity in Older Adults: A Systematic Review and Meta-Analysis.

作者信息

Liu Wei, Qin Rixin, Zhang Xueyan, Li Guichen, Qiu Yiming, Zhang Guangwei, Chen Li

机构信息

School of Nursing, Jilin University, Changchun, China.

School of Nursing, Beihua University, Jilin, China.

出版信息

J Clin Nurs. 2025 Mar;34(3):1013-1031. doi: 10.1111/jocn.17432. Epub 2024 Oct 11.

Abstract

OBJECTIVE

Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta-analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults.

METHODS

Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion).

RESULTS

The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = -0.70; 95% CI, -0.96 to -0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, -0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta-regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition.

CONCLUSION

The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing.

摘要

目的

对现有的关于内在能力(IC)的研究进行系统评价,并对评估综合照护预防老年人失能计划(ICOPE)改善老年人IC总体效果的研究进行荟萃分析。

方法

从数据库建库至2023年11月8日对10个数据库进行系统检索,最后一次更新检索是在2024年1月2日。纳入随机对照试验(RCT)。主要结局为IC(认知、心理、感官、活力和运动能力)。

结果

结果显示,ICOPE在改善认知功能方面有显著效果(标准化均数差[SMD]=0.36;95%可信区间[CI],0.17至0.56,p<0.001,12项RCT,7926名参与者)以及抑郁症状(SMD=-0.70;95%CI,-0.96至-0.43,p<0.001,26项RCT,11034名参与者),但在改善运动能力方面无统计学显著差异(SMD=0.16;95%CI,-0.03至0.34,p=0.098,3项RCT,1580名参与者)。荟萃回归分析表明,在讨论认知方面的异质性来源时应关注干预持续时间。

结论

结果表明,ICOPE可能是帮助改善老年人IC的一种潜在有效方法,尤其在改善认知功能和减轻抑郁症状方面显示出显著潜力。

对专业和/或患者护理的启示:ICOPE有望提供有效的策略来增强IC等问题,可能是改善老年人整体健康的一种创新方式。这一结果为老年护理实践提供了有力支持,并鼓励采用ICOPE作为促进健康老龄化的可行护理方法。

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