Qiu Wenhui, Zhang Yixiong
Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Res Nurs Health. 2025 Feb;48(1):73-84. doi: 10.1002/nur.22428. Epub 2024 Nov 29.
To perform a systematic review and meta-analysis clarifying potential modifiable risk factors for cognitive frailty in older Chinese persons with diabetes. We conducted a comprehensive search across four English and four Chinese databases, spanning from 1980 to May 2024. The aim was to identify studies that investigate potential modifiable risk factors for cognitive frailty in older patients with diabetes. Meta-analysis was performed using Stata16.0. Out of the 237 records identified, 19 studies met the inclusion criteria and were consequently included for analysis. The results of the meta-analysis revealed that the prevalence of cognitive frailty among older patients with diabetes was 22.2% (95% confidence interval [CI]: 0.177-0.270, I = 93.92%). Depression (OR = 3.18, 95% CI: 2.19-4.62, I = 79.6%), HbA1c (OR = 2.18, 95% CI: 1.66-2.85, I = 41.5%) and malnutrition (OR = 4.04, 95% CI: 1.58-10.34, I = 95.0%) were significantly associated with cognitive frailty in this population. Regular exercise (OR = 0.30, 95% CI: 0.11-0.84, p < 0.01, I = 87.3%) and higher education (OR = 0.30, 95% CI: 0.16-0.58, p < 0.01, I = 69.7%) are identified as protective factors against cognitive frailty. This systematic review and meta-analysis demonstrates that interventions targeting depression, HbA1c level, malnutrition, exercise and education can effectively reduce the risk of cognitive frailty in older patients with diabetes.
为进行一项系统评价和荟萃分析，以阐明中国老年糖尿病患者认知衰弱的潜在可改变风险因素。我们对四个英文数据库和四个中文数据库进行了全面检索，时间跨度从1980年至2024年5月。目的是识别调查老年糖尿病患者认知衰弱潜在可改变风险因素的研究。使用Stata16.0进行荟萃分析。在识别出的237条记录中，19项研究符合纳入标准，因此被纳入分析。荟萃分析结果显示，老年糖尿病患者认知衰弱的患病率为22.2%（95%置信区间[CI]：0.177 - 0.270，I = 93.92%）。抑郁（OR = 3.18，95% CI：2.19 - 4.62，I = 79.6%）、糖化血红蛋白（HbA1c）（OR = 2.18，95% CI：1.66 - 2.85，I = 41.5%）和营养不良（OR = 4.04，95% CI：1.58 - 10.34，I = 95.0%）与该人群的认知衰弱显著相关。规律运动（OR = 0.30，95% CI：0.11 - 0.84，p < 0.01，I = 87.3%）和高等教育（OR = 0.30，95% CI：0.16 - 0.58，p < 0.01，I = 69.7%）被确定为预防认知衰弱的保护因素。这项系统评价和荟萃分析表明，针对抑郁、HbA1c水平、营养不良、运动和教育的干预措施可有效降低老年糖尿病患者认知衰弱的风险。
