Shan Dan, Wang Congxiyu, Crawford Trevor, Holland Carol
Centre for Ageing Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Health Innovation Campus, Sir John FisBailrigg, Lancasterher Drive, Bailrigg, Lancaster, LA1 4YT, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
BMC Geriatr. 2024 Dec 15;24(1):940. doi: 10.1186/s12877-024-05538-5.
The relationship between COVID-19 infection and a possible increased likelihood of older adults developing new-onset dementia (NOD) remains elusive.
A thorough search was performed across several databases including MEDLINE/PubMed, PsycINFO, Scopus, medRxiv, and PQDT Global for studies published in English from January 2020 to December 2023. Only original investigations exploring the link between COVID-19 infection and NOD were selected for inclusion. We assessed the risk of developing NOD, using Risk Ratio (RR) for measurement. Control groups were categorized as: (i) a non-COVID cohort with other respiratory infections [control group (C1)]; and (ii) a non-COVID cohort with otherwise unspecified health status [control group (C2)]. Follow-up periods were divided into intervals of 3, 6, 12, and 24 months post-COVID.
11 studies (involving 939,824 post-COVID-19 survivors and 6,765,117 controls) were included in the review. Across a median observation period of 12 months post-COVID, the overall incidence of NOD was about 1.82% in the COVID-infected group, compared to 0.35% in the non-COVID-infected group. The overall pooled meta-analysis showed a significantly increased NOD risk among COVID-19 older adult survivors compared to non-COVID-19 controls (RR = 1.58, 95% CI 1.21-2.08). Similar increased NOD risks were observed in subgroup analyses restricted to an observational period of 12 months (RR = 1.56, 95% CI 1.21-2.01), as well as in five studies that employed propensity score matching to sufficiently and effectively control for multiple confounding covariates (RR = 1.46, 95% CI 1.10-1.94). COVID-19 group and C1 group shared a comparably increased risk of developing NOD (overall RR = 1.13, 95% CI 0.92-1.38).
Under normal circumstances, we believe that COVID-19 infection is likely to be a risk factor for developing NOD in older adults over time. While the increased NOD risk due to COVID-19 infection appears to be similar to that associated with other respiratory infections, it warrants and necessitates investigation with longer observations.
2019冠状病毒病（COVID-19）感染与老年人患新发痴呆症（NOD）可能性增加之间的关系仍不明确。
对多个数据库进行全面检索，包括MEDLINE/PubMed、PsycINFO、Scopus、medRxiv和PQDT Global，以查找2020年1月至2023年12月期间发表的英文研究。仅选择探索COVID-19感染与NOD之间联系的原创性研究纳入。我们使用风险比（RR）评估患NOD的风险。对照组分为：（i）患有其他呼吸道感染的非COVID队列[对照组（C1）]；以及（ii）健康状况未明确说明的非COVID队列[对照组（C2）]。随访期分为COVID感染后3、6、12和24个月的时间段。
该综述纳入了11项研究（涉及939,824名COVID-19康复者和6,76,117名对照）。在COVID感染后的中位观察期12个月内，COVID感染组中NOD的总体发病率约为1.82%，而非COVID感染组为0.35%。总体汇总的荟萃分析显示，与非COVID-19对照组相比，COVID-19老年康复者患NOD的风险显著增加（RR = 1.58，95% CI 1.21 - 2.08）。在限于12个月观察期的亚组分析中也观察到类似的患NOD风险增加（RR = 1.56，95% CI 1.21 - 2.01），以及在五项采用倾向得分匹配以充分有效控制多个混杂协变量的研究中（RR = 1.46，95% CI 1.10 - 1.94）。COVID-19组和C1组患NOD的风险增加程度相当（总体RR = 1.13，95% CI 0.92 - 1.38）。
在正常情况下，我们认为随着时间推移，COVID-19感染可能是老年人患NOD的一个风险因素。虽然COVID-19感染导致的患NOD风险增加似乎与其他呼吸道感染相关的风险相似，但仍需要进行更长时间观察的调查。
