Hajek André, König Hans-Helmut
Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
BJPsych Open. 2025 Mar 11;11(2):e44. doi: 10.1192/bjo.2024.865.
A systematic review/meta-analysis synthesising the existing evidence regarding the prevalence of loneliness and social isolation among individuals with mild cognitive impairment (MCI) or dementia is lacking.
A systematic review and meta-analysis was conducted to investigate the prevalence and factors associated with loneliness and social isolation among individuals with MCI or dementia.
A search was conducted in five established electronic databases. Observational studies reporting prevalence and, where available, factors associated with loneliness/isolation among individuals with MCI and individuals with dementia, were included. Important characteristics of the studies were extracted.
Out of 7427 records, ten studies were included. The estimated prevalence of loneliness was 38.6% (95% CI 3.7-73.5%, = 99.6, < 0.001) among individuals with MCI. Moreover, the estimated prevalence of loneliness was 42.7% (95% CI 33.8-51.5%, ² = 90.4, < 0.001) among individuals with dementia. The estimated prevalence of social isolation was 64.3% (95% CI 39.1-89.6%, ² = 99.6, < 0.001) among individuals with cognitive impairment. Study quality was reasonably high. It has been found that living alone and more depressive symptoms are associated with a higher risk of loneliness among individuals with dementia.
Social isolation, and in particular loneliness, are significant challenges for individuals with MCI and dementia. This knowledge can contribute to supporting successful ageing among such individuals. Future research in regions beyond Asia and Europe are clearly required. In addition, challenges such as chronic loneliness and chronic social isolation should be examined among individuals with MCI or dementia.
缺乏一项综合现有证据，探讨轻度认知障碍（MCI）或痴呆症患者中孤独感和社会隔离患病率的系统评价/荟萃分析。
进行一项系统评价和荟萃分析，以调查MCI或痴呆症患者中孤独感和社会隔离的患病率及相关因素。
在五个知名电子数据库中进行检索。纳入报告MCI患者和痴呆症患者孤独感/隔离患病率及（若有）相关因素的观察性研究。提取研究的重要特征。
在7427条记录中，纳入了10项研究。MCI患者中孤独感的估计患病率为38.6%（95%可信区间3.7 - 73.5%，I² = 99.6，P < 0.001）。此外，痴呆症患者中孤独感的估计患病率为42.7%（95%可信区间33.8 - 51.5%，I² = 90.4，P < 0.001）。认知障碍患者中社会隔离的估计患病率为64.3%（95%可信区间39.1 - 89.6%，I² = 99.6，P < 0.001）。研究质量相当高。已发现独居和更多抑郁症状与痴呆症患者孤独感风险较高相关。
社会隔离，尤其是孤独感，是MCI和痴呆症患者面临的重大挑战。这一认识有助于支持此类患者实现成功老龄化。显然需要在亚洲和欧洲以外地区开展未来研究。此外，应在MCI或痴呆症患者中研究慢性孤独和慢性社会隔离等挑战。
