中国老年轻度认知障碍病人抑郁情绪检出率及影响因素的系统评价

The detection rate and influencing factors of depressive symptoms among the elderly with mild cognitive impairment in China:a systematic review

目的:系统评价中国老年轻度认知障碍(MCI)病人抑郁情绪现状及影响因素。方法:计算机检索EMbase、CINAHL、PubMed、the Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、维普(VIP)、中国知网(CNKI)及万方数据库(WanFang Database)中关于老年MCI病人抑郁情绪检出率及影响因素的相关文献,检索时限为建库至2022年3月。文献筛选、资料提取及文献质量评价过程由2名研究者独立完成,抑郁情绪检出率采用Stata 15.0软件进行Meta分析,影响因素采用描述性分析。结果:最终纳入12个研究,共2572例MCI病人。Meta分析结果显示,中国老年MCI病人抑郁情绪总检出率为33%[95%CI(0.25,0.40)]。亚组分析结果显示,女性检出率高于男性(38%vs 34%)、60~69岁检出率高于70~79岁者及≥80岁者(46%vs 43%vs 26%)、养老机构和社区检出率高于医院(45%vs 29%vs 25%)、南方检出率高于北方(35%vs 27%)、老年抑郁量表(GDS)检出率高于其他抑郁情绪测量工具检出率。影响因素的描述性分析显示,丧偶或独居、无子女经济资助、认知功能减退、日常生活能力差、患慢性疾病等因素可能是MCI病人抑郁情绪的危险因素;经济满意度高、高社会支持等因素可能是抑郁情绪的保护因素。结论:现有证据表明,中国老年MCI病人抑郁情绪检出率高,抑郁情绪可能受婚姻状况、社会支持、认知功能、日常生活能力、患慢性病等因素的影响。但由于纳入研究数量少、研究质量中等,建议今后开展大样本、多中心的研究,进一步探讨MCI病人抑郁情绪检出率及其影响因素。

Objective:To systematically evaluate the status and influencing factors of depressive symptoms in elderly patients with mild cognitive impairment.Methods:The detection rate and influencing factors of depressive symptoms in elderly patients with mild cognitive impairment were retrieved from EMbase,CINAHL,PubMed,the Cochrane Library,Web of Science,CBM,VIP,CNKI and WanFang Database.The retrieval time was from the inception to March 2022.Literature screening,data extraction,and quality assessment of the literature were performed by 2 researchers independently,and the detection rate of depressive symptoms was analyzed by Meta-analysis using Stata 15.0 software.Results:12 studies(2572 patients with mild cognitive impairment)were included.The overall detection rate of depressive mood in elderly patients with mild cognitive impairment was 33%(95CI%0.25-0.40).Subgroup analysis indicated that the detection rate of females was higher than males(38%vs 34%);the detection rate in the south was higher than that in the north(35%vs 27%);46%,43%,and 26%for those aged among 60-69,70-79,and above 80,respectively.The detection rate of nursing home and community was higher than that of hospital(45%vs 29%vs 25%),and higher with GDS than with other scales.The descriptive analysis of the influencing factors showed that widow or living alone,childless financial support,cognitive decline,poor ability to daily living and other factors may be risk factors for depressive symptoms in patients with mild cognitive impairment.Factors such as high economic satisfaction and high social support may be protective factors of depression.Conclusion:Current evidence shows that the detection rate of depressive symptoms in elderly patients with mild cognitive impairment is high,and marital status,monthly economic income,social support,cognitive function and so on may be the influencing factors of depression.More high-quality studies are needed due to quantitative limitations.