老年人内在能力下降影响因素的Meta分析

Meta-analysis of influencing factors for the decline of intrinsic capacity in the elderly

目的通过Meta分析识别老年人内在能力(intrinsic capacity,IC)下降影响因素。方法系统检索PubMed、Embase、Web of Science、the Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普数据库等从建库至2023年7月24日发表的有关老年人IC下降影响因素的横断面或队列研究,采用RevMan 5.4和StataMP 17软件分析纳入文献,计算各影响因素比值比(odd ratio,OR)及95%置信区间(confidence interval,CI)。结果共纳入17篇文献,共51243例,Meta分析结果显示,年龄(OR=1.63,95%CI:1.17,2.27)、未再婚(OR=1.6,95%CI:1.12,2.27)、营养不良(OR=1.37,95%CI:1.16,1.61)、教育年限(初中以下)(OR=1.36,95%CI:1.07,1.72)、低体力活动(OR=2.26,95%CI:1.31,3.89)、握力下降(OR=4.08,95%CI:1.65,10.10)、跌倒(OR=3.09,95%CI:2.43,3.94)、服药种数≥2(OR=1.5,95%CI:1.02,1.99)、多病共存(OR=1.32,95%CI:1.1,1.58)、CRP(OR=1.21,95%CI:1.01,1.44)为IC下降的危险因素;工具性日常生活能力(OR=0.87,95%CI:0.79,0.97)为IC下降的保护因素。结论老年人易受多种因素影响发生IC下降,提示社区、医院及家庭重点关注老年人IC及进一步制定个性化干预方案,以延缓IC的下降,提升老年人生活质量。

Objective To identify the influencing factors for the decline of intrinsic capacity(IC)in the elderly by meta-analysis.Methods Cross-sectional or cohort studies reporting the influencing factors for the decline of IC in the elderly were systematically searched in PubMed,Embase,Web of Science,the Cochrane Library,Chinese Biomedical Database(CBM),CNKI,Wanfang,and VIP databases from the establishment of the database to July 24,2023.The included literatures were analyzed using RevMan 5.4 and StataMP 17 software,and the oddsratio(OR)and 95%confidence interval(CI)of each influencing factor were calculated.Results A total of 17 articles were included,with a total of 51243 cases.The Meta-analysis results showed that age(OR=1.63,95%CI:1.17,2.27),unmarried statue(OR=1.6,95%CI:1.12,2.27),malnutrition(OR=1.37,95%CI:1.16,1.61),education level below junior high school(OR=1.36,95%CI:1.07,1.72),low physical activity(OR=2.26,95%CI:1.31,3.89),decreased grip strength(OR=4.08,95%CI:1.65,10.10),falls(OR=3.09,95%CI:2.43,3.94),number of medication types≥2(OR=1.5,95%CI:1.02,1.99),coexistence of multiple diseases(OR=1.32,95%CI:1.1,1.58),and C-reactive protein(CRP,OR=1.21,95%CI:1.01,1.44)were the risk factors for the decline of IC in the elderly;while the instrumental activities of daily living(OR=0.87,95%CI:0.79,0.97)was a protective factor.Conclusion Elderly people are susceptible to the decline of IC caused by multiple factors.The communities,hospitals,and families should focus on preventive interventions to delay the decline of IC and improve the quality of life of the elderly.