认知衰弱与老年人死亡率及住院率相关性的Meta分析

Association of cognitive frailty with mortality and hospitalization in older adults:a meta-analysis

目的系统评价认知衰弱与老年人死亡率及住院率的相关性。方法计算机检索VIP、PubMed、CNKI、WanFang Data、CBM、Embase、Cochrane Library和Web of Science数据库,搜集关于认知衰弱与老年人死亡率或住院率相关性的队列研究,检索时限均为建库至2023年5月。由两名研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用R 4.2.2软件进行Meta分析。结果共纳入19项队列研究,包括63624例老年人。Meta分析结果显示:与非衰弱且认知功能正常的老年人相比,患认知衰弱的老年人死亡[OR=2.75,95%CI(2.10,3.59),P<0.01]和住院[OR=1.67,95%CI(1.40,2.00),P<0.01]的风险更高。亚组分析结果显示:在不同衰弱及认知功能状态、不同评估工具、不同发展程度国家、不同随访时间及不同研究场所,认知衰弱均与死亡的发生风险密切相关。在不同衰弱及认知功能状态和不同发展程度国家,认知衰弱与住院的发生风险密切相关。结论当前证据表明,认知衰弱可增加老年人住院及死亡的风险,建议进行认知衰弱的早期筛查和干预以有效降低不良后果的发生风险,从而实现健康老龄化。

Objective To systematically review the associations of cognitive frailty with mortality and hospitalization in the elderly.Methods The VIP,PubMed,CNKI,WanFang Data,CBM,Embase,Cochrane Library and Web of Science databases were electronically searched to collect cohort studies on the association of cognitive frailty with mortality or hospitalization in the elderly from inception to May,2023.Two reviewers independently screened the literature,extracted data and assessed risk of bias of the included studies.Meta-analysis was performed by R 4.2.2 software.Results A total of 19 cohort studies involving 63624 elderly were included.The results of meta-analysis showed that compared with healthy elder,the elder with cognitive frailty had a higher mortality(OR=2.75,95%CI 2.10 to 3.59,P<0.01)and hospitalization(OR=1.67,95%CI 1.40 to 2.00,P<0.01).Subgroup analysis showed that cognitive frailty was related to the risk of death in different status of frailty and cognitive function,different assessment tools,different countries of development,different follow-up time and research sites.At the same time,different status of frailty and cognitive function and different levels of development of countries were related to the risk of hospitalization.Conclusion Current evidence shows that cognitive frailty can increase the risk of hospitalization and mortality in the elderly.It is suggested that early screening and intervention of cognitive frailty should be carried out to effectively reduce the risk of adverse consequences,so as to achieve healthy aging.