中国老年人群认知衰弱患病率及相关因素的系统评价

Prevalence and Relevant Factors of Cognitive Frailty in Older Adults in China:A Systematic Review

目的系统评价中国老年人群的认知衰弱患病率及相关因素。方法通过计算机系统检索Pub Med/Medline、Embase等11个数据库和国际临床试验注册中心、中国临床试验注册中心2个临床试验注册平台,搜集报告中国≥60岁老年人认知衰弱患病率及相关因素的横断面研究、队列研究的中英文文献。采用美国的卫生保健研究与质量机构(AHRQ)推荐的偏倚风险评价工具,对符合纳入标准的研究文献进行偏倚风险评价。采用Stata 17.0软件进行meta分析,采用森林图呈现结果。结果meta分析结果显示:中国老年人群认知衰弱患病率为18.9%[95%CI(16.3%,21.6%)],可逆型认知衰弱患病率为19.5%[95%CI(14%,25%)],潜在可逆型患病率为17.5%[95%CI(13.5%,19.9%)],社区老年人认知衰弱患病率为14.3%[95%CI(11%,17.7%)],养老院老年人认知衰弱患病率为22.7%[95%CI(17%,28.3%)],住院老年人认知衰弱患病率为25.2%[95%CI(20.9%,29.4%)]。年龄、性别、文化程度、营养、抑郁、锻炼、睡眠、共病是认知衰弱的相关因素。结论中国老年人认知衰弱患病率较高,可逆型认知衰弱患病率可能被低估。增龄、女性、营养不良、抑郁、睡眠质量差、共病是我国老年人发生认知衰弱的危险风险,较高文化程度与规律锻炼是认知衰弱的保护因素。

To systematically evaluate the prevalence of cognitive frailty and its associated factors among the elderly population in China,we searched the literature of cross-sectional studies and cohort studies on prevalence of cognitive frailty and related factors in Chinese older adults(≥60)both in Chinese and English from 11 databases including PubMed/Medline,Embase,et al.,as well as two clinical trial registration platforms,namely,the International Clinical Trials Registry Platform(ICTRP)and Chinese Clinical Trial Registry.The risk of bias of the literature that met the inclusion criteria was assessed through the bias risk assessment tool recommended by the Agency for Healthcare Research and Quality(AHRQ),meta-analysis was performed using Stata 17.0 software,and the results were presented using forest plots.Results of the meta-analysis show that the prevalence of cognitive frailty among the elderly population in China is 18.9%[95%CI(16.3%,21.6%)];the prevalence of reversible cognitive frailty is 19.5%[95%CI(14%,25%)];the prevalence of potentially reversible cognitive frailty is 17.5%[95%CI(13.5%,19.9%)];the prevalence of cognitive frailty among community-dwelling older adults is 14.3%[95%CI(11%,17.7%)];the prevalence of cognitive frailty among the elderly in nursing homes is 22.7%[95%CI(17%,28.3%)];the prevalence of cognitive frailty among the hospitalized elderly is 25.2%[95%CI(20.9%,29.4%)].Factors associated with cognitive frailty include age,gender,educational level,nutrition,depression,exercise,sleep,and comorbidities.It is concluded that the prevalence of cognitive frailty among the elderly population in China is relatively high,and the prevalence of reversible cognitive frailty may be underestimated.Risk factors for cognitive frailty among the elderly in China include advanced age,being a female,malnutrition,depression,poor sleep quality,and comorbidities,while higher educational level and regular exercise are protective factors.