我国老年糖尿病患者认知衰弱患病率及影响因素的Meta分析

目的:系统评价我国老年糖尿病患者认知衰弱(cognitive frailty,CF)的患病率及影响因素。方法:计算机检索PubMed、Embase、Web of Science、CINAHL、Cochrane Library、中国知网、万方、中国生物医学数据库中有关老年糖尿病患者CF患病率及影响因素的横断面研究,检索时限为建库至2022年11月1日。对符合标准的文献进行质量评价和数据提取,采用R4.2.2软件进行数据分析。结果:本研究共纳入8篇文献,7篇中文文献,1篇英文文献,共2028名研究对象。Meta分析结果显示,我国老年糖尿病患者CF患病率为17.1%(95%CI:8.7%~30.9%)。亚组分析结果显示:按病例来源分组,我国社区老年糖尿病患者CF患病率为10.2%(95%CI:5.0%~19.7%),住院为35.7%(95%CI:20.8%~53.9%),差异有统计学意义(P=0.0037);按性别分组,我国老年男性糖尿病患者CF患病率为21.7%(95%CI:10.3%~40.2%),女性为24.2%(95%CI:13.3%~40.1%),差异无统计学意义(P=0.81);按年龄分组,60~69岁老年糖尿病患者CF患病率为12.6%(95%CI:6.6%~22.5%),70~79岁为25.8%(95%CI:12.6%~45.5%),≥80岁为53.0%(95%CI:23.9%~80.2%),差异有统计学意义(P=0.02)。老年糖尿病患者CF的影响因素包括文化程度[OR=0.230,95%CI(0.117~0.454),P<0.0001]、规律运动[OR=0.357,95%CI(0.217~0.588),P<0.01]、营养不良[OR=2.372,95%CI(1.472~3.822),P=0.0004]、抑郁[OR=3.207,95%CI(2.156~4.768),P<0.0001]、HbA_(1)c≥7.0%[OR=3.112,95%CI(1.880~5.152),P<0.0001]。结论:我国老年糖尿病患者CF患病率较高,不同来源、不同年龄段的患者CF患病率存在差异。文化程度、运动习惯、营养状况、抑郁、HbA_(1)c是老年糖尿病患者CF的影响因素,抑郁、营养不良、HbA_(1)c≥7.0%是危险因素,高文化程度、规律运动是保护因素,应注重对CF的早期准确识别并针对影响因素进行干预,从而延缓或逆转其向不良健康结局的发展。

Prevalence and influencing factors of cognitive frailty in elderly with diabetes mellitus in China:A meta-analysis

Objective:To systematically review the epidemiological characteristics and influencing factors of cognitive frailty in Chinese elderly with diabetes mellitus.Methods:PubMed,Embase,Web of Science,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang and Chinese biomedical literature database(CBM)were electronically searched to collect cross-sectional studies on the prevalence and influencing factors of cognitive frailty in Chinese elderly with diabetes mellitus from inception to November 1st,2022.After quality evaluation and data extraction of included studies,R4.2.2 software was used to perform metaanalysis.Results:A total of 7 Chinese and one English literatures involving 2208 participants were included.The results of meta-analysis showed that the prevalence rate of cognitive frailty in elderly diabetic patients was 17.1%(95%CI 8.7%to 30.9%).Subgroup analysis showed that the prevalence rate of cognitive frailty was 10.2%(95%CI 5.0%to 19.7%)in old diabetic adults in community,35.7%(95%CI 20.8%to 53.9%)in hospital,and the difference was statistically significant(P=0.01).The prevalence rate of cognitive frailty was 21.7%(95%CI 10.3%to 40.2%)in male diabetic old adults,24.2%(95%CI 13.3%to 40.1%)in female diabetic old adults,and the difference was not statistically significant(P=0.81).The rate was 12.6%(95%CI 6.6%to 22.5%)in 60~69 years old group,25.8%(95%CI 12.6%to 45.5%)in 70~79 years old group,53.0%(95%CI 23.9%to 80.2%)in diabetic old adults aged 80 years and above,and the difference was statistically significant(P=0.02).The influencing factors for cognitive frailty in diabetic old adults included educational level[OR=0.230,95%CI(0.117~0.454),P<0.0001],regular exercise[OR=0.357,95%CI(0.217~0.588),P<0.01],malnutrition[OR=2.372,95%CI(1.472~3.822),P=0.0004],depression[OR=3.207,95%CI(2.156~4.768),P<0.0001],and HbA1c≥7.0%[OR=3.112,95%CI(1.880~5.152),P<0.0001].Conclusion:The prevalence of cognitive frailty in Chinese elderly patients with diabetes is high,and there are differences in cognitive frailty prevalence among different sources and different ages.Educational level,exercise habits,nutritional status,depression and HbA1c are the factors affecting cognitive frailty in elderly patients with diabetes.Depression,malnutrition,HbA1c≥7.0%were risk factors,and high educational level,regular exercise were protective factors.Attention should be paid to early and accurate identification of cognitive frailty and intervention targeting influencing factors to delay or reverse its progression to adverse health outcomes.

决策支持系统在信息化条件下卫勤领域的应用综述

介绍了决策支持系统的概念,综述了决策支持系统在指挥决策、医疗后送、物资保障、卫勤训练、应急医学救援领域的研究及应用。结合我军卫勤信息化保障的现状,分析了决策支持系统应用存在的问题,并展望了其未来的发展方向,为我军卫勤信息化建设、发展提供了借鉴。

机动卫勤力量护理人员抽组信息平台的设计与实现

目的:设计机动卫勤力量护理人员抽组信息平台,为多样化卫勤保障任务下的护理人员抽组提供快捷、高效的技术手段。方法:该平台基于前后端分离模式进行开发,采用浏览器/服务器(Browser/Server,B/S)架构进行分层设计。其中,展示层采用Vue架构开发,应用服务层采用Springboot框架设计,数据访问层采用MyBatis框架实现数据交互,数据资源层采用MySQL数据库存储和管理数据。整个平台包括综合管理、人员抽组和任务管理3个模块。结果:该平台可以实现多样化卫勤保障任务下的护理人员抽组,而且能缩短抽组用时和保证抽组质量。结论:该平台可以提高卫勤力量护理人员抽组效率,为指挥官指挥决策提供了快捷、高效的信息化辅助决策工具。