{"title":"居住在社区的老年人认知能力衰弱的发生率和结果：系统回顾与元分析》。","authors":"Yixiong Zhang, Haozhi Xia, Xing Jiang, Qiuling Wang, Lili Hou","doi":"10.3928/19404921-20240621-01","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults.</p><p><strong>Method: </strong>The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023).</p><p><strong>Results: </strong>Twenty-four studies were included (<i>N</i> = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]).</p><p><strong>Conclusion: </strong>Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [<i>Research in Gerontological Nursing, 17</i>(4), 202-212.].</p>","PeriodicalId":51272,"journal":{"name":"Research in Gerontological Nursing","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence and Outcomes of Cognitive Frailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.\",\"authors\":\"Yixiong Zhang, Haozhi Xia, Xing Jiang, Qiuling Wang, Lili Hou\",\"doi\":\"10.3928/19404921-20240621-01\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults.</p><p><strong>Method: </strong>The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023).</p><p><strong>Results: </strong>Twenty-four studies were included (<i>N</i> = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]).</p><p><strong>Conclusion: </strong>Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [<i>Research in Gerontological Nursing, 17</i>(4), 202-212.].</p>\",\"PeriodicalId\":51272,\"journal\":{\"name\":\"Research in Gerontological Nursing\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research in Gerontological Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3928/19404921-20240621-01\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research in Gerontological Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3928/19404921-20240621-01","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
摘要
目的：系统回顾有关认知功能虚弱（一种临床综合征，其特征是身体虚弱和认知功能障碍并存，但不伴有痴呆症）在社区老年人中的患病率和结果的现有证据：方法：对以下数据库进行了检索：方法：检索了以下数据库：PubMed、Web of Science、Embase、EBSCO、Cochrane Central Register of Controlled Trials、ProQuest、CNKI、Wanfang、VIP 和 CBMdisc（开始至 2023 年 10 月 2 日）：结果：共纳入 24 项研究（样本数 = 62,169 例），这些研究报告了社区老年人认知功能虚弱的中位流行率为 12.2%。伴有认知障碍的虚弱与全因死亡率的增加密切相关（调整后的 8 年危险比 [HR] = 2.6，95% 置信区间 [CI] [2.05, 3.30]）。有证据表明，体弱（调整后的 HR = 1.92，95% CI [1.26，2.93]）和体弱前（调整后的 HR = 1.79，95% CI [1.33，2.41]）伴有认知障碍的患者 3 年死亡风险增加。也有证据表明，有认知障碍的虚弱（调整后的 24 个月 HR = 6.19，95% CI [2.74，13.99]；调整后的 4 年 HR = 4.98，95% CI [2.17，11.41]）和虚弱前（调整后的 4 年 HR = 5.21，95% CI [2.95，9.20]；调整后的 5 年 HR = 14.5，95% CI [1.68，125.1]）患者患痴呆症的风险增加。日常生活活动（ADL）依赖在有认知障碍和体弱的人中更为常见（调整后的4年几率=5.6，95% CI [2.13，14.72]）：结论：在社区居住的老年人中，有 12.2% 的人存在认知功能虚弱问题，同时也增加了全因死亡、痴呆和 ADL 依赖的风险。有必要对认知虚弱的预防和治疗进行进一步研究。医疗服务提供者应制定具体的干预措施，以减少认知虚弱的影响。[老年护理研究》（Research in Gerontological Nursing），17（4），202-212。
Prevalence and Outcomes of Cognitive Frailty Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis.
Purpose: To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty-a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia-in community-dwelling older adults.
Method: The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023).
Results: Twenty-four studies were included (N = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]).
Conclusion: Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [Research in Gerontological Nursing, 17(4), 202-212.].
期刊介绍：
Research in Gerontological Nursing is a forum for disseminating peer-reviewed, interdisciplinary, cutting-edge gerontological nursing research and theory to investigators, educators, academicians, clinicians, and policymakers involved with older adults in all health care settings. The Journal accepts manuscripts reporting research, theory, integrative and systematic reviews, instrument development, and research methods with the aims of improving the wellness and quality of care of the older adult population. Theory papers should advance gerontological knowledge, and integrative reviews should provide an analysis of the state of the science and provide direction for future research.
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