评估老年人认知衰弱的数字健康干预的有效性和实施：系统回顾和荟萃分析。

IF 12.4 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-06-30 DOI:10.1016/j.arr.2025.102819

Yanyan Li , Meijun Liu , Jieru Yang , Qinqin Liu , Wendie Zhou , Jiaqi Yu , Xue Wang , Cuili Wang

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引用次数: 0

摘要

目的：评价数字健康干预对老年认知衰弱患者的有效性和实施情况，并与对照组进行比较。方法：我们对随机对照试验（rct）和非随机干预研究（nrsi）进行了系统回顾，检索了10个电子数据库和灰色文献来源，从它们开始到2024年3月17日，并于2025年3月15日进行了更新。计算95% ci的标准化平均差（SMD）。采用Cochrane RoB2和ROBINS-I评估方法学质量。结果：纳入11项rct和2项nris，共1059名受试者。meta分析显示，数字健康干预显著提高了认知衰弱老年人的整体认知功能（SMD = 0.57, 95%CI = 0.32, 0.83, P < 0.001）、执行功能（SMD = -0.54, 95%CI =-0.99, -0.09, P = 0.02）和身体生活质量（PCS）（SMD = 0.30, 95%CI = 0.06, 0.55, P =0.01），降低了衰弱（SMD =-0.41, 95%CI = -0.81, -0.01, P = 0.04）、抑郁症状（SMD =-0.41, 95%CI =-0.73, -0.08, P =0.01）。RoB2评估显示，6项研究被评为高风险，4项被评为低风险，其中一项有一些担忧。此外，两项研究使用ROBINS-I工具被评估为中度风险。结论：针对认知脆弱的老年人的数字健康干预已证明在改善认知功能、心理健康和PCS方面有效，同时也减少了脆弱性。未来需要进一步的高质量研究来支持这些领域的证据。

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Evaluating effectiveness and implementation of digital health interventions for older adults with cognitive frailty: A systematic review and meta-analysis

Objective

To evaluate the effectiveness and implementation of digital health interventions compared with control group for older adults with cognitive frailty.

Methods

We conducted a systematic review of randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs), searching ten electronic databases and grey literature sources from their inception to 17 March 2024, with an update performed on 15 March 2025. The standardized mean difference (SMD) with 95 % CIs was calculated. The methodological quality was assessed by the Cochrane RoB2 and ROBINS-I.

Results

Eleven RCTs and two NRSIs with a total of 1069 participants were included. The meta-analysis showed that the digital health intervention among older adults with cognitive frailty significantly increased global cognitive function (SMD = 0.58, 95 %CI = 0.32, 0.83, P < 0.001), executive function (SMD = −0.54, 95 %CI =-0.99, −0.09, P = 0.02) and physical domain of quality of life (PCS) (SMD = 0.30, 95 %CI = 0.06, 0.55, P = 0.01), and decreased frailty (SMD = −0.41, 95 %CI = −0.81, −0.01, P = 0.04), depressive symptom (SMD =-0.41, 95 %CI =-0.73, −0.08, P = 0.01). RoB2 assessment revealed that six RCTs were rated as high risk, four as low risk, and one as some concerns. Additionally, two NRSIs were assessed as moderate risk using the ROBINS-I tool.

Conclusions

Digital health interventions targeting older adults with cognitive frailty have demonstrated effectiveness in improving cognitive function, mental health, and PCS, as well as reducing frailty. High-quality research is warranted to bolster the evidence in these fields in the future.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.