综合护理干预对老年人认知能力下降的影响：系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2025-07-17 DOI:10.1016/j.archger.2025.105952

Rixin Qin , Zhong Li , Ling Gong , Beibei Miao , Yali Sun , Wei Liu , Li Chen

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引用次数: 0

摘要

目的汇总现有研究，以确定综合护理干预对减轻老年人认知能力下降的疗效。设计采用随机对照试验（RCTs）的荟萃分析进行系统评价。方法从数据库建立至2024年6月18日进行检索，并于2024年11月10日进行更新。采用随机效应模型计算标准化平均差（SMD）。使用cochrane随机试验偏倚风险评估工具第2版（RoB 2）和推荐、评估、发展和评价分级指南制定工具（GRADEpro GDT）来评估方法学质量和累积证据的置信度。采用漏斗图、egger检验和begg检验分析发表偏倚。进行敏感性分析、亚组分析和元回归分析以探索潜在的异质性来源。结果26项研究结果显示，综合护理干预对缓解认知能力下降有显著作用(SMD=0.54；95% CI, 0.34 ~ 0.73；术中,0.001;26项随机对照试验，5615名受试者；moderate-quality证据)。亚组分析显示，干预组以平均年龄（60-70岁）、干预时间6 - 12个月、性别（女性占50%）、垂直整合（VI）更有效为特征。敏感性分析发现结果是稳健的。结论综合护理干预是解决老年人认知能力下降的有效方法。然而，需要进一步的高质量研究来提高证据的确定性。

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The effect of integrated care interventions on cognitive decline among older adults: A systematic review and meta-analysis

Objective

To pool existing studies to determine the efficacy of integrated care interventions on mitigating cognitive decline among older adults.

Design

Systematic review with a meta-analysis of randomized controlled trials (RCTs).

Methods

Ten databases were searched from their inception to June 18th, 2024, with an update on November 10th, 2024. Standardized mean difference (SMD) was calculated using random effects models. The version 2 of the cochrane tool for assessing the risk of bias in randomized trials (RoB 2) and the Grades of Recommendation, Assessment, Development and Evaluation profiler Guideline Development Tool (GRADEpro GDT) were used to assess the methodological quality and confidence in the cumulative evidence. Funnel plots, egger's test, and begg's test were used to analyze publication bias. Sensitivity, subgroup and meta-regression analyses were performed to explore potential sources of heterogeneity.

Results

The results of 26 studies showed integrated care interventions had a significant effect on mitigating cognitive decline (SMD=0.54; 95 % CI, 0.34 to 0.73; P<0.001; 26 RCTs, 5615 participants; moderate-quality evidence). Subgroup analysis showed the intervention group was characterized by mean age (60–70 years old), intervention duration between 6 and 12 months, gender (female<50 %), and vertical integration (VI) appeared to be more effective. Sensitivity analysis found the results to be robust.

Conclusion

Integrated care interventions demonstrate potential as an effective approach for addressing cognitive decline in older adults. However, further high-quality studies are necessary to enhance the certainty of evidence.

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.