老年人认知衰弱影响因素的系统评价再评价-现代医学

老年人认知衰弱影响因素的系统评价再评价

单位：1. 重庆医科大学护理学院, 重庆 400016;
2. 重庆医科大学附属第一医院心血管内科, 重庆 400016;
3. 重庆医科大学附属第一医院乳腺甲状腺外科, 重庆 400016;
4. 重庆医科大学附属第一医院全科医学科, 重庆 400016

关键词：认知衰弱|老年人|影响因素|系统评价再评价|伞形综述

分类号：R749.1

出版年·卷·期（页码）：2025·53·第四期（594-601）

摘要：

目的： 对老年人认知衰弱影响因素进行系统评价再评价，为老年人认知衰弱的管理提供参考。方法： 计算机检索PubMed、Web of Science、Cochrane Library、Embase、CINAHL、JBI、知网、维普网、万方及中国生物医学文献数据库中关于老年人认知衰弱影响因素的系统评价或Meta分析，检索时限为建库至2024年5月。由两名研究者独立进行文献筛选、资料提取，采用系统评价方法学质量评价工具2(AMSTAR 2)量表和证据质量与推荐强度分级(GRADE)系统进行方法学和证据质量评价。结果： 最终纳入7篇文献，方法学质量整体偏低。共提取21个影响因素，57个Meta分析结果，证据质量在中等及以下。根据健康生态学模型对影响因素进行汇总，个人特质层面的糖尿病病史、多病共存，行为特征层面的运动情况、抑郁、营养不良、跌倒史、低计时起立行走测试评分、久坐行为及无智力活动是老年人认知衰弱的影响因素，其余因素仍存在争议或与认知衰弱无明显关联。结论： 老年人认知衰弱受多重因素的影响，现有研究多局限于个人特质和行为特征层面，未来需进一步探索人际网络、生活工作条件及政策环境等层面因素对老年人认知衰弱的影响及作用机制。

Objective: To overview the systematic reviews on the influencing factors of cognitive frailty in older adults，and to provide evidence support for the management of cognitive frailty. Methods: Systematic reviews or Meta-analyses on the risk factors of cognitive frailty in older adults were retrieved from PubMed，Web of Science，Cochrane Library，Embase，CINAHL，JBI，CNKI，VIP，WanFang Data and SinoMed, the retrieval time limit was from the establishment of the database to May 2024. Two researchers independently screened literature and extracted data. The quality of methodology and evidence were evaluated by the AMSTAR 2 scale and GRADE system. Results: A total of 7 studies were included. The AMSTAR 2 evaluation results showed that the methodological quality of studies was generally low. 21 influencing factors and 57 Meta-analysis results were extracted，and the quality of evidence was moderate or lower. Based on the health ecology model，several influencing factors of cognitive frailty were identified in older adults. In the personal characteristics dimension，history of diabetes and multimorbidity were recognized as influencing factors. In the behavioral lifestyles dimension，exercise，depression，malnutrition，history of falls，low Time Up and Go test score，sedentary behaviors and intellectual inactivity were found to significantly influence cognitive frailty. The other factors remained either controversial or insignificant. Conclusion: Cognitive frailty is influenced by multiple factors. The existing studies mainly focus on the dimension of personal characteristics and behavioral lifestyles. Further studies are needed to investigate the impact and mechanism of influencing factors associated with cognitive frailty in interpersonal network，living and working conditions and policy environment among older adults.

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