An Etiological Study of Cognitive Impairment in the Institutional Elderly: A Meta-analysis_West China Medical Journal

Authors：

SHU Defen ¹ , SHU Chi ² ,  DONG Birong. ¹

1. Department of Gerontology, West China Hospital; 2. West China Medical School; Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

DONG Birong., Email: shudefen100@163.com

Keywords：

养老机构老人; 认知障碍; 影响因素; Meta分析

DOI：

10.7507/1002-0179.20130579

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目的　全面了解空巢老人认知功能障碍危险因素。方法　检索Ovid Medline、Ovid Embase、Cochrane 图书馆及中国生物医学文献数据库（光盘版）等数据库，检索时间为各数据库建库至2011年12月31日。文献纳入标准：年龄≥60岁或作者指明以老人为研究对象；居住状态包括老人无子女或未与子女同住。两位研究者独立地对符合纳入标准的试验进行质量评价和资料提取。结果　4篇文献（共1 485例）分析了养老机构老人认知障碍的影响因素，合并分析显示年龄[WMD=2.10岁，95%CI（1.28，2.92）岁，P＜0.000 01]、女性[OR=3.61，95%CI（1.63，8.01），P=0.002]、失能[SMD=0.78，95%CI （0.36，1.20），P=0.000 2]、躯体健康[SMD=0.06，95%CI （0.01，0.11），P=0.02]、未婚/寡居[OR=3.16，95%CI（1.43，6.96），P＜0.000 01]、文盲[OR=2.94，95%CI（1.06，8.14），P=0.04]、社会支持差[OR=7.29，95%CI（2.27，23.39），P=0.000 8]、朋友关系差[OR=2.14，95%CI（1.35，3.39），P=0.001]、参加活动少[OR=2.11，95%CI（1.36，3.29），P=0.000 9]及远离子女[OR=5.73，95%CI（3.33，9.87），P＜0.05]是其危险因素。结论　养老机构老人认知功能障碍的危险因素包括老年、女性、文盲、未婚/寡居、社交差、与子女距离远、躯体健康水平差及抑郁等。结果仅来源于较少的研究和数量较小的对象，且均为横断面研究，需谨慎看待上述结论。

Citation： SHU Defen,SHU Chi,DONG Birong.. An Etiological Study of Cognitive Impairment in the Institutional Elderly: A Meta-analysis. West China Medical Journal, 2013, 28(12): 1827-1831. doi: 10.7507/1002-0179.20130579 Copy

1.	中国防治认知功能障碍专家共识专家组. 中国防治认知功能障碍专家共识[J]. 中华内科杂志, 2006, 45(2): 171-173.
2.	Brown JH, Fukaya T, Krause N, et al. Transitions in living arrangements among elders in Japan: does health make a difference? [J]. J Gerontol B Psychol Sci Soc Sci, 2002, 57(4): S209-S220.
3.	杨伟民, 滕军放, 刘书红, 等. 康复训练对空巢老人生活自理能力的影响[J]. 中国实用神经疾病杂志, 2010, 13(23): 16-18.
4.	Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group[J]. JAMA, 2000, 283(15): 2008-2012.
5.	Olmos M, Antelo M, Vazquez H, et al. Systematic review and meta-analysis of observational studies on the prevalence of fractures in coeliac disease[J]. Dig Liver Dis, 2008, 40(1): 46-53.
6.	Higgins J, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.0.0 [updated February 2008] [EB/OL].[2012-03-04]. http://www.mrc-bsu.cam.ac.uk/cochrane/handbook500/.
7.	Parmelee PA, Smith B, Katz IR. Pain complaints and cognitive status among elderly institution resicents[J]. J Am Geriatr Soc, 1993, 41(5): 517-522.
8.	赵春双, 陈长香, 张红, 等. 婚姻及社会支持状况对老年人认知功能的影响[J]. 护理研究, 2010, 24(31): 2852-2853, 2857.
9.	Chung PJ, Chiou CJ, Chou FH. Relationships between health status, depression and cognitive functions of institutionalized male veterans[J]. Arch Gerontol Geriatr, 2009, 49(2) 215-219.
10.	Chahine1 LM, Bijlsma A, Hospers APN, et al. Dementia and depression among nursing home residents in Lebanon: a pilot study[J]. Int J Geriatr Psychiatry, 2007, 22(4): 283-285.
11.	中华人民共和国卫生部. 2009中国卫生统计年鉴[M]. 北京: 中国协和医科大学出版社, 2009: 224-225.
12.	顾大男, 仇莉. 中国高龄老人认知功能特征和影响因素分析[J]. 南京人口管理干部学院学报, 2003, 19(2): 3-9, 13.
13.	孟琛, 汤哲, 陈彪. 老年人认知功能减退影响因索的纵向研究[J]. 中国老年医学杂志, 2000, 19(3): 211-214.
14.	Forette F, Seux ML, Thijs L, et al. Detection of cerebral aging, an absolute need: predictive value of cognitive status[J]. Eur Neurol, 1998, 39(Suppl 1): 2-6.
15.	王义祥. 当代中国社会变迁[M]. 上海: 华东师范大学出版社, 2006: 6.
16.	Brayne C, Best N, Muir M, et al. Five-year incidence and prediction of dementia and cognitive decline in a population sample of women aged 70-79 at baseline[J]. Int J Geriatr Psychiatry, 1997, 12(11): 1107-1118.
17.	Unverzagt FW, Hui SL, Farlow MR, et al. Cognitive decline and education in mild dementia[J]. Neurology, 1998, 50(1): 181-185.
18.	Zunzunegui MV, Beland F, Otero A. Support from children, living arrangements, self-rated health and depressive symptoms of older people in Spain[J]. Int J Epidemiol, 2001, 30(5): 1090-1099.
19.	张卫华, 赵贵芳, 刘贤臣, 等. 城市老年人认知功能的相关因素分析[J]. 中国心理卫生杂志, 2001, 15(5): 327-330.

1. 　中国防治认知功能障碍专家共识专家组. 中国防治认知功能障碍专家共识[J]. 中华内科杂志, 2006, 45(2): 171-173.
2. 　Brown JH, Fukaya T, Krause N, et al. Transitions in living arrangements among elders in Japan: does health make a difference? [J]. J Gerontol B Psychol Sci Soc Sci, 2002, 57(4): S209-S220.
3. 　杨伟民, 滕军放, 刘书红, 等. 康复训练对空巢老人生活自理能力的影响[J]. 中国实用神经疾病杂志, 2010, 13(23): 16-18.
4. 　Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group[J]. JAMA, 2000, 283(15): 2008-2012.
5. 　Olmos M, Antelo M, Vazquez H, et al. Systematic review and meta-analysis of observational studies on the prevalence of fractures in coeliac disease[J]. Dig Liver Dis, 2008, 40(1): 46-53.
6. 　Higgins J, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.0.0 [updated February 2008] [EB/OL].[2012-03-04]. http://www.mrc-bsu.cam.ac.uk/cochrane/handbook500/.
7. 　Parmelee PA, Smith B, Katz IR. Pain complaints and cognitive status among elderly institution resicents[J]. J Am Geriatr Soc, 1993, 41(5): 517-522.
8. 　赵春双, 陈长香, 张红, 等. 婚姻及社会支持状况对老年人认知功能的影响[J]. 护理研究, 2010, 24(31): 2852-2853, 2857.
9. 　Chung PJ, Chiou CJ, Chou FH. Relationships between health status, depression and cognitive functions of institutionalized male veterans[J]. Arch Gerontol Geriatr, 2009, 49(2) 215-219.
10. 　Chahine1 LM, Bijlsma A, Hospers APN, et al. Dementia and depression among nursing home residents in Lebanon: a pilot study[J]. Int J Geriatr Psychiatry, 2007, 22(4): 283-285.
11. 　中华人民共和国卫生部. 2009中国卫生统计年鉴[M]. 北京: 中国协和医科大学出版社, 2009: 224-225.
12. 　顾大男, 仇莉. 中国高龄老人认知功能特征和影响因素分析[J]. 南京人口管理干部学院学报, 2003, 19(2): 3-9, 13.
13. 　孟琛, 汤哲, 陈彪. 老年人认知功能减退影响因索的纵向研究[J]. 中国老年医学杂志, 2000, 19(3): 211-214.
14. 　Forette F, Seux ML, Thijs L, et al. Detection of cerebral aging, an absolute need: predictive value of cognitive status[J]. Eur Neurol, 1998, 39(Suppl 1): 2-6.
15. 　王义祥. 当代中国社会变迁[M]. 上海: 华东师范大学出版社, 2006: 6.
16. 　Brayne C, Best N, Muir M, et al. Five-year incidence and prediction of dementia and cognitive decline in a population sample of women aged 70-79 at baseline[J]. Int J Geriatr Psychiatry, 1997, 12(11): 1107-1118.
17. 　Unverzagt FW, Hui SL, Farlow MR, et al. Cognitive decline and education in mild dementia[J]. Neurology, 1998, 50(1): 181-185.
18. 　Zunzunegui MV, Beland F, Otero A. Support from children, living arrangements, self-rated health and depressive symptoms of older people in Spain[J]. Int J Epidemiol, 2001, 30(5): 1090-1099.
19. 　张卫华, 赵贵芳, 刘贤臣, 等. 城市老年人认知功能的相关因素分析[J]. 中国心理卫生杂志, 2001, 15(5): 327-330.

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An Etiological Study of Cognitive Impairment in the Institutional Elderly: A Meta-analysis

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