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目的：系统评价我国老年糖尿病患者认知衰弱(cognitive frailty,CF)的患病率及影响因素。方法：计算机检索PubMed、Embase、Web of Science、CINAHL、Cochrane Library、中国知网、万方、中国生物医学数据库中有关老年糖尿病患者CF患病率及影响因素的横断面研究，检索时限为建库至2022年11月1日。对符合标准的文献进行质量评价和数据提取，采用R4.2.2软件进行数据分析。结果：本研究共纳入8篇文献，7篇中文文献，1篇英文文献，共2 028名研究对象。Meta分析结果显示，我国老年糖尿病患者CF患病率为17.1%(95%CI:8.7%～30.9%)。亚组分析结果显示：按病例来源分组，我国社区老年糖尿病患者CF患病率为10.2%(95%CI:5.0%～19.7%)，住院为35.7%(95%CI:20.8%～53.9%)，差异有统计学意义(P=0.003 7)；按性别分组，我国老年男性糖尿病患者CF患病率为21.7%(95%CI:10.3%～40.2%)，女性为24.2%(95%CI:13.3%～40.1%)，差异无统计学意义(P=0.81)；按年龄分组，60～69岁老年糖尿病患者CF患病率为12.6%(95%CI:6.6%～22.5%),70～79岁为25.8%(95%CI:12.6%～45.5%)，≥80岁为53.0%(95%CI:23.9%～80.2%)，差异有统计学意义(P=0.02)。老年糖尿病患者CF的影响因素包括文化程度[OR=0.230,95%CI(0.117～0.454),P<0.000 1]、规律运动[OR=0.357,95%CI(0.217～0.588),P<0.01]、营养不良[OR=2.372,95%CI(1.472～3.822),P=0.000 4]、抑郁[OR=3.207,95%CI(2.156～4.768),P<0.000 1]、HbA_1c≥7.0%[OR=3.112,95%CI(1.880～5.152),P<0.000 1]。结论：我国老年糖尿病患者CF患病率较高，不同来源、不同年龄段的患者CF患病率存在差异。文化程度、运动习惯、营养状况、抑郁、HbA_1c是老年糖尿病患者CF的影响因素，抑郁、营养不良、HbA_1c≥7.0%是危险因素，高文化程度、规律运动是保护因素，应注重对CF的早期准确识别并针对影响因素进行干预，从而延缓或逆转其向不良健康结局的发展。
Abstract：Objective:To systematically review the epidemiological characteristics and influencing factors of cognitive frailty(CF) in Chinese elderly with diabetes mellitus.Methods:PubMed,Embase,Web of Science,CINAHL,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang and Chinese biomedical literature database(CBM) were electronically searched to collect cross-sectional studies on the prevalence and influencing factors of cognitive frailty in Chinese elderly with diabetes mellitus from inception to November 1st,2022.After quality evaluation and data extraction of included studies,R4.2.2 software was used to perform meta-analysis.Results:A total of 7 Chinese and one English literatures involving 2 028 participants were included.The results of meta-analysis showed that the prevalence rate of cognitive frailty in elderly diabetic patients was 17.1%(95%CI 8.7% to 30.9%).Subgroup analysis showed that the prevalence rate of cognitive frailty was 10.2%(95% CI 5.0% to 19.7%) in elderly diabetic adults in community,35.7%(95%CI 20.8% to 53.9%) in hospital,and the difference was statistically significant(P=0.01).The prevalence rate of cognitive frailty was 21.7%(95%CI 10.3% to 40.2%) in male diabetic elderly adults,24.2%(95% CI 13.3% to 40.1%) in female diabetic elderly adults,and the difference was not statistically significant(P-0.81).The rate was 12.6%(95%CI 6.6% to 22.5%) in 60～69 years old group,25.8%(95%CI 12.6% to 45.5%) in 70～79years old group,53.0%(95%CI 23.9% to 80.2%) in diabetic elderly adults aged 80 years and above,and the difference was statistically significant(P=0.02).The influencing factors for cognitive frailty in diabetic elderly adults included educational level[OR=0.230,95% CI(0.117～0.454),P<0.0001],regular exercise[OR=0.357,95%CI(0.217～0.588),P<0.01],malnutrition[OR=2.372,95%CI(1.472～3.822),P=0.000 4],depression[OR=3.207,95%CI(2.156～4.768),P<0.00 1],and HbA_1c≥7.0%[OR=3.112,95%CI(1.880～5.152),P<0.000 1].Conclusion:The prevalence of cognitive frailty in Chinese elderly patients with diabetes is high,and there are differences in cognitive frailty prevalence among different sources and different ages.Educational level,exercise habits,nutritional status,depression and HbA_1c are the factors affecting cognitive frailty in elderly patients with diabetes.Depression,malnutrition,HbAlc≥7.0% were risk factors,and high educational level,regular exercise were protective factors.Attention should be paid to early and accurate identification of cognitive frailty and intervention targeting influencing factors to delay or reverse its progression to adverse health outcomes.
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基本信息:
DOI：10.13210/j.cnki.jhmu.20230509.001
中图分类号:R587.2;R749.1
引用信息:
[1]刘庭,宋咪,刁子晏,等.我国老年糖尿病患者认知衰弱患病率及影响因素的Meta分析[J].海南医学院学报,2023,29(22):1739-1747.DOI:10.13210/j.cnki.jhmu.20230509.001.
基金信息:
军事医学创新工程专项资助项目（18CXZ034）; 国家重点研发计划（2018YFC2001400,2020YFC2008601）~~
2023-05-10
2023-05-10
2023-05-10