中国老年人群认知衰弱风险预测模型系统评价  

Risk prediction models of cognitive frailty in older adults in China:a systematic review

作　　者：奚婧 孟红燕[1,2] 施旻昊[2] 毛祉瑜 牛柯雯 Xi Jing;Meng Hongyan;Shi Minhao;Mao Zhiyu;Niu Kewen(Department of Nursing,The First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院护理部,江苏苏州215000 [2]苏州大学苏州医学院护理学院

出　　处：《护理学杂志》2024年第2期23-27,共5页Journal of Nursing Science

基　　金：2022年江苏省老年病预防与转化重点实验室开放课题(KJS2223)。

摘　　要：目的系统评价我国老年人群认知衰弱风险预测模型,为护理人员选择或开发合适的老年人认知衰弱风险预测模型提供参考,并为老年人认知衰弱干预方案的制定提供依据。方法计算机系统检索Cochrane Library、Embase、PubMed、Web of Science、中国知网、万方数据及维普数据库发表的与主题相关的中国人群研究,检索时间为建库至2023年7月1日,根据纳入、排除标准筛选文献,2名研究者依据预测模型研究数据提取表和偏倚风险评估工具独立提取资料和评价质量。结果共纳入10篇文献,10个老年认知衰弱风险预测模型,总样本量为268~1182例,发生认知衰弱事件数为54~293例。1个模型未行内外部验证,2个模型仅行内部验证,3个模型仅行外部验证,4个模型行内外部验证,模型受试者工作特征曲线下面积为0.710~0.991,8篇研究对模型进行校准。多变量模型重复报告的独立预测因子包括年龄、运动习惯、抑郁、合并症及营养状况。纳入模型偏倚风险均为高风险,适用性评价均为好。结论我国老年人认知衰弱风险预测模型具有良好的区分度及适用性,但存在显著的方法学缺陷和高偏倚风险。未来研究应严格按照风险预测模型报告规范来开发和评估我国老年人群认知衰弱风险预测模型,并验证其在临床实践中的可行性。Objective To systematically evaluate the risk prediction models of cognitive frailty in older adults in China,so as to provide a reference for nursing staff choosing or developing suitable risk prediction models of cognitive frailty in older adults,and to provide evidence for forming intervention programs.Methods The Cochrane Library,Embase,PubMed,Web of Science,CNKI,Wanfang and VIP databases were searched for relevant studies on the Chinese population from the date of inception to 1 July 2023.Literature screening was performed based on inclusion and exclusion criteria.Two researchers independently extracted data with a data extraction table and assessed the quality of studies with a bias risk assessment tool.Results A total of 10 articles were included,and 10 risk prediction models of cognitive frailty in older adults were identified,with a total sample size of 268-1182,and 54-293 of them suffered from cognitive frailty events.One model wasn′t validated,two models were only internally validated,three models were externally validated,and four models were internally and externally validated,the area under the curve(AUC)of the model was 0.710-0.991,and eight studies calibrated the model.Independent predictors of the multivariate model included age,exercise habits,depression,comorbidities,and nutritional status.The bias risk of the included models was high,and the applicability evaluation was reasonable.Conclusion The risk prediction models of cognitive frailty for older adults in China have good discrimination and applicability,but there are significant methodological flaws and high bias risk.Future researchers should strictly follow the reporting standards for developing and evaluating the risk prediction models of cognitive frailty in Chinese older adults,and verify their feasibility in clinical practice.

关 键 词：老年人 认知衰弱 身体衰弱 认知障碍 风险预测 偏倚风险 系统评价 影响因素 

分 类 号：R473.74[医药卫生—护理学] R339.34[医药卫生—临床医学]