中国老年轻度认知障碍患病率的系统评价

目的系统评价中国老年轻度认知障碍(mild cognitive impairment,MCI)的患病率。方法计算机检索PubMed、EMbase、The Cochrane Library、CNKI、VIP、WanFang Data和CBM数据库,搜集关于中国老年轻度认知障碍患病率的研究,检索时限均从建库至2019年5月。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析。结果共纳入25个研究,包括56 720例患者。Meta分析结果显示:中国老年MCI的患病率为14%95%CI(12%,17%)],其中男性为12.1%95%CI(9.7%,14.5%)],女性为14.8%95%CI(12.5%,17.2%)]。按年龄分组:60~69岁为8%95%CI(6.0%,10.1%)],70~79岁为13.1%95%CI(10.6%,15.6%)],≥80岁为23.4%95%CI(18.3%,28.6%)]。按学历分组:文盲为23%95%CI(18.3%,27.6%)],小学学历为15.2%95%CI(11.2%,19.2%)],学历在初中或初中以上的为9.8%95%CI(7.1%,12.6%)]。按地区分组:城市为9.9%95%CI(5.5%,14.2%)],农村为16.7%95%CI(11.2%,22.2%)]。按婚姻状况分组:已婚为12.1%95%CI(7.7%,16.5%)],独身为17.1%95%CI(13.9%,20.2%)]。按地域分组:华北地区为15.4%95%CI(11.4%,19.4%)],华东地区为14.1%95%CI(11.1%,17.2%)],东北地区为5.4%95%CI(3.9%,6.9%)],中南地区为13%95%CI(6.2%,19.8%)],西南地区为11.7%95%CI(10.2%,13.2%)],西北地区为17.4%95%CI(2.5%,32.3%)]。按诊断标准分组:采用1999年Petersen标准为15.2%95%CI(11.8%,18.7%)],采用DSM-Ⅳ标准为12.4%95%CI(9.4%,15.4%)]。结论中国老年MCI的患病率较高,不同性别、年龄、学历、地区、婚姻状况及地域的老年MCI患病率不同,且MCI的患病率受诊断标准的影响。

Epidemiological of mild cognitive impairment in Chinese elderly population: a systematic review

Objectives To systematically review the epidemiological characteristics of mild cognitive impairment(MCI) in Chinese elderly population. Methods PubMed, EMbase, The Cochrane Library, CNKI, VIP, WanFang Data and CBM databases were electronically searched to collect studies on the epidemiological characteristics of mild cognitive impairment in the elderly in China from inception to May 2019. Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using Stata 12.0 software. Results A total of 25 studies involving 56 720 patients were included. The results of meta-analysis showed that the prevalence of MCI in Chinese elderly population was 14%(95%CI 12% to 17%), in which 12.1%(95%CI 9.7% to14.5%) was male and 14.8%(95%CI 12.5% to 17.2%) was female. The prevalence of MCI was 8%(95%CI 6.0% to 10.1%) in the elderly aged 60 to 69, 13.1%(95%CI 10.6% to 15.6%) in the elderly aged 70 to 79 and 23.4%(95%CI 18.3% to 28.6%) in the elderly aged above 80. The prevalence of MCI was 23%(95%CI 18.3% to 27.6%) in the elderly who were illiterate,15.2%(95%CI 11.2% to 19.2%) among the elderly with a primary education and 9.8%(95%CI 7.1% to 12.6%) among the elderly with an education above junior high school. The prevalence of MCI was 9.9%(95%CI 5.5% to 14.2%) in urban areas, and 16.7%(95%CI 11.2% to 22.2%) in rural areas. The prevalence of MCI was 12.1%(95%CI 7.7% to 16.5%)in married individuals and 17.1%(95%CI 13.9% to 20.2%) in single individuals. The prevalence of MCI was 15.4%(95%CI11.4% to 19.4%) in northern China, 14.1%(95%CI 11.1% to 17.2%) in eastern China, 5.4%(95%CI 3.9% to 6.9%) in northeast China, 13%(95%CI 6.2% to 19.8%) in Central-south China, 11.7%(95%CI 10.2% to 13.2%) in the southwest China and17.4%(95%CI 2.5% to 32.3%) in northwest China. By using the diagnostic criteria proposed by Petersen, the prevalence of MCI was 15.2%(95%CI 11.8% to 18.7%), and was 12.4%(95%CI 9.4% to 15.4%) using the criteria of the DSM-Ⅳ.Conclusions The prevalence of MCI is high in China, and varies with gender, age, education, location, marital status,region and diagnostic criteria.