针对老年人认知障碍的查:美国预防服务工作组的最新证据报告和系统审查
Carrie D Patnode1, Leslie A Perdue1, Rebecca C Rossom2
1Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon.
JAMA
|February 26, 2020
概括
早期认知障碍查能够准确检测疾病, 对患者和护理人员来说, 干预的好处很小, 需要进一步的研究.
科学领域:
- 老年学
- 神经学
- 预防医学
背景情况:
- 早期识别认知障碍对于改善老年人和他们的护理人员的健康结果至关重要.
- 认知障碍,包括轻度认知障碍 (MCI) 和痴呆症,影响着老年人口的很大一部分.
研究的目的:
- 在老年人 (≥65岁) 中系统地审查认知查仪器的准确性.
- 评估治疗老年人的认知障碍的好处和危害.
- 根据美国预防服务工作组的建议.
主要方法:
- 对MEDLINE,PubMed,PsycINFO和Cochrane控制试验中心注册的系统审查.
- 包括对MCI或轻度至中度痴呆症的查仪器和治疗方法的英语研究.
- 使用随机效应元分析和定性合成的数据提取和合成.
主要成果:
- 研究人员回顾了287项涉及28万名老年人的研究.
- 认知查仪表表现出足够的准确性 (例如,迷你精神状态检查:灵敏度为0.89,特异性为0.89).
- 从查结果中没有发现患者或护理人员的显著改善;干预措施显示了微小的,不确定的临床益处.
结论:
- 认知查仪器有效地检测认知障碍.
- 目前的证据不支持查改善患者或护理人员的结果或防止伤害.
- 对早期发现认知障碍的干预措施的临床重要性仍然不确定.
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