在没有已知的认知障碍的中年成人中使用的多域预后模型,用于预测随后的痴呆症
Gopisankar Mohanannair Geethadevi1, Terry J Quinn2, Johnson George1,3
1Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
The Cochrane database of systematic reviews
|June 2, 2023
概括
这项研究审查了中年成年人的14种痴呆症预后模型,发现了糖尿病和高血压等常见预测因素. 然而,大多数模型都有很高的偏差和有限的验证,突出了需要更强大的研究.
科学领域:
- 老年学是一门学科.
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 痴呆症是一个日益增长的全球健康问题,没有治疗方法,影响全球数百万人.
- 确定预测因素和开发准确的预后模型对于早期干预和中年成人风险降低至关重要.
研究的目的:
- 确定用于预测中年成人 (45-65岁) 痴呆症或认知障碍的多领域预后模型.
- 总结这些模型,评估它们的预测准确性,并探索对临床管理的影响.
主要方法:
- 在多个数据库 (MEDLINE,Embase等) 中进行系统搜索. 在2022年6月之前.
- 包括开发和验证研究,至少有五年后续研究.
- 使用CHARMS和PROBAST工具进行数据提取和偏差风险评估.
主要成果:
- 确定了14种独特的预后模型,其中糖尿病,高血压,肥胖和吸烟是常见的可修改预测因素.
- 大多数研究 (19/20) 具有高偏差风险;只有CAIDE模型在多项研究中得到了外部验证.
- 该CAIDE模型显示预测准确度的确定性非常低 (痴呆症诊断的C-统计值为0.71).
结论:
- 现有的中年老年痴呆症多领域预后模型缺乏强大的外部验证,并表现出显著的偏差.
- 需要进一步进行高质量的研究,以开发和验证可靠的模型来预测未来的痴呆风险.
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