对痴呆风险评估工具进行批判性审查和分类,以帮助减少痴呆风险
Md Hamidul Huque1, Ranmalee Eramudugolla1, Meiwei Li2
1School of Psychology, University of New South Wales, High St, Kensington, NSW 2052, Australia; Neuroscience Research Australia, 139 Barker St, Randwick, NSW 2031, Australia; UNSW Ageing Futures Institute, University of NSW, High St, Kensington, NSW 2052, Australia.
可靠的痴呆风险评估对于解决可改变的风险因素至关重要. 有几种经过验证的痴呆症和阿尔茨海默病风险评分,可提供成本效益评估和风险降低建议.
科学领域:
- 神经科学
- 流行病学
- 公共卫生
背景情况:
- 有效的痴呆风险降低策略取决于准确的风险评估.
- 确定和评估现有的痴呆风险得分对于临床实施至关重要.
- 现有的风险评分因其目标人群,内容和验证严格而有所不同.
研究的目的:
- 系统地审查和分类所有原因痴呆症,阿尔茨海默病 (AD) 和血管痴呆症的痴呆风险得分.
- 评估这些风险评分的内容,成本,验证和适用于实施风险降低指导方针.
- 确定可修改的痴呆风险因素的验证风险得分.
主要方法:
- 在多个主要数据库 (PubMed,Cochrane,Scopus等) 进行了系统的文献搜索. 使用预先注册的协议.
- 数据提取重点是风险因素,目标人群,预测有效性,成本和与世卫组织指导方针一致.
- 用随机效应的元分析来综合有关痴呆风险得分的结果.
主要成果:
- 确定了45个风险评分;29个是所有原因的痴呆症,不同的队列重点 (中年,晚年).
- 痴呆风险得分的C统计值为0. 69; 然而,验证AUC低于发育AUC.
- 对于血管性痴呆症没有得到验证的风险评分,但Dem-NCD,CogDrisk,ANU-ADRI和LIBRA对全因痴呆症和AD有希望.
结论:
- 在验证和比较痴呆风险评估工具方面存在方法上的局限性.
- 对所有原因的痴呆症和阿尔茨海默病的验证风险得分可用,包括可修改的因素.
- 这些经过验证的评分为痴呆风险评估提供了成本效益的方法,并为降低风险提供了指导.
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