老年糖尿病患者认知衰弱影响因素的Meta分析 [中文引用][英文引用]

目的  系统评价我国老年糖尿病患者认知衰弱的影响因素，为临床制定个体化干预措施提供依据。方法  系统检索 PubMed，EMbase，Web of Science，Scopus，Cochrane Library、中国知网、万方、维普、SinoMed，收集老年糖尿病患者认知衰弱影响因素的研究，检索时限为 2013 年 1 月 1 日至 2025 年 4 月 1 日。由 2 名研究者独立依照纳入标准与排除标准筛选文献，评价文献质量并提取资料，使用 Stata17.0 软件进行 Meta 分析，并计算影响因素的合并比值比（odds ratio，OR）及 95% 置信区间（confidence interval，CI）以综合评价老年糖尿病患者认知衰弱的影响因素。结果  本研究中老年糖尿病患者认知衰弱发生率平均为 18.09%，处于较高水平；Meta 分析（包括 11 篇文献和 3 524 例患者）结果显示，糖化血红蛋白（OR=3.54，95%CI［2.17，5.76］）、抑郁（OR=3.68，95%CI［2.83，4.78］）、规律运动（OR=0.29，95%CI［0.20，0.41］）、营养不良（OR=3.07，95%CI［2.24，4.20］）、糖尿病病程（OR=4.89，95%CI［2.69，8.88］）、文化程度（OR=0.29，95%CI［0.15，0.49］）是老年糖尿病患者认知衰弱的影响因素。结论  老年糖尿病患者认知衰弱危险因素为糖化血红蛋白、抑郁、营养不良、糖尿病病程，保护因素为规律运动、文化程度，应早期识别认知衰弱影响因素并针对性进行干预，有助于延缓或逆转认知衰弱的发展。

Objective To systematically review the factors influencing cognitive frailty in elderly patients with diabetes in China，and to provide a guidance for developing individualised clinical interventions. Methods Systematic searches were conducted in PubMed，EMbase，Web of Science，Scopus，Cochrane Library，CNKI，Wanfang Data，VIP，and SinoMed to identify observational studies on cognitive frailty in elderly patient with diabetes，with the search period spanning from January 2013 to April 2025. Two researchers independently screened the literature according to inclusion and exclusion criteria，assessed the study quality and extracted relevant data. Meta-analysis was performed using Stata 17.0 software，and the pooled odds ratios（ORs）with 95% confidence intervals（CIs） were calculated to comprehensively evaluate the influencing factors. Results The incidence of cognitive frailty in elderly patients with diabetes averaged 18.09%. The meta-analysis（including 11 studies and 3，524 patients）revealed that glycated haemoglobin（OR=3.54， 95%CI［2.17，5.76］），depression（OR=3.68，95%CI［2.83，4.78］），regular exercise（OR=0.29，95%CI［0.20，0.41］），malnutrition （OR=3.07，95%CI［2.24，4.20］），duration of diabetes（OR=4.89，95%CI［2.69，8.88］），and education（OR=0.29，95% CI［0.15，0.49］） were the significant factors influencing cognitive frailty in elderly patients with diabetes. Conclusion Risk factors for cognitive frailty in elderly patients with diabetes include glycated haemoglobin，depression，malnutrition and duration of diabetes，while the protective factors include regular exercise and education. Early identification and targeted interventions of the influencing factors may help delay or reverse the progression of cognitive frailty.