METHODS: A comprehensive literature search was conducted through the PubMed, Scopus and CENTRAL databases up to August 2022. Study quality was assessed using the Newcastle-Ottawa scale. Associations were calculated as odds ratio (OR) with 95 % confidence interval (CI). The I2 index was employed for heterogeneity.
RESULTS: Eleven studies (nine assessed as of good and two as of fair quality) were included in the meta-analysis (n = 4,716,862). Women with EM demonstrated a greater risk of dementia of any type than women of normal age at menopause (OR 1.37, 95 % CI 1.22-1.54; I2 93%). However, after excluding a large retrospective cohort study, the results were altered (OR 1.07, 95 % CI 0.78-1.48; I2 94%). Increased risk of dementia was also found in women with POI (OR 1.18, 95 % CI 1.15-1.21; I2 0%). Subgroup analysis showed that this risk was mostly evident in cohort studies, and those which included women with natural menopause.
CONCLUSIONS: Women with EM or POI may be at increased risk of dementia compared with women of normal age at menopause, but further research investigating that hypothesis is warranted.
方法:通过PubMed进行了全面的文献检索,截至2022年8月的Scopus和CENTRAL数据库。使用纽卡斯尔-渥太华量表评估研究质量。关联计算为比值比(OR),95%置信区间(CI)。I2指数用于异质性。
结果:11项研究(9项评估为良好,2项评估为一般质量)纳入荟萃分析(n=4,716,862)。与绝经时正常年龄的女性相比,患有EM的女性患痴呆的风险更高(OR1.37,95%CI1.22-1.54;I293%)。然而,排除大型回顾性队列研究后,结果改变(OR1.07,95%CI0.78-1.48;I294%)。患有POI的女性患痴呆的风险也增加(OR1.18,95%CI1.15-1.21;I20%)。亚组分析显示,这种风险在队列研究中最为明显,包括自然更年期女性。
结论:患有EM或POI的女性在绝经时与正常年龄的女性相比,患痴呆的风险增加,但进一步的研究调查这一假设是有必要的。