介绍轻度和重度神经认知障碍(NCDs)的患病率,也被称为轻度认知障碍和痴呆,正在全球崛起。预防非传染性疾病是一项重大的全球公共卫生利益。我们试图综合有关非传染性疾病潜在可改变的危险因素的文献。方法我们在多个数据库中进行了系统检索,以确定相关的系统评价和荟萃分析。符合条件的审查检查了轻度或主要非传染性疾病的潜在可改变的危险因素。我们使用随机效应多级荟萃分析方法来综合每个风险因素的风险比,同时考虑到评论中的重叠。我们进一步研究了由于两种常见病因导致的主要NCD的危险因素:阿尔茨海默病和血管性痴呆。结果共纳入45篇综述和212项荟萃分析。我们确定了14种与这些疾病显着相关的广泛定义的可改变的风险因素:饮酒,体重,抑郁症,糖尿病,饮食,高血压,少受教育,缺乏身体活动,感官损失,睡眠障碍,吸烟,社会孤立,创伤性脑损伤,维生素D缺乏。所有14个因素都与主要NCD的风险相关,5例伴有轻度NCD。我们发现对血管性痴呆和轻度NCD的研究相当少。结论我们的综述量化了与轻度和主要非传染性疾病的14种潜在可改变的危险因素相关的风险。包括痴呆症行动计划中很少包含的几个因素。预防策略应考虑通过促进健康来降低这些危险因素的发生率和严重程度的方法。identification,早期管理。
BACKGROUND: The prevalence of mild and major neurocognitive disorders (NCDs), also referred to as mild cognitive impairment and dementia, is rising globally. The prevention of NCDs is a major global public health interest. We sought to synthesize the literature on potentially modifiable risk factors for NCDs.
METHODS: We conducted an umbrella
review using a systematic search across multiple databases to identify relevant systematic reviews and meta-analyses. Eligible reviews examined potentially modifiable risk factors for mild or major NCDs. We used a random-effects multi-level meta-analytic approach to synthesize risk ratios for each risk factor while accounting for overlap in the reviews. We further examined risk factors for major NCD due to two common etiologies: Alzheimer\'s disease and vascular dementia.
RESULTS: A total of 45 reviews with 212 meta-analyses were synthesized. We identified fourteen broadly defined modifiable risk factors that were significantly associated with these disorders: alcohol consumption, body weight, depression, diabetes mellitus, diet, hypertension, less education, physical inactivity, sensory loss, sleep disturbance, smoking, social isolation, traumatic brain injury, and vitamin D deficiency. All 14 factors were associated with the risk of major NCD, and five were associated with mild NCD. We found considerably less research for vascular dementia and mild NCD.
CONCLUSIONS: Our
review quantifies the risk associated with 14 potentially modifiable risk factors for mild and major NCDs, including several factors infrequently included in dementia action plans. Prevention strategies should consider approaches that reduce the incidence and severity of these risk factors through health promotion, identification, and early management.