背景:本系统评价旨在全面评估伊朗老年人验证的认知筛查工具的诊断准确性,为临床医生和研究人员提供循证建议。
方法:2023年3月在WebofScience上进行的全面搜索,PubMed,Scopus,ScienceDirect,SID,IranMedex,和伊朗医生,通过手工搜索参考文献和谷歌学者增强,已确定的伊朗老年人认知筛查的横断面研究。我们评估了诊断的准确性,认知领域,测试优势和劣势。双变量随机效应荟萃分析提供了汇总估计和95%置信区间,在森林地块中说明。
结果:我们的评论,从38篇文章的初步筛选中得出,重点研究了17项研究,涉及14项认知筛查工具,参与者数量从60到350,主要来自专门诊所。MMSE是至少三项研究中唯一检查的工具,提示荟萃分析显示其对痴呆症检测的敏感性为0.89,特异性为0.77,尽管存在显著的异质性(I^2>80%)。ACE-III对MCI和痴呆的诊断准确率最高,而MoCA的表现被认为是足够的MCI和优秀的痴呆。研究中的高偏倚风险限制了解释。
结论:本综述确定了伊朗老年人痴呆和MCI的关键认知工具,适合教育水平,用于初级和专门护理。它强调需要进一步验证,以提高跨不同设置的诊断精度,在一个简洁的框架内,优先考虑临床适用性的简洁性和准确性。
BACKGROUND: This systematic review aims to comprehensively assess the diagnostic accuracy of cognitive screening tools validated for older adults in Iran, providing evidence-based recommendations for clinicians and researchers.
METHODS: A comprehensive search in March 2023 across Web of Science, PubMed, Scopus, ScienceDirect, SID, IranMedex, and IranDoc, enhanced by hand-searching references and Google Scholar, identified cross-sectional studies on cognitive screening in Iranian seniors. We assessed diagnostic accuracy, cognitive domains, and test strengths and weaknesses. A bivariate random-effects meta-analysis provided summary estimates and 95% confidence intervals, illustrated in forest plots.
RESULTS: Our review, derived from an initial screening of 38 articles, focused on 17 studies involving 14 cognitive screening tools and participant counts from 60 to 350, mostly from specialized clinics. The MMSE was the only tool examined in at least three studies, prompting a meta-analysis revealing its sensitivity at 0.89 and specificity at 0.77 for dementia detection, albeit amidst significant heterogeneity (I^2 > 80%). ACE-III demonstrated the highest diagnostic accuracy for MCI and dementia, while MoCA\'s performance was deemed adequate for MCI and excellent for dementia. High bias risk in studies limits interpretation.
CONCLUSIONS: This review identifies key cognitive tools for dementia and MCI in Iranian older adults, tailored to educational levels for use in primary and specialized care. It emphasizes the need for further validation to enhance diagnostic precision across diverse settings, within a concise framework prioritizing brevity and accuracy for clinical applicability.