社会经济地位与脑卒中后认知功能的关系：系统回顾与荟萃分析。

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY International Journal of Geriatric Psychiatry Pub Date : 2024-04-02 DOI:10.1002/gps.6082

Jingyuan Tian, Qiuyi Wang, Shuang Guo, Xiaoqing Zhao

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引用次数: 0

摘要

背景：中风幸存者在中风后应对认知问题的风险很高。近几十年来，社会经济地位（SES）与健康相关结果之间的关系一直是备受关注的话题。进一步了解社会经济地位对脑卒中后认知功能障碍的潜在影响具有重要意义：本系统综述和荟萃分析旨在通过量化现有研究的效应大小，总结 SES 与脑卒中后认知功能之间的关系：我们检索了 PubMed、Ovid、Embase、Cochrane、Scopus 和 PsychINFO 中截至 2024 年 1 月 30 日的研究以及相关综述的参考文献。纳入了通过分类 SES 指标评估卒中后认知功能障碍风险的研究。研究质量采用纽卡斯尔-渥太华量表和美国医疗保健研究与质量机构（Agency for Healthcare Research and Quality）进行评估。使用固定效应模型或基于研究异质性的随机效应模型进行元分析，以估计 SES 对卒中后认知功能的影响，然后根据研究特征进行亚组分析：34 项研究符合本系统综述和荟萃分析的条件。其中，19 项研究以卒中后认知功能障碍（PSCI）为研究结果，13 项研究以卒中后痴呆（PSD）为研究结果，1 项研究同时以卒中后认知功能障碍和卒中后痴呆为研究结果，1 项研究以血管性认知功能障碍和痴呆为研究结果。研究结果显示，社会经济地位较低的人合并卒中后认知功能障碍（比值比 (OR) = 1.91，95% 置信区间 (CI) = 1.59-2.29）、PSCI（比值比 = 2.09，95% 置信区间 (CI) = 1.57-2.78）和 PSD（比值比 = 1.95，95% 置信区间 (CI) = 1.48-2.57）的风险较高。根据社会经济地位指标进行的分组分析表明，教育和职业对脑卒中后认知功能障碍、脑卒中后认知功能障碍和脑卒中后认知功能障碍具有保护作用：结论：社会经济地位低的脑卒中幸存者是脑卒中后认知功能障碍的高危人群。我们的研究结果为通过减少社会经济地位不平等来降低卒中后认知功能障碍风险的公共卫生策略提供了证据。

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Association of socioeconomic status and poststroke cognitive function: A systematic review and meta-analysis

Background

Stroke survivors are at high risk of coping with cognitive problems after stroke. In recent decades, the relationship between socioeconomic status (SES) and health-related outcomes has been a topic of considerable interest. Learning more about the potential impact of SES on poststroke cognitive dysfunction is of great importance.

Objective

The purpose of this systematic review and meta-analysis was to summarize the association between SES and poststroke cognitive function by quantifying the effect sizes of the existing studies.

Method

We searched studies from PubMed, Ovid, Embase, Cochrane, Scopus, and PsychINFO up to January 30^th 2024 and the references of relevant reviews. Studies reporting the risk of poststroke cognitive dysfunction as assessed by categorized SES indicators were included. The Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the study quality. Meta-analyses using fixed-effect models or random-effect models based on study heterogeneity were performed to estimate the influence of SES on cognitive function after stroke, followed by subgroup analyses stratified by study characteristics.

Results

Thirty-four studies were eligible for this systematic review and meta-analysis. Of which, 19 studies reported poststroke cognitive impairment (PSCI) as the outcome, 13 reported poststroke dementia (PSD), one reported both PSCI and PSD, and one reported vascular cognitive impairment no dementia. The findings showed that individuals with lower SES levels had a higher risk of combined poststroke cognitive dysfunction (odds ratio (OR) = 1.91, 95% confidence interval (CI) = 1.59–2.29), PSCI (OR = 2.09, 95% CI = 1.57–2.78), and PSD (OR = 1.95, 95% CI = 1.48–2.57). Subgroup analyses stratified by SES indicators demonstrated the protective effects of education and occupation against the diagnoses of combined poststroke cognitive dysfunction, PSCI, and PSD.

Conclusions

Stroke survivors belonging to a low SES are at high risk of poststroke cognitive dysfunction. Our findings add evidence for public health strategies to reduce the risk of poststroke cognitive dysfunction by reducing SES inequalities.

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.