Prevalence of Depression in Patients With Mild Cognitive Impairment A Systematic Review and Meta-analysis
Prevalence of Depression in Patients With Mild Cognitive Impairment A Systematic Review and Meta-analysis
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DOI：
10.1001/jamapsychiatry.2016.3162
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发表时间：
2017-01-01
期刊：
影响因子：
25.8
通讯作者：
Fiest, Kirsten M.
中科院分区：
文献类型：
--
作者：
Ismail, Zahinoor;Elbayoumi, Heba;Fiest, Kirsten M.
抑郁症在轻度认知障碍（MCI）患者中很常见，并且可能导致更高的进展为痴呆的可能性。MCI患者抑郁症患病率的估计需要指导临床决策和公共卫生政策，但已发表的结果是可变的，缺乏precision. ObjectiveTo提供MCI患者抑郁症患病率的精确估计，并确定报告结果异质性的原因。PsycInfo的对所有纳入的文章进行手工检索，包括Google Scholar检索纳入文章的引文。研究选择如果文章（1）以英文发表，（2）报告MCI患者作为主要研究组，（3）使用经验证的工具报告抑郁症或抑郁症状，（4）报告了MCI患者抑郁症的患病率。资料提取与综合所有的摘要、全文文章和其他来源的资料均被回顾，数据提取一式两份。MCI患者抑郁症的总体患病率采用随机效应模型进行汇总。采用分层和随机效应meta-regression.Main Outcomes AND Measures探讨MCI患者抑郁症的患病率，报告为95%CI的百分比。估计数也按人口来源分层（基于社区或基于诊所的样本），抑郁症诊断方法（临床医生管理的、基于信息者的或自我报告的）和MCI诊断的方法结果：在5687篇独特的摘要中，255篇被选为全文综述，57项研究，代表20892例患者，符合所有入选标准。MCI患者抑郁症的总体合并患病率为32%（95%CI，27-37），估计值之间存在显著异质性（I-2 = 90.7%）。当按来源分层时，社区样本中MCI患者的抑郁患病率为25%（95%CI，19-30），临床样本中为40%（95%CI，32-48），差异有统计学意义（P <0.001）。用于诊断抑郁症的方法并没有显着影响的患病率估计，也没有用于MCI诊断或MCI subtype.CONCLUSIONS和相关性MCI患者抑郁症的患病率高的标准。报告文献中异质性的一个贡献者是样本的来源，基于临床的样本中普遍存在更大的抑郁负担。
IMPORTANCE Depression is common in individuals with mild cognitive impairment (MCI) and may confer a higher likelihood of progression to dementia. Prevalence estimates of depression in those with MCI are required to guide both clinical decisions and public health policy, but published results are variable and lack precision.OBJECTIVE To provide a precise estimate of the prevalence of depression in individuals with MCI and identify reasons for heterogeneity in the reported results.DATA SOURCES A search of literature from database inception to March 2016 was performed using Medline, Embase, and PsycINFO. Hand searching of all included articles was performed, including a Google Scholar search of citations of included articles.STUDY SELECTION Articles were included if they (1) were published in English, (2) reported patients with MCI as a primary study group, (3) reported depression or depressive symptoms using a validated instrument, and (4) reported the prevalence of depression in patients with MCI.DATA EXTRACTION AND SYNTHESIS All abstracts, full-text articles, and other sourceswere reviewed, with data extracted in duplicate. The overall prevalence of depression in patients with MCI was pooled using a random-effects model. Heterogeneity was explored using stratification and random-effects meta-regression.MAIN OUTCOMES AND MEASURES The prevalence of depression in patients with MCI, reported as a percentage with 95% CIs. Estimates were also stratified by population source (community-based or clinic-based sample), method of depression diagnosis (clinician-administered, informant-based, or self-report), and method of MCI diagnosis (cognitive vs global measure and amnestic vs nonamnestic).RESULTS Of 5687 unique abstracts, 255 were selected for full-text review, and 57 studies, representing 20 892 patients, met all inclusion criteria. The overall pooled prevalence of depression in patients with MCI was 32%(95% CI, 27-37), with significant heterogeneity between estimates (I-2 = 90.7%). When stratified by source, the prevalence of depression in patients with MCI in community-based samples was 25%(95% CI, 19-30) and was 40% (95% CI, 32-48) in clinic-based samples, which was significantly different (P < .001). The method used to diagnose depression did not significantly influence the prevalence estimate, nor did the criteria used for MCI diagnosis or MCI subtype.CONCLUSIONS AND RELEVANCE The prevalence of depression in patients with MCI is high. A contributor to heterogeneity in the reported literature is the source of the sample, with greater depression burden prevalent in clinic-based samples.