Common Bacterial Infections and Risk of Dementia or Cognitive Decline: A Systematic Review.
Common Bacterial Infections and Risk of Dementia or Cognitive Decline: A Systematic Review.
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DOI：
10.3233/jad-200303
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Warren-Gash C
中科院分区：
文献类型：
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作者：
Muzambi R;Bhaskaran K;Brayne C;Davidson JA;Smeeth L;Warren-Gash C
细菌感染可能与痴呆症有关，但任何关系的暂时性仍不清楚。总结现有文献中关于常见细菌感染与痴呆和认知能力下降风险之间关系的纵向研究。我们使用常见细菌感染、痴呆、认知下降和纵向研究设计的检索词，对从成立到2019年3月18日的10个已发表文献和灰色文献数据库进行了全面检索。两名评价者独立进行研究选择、数据提取、偏倚风险和总体质量评估。通过叙述性综合总结数据，因为高异质性排除了荟萃分析。我们发现了3，488项研究。9项符合合格性标准; 6项在美国进行，3项在中国台湾进行。7项研究报告了痴呆症，2项研究了认知能力下降。在两项研究中评估了多重感染。所有研究均发现脓毒症（n = 6）、肺炎（n = 3）、尿路感染（n = 1）和蜂窝织炎（n = 1）使痴呆风险（HR 1.10; 95% CI 1.02-1.19）增加至（OR 2.60; 95% CI 1.84-3.66）。 当仅限于三项没有高偏倚风险领域的研究时，效应估计值的范围相似。然而，证据的总体质量被评为非常低。对认知能力下降的研究发现，这与感染无关，但效力较低。我们的综述表明，在调整多个混杂因素后，常见的细菌感染可能与随后痴呆的风险增加有关，但建议在不同的医疗环境中进行进一步的高质量，大规模的纵向研究，以进一步探讨这种关联。
Bacterial infections may be associated with dementia, but the temporality of any relationship remains unclear. To summarize existing literature on the association between common bacterial infections and the risk of dementia and cognitive decline in longitudinal studies. We performed a comprehensive search of 10 databases of published and grey literature from inception to 18 March 2019 using search terms for common bacterial infections, dementia, cognitive decline, and longitudinal study designs. Two reviewers independently performed the study selection, data extraction, risk of bias and overall quality assessment. Data were summarized through a narrative synthesis as high heterogeneity precluded a meta-analysis. We identified 3,488 studies. 9 met the eligibility criteria; 6 were conducted in the United States and 3 in Taiwan. 7 studies reported on dementia and 2 investigated cognitive decline. Multiple infections were assessed in two studies. All studies found sepsis (n = 6), pneumonia (n = 3), urinary tract infection (n = 1), and cellulitis (n = 1) increased dementia risk (HR 1.10; 95% CI 1.02–1.19) to (OR 2.60; 95% CI 1.84–3.66). The range of effect estimates was similar when limited to three studies with no domains at high risk of bias. However, the overall quality of evidence was rated very low. Studies on cognitive decline found no association with infection but had low power. Our review suggests common bacterial infections may be associated with an increased risk of subsequent dementia, after adjustment for multiple confounders, but further high-quality, large-scale longitudinal studies, across different healthcare settings, are recommended to further explore this association.