收稿日期: 2021-10-18
网络出版日期: 2022-10-25
基金资助
天津市医学重点学科（专科）建设项目(TJYXZDXK-011A)
A systematic review of the effects of the comprehensive intervention on frailty in older population
目的 系统评价综合护理干预对衰弱老年人的影响。方法 计算机检索从2010年1月至2020年12月Cochrane Library、Embase、PubMed、Web of Science、CINAHL、CNKI、中国生物医学文献数据库、万方和维普数据库中公开发表的关于综合护理干预对衰弱老年人影响的随机对照试验。 结果 共纳入11篇文献,2 714例衰弱老年人。Meta分析结果显示,综合护理干预对步速[SMD=0.13,95%CI（0.03,0.22）,P=0.007]、Barthel指数[WMD=2.52,95%CI（0.81,4.23）,P=0.004]、抑郁[SMD=-0.09,95%CI（-0.18,-0.00）,P=0.04]具有积极影响,对衰弱评分[WMD=-0.12, 95%CI（-0.43,0.18）,P=0.42]、握力[WMD=1.35,95%CI（-0.92,3.61）,P=0.24]及生活质量[WMD=-0.42,95%CI（-0.97, 0.13）,P=0.13]无明显作用。 结论 综合护理干预可以提高衰弱老年人步速、Barthel指数,改善其抑郁状态,但对衰弱评分、握力和生活质量无明显影响。目前有关综合护理干预对衰弱老年人影响的研究证据尚不充足,且各研究间差异较大,需进行更多高质量的研究以验证其效果。
韩旭亚 , 田丽 , 吕丹 , 曹亭 , 陈昌连 , 曹家燕 . 衰弱老年人综合护理干预效果的系统评价[J]. 中华护理教育, 2022 , 19(10) : 938 -943 . DOI: 10.3761/j.issn.1672-9234.2022.10.014
Objective To identify the effects of the comprehensive intervention on frailty in older population through meta-analysis. Methods Randomized controlled trials on the effectiveness of the comprehensive intervention on frailty of older population were retrieved from the electronic databases of Cochrane Library,PubMed,Embase,Web of Science,CINAHL,CNKI,CBM,Wanfang and VIP from January 2010 to December 2020. Results A total of 11 articles involving 2 714 old people were finally included. Meta-analysis results showed that the comprehensive intervention had a positive effect on gait speed[SMD=0.13,95%CI（0.03,0.22）,P=0.007],Barthel Index[WMD=2.52,95%CI（0.81,4.23）,P=0.004] and depression [SMD=-0.09,95%CI（-0.18,-0.00）,P=0.04]. The comprehensive intervention had no significant effects on frailty score[WMD=-0.12,95%CI（-0.43,0.18）,P=0.42],grip strength [WMD=1.35,95%CI（-0.92,3.61）,P=0.24] and quality of life in older population[WMD=-0.42,95%CI（-0.97,0.13）,P=0.13]. Conclusion The comprehensive intervention significantly improves the gait speed,Barthel Index and depression,but cannot improve frailty score,grip strength and quality of life. At present,the evidence on the effects of the comprehensive intervention on frailty in older population is still insufficient. There are many differences among studies. More high-quality studies are needed to verify the effects of the comprehensive intervention on frailty in older adults.
Key words： Aged; Frailty; Comprehensive intervention; Systematic review
| [1] | Fried LP, Tangen CM, Walston J, et al. Frailty in older adults:evidence for a phenotype[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(3):146-156. |
| [2] | Fairhall N, Aggar C, Kurrle SE, et al. Frailty intervention trial(FIT)[J]. BMC Geriatr, 2008, 8:27. |
| [3] | Dent E, Lien C, Lim WS, et al. The Asia-Pacific clinical practice guidelines for the management of frailty[J]. J Am Med Dir Assoc, 2017, 18(7):564-575. |
| [4] | Ruiz JG, Dent E, Morley JE, et al. Screening for and managing the person with frailty in primary care:ICFSR consensus guidelines[J]. J Nutr Health Aging, 2020, 24(9):920-927. |
| [5] | Li CM, Chen CY, Li CY, et al. The effectiveness of a comprehensive geriatric assessment intervention program for frailty in community-dwelling older people:a randomized,controlled trial[J]. Arch Gerontol Geriatr, 2010, 50:39-42. |
| [6] | Cameron ID, Fairhall N, Langron C, et al. A multifactorial interdisciplinary intervention reduces frailty in older people:randomized trial[J]. BMC Med, 2013, 11:65. |
| [7] | Fairhall N, Sherrington C, Lord SR, et al. Effect of a multifactorial,interdisciplinary intervention on risk factors for falls and fall rate in frail older people:a randomised controlled trial[J]. Age Ageing, 2014, 43(5):616-622. |
| [8] | Fairhall N, Sherrington C, Kurrle SE, et al. Economic evaluation of a multifactorial,interdisciplinary intervention versus usual care to reduce frailty in frail older people[J]. J Am Med Dir Assoc, 2015, 16(1):41-48. |
| [9] | Ng TP, Feng L, Nyunt MSZ, et al. Nutritional,physical,cognitive,and combination interventions and frailty reversal among older adults:a randomized controlled trial[J]. Am J Med, 2015, 128(11):1225-1236. |
| [10] | Ng TP, Nyunt MSZ, Feng L, et al. Multi-domains lifestyle interventions reduces depressive symptoms among frail and pre-frail older persons:randomized controlled trial[J]. J Nutr Health Aging, 2017, 21(8):918-926. |
| [11] | Andrieu S, Guyonnet S, Coley N, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints(MAPT):a randomised,placebo-controlled trial[J]. Lancet Neurol, 2017, 16(5):377-389. |
| [12] | Gené Huguet L, Navarro González M, Kostov B, et al. Pre frail 80:multifactorial intervention to prevent progression of pre-frailty to frailty in the elderly[J]. J Nutr Health Aging, 2018, 22(10):1266-1274. |
| [13] | Romera-Liebana L, Orfila F, Segura JM, et al. Effects of a pri-mary care-based multifactorial intervention on physical and cognitive function in frail,elderly individuals:a randomized controlled trial[J]. J Gerontol A Biol Sci Med Sci, 2018, 73(12):1688-1674. |
| [14] | 倪洁, 葛兆霞. 衰弱前期老年患者运动衰弱干预试验效果观察[J]. 护理学报, 2019, 26(15):65-69. |
| [14] | Ni J, Ge ZX. Observation on the effect of exercise intervention experiment on elderly patients with prefrail[J]. J Nurs (China), 2019, 26(15):65-69. |
| [15] | Chen LK, Hwang AC, Lee WJ, et al. Efficacy of multidomain interventions to improve physical frailty,depression and cognition:data from cluster-randomized controlled trials[J]. J Cachexia Sarcopenia Muscle, 2020, 11:650-662. |
| [16] | 曹亭, 刘启帆, 施月仙, 等. 运动联合营养支持对衰弱期及衰弱前期老年人影响的Meta分析[J]. 中国护理管理, 2019, 19(1):52-59. |
| [16] | Cao T, Liu QF, Shi YX, et al. Effects of exercise combined with nutrition support on the elderly with frailty or pre-frailty:a Meta-analysis[J]. Chin Nurs Manag, 2019, 19(1):52-59. |
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