Zhongguo quanke yixue (Nov 2023)
A Meta-analysis of the Prevalence and Influencing Factors of Post-stroke Cognitive Impairment in Chinese Elderly Patients
Abstract
Background China has entered a comprehensive aging society, and stroke is the primary cause of death and disability among adults in China, post-stroke cognitive impairment has become an important cause for long-term disability and quality of life decline in stroke patients. Objective To analyse and clarify the prevalence and influencing factors of cognitive impairment in elderly stroke patients in China by Meta-analysis. Methods CNKI, Wanfang Data, VIP, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science were searched by computer to collect cohort, case-control, and cross-sectional studies on influencing factors of cognitive impairment in elderly stroke patients from inception to 2023-02-12. After independent screening of the literature and data extraction by two investigators, the quality of the literature was assessed and a Meta-analysis of the prevalence and influencing factors of cognitive impairment in elderly stroke patients in China was performed using Stata 14.0 software. Results A total of 46 papers were included, with 3 281 cases of cognitive impairment and 27 influencing factors involved. The Meta-analysis results showed that the prevalence of cognitive impairment in elderly stroke patients in China was 42.4%〔95%CI (36.6%, 48.3%) 〕; female〔OR=4.167, 95%CI (1.937, 8.967), P<0.001〕, hypertension〔OR=2.824, 95%CI (2.292, 3.481), P<0.001〕, systolic blood pressure〔OR=1.572, 95%CI (1.444, 1.711), P<0.001〕, diabetes mellitus〔OR=3.344, 95%CI (2.611, 4.284), P<0.001〕, hyperlipidemia 〔OR=2.228, 95%CI (1.091, 4.547), P=0.028〕, carotid plaque 〔OR=2.544, 95%CI (1.076, 6.014), P=0.033〕, infarction location of frontal lobe〔OR=1.615, 95%CI (1.167, 2.235), P=0.004〕, infarction location of temporal lobe〔OR=1.739, 95%CI (1.246, 2.427), P=0.001〕, multiple cerebral infarction〔OR=2.583, 95%CI (2.009, 3.321), P<0.001〕, encephalanalosis 〔OR=2.943, 95%CI (1.938, 4.469), P<0.001〕, homocysteine (Hcy) 〔OR=2.209, 95%CI (1.656, 2.948), P<0.001〕, hyperhomocysteinemia〔OR=3.043, 95%CI (2.092, 4.426), P<0.001〕, high-sensitivity C-reactive protein (hs-CRP) 〔OR=4.331, 95%CI (1.756, 10.685), P=0.001〕, and National Institutes of Health Stroke Scale (NIHSS) score >10〔OR=1.977, 95%CI (1.320, 2.961), P=0.001〕 were influencing factors for cognitive impairment in elderly stroke patients in China. Conclusion The prevalence of cognitive impairment in elderly stroke patients in China was high (42.4%), and female, hypertension, systolic blood pressure, diabetes mellitus, hyperlipidemia, carotid plaque, infarction location of frontal lobe and temporal lobe, multiple cerebral infarction, encephalanalosis, Hcy, hyperhomocysteinemia, hs-CRP, and NIHSS score >10 were influencing factors for cognitive impairment in elderly stroke patients in China.
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