Yuan Lu1,2,3,4, Chaojie Liu5, Dehua Yu6,7,8, Sally Fawkes2, Jia Ma3, Min Zhang3, Chunbo Li9. 1. Department of General Practice, Yangpu hospital, Tongji University School of Medicine, Shanghai, 200090, China. 2. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia. 3. Academic Department of General Practice, Yangpu hospital, Tongji University School of Medicine, Shanghai, 200090, China. 4. Shanghai General Practice and Community Health Development Research Center, 200090, Shanghai, China. 5. School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3086, Australia. c.liu@latrobe.edu.au. 6. Department of General Practice, Yangpu hospital, Tongji University School of Medicine, Shanghai, 200090, China. ydh1404@sina.com. 7. Academic Department of General Practice, Yangpu hospital, Tongji University School of Medicine, Shanghai, 200090, China. ydh1404@sina.com. 8. Shanghai General Practice and Community Health Development Research Center, 200090, Shanghai, China. ydh1404@sina.com. 9. Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shangha, China.
Abstract
BACKGROUND: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review. METHODS: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses. RESULTS: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6, 14.2%] for MCI and 10.9% [95% CI, 7.7, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association's Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer's Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. CONCLUSION: Higher MCI prevalence was identified in community-dwelling older adult populations in China compared with some other countries, possibly due to more broadened criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019134686.
BACKGROUND: Mild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and overt dementia, with amnesic MCI (aMCI) being the dominant subtype. This study aims to synthesise the prevalence results of MCI and aMCI in community-dwelling populations in China through a meta-analysis and systematic review. METHODS: The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol. English and Chinese studies published before 1 March 2020 were searched from ten electronic bibliographic databases. Two reviewers screened for relevance of the studies against the pre-defined inclusion and exclusion criteria and assessed the quality of the included studies using the Risk of Bias Tool independently. A random-effect model was adopted to estimate the prevalence of MCI and aMCI, followed by sub-group analyses and meta-regression. Sensitivity and publication bias tests were performed to verify the robustness of the meta-analyses. RESULTS: A total of 41 studies with 112,632 participants were included in the meta-analyses. The Chinese community-dwelling populations over 55 years old had a pooled prevalence of 12.2% [95% confidence interval (CI): 10.6, 14.2%] for MCI and 10.9% [95% CI, 7.7, 15.4%] for aMCI, respectively. The prevalence of MCI increased with age. The American Psychiatric Association's Diagnostic tool (DSM-IV) generated the highest MCI prevalence (13.5%), followed by the Petersen criteria (12.9%), and the National Institute on Aging Alzheimer's Association (NIA-AA) criteria (10.3%). Women, rural residents, and those who lived alone and had low levels of education had higher MCI prevalence than others. CONCLUSION: Higher MCI prevalence was identified in community-dwelling older adult populations in China compared with some other countries, possibly due to more broadened criteria being adopted for confirming the diagnosis. The study shows that aMCI accounts for 66.5% of MCI, which is consistent with findings of studies undertaken elsewhere. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019134686.
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