Construction And Validation Of A Risk Assessment Model For Mild Cognitive Impairment In Chinese Elderly Based On Meta-analysis

Objectives:Mild cognitive impairment(MCI)is a chronic degenerative disease of the nervous system,which is a cognitive deficit state between normal aging and dementia.This study intends to conduct a Meta-analysis inorder to obtain the influencing factors of MCI and the its effect measurement indices,so as to construct a risk assessment model for MCI in Chinese elderly population and to provide theoretical foundation for screening and individual prevention.Methods:1.Systematic evaluation and Meta-analysis of influencing factors of MCI among Chinese elderly:China National Knowledge Network,Wanfang,VIP,PubMed,Embase and Web of Science were systematically searched to collect relevant literatures on influencing factors of MCI among Chinese elderly published at home and abroad from the establishment of the database to March 13,2022.Literature screening and information extraction were conducted independently by two researchers,and Stata 17.0 was used to combine the risk values of each influencing factor.2.Construction of MCI risk assessment model in Chinese elderly:According to literature retrieval and meta-analysis results,the risk assessment model of MCI in Chinese elderly based on Rothman-Keller was constructed.3.Validation of the MCI risk assessment model in Chinese elderly:The elderly aged 60 years and above were recruited from the physical examination center of Penglai People’s Hospital and Rongcheng People’s Hospital of Shandong Province to collect general demographic characteristics and physical examination informations from November 2021 to June 2022.Montreal Cognitive Assessment(MoCA)was used for MCI assessment.Area under the curve(AUC),sensitivity and specificity were calculated to evaluate the model effect.Results:1.Meta-analysis results of factors influencing MCI in Chinese elderly:A total of 2450 papers were retrieved,and 49 papers were finally included after excluding duplicates,initial screening and re-screening according to inclusion and exclusion criteria.The results showed that the risk of MCI was lower in men(RR=0.778,95%CI:0.696～0.870),those education>6 years(RR=0.428,95%Cl:0.374-0.490),and those who exercised regularly(RR=0.4～96,95%CI:0.421～0.585);while the risk of MCI was higher in those aged≥70 years(RR=2.431,95%CI:2.086～2.833),family history of dementia(RR=3.228,95%CI:2.140～4.867),smoking(RR=1.214,95%CI:1.098～1.342),alcohol consumption(RR=1.165,95%CI:1.047～1.297),living alone(RR=2.816,95%CI:2.123～3.736),insomnia(RR=1.402,95%CI:1.093～1.799),overweight/obesity(RR=1.431,95%CI:1.207～1.696),hypertension(RR=1.731,95%CI:1.589～1.886),hyperlipidemia(RR=1.722,95%CI:1.541～1.924),diabetes mellitus(RR=1.495,95%CI:1.341～1.666),cardiovascular disease(RR=1.671,95%CI:1.446～1.932),and cerebrovascular disease(RR=2.309,95%CI:2.040～2.613).2.Construction of the risk assessment model of MCI in Chinese elderly:The Rothman-Keller risk assessment model of MCI in Chinese elderly was constructed based on the results of Meta-analysis.A total of 15 influencing factors were included in the model,and the cut-off point of high-risk classification was R=0.0325.3.Validation of the risk assessment model of MCI in Chinese elderly:A total of 2545 elderly people aged 60 years and above from Rongcheng People’s Hospital and Penglai People’s Hospital in Shandong Province were included in the study,including 1363 males and 1182 females,with 642 MCI cases.The AUC of the MCI risk assessment model established in this study was 0.772(95%CI:0.753～0.791),with a sensitivity of 78.04%and specificity of 63.95%.Conclusions:Male,education>6 years,and regular exercise were protective factors of MCI,while age ≥ 70 years,family history of dementia,smoking,alcohol consumption,living alone,insomnia,overweight/obesity,hypertension,hyperlipidemia,diabetes,cardiovascular diseases,and cerebrovascular diseases were risk factors of MCI.The MCI risk assessment model established based on Meta-analysis is effective in Chinese elderly population.The model with its high sensitivity can be used for MCI screening in primary health care institutions or in the community,which is conductive to identify high-risk population earlier and take proper intervention measures.