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Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis

Non-affective psychotic disorders have been associated with an increased risk of developing dementia. However, research in this area remains limited, highlighting the need for an up-to-date systematic review and meta-analysis of the evidence. We aimed to systematically review and quantify the risk o...

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Autores principales: Miniawi, Sara El, Orgeta, Vasiliki, Stafford, Jean
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772917/
https://www.ncbi.nlm.nih.gov/pubmed/36200264
http://dx.doi.org/10.1017/S0033291722002781
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author Miniawi, Sara El
Orgeta, Vasiliki
Stafford, Jean
author_facet Miniawi, Sara El
Orgeta, Vasiliki
Stafford, Jean
author_sort Miniawi, Sara El
collection PubMed
description Non-affective psychotic disorders have been associated with an increased risk of developing dementia. However, research in this area remains limited, highlighting the need for an up-to-date systematic review and meta-analysis of the evidence. We aimed to systematically review and quantify the risk of dementia associated with psychotic disorders. We searched four electronic databases for longitudinal studies investigating non-affective psychotic disorders and subsequent dementia. We used random-effects meta-analyses to pool estimates across studies and assessed risk of bias for each study. Non-affective psychotic disorders were associated with increased risk of all-cause dementia; pooled risk ratio (RR) = 2.52, 95% confidence interval (CI) (1.67–3.80), I(2) = 99.7%, n = 12,997,101; 11 studies, with high heterogeneity between studies. Subgroup analyses indicated stronger associations in studies with shorter follow-up periods, conducted in non-European countries, published after 2020, and where ≥60% of the sample were female. The risk was higher in people aged <60 years at baseline, in typical and late-onset psychotic disorders versus very late-onset psychosis, in broader psychotic disorders vs schizophrenia, and in prospective vs retrospective studies. Associations remained after excluding low quality studies (pooled RR = 2.50, 95% CI (1.71–3.68), I(2) = 99.0%). Our review finds a substantial association between psychotic disorders and subsequent dementia. Our findings indicate that psychotic disorders are a potentially modifiable risk factor for dementia and suggest that individuals with psychotic disorders need to be closely monitored for cognitive decline in later life. Further research is needed to investigate the mechanisms underlying the association between psychotic disorders and dementia.
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spelling pubmed-97729172022-12-28 Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis Miniawi, Sara El Orgeta, Vasiliki Stafford, Jean Psychol Med Review Article Non-affective psychotic disorders have been associated with an increased risk of developing dementia. However, research in this area remains limited, highlighting the need for an up-to-date systematic review and meta-analysis of the evidence. We aimed to systematically review and quantify the risk of dementia associated with psychotic disorders. We searched four electronic databases for longitudinal studies investigating non-affective psychotic disorders and subsequent dementia. We used random-effects meta-analyses to pool estimates across studies and assessed risk of bias for each study. Non-affective psychotic disorders were associated with increased risk of all-cause dementia; pooled risk ratio (RR) = 2.52, 95% confidence interval (CI) (1.67–3.80), I(2) = 99.7%, n = 12,997,101; 11 studies, with high heterogeneity between studies. Subgroup analyses indicated stronger associations in studies with shorter follow-up periods, conducted in non-European countries, published after 2020, and where ≥60% of the sample were female. The risk was higher in people aged <60 years at baseline, in typical and late-onset psychotic disorders versus very late-onset psychosis, in broader psychotic disorders vs schizophrenia, and in prospective vs retrospective studies. Associations remained after excluding low quality studies (pooled RR = 2.50, 95% CI (1.71–3.68), I(2) = 99.0%). Our review finds a substantial association between psychotic disorders and subsequent dementia. Our findings indicate that psychotic disorders are a potentially modifiable risk factor for dementia and suggest that individuals with psychotic disorders need to be closely monitored for cognitive decline in later life. Further research is needed to investigate the mechanisms underlying the association between psychotic disorders and dementia. Cambridge University Press 2022-11 2022-10-06 /pmc/articles/PMC9772917/ /pubmed/36200264 http://dx.doi.org/10.1017/S0033291722002781 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Review Article
Miniawi, Sara El
Orgeta, Vasiliki
Stafford, Jean
Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title_full Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title_fullStr Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title_full_unstemmed Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title_short Non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
title_sort non-affective psychotic disorders and risk of dementia: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9772917/
https://www.ncbi.nlm.nih.gov/pubmed/36200264
http://dx.doi.org/10.1017/S0033291722002781
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