Article(id=1324078395549692401, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202508214, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1755014400000, receivedDateStr=2025-08-13, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614489686, onlineDateStr=2026-11-02, pubDate=1767974400000, pubDateStr=2026-01-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614489686, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614489686, creator=13701087609, updateTime=1793614489686, updator=13701087609, issue=Issue{id=1324078333767594037, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='1', pageStart='1', pageEnd='192', issueExtLink='null', onlineDate='null', pubDate='1767974400000', pubDateStr='2026-01-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614474956, creator='13701087609', updateTime=1793614571752, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324078739914621270, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324078739914621271, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324078333767594037, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=39, endPage=45, ext={EN=ArticleExt(id=1324078395864265202, articleId=1324078395549692401, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Research hotspots and trend analysis of cognitive frailty in patients with chronic diseases at home and abroad, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To systematically analyze the research hotspots, development trends and regional differences in the field of cognitive frailty of patients with chronic diseases at home and abroad from 2013 to 2025 through bibliometric methods, so as to provide directional guidance for future research.

Methods

Literature on the theme of cognitive frailty among patients with chronic diseases was collected from CNKI, VIP, Wanfang, and the Web of Science core collection, and a total of 691 articles(220 in Chinese and 471 in English) were visualized using CiteSpace and VOSviewer.

Results

A total of 220 Chinese and 471 English articles were included. The annual number of publications on cognitive frailty among patients with chronic diseases globally showed an increasing trend. International research mainly focused on pathological mechanisms (such as blood-brain barrier injury, neuroinflammation-metabolic coupling mechanism) and digital health interventions (such as virtual reality training, artificial intelligence prediction model). However, domestic research focused on the early screening and risk assessment of community population and on the standardized management of patients with chronic diseases such as hypertension and diabetes (such as drug adjustment, follow-up management). The keyword burst showed that “physical activity” (English) and “influencing factor analysis” (Chinese) had emerged simultaneously since 2023, marking that intervention research had become a common focus. Compared with foreign countries, the analysis of the cooperation network between authors and institutions in China showed that the substantive cooperation between interdisciplinary and cross-team was weak.

Conclusion

Future research should align with international mechanistic explorations and local clinical practice needs, prioritizing breakthroughs in digital technology clinical translation and the establishment of interdisciplinary health management models. This method may provide a new way to delay cognitive frailty in patients with chronic diseases.

, authors=Zhen-peng LIN1, Yu-long WU2, Shu-feng LI1, An-qi LI1, Fan-qun KONG1, Yu-chen XUE1, Jian-jun DU1, Dan LI1, Mei CHENG1, authorsList=Zhen-peng LIN, Yu-long WU, Shu-feng LI, An-qi LI, Fan-qun KONG, Yu-chen XUE, Jian-jun DU, Dan LI, Mei CHENG, authorCompany=null, correspAuthors=Mei CHENG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324078398762529280, articleId=1324078395549692401, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=慢性病患者认知衰弱国内外研究热点与趋势分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

通过文献计量学方法,系统分析2013—2025年国内外慢性病患者认知衰弱领域的研究热点、发展趋势及区域差异,为未来研究提供方向性指导。

方法

收集中国知网(CNKI)、维普网、万方数据库及Web of Science核心数据集中“慢性病患者认知衰弱”相关主题的文献,借助CiteSpace和VOSviewer软件对691篇文献(中文220篇,英文471篇)进行可视化分析。

结果

共纳入符合标准的中文文献220篇,英文文献471篇。国内外慢性病患者认知衰弱领域的发文量整体呈上升趋势。国际研究主要聚焦病理机制(如:血脑屏障损伤、神经炎症-代谢耦合机制)和数字健康干预(如:虚拟现实训练、人工智能预测模型);国内研究则侧重社区人群的早期筛查及风险评估,并关注高血压、糖尿病等慢性病患者的标准化管理(如:药物调整、随访管理)。关键词“physical activity”(英文)与“影响因素分析”(中文)自2023年起同步突现,标志着干预性研究成为共同焦点。相较于国外,我国作者与机构合作网络分析均显示,跨学科、跨团队的实质性合作薄弱。

结论

未来需国际机制前延与本土临床实践需求,重点突破数字技术临床转化及构建跨学科的健康管理模式,为延缓慢性病患者认知衰弱提供新路径。

, authors=林桢朋1, 吴玉龙2, 李淑凤1, 黎安琪1, 孔凡群1, 薛雨晨1, 杜健君1, 李丹1, 程梅1, authorsList=林桢朋, 吴玉龙, 李淑凤, 黎安琪, 孔凡群, 薛雨晨, 杜健君, 李丹, 程梅, authorCompany=null, correspAuthors=程梅, authorNote=

林桢朋(1999—)女,硕士在读,研究方向:临床护理、慢病管理

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程梅,E-mail:
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Lancet Digital Health, 2023, 5(4): e230-e238., articleTitle=Blockchain-based digital health passports for cognitive health management in chronic disease patients: protocol for a multicenter clinical trial, refAbstract=null), Reference(id=1324078412662452842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, doi=null, pmid=null, pmcid=null, year=2025, volume=28, issue=15, pageStart=1842, pageEnd=1848, url=null, language=null, rfNumber=[24], rfOrder=27, authorNames=张丽, 王晓, 李岩, journalName=中国全科医学, refType=null, unstructuredReference=张丽,王晓,李岩,等.社区老年人衰弱影响认知功能的链式中介效应:抑郁症状和日常生活活动能力的作用及社会参与的调节[J].中国全科医学,2025,28(15):1842-1848., articleTitle=社区老年人衰弱影响认知功能的链式中介效应:抑郁症状和日常生活活动能力的作用及社会参与的调节, refAbstract=null), Reference(id=1324078412733756011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, doi=null, pmid=null, pmcid=null, year=2025, volume=28, issue=15, pageStart=1842, pageEnd=1848, url=null, language=null, rfNumber=[24], rfOrder=28, authorNames=Zhang L, Wang X, Li Y, journalName=Chinese General Practice, refType=null, unstructuredReference=Zhang L, Wang X, Li Y, et al. 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(In Chinese), articleTitle=Chain mediating effect of frailty on cognitive function in community-dwelling older adults: the role of depressive symptoms and activities of daily living and the moderating effect of social participation, refAbstract=null)], funds=[Fund(id=1324078405720879693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, awardId=ZR2022MH109, language=CN, fundingSource=山东省自然科学基金面上项目(ZR2022MH109), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324078398993216001, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, xref=1., ext=[AuthorCompanyExt(id=1324078398997410306, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, companyId=1324078398993216001, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Nursing (School of Geriatric Medicine), Binzhou Medical University, Yantai, Shandong 264003, China), AuthorCompanyExt(id=1324078399009993219, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, companyId=1324078398993216001, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.滨州医学院护理学院(老年医学院),山东 烟台 264003)]), AuthorCompany(id=1324078399077102084, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, xref=2., ext=[AuthorCompanyExt(id=1324078399085490693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, companyId=1324078399077102084, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.滨州医学院基础医学院)])], figs=[ArticleFig(id=1324078403833442877, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 1, caption=Publications on cognitive frailty among patients with chronic diseases, figureFileSmall=03cyfq93RLFK3q3gRfsF0w==, figureFileBig=0kRYtXvQSsBMa8CGhaLJ5w==, tableContent=null), ArticleFig(id=1324078403904746046, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图1, caption=慢性病患者认知衰弱领域发文情况, figureFileSmall=03cyfq93RLFK3q3gRfsF0w==, figureFileBig=0kRYtXvQSsBMa8CGhaLJ5w==, tableContent=null), ArticleFig(id=1324078404143821375, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 2, caption=Author collaboration networks in cognitive frailty research among patients with chronic diseases, figureFileSmall=qFpVw/ZbocCdkmIBKTtmnA==, figureFileBig=yVnYJm9mqmZ7m3sdAAuTBg==, tableContent=null), ArticleFig(id=1324078404223513152, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图2, caption=慢性病患者认知衰弱领域研究作者合作网络可视化图谱

注:A为国际作者合作网络可视化图谱;B为国内作者合作网络可视化图谱。

, figureFileSmall=qFpVw/ZbocCdkmIBKTtmnA==, figureFileBig=yVnYJm9mqmZ7m3sdAAuTBg==, tableContent=null), ArticleFig(id=1324078404332565057, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 3, caption=Institutional collaboration network in cognitive frailty research among patients with chronic diseases, figureFileSmall=BbGdou92kJWLAc+TMH2KTQ==, figureFileBig=ITQrb/yvlO95P6ipYkzhiQ==, tableContent=null), ArticleFig(id=1324078404420645442, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图3, caption=慢性病患者认知衰弱领域机构合作网络可视化图谱

注:A为国际机构合作网络可视化图谱;B为国内机构合作网络可视化图谱。

, figureFileSmall=BbGdou92kJWLAc+TMH2KTQ==, figureFileBig=ITQrb/yvlO95P6ipYkzhiQ==, tableContent=null), ArticleFig(id=1324078404517114435, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 4, caption=Keyword co-occurrence network analysis of cognitive frailty among patients with chronic diseases, figureFileSmall=m/lKimkpxEb0jYz+V9TeoQ==, figureFileBig=O5vqaV7gmFFishySxKvM2w==, tableContent=null), ArticleFig(id=1324078404609389124, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图4, caption=慢性病患者认知衰弱研究的关键词共现网络

注:A为国际慢性病患者认知衰弱领域的关键词共现网络;B为国内慢性病患者认知衰弱领域的关键词共现网络。

, figureFileSmall=m/lKimkpxEb0jYz+V9TeoQ==, figureFileBig=O5vqaV7gmFFishySxKvM2w==, tableContent=null), ArticleFig(id=1324078404722635333, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 5, caption=Keyword clustering network in cognitive frailty research among patients with chronic diseases, figureFileSmall=/iiceEw9wibBIRDYnk9o0g==, figureFileBig=A5+LzIJhZatImCVU0HP+5Q==, tableContent=null), ArticleFig(id=1324078404823298630, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图5, caption=慢性病患者认知衰弱研究的关键词聚类网络

注:A为国际慢性病患者认知衰弱研究的关键词聚类网络;B为国内慢性病患者认知衰弱领域研究的关键词聚类网络。

, figureFileSmall=/iiceEw9wibBIRDYnk9o0g==, figureFileBig=A5+LzIJhZatImCVU0HP+5Q==, tableContent=null), ArticleFig(id=1324078405066568263, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Figure 6, caption=Keyword burst detection results in cognitive frailty research in patients with chronic diseases: a comparison of Chinese and English literature, figureFileSmall=tcR0zTSyPYAOSbjDijUNew==, figureFileBig=MyExMEbzQ8bukdS+mme8Fw==, tableContent=null), ArticleFig(id=1324078405154648648, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=图6, caption=慢性病患者认知衰弱领域中英文文献关键词突现结果

注:A为慢性病患者认知衰弱领域英文文献突现词前20;B为慢性病患者认知衰弱领域中文文献突现词前20。

, figureFileSmall=tcR0zTSyPYAOSbjDijUNew==, figureFileBig=MyExMEbzQ8bukdS+mme8Fw==, tableContent=null), ArticleFig(id=1324078405225951817, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Table 1, caption=

Top 10 high-frequency keywords in cognitive frailty research among patients with chronic diseases in China and abroad

, figureFileSmall=null, figureFileBig=null, tableContent=
英文关键词中文关键词
序号频次关键词中心性年份(年)序号频次关键词中心性年份(年)
1362dementia0.0120131106认知衰弱0.122019
2310alzheimers disease0.042013296老年人0.272017
3229cognitive impairment0.022013381衰弱0.332015
4170mellitus0.052013454影响因素0.182018
5164risk0.052013540糖尿病0.202018
6155dysfunction0.0620146272型糖尿病0.332020
7149type 2 diabetes mellitus0.072014725老年0.082021
8147mild cognitive impairment0.052014819高血压0.012021
9134association0.052013916认知功能0.222020
10131decline0.0420131015认知障碍0.222018
), ArticleFig(id=1324078405460832842, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=表1, caption=

慢性病患者认知衰弱领域国内外高频关键词前10词频分布

, figureFileSmall=null, figureFileBig=null, tableContent=
英文关键词中文关键词
序号频次关键词中心性年份(年)序号频次关键词中心性年份(年)
1362dementia0.0120131106认知衰弱0.122019
2310alzheimers disease0.042013296老年人0.272017
3229cognitive impairment0.022013381衰弱0.332015
4170mellitus0.052013454影响因素0.182018
5164risk0.052013540糖尿病0.202018
6155dysfunction0.0620146272型糖尿病0.332020
7149type 2 diabetes mellitus0.072014725老年0.082021
8147mild cognitive impairment0.052014819高血压0.012021
9134association0.052013916认知功能0.222020
10131decline0.0420131015认知障碍0.222018
), ArticleFig(id=1324078405532136011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=EN, label=Table 2, caption=

Comparative keyword clustering in cognitive frailty research among patients with chronic diseases in China and abroad

, figureFileSmall=null, figureFileBig=null, tableContent=
序号国际序号国内
0认知障碍(cognitive impairment)0社区老年人
1执行功能(executive functions)1影响因素
2认知功能(cognitive functions)2认知衰弱
3阿尔茨海默病(Alzheimer's disease)3认知障碍
4糖尿病(diabetes mellitus)4meta分析
5肺康复(pulmonary rehabilitation)5跌倒恐惧
6脑小血管疾病(cerebral small vessel disease)7老年高血压
7受损的认知功能(impaired cognitive function)8蛋白质能量营养不良
9反应性充血(reactive hyperemia)9变化轨迹
10认知下降(cognitive decline)10老年患者
11神经心理学测试(neuropsychological test)
), ArticleFig(id=1324078405611827788, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324078395549692401, language=CN, label=表2, caption=

国内外慢性病患者认知衰弱领域关键词聚类对比

, figureFileSmall=null, figureFileBig=null, tableContent=
序号国际序号国内
0认知障碍(cognitive impairment)0社区老年人
1执行功能(executive functions)1影响因素
2认知功能(cognitive functions)2认知衰弱
3阿尔茨海默病(Alzheimer's disease)3认知障碍
4糖尿病(diabetes mellitus)4meta分析
5肺康复(pulmonary rehabilitation)5跌倒恐惧
6脑小血管疾病(cerebral small vessel disease)7老年高血压
7受损的认知功能(impaired cognitive function)8蛋白质能量营养不良
9反应性充血(reactive hyperemia)9变化轨迹
10认知下降(cognitive decline)10老年患者
11神经心理学测试(neuropsychological test)
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慢性病患者认知衰弱国内外研究热点与趋势分析
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林桢朋 1 , 吴玉龙 2 , 李淑凤 1 , 黎安琪 1 , 孔凡群 1 , 薛雨晨 1 , 杜健君 1 , 李丹 1 , 程梅 1
现代预防医学 | 流行病与统计方法 2026,53(1): 39-45
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现代预防医学 |流行病与统计方法 2026 , 53 (1) : 39 -45
慢性病患者认知衰弱国内外研究热点与趋势分析
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林桢朋1, 吴玉龙2, 李淑凤1, 黎安琪1, 孔凡群1, 薛雨晨1, 杜健君1, 李丹1, 程梅1
作者信息
  • 1.滨州医学院护理学院(老年医学院),山东 烟台 264003
  • 2.滨州医学院基础医学院
通讯作者:
程梅,E-mail:
作者简介:

林桢朋(1999—)女,硕士在读,研究方向:临床护理、慢病管理

Research hotspots and trend analysis of cognitive frailty in patients with chronic diseases at home and abroad
Zhen-peng LIN1, Yu-long WU2, Shu-feng LI1, An-qi LI1, Fan-qun KONG1, Yu-chen XUE1, Jian-jun DU1, Dan LI1, Mei CHENG1
Affiliations
  • School of Nursing (School of Geriatric Medicine), Binzhou Medical University, Yantai, Shandong 264003, China
出版时间: 2026-01-10 doi: 10.20043/j.cnki.MPM.202508214
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目的

通过文献计量学方法,系统分析2013—2025年国内外慢性病患者认知衰弱领域的研究热点、发展趋势及区域差异,为未来研究提供方向性指导。

方法

收集中国知网(CNKI)、维普网、万方数据库及Web of Science核心数据集中“慢性病患者认知衰弱”相关主题的文献,借助CiteSpace和VOSviewer软件对691篇文献(中文220篇,英文471篇)进行可视化分析。

结果

共纳入符合标准的中文文献220篇,英文文献471篇。国内外慢性病患者认知衰弱领域的发文量整体呈上升趋势。国际研究主要聚焦病理机制(如:血脑屏障损伤、神经炎症-代谢耦合机制)和数字健康干预(如:虚拟现实训练、人工智能预测模型);国内研究则侧重社区人群的早期筛查及风险评估,并关注高血压、糖尿病等慢性病患者的标准化管理(如:药物调整、随访管理)。关键词“physical activity”(英文)与“影响因素分析”(中文)自2023年起同步突现,标志着干预性研究成为共同焦点。相较于国外,我国作者与机构合作网络分析均显示,跨学科、跨团队的实质性合作薄弱。

结论

未来需国际机制前延与本土临床实践需求,重点突破数字技术临床转化及构建跨学科的健康管理模式,为延缓慢性病患者认知衰弱提供新路径。

慢性病  /  认知衰弱  /  可视化  /  CiteSpace  /  VOSviewer
Objective

To systematically analyze the research hotspots, development trends and regional differences in the field of cognitive frailty of patients with chronic diseases at home and abroad from 2013 to 2025 through bibliometric methods, so as to provide directional guidance for future research.

Methods

Literature on the theme of cognitive frailty among patients with chronic diseases was collected from CNKI, VIP, Wanfang, and the Web of Science core collection, and a total of 691 articles(220 in Chinese and 471 in English) were visualized using CiteSpace and VOSviewer.

Results

A total of 220 Chinese and 471 English articles were included. The annual number of publications on cognitive frailty among patients with chronic diseases globally showed an increasing trend. International research mainly focused on pathological mechanisms (such as blood-brain barrier injury, neuroinflammation-metabolic coupling mechanism) and digital health interventions (such as virtual reality training, artificial intelligence prediction model). However, domestic research focused on the early screening and risk assessment of community population and on the standardized management of patients with chronic diseases such as hypertension and diabetes (such as drug adjustment, follow-up management). The keyword burst showed that “physical activity” (English) and “influencing factor analysis” (Chinese) had emerged simultaneously since 2023, marking that intervention research had become a common focus. Compared with foreign countries, the analysis of the cooperation network between authors and institutions in China showed that the substantive cooperation between interdisciplinary and cross-team was weak.

Conclusion

Future research should align with international mechanistic explorations and local clinical practice needs, prioritizing breakthroughs in digital technology clinical translation and the establishment of interdisciplinary health management models. This method may provide a new way to delay cognitive frailty in patients with chronic diseases.

Chronic disease  /  Cognitive frailty  /  Visualization  /  CiteSpace  /  VOSviewer
林桢朋, 吴玉龙, 李淑凤, 黎安琪, 孔凡群, 薛雨晨, 杜健君, 李丹, 程梅. 慢性病患者认知衰弱国内外研究热点与趋势分析. 现代预防医学, 2026 , 53 (1) : 39 -45 . DOI: 10.20043/j.cnki.MPM.202508214
Zhen-peng LIN, Yu-long WU, Shu-feng LI, An-qi LI, Fan-qun KONG, Yu-chen XUE, Jian-jun DU, Dan LI, Mei CHENG. Research hotspots and trend analysis of cognitive frailty in patients with chronic diseases at home and abroad[J]. Modern Preventive Medicine, 2026 , 53 (1) : 39 -45 . DOI: 10.20043/j.cnki.MPM.202508214
慢性非传染性疾病(noncommunicable chronic diseases,NCDs),是起病隐匿、病程长、病因复杂的一类疾病。据《中国居民营养与慢性病状况报告(2020年)》显示,2019年我国慢性病致死人数占总死亡率的88.5%[1],且患病率呈持续攀升态势,已对公众健康和社会经济构成严峻挑战。2013年,国际营养与衰老研究所与国际老年医学协会共识首次提出“认知衰弱”(cognitive frailty)概念,定义为身体衰弱与轻度认知障碍共存,且排除痴呆的临床综合征[2]。循证医学研究证实[3],冠心病与糖尿病等慢性病患者的认知衰弱发生率显著高于健康人群,且认知衰弱作为独立预测因子,与慢性病患者全因死亡风险及功能独立性下降密切相关。慢性病与认知衰弱关系复杂、相互影响,但目前缺乏直观展示其共病模式与动态演变的可视化工具。本研究采用文献计量学方法,借助Vosviewer和CiteSpace可视化软件,系统描绘慢性病患者认知衰弱领域的研究图谱,揭示该领域发展轨迹及趋势,旨在为优化本土化认知衰弱防控策略提供循证锚点。
中文文献通过中国知网(CNKI)、万方和维普平台检索。主题为:(“慢性病”OR“慢性非传染性疾病”OR“慢病”)AND(“认知衰弱”OR“衰弱”OR“认知障碍”),时间跨度设定为2013年1月—2025年5月,文献类型限定为研究性或综述性论文,共获得417篇文献。英文文献在Web of Science核心数据集检索,限定语言为English,主题词包括:(“chronic diseases”OR“non-communicable”OR“chronic illness”)AND(“cognitive frailty”OR“frailty”OR“cognitive decline”OR“cognitive impairment”OR“MCI”),排除中文机构文献同期限英文论文与研究型/综述类文章,最终检出1 050篇。
纳入标准:(1)慢性病患者认知衰弱相关主题,对认知衰弱有明确诊断标准,即躯体衰弱和认知障碍并存,且排除痴呆及阿尔兹海默症;(2)研究性或综述性论文;(3)中/英文文献。排除标准:(1)重复文献;(2)机构信息缺失文献;(3)无法获取全文的文献。初检共获得文献1 467篇,将检索获取得中英文文献分别导入文献管理软件NoteExpress 4.1并进行文献初筛去重,复筛通过阅读标题、摘要及全文内容后,最终共纳入691篇文献进行分析。
本研究采用CiteSpace 6.2R6和VOSviewer 1.6.20软件进行文献计量分析。分析过程中,两款软件的时间切片均设置为2013—2025年,时间间隔为1年,参数k值取25。具体分析内容包括发文量统计、关键词共现分析、聚类分析以及前沿趋势分析。通过可视化技术呈现分析结果,并构建关键词突现图谱,以识别研究热点和发展趋势。
截至2025年5月,该领域发文总量达691篇,其中,英文文献471篇,中文文献220篇;其中,2013年17篇,2024年达峰值,59篇。我国于2015年发表首篇相关文献,自2017年起发文量总体呈上升趋势,2023年发文量达峰值,为57篇,2024年发表数量为41篇。见图1。
国外团队如Biessels Geert-Jan、Price Jackie F、Gallagher Jenifer R等呈现小范围紧密合作特征,不同颜色聚类间存在部分连接,说明存在跨团队协作,但合作强度弱于团队内部。国内作者合作以赵雅宁、毛美琦、陈燕语、王双等为代表形成多个稳定小团队,团队内合作紧密,但跨团队协作较少。见图2。
国际机构间呈现出更为紧密的合作关系,例如,匹兹堡大学与梅奥诊所之间建立了跨机构合作网络,约翰斯·霍普金斯大学与爱丁堡大学等机构也保持稳定合作关系。国内机构间合作则以区域性合作为主,如中南大学与山东中医药大学的合作网络较为突出。见图3。
在Web of Science数据库检索的文献中,痴呆(dementia)、阿尔茨海默症(Alzheimer disease)、认知障碍(cognitive impairment)、糖尿病(mellitus)、危险(risk)、功能障碍(dysfunction)、2型糖尿病(type 2 diabetes mellitus)、轻度认知障碍(mild cognitive impairment)、关联(association)、下降(decline)等主要关键词的高频出现,说明国际研究聚焦糖尿病相关认知衰弱机制,核心关键词包括痴呆、阿尔茨海默病、功能障碍及风险因素。在涵盖中国知网、万方数据知识服务平台以及维普网的中文数据库所检索到的文献中,认知衰弱、老年人、衰弱、影响因素、糖尿病、2型糖尿病、老年、高血压、认知功能、认知障碍、预测模型等主要关键词构成了国内该领域研究热点,以老年人群为核心,关注影响因素、预测模型及高血压等慢性病管理。见图4,表1。
国际研究显示出有效的聚类结构(Q=0.758 5,S=0.898 6),形成11个主要聚类,重点关注慢性病致认知衰弱病理机制、高风险人群早期识别及干预策略研发与评估三个核心方向,见图5A。国内研究聚类模块值(Q=0.784 2>0.300 0)和轮廓值(S=0.943 7>0.500 0)表明聚类结构显著,识别出10个主要聚类,研究重点集中在老年群体(尤其是社区老年人)慢性病管理(如高血压、糖尿病)、认知健康(认知衰弱与障碍)及影响因素分析,见图5B。同时关注营养状况、跌倒风险等老年健康安全问题,并倾向于通过meta分析和变化轨迹研究揭示潜在规律,见表2。
英文突现关键词中突现强度最高的是:“inflammation”(3.77,2019-2020),“mice”与“mechanisms”持续突现至2025年,揭示动物模型与病理机制研究前沿。中文文献中“抑郁”突现强度最强(2.98,2019-2021),列线图作为方法学热点持续到2025年。“physical activity”(英文)与“影响因素分析”(中文)自2023年起同步突现,标志干预研究成为跨文化焦点。见图6。
关于慢性病患者认知衰弱研究领域现状,国内外研究各有侧重:国际聚焦病理机制与早期干预,国内则更关注影响因素与预测模型构建。
(1)慢性病患者认知衰弱病理机制的深入探索。BIESSELS团队证实[4]持续高血糖可破坏血脑屏障完整性,显著增加认知障碍风险。临床观察显示,高血压及相关脑血管病变会加速认知功能衰退进程[5]。神经病理学研究发现,60%的阿尔茨海默病患者合并脑血管病变特征,提示血管因素在认知衰弱中的重要作用。这些发现为理解慢性病患者致认知衰弱的病理机制提供了重要依据。其中,脑小血管疾病(cerebral small vessel disease,CSVD)作用尤为关键,研究表明[6] CSVD可通过损害脑血流自动调节功能、降低脑组织灌注水平,显著加速认知衰弱进程。(2)生物标志物、神经影像学与算法模型在高风险人群中的早期识别及应用。国外研究重视借助生物标志物、神经影像学检查及临床评估工具开展早期筛查。在生物标志物检测方面,通过检测Aβ-淀粉样蛋白(Amyloid-β)和tau蛋白,结合MRI对脑结构的影像学分析,预测认知衰弱发展趋势[7]。然而,单一维度的生物标志物或影像学指标往往难以全面反映疾病复杂性,因此研究者开始探索多模态数据整合分析,机器学习算法逐渐被引入预测模型构建,提升了高风险人群早期识别的准确性[8]。(3)基础研究推动的转化医学突破。利用转基因小鼠模型(如APP/PS1小鼠),研究证实,Aβ沉积、异常tau蛋白和神经炎症协同作用,构成认知衰弱的关键病理基础[9]。这些发现催生了抗Aβ单克隆抗体(如Lecanemab)等靶向药物的III期临床试验,其中三项研究显示可延缓临床前阿尔茨海默病患者的认知衰弱速度减缓27%[10]。
(1)国内慢性病患者认知衰弱相关研究呈现明显的社区化特征。“社区老年人”这一核心研究对象,与“老年高血压”“2型糖尿病”“认知衰弱”等健康问题形成显著关联网络,体现了我国应对老龄化社会的实际需求。流行病学研究提示,社区老年慢性病人群认知衰弱发生率显著升高,其中高血压、糖尿病等代谢性疾病的共病状态与认知衰弱进展密切相关[11]。当前研究主要从三个层面推进:首先,通过社区健康调查,分析慢性病与认知衰弱相互关系;其次,研制适合社区使用的快速筛查工具;最后,尝试将慢性病患者认知衰弱防控与干预有机结合,形成延续性社区健康管理方案。此类研究,以社区为依托,与我国基层医疗卫生服务体系相契合,为制定符合国家实际情况的老年健康政策提供了理论依据。(2)深入探究多维影响因素。国内老年人群所患慢性病种类繁多,高血压、跌倒恐惧、蛋白质能量营养不良等因素与认知衰弱之间存在着复杂的交互关系。王彦等人[12]研究证实老年高血压患者因脑血管病变影响脑血流灌注,增加认知衰弱发生风险;跌倒恐惧通过限制日常活动,加速身体机能与认知功能衰退。系统挖掘这些因素,可精准识别认知衰弱高危人群,为早期干预提供靶点,满足临床实践中“风险分层管理”的需求[13]。(3)研究方法与工具的适应性改良有效支撑本土化实践。国内研究以meta分析、预测模型构建为代表,注重整合循证医学方法与本土证据。Meta分析汇总不同地区、研究设计结果,提升证据质量与普适性;构建适配国内老年人群的认知衰弱预测模型(如结合慢性病病史、生活习惯的列线图模型),能在基层医疗场景快速识别风险,这契合“健康中国”战略下慢性病防控与老年健康管理实践需求,推动研究成果向临床应用转化[14]。
关键词突现分析表明,近两年该领域研究活跃度显著上升,主要得益于人工智能与数据驱动方法的突破。机器学习在风险预测模型中表现突出,例如深度神经网络整合多模态数据可将预测准确率提升至92.9%[15],这一进展正重塑认知衰弱的早期识别与干预体系。鉴于国内外研究路径不同,未来该领域的发展方向预计将进一步分化。
(1)慢性病患者认知衰弱关联机制纵深突破。新近的临床证据[16-17]显示:糖尿病等代谢疾病会破坏屏障紧密连接蛋白结构,导致血脑屏障通透性异常,促使神经毒素入脑,加速认知衰弱。图6A的突现词中,“血脑屏障(brain barrier)”“机制(mechanisms)”“小鼠(mice)”等术语高频活跃,表明学界通过动物模型,关注血脑屏障功能改变在认知衰弱发生发展中的作用机制。在分子层面,IL-6通过激活JAK2/STAT3信号通路显著促进神经元凋亡,证实慢性炎症是神经退行性病变的核心驱动因素[18];在载体实验层面,脑缺血模型验证了血管病变与认知衰弱的剂量效应关联[19]。(2)认知衰弱临床疗效验证与精准干预的突破。图6A的突现词分析揭示了两个显著趋势:“功能障碍(dysfunction)”的聚类特征显著,映射出研究锚点从广泛人群筛查向认知缺陷亚群精准干预的迁移,而“验证(validation)”持续突现则标志研究范式向技术成熟度导向的验证阶段跃迁。在近期随机对照试验证实VR技术通过整合认知与运动训练,在老年糖尿病患者群体中展现出显著效果,患者执行功能和步态稳定性分别提升40%和32%[20]。与此同时,智能诊疗技术取得突破性进展,基于多源健康数据的AI系统可实时优化干预方案[21],机器学习预警模型实现92%的识别准确率[22]。区块链技术的临床应用价值正通过III期试验进行评估[23],这些进展共同构建起一个从精准识别到动态干预的完整技术体系,标志着认知衰弱管理正迈向数据驱动的精准干预新阶段。
(1)在慢性病共病背景下,构建认知衰弱风险预测模型并优化早期干预路径已成为当前研究重要方向。从关键词突现(图6B)中,“列线图”“影响因素分析”“临床实践指南”等词汇的出现,印证了这一趋势。当前,研究核心聚焦开发适用于中国老年人群的认知衰弱风险评估工具。我国研究团队创新性融合慢性病核心临床指标,包括病种(高血压、糖尿病等)、量化参数(收缩压值、HbA1c水平等)及共病负荷(Charlson指数)等,开发出认知衰弱列线图预测模型,在社区医疗场景中展现出显著价值,帮助基层医生对高风险人群实施快速初筛。(2)在多维协同框架下,以社区预防和医院诊疗为双核心场景,对老年慢性病患者认知衰弱实施多学科协作、技术驱动的精准化管理,正成为国内学界攻关重点。图6B突现词显示,研究正聚焦“社区老年人”(心理社会评估)与“住院病人”(多病共管)两大场景。研究证实疾病感知等心理社会因素与认知衰弱密切相关[24],促使干预模式从单一疾病管理转向整合生理、心理和社会因素的综合干预。随着电子健康档案普及和可穿戴设备的迭代,瞬时动态监测为个性化干预提供了新契机。例如,通过智能手环监测日常活动数据,可触发预设阈值驱动的早期干预,增强风险分层管理的空间-时间特异性。
本研究采用文献计量学方法,对国内外慢性病患者认知衰弱研究领域中英文文章进行了可视化分析。该领域研究在全球范围内呈现快速增长态势,但研究主题、方法学应用及机构合作上存在显著地域差异。国际研究主要聚焦于分子机制解析、生物标志物发掘及数字疗法开发等方向。国内研究主题侧重于社区老年人的慢性病认知衰弱管理,致力于构建“社区-医院”协同干预体系,开发适用于基层的早期筛查与风险评估方法。在初步筛查基础上,借助列线图模型对高危人群进行可视化风险评估,以支持分级管理。研究方法遵循循证医学原则,主要包括meta分析、预测模型构建及干预性研究等。本研究存在以下局限性:机构合作不足,跨学科协作薄弱,制约突破;相较国际领先水平,我国在慢性病与认知衰弱交互机制研究、数字干预疗法及智能健康技术研发上仍显滞后。未来应深化病理机制研究,结合国情探索本土化路径;加强真实世界研究,推动数字疗法与个性化健康管理的社区应用,应对老龄化认知健康挑战。
  • 山东省自然科学基金面上项目(ZR2022MH109)
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2026年第53卷第1期
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doi: 10.20043/j.cnki.MPM.202508214
  • 接收时间:2025-08-13
  • 首发时间:2026-11-02
  • 出版时间:2026-01-10
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  • 收稿日期:2025-08-13
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山东省自然科学基金面上项目(ZR2022MH109)
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    1.滨州医学院护理学院(老年医学院),山东 烟台 264003
    2.滨州医学院基础医学院

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Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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