The prevalence of Alzheimer’s disease (AD) is increasing as the population ages, and patients with AD have a poor prognosis. However, knowledge on factors for predicting the survival of AD remains sparse. Here, we aimed to systematically explore predictors of AD survival. We searched the PubMed, Embase and Cochrane databases for relevant literature from inception to December 2022. Cohort and case-control studies were selected, and multivariable adjusted relative risks (RRs) were pooled by random-effects models. A total of 40,784 reports were identified, among which 64 studies involving 297,279 AD patients were included in the meta-analysis after filtering based on predetermined criteria. Four aspects, including demographic features (n = 7), clinical features or comorbidities (n = 13), rating scales (n = 3) and biomarkers (n = 3), were explored and 26 probable prognostic factors were finally investigated for AD survival. We observed that AD patients who had hyperlipidaemia (RR: 0.69) were at a lower risk of death. In contrast, male sex (RR: 1.53), movement disorders (including extrapyramidal signs) (RR: 1.60) and cancer (RR: 2.07) were detrimental to AD patient survival. However, our results did not support the involvement of education, hypertension, APOE genotype, Aβ₄₂ and t-tau in AD survival. Our study comprehensively summarized risk factors affecting survival in patients with AD, provided a better understanding on the role of different factors in the survival of AD from four dimensions, and paved the way for further research.

随着人口老龄化，阿尔茨海默病（AD）的患病率不断增加，而AD患者的预后较差。然而，关于预测 AD 生存的因素的知识仍然很少。在这里，我们的目的是系统地探索 AD 生存的预测因素。我们在 PubMed、Embase 和 Cochrane 数据库中检索了从成立到 2022 年 12 月的相关文献。选择了队列研究和病例对照研究，并通过随机效应模型汇总了多变量调整相对风险 (RR)。共识别出 40,784 份报告，其中 64 项研究涉及 297,279 名 AD 患者，根据预定标准筛选后纳入荟萃分析。探讨了人口特征 ( n  = 7)、临床特征或合并症 ( n  = 13)、评分量表 ( n  = 3) 和生物标志物 ( n  = 3) 等四个方面，并最终研究了 26 个可能的 AD 生存预后因素。我们观察到患有高脂血症（RR：0.69）的 AD 患者死亡风险较低。相反，男性（RR：1.53）、运动障碍（包括锥体外系体征）（RR：1.60）和癌症（RR：2.07）不利于AD患者的生存。然而，我们的结果并不支持教育、高血压、APOE 基因型、Aβ ₄₂和 t-tau 参与 AD 生存。我们的研究全面总结了影响AD患者生存的危险因素，从四个维度更好地理解不同因素对AD患者生存的作用，为进一步研究奠定了基础。