Gussekloo Jacobijn, de Craen Anton J M, Oduber Charlène, van Boxtel Martin P J, Westendorp Rudi G J
Department of Gerontology and Geriatrics, C-2-R, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Am J Geriatr Psychiatry. 2005 Sep;13(9):781-6. doi: 10.1176/appi.ajgp.13.9.781.
Because studies on the association of sensory impairment (both hearing and visual impairment) and cognitive functioning in elderly persons yielded conflicting results, the authors explored this association within the Leiden 85+ Study.
Within this population-based study of 459 participants aged 85+ years, hearing impairment was measured by audiometry and visual impairment by a visual acuity chart, both under standardized conditions. The Mini-Mental State Exam (MMSE) assessed global cognitive functioning. In participants with MMSE scores >18, the authors further assessed memory (Word-Learning Test, Immediate and Delayed Recall) and cognitive speed (by Stroop Test, Letter-Digit Coding test).
Both hearing impairment (prevalence: 85%) and visual impairment (prevalence: 59%) were associated with lower scores on the MMSE. Increasing visual impairment was associated with poorer scores on memory and cognitive speed, as measured with visually presented cognitive tests. In contrast, there was no association between hearing impairment and memory and cognitive speed.
In elderly people, cognitive functioning as assessed by visual cognitive tests relates to visual impairment but not to hearing impairment. The authors therefore assume that the association between sensory impairment and cognitive functioning is, at least partly, based on practical disadvantages of elderly persons with sensory impairment during cognitive assessments.
由于关于老年人感觉障碍(听力和视力障碍)与认知功能之间关联的研究结果相互矛盾,作者在莱顿85岁及以上老人研究中探讨了这种关联。
在这项针对459名85岁及以上参与者的基于人群的研究中,在标准化条件下,通过听力测定法测量听力障碍,通过视力表测量视力障碍。简易精神状态检查表(MMSE)评估整体认知功能。对于MMSE得分>18的参与者,作者进一步评估了记忆力(单词学习测试、即时和延迟回忆)和认知速度(通过斯特鲁普测试、字母数字编码测试)。
听力障碍(患病率:85%)和视力障碍(患病率:59%)均与MMSE得分较低相关。视力障碍加重与通过视觉呈现的认知测试所测量的记忆力和认知速度得分较差相关。相比之下,听力障碍与记忆力和认知速度之间没有关联。
在老年人中,通过视觉认知测试评估的认知功能与视力障碍有关,而与听力障碍无关。因此,作者认为感觉障碍与认知功能之间的关联至少部分基于感觉障碍老年人在认知评估过程中的实际不利因素。