Fischer Mary E, Cruickshanks Karen J, Schubert Carla R, Pinto Alex A, Carlsson Cynthia M, Klein Barbara E K, Klein Ronald, Tweed Ted S
Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
J Am Geriatr Soc. 2016 Oct;64(10):1981-1987. doi: 10.1111/jgs.14308. Epub 2016 Sep 9.
To evaluate the associations between sensory impairments and 10-year risk of cognitive impairment.
The Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population-based study of aging in the Beaver Dam, Wisconsin community. Baseline examinations were conducted in 1993 and follow-up examinations have been conducted every 5 years.
General community.
EHLS members without cognitive impairment at EHLS-2 (1998-2000). There were 1,884 participants (mean age 66.7) with complete EHLS-2 sensory data and follow-up information.
Cognitive impairment was defined as a Mini-Mental State Examination score of <24 or history of dementia or Alzheimer's disease. Hearing impairment was a pure-tone average of hearing thresholds (0.5, 1, 2, 4 kHz) of >25 dB hearing level in either ear, visual impairment was a Pelli-Robson contrast sensitivity of <1.55 log units in the better eye, and olfactory impairment was a San Diego Odor Identification Test score of <6.
Hearing, visual, and olfactory impairment were independently associated with cognitive impairment risk (hearing: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.11-3.26; vision: HR = 2.05, 95% CI = 1.24-3.38; olfaction: HR = 3.92, 95% CI = 2.45-6.26)). Nevertheless, 85% of participants with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up.
The relationship between sensory impairment and cognitive impairment was not unique to one sensory system, suggesting that sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging.
评估感觉障碍与认知障碍10年风险之间的关联。
听力损失流行病学研究（EHLS），一项基于威斯康星州比弗代尔社区人群的衰老纵向研究。1993年进行了基线检查，此后每5年进行一次随访检查。
普通社区。
EHLS - 2（1998 - 2000年）时无认知障碍的EHLS成员。共有1884名参与者（平均年龄66.7岁）拥有完整的EHLS - 2感觉数据和随访信息。
认知障碍定义为简易精神状态检查表得分<24分，或有痴呆或阿尔茨海默病病史。听力障碍定义为任一耳纯音平均听阈（0.5、1、2、4千赫）>25分贝听力水平，视力障碍定义为较好眼的佩利 - 罗布森对比敏感度<1.55对数单位，嗅觉障碍定义为圣地亚哥嗅觉识别测试得分<6分。
听力、视力和嗅觉障碍均与认知障碍风险独立相关（听力：风险比（HR）= 1.90，95%置信区间（CI）= 1.11 - 3.26；视力：HR = 2.05，95% CI = 1.24 - 3.38；嗅觉：HR = 3.92，95% CI = 2.45 - 6.26））。然而，85%的听力障碍参与者、81%的视力障碍参与者和76%的嗅觉障碍参与者在随访期间未发生认知障碍。
感觉障碍与认知障碍之间的关系并非某一个感觉系统所特有，这表明感觉神经健康可能是脑衰老的一个标志。开发一种综合的感觉神经认知测量方法可能有助于揭示健康脑衰老的机制。
