听力损失与轻度认知障碍和痴呆症风险：新加坡纵向老龄化研究的结果

Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study.

作者信息

Heywood Rebecca, Gao Qi, Nyunt Ma Shwe Zin, Feng Lei, Chong Mei Sian, Lim Wee Shiong, Yap Philip, Lee Tih-Shih, Yap Keng Bee, Wee Shiou Liang, Ng Tze Pin

机构信息

Department of Otolaryngology, Ng Teng Fong General Hospital, Singapore, Singapore.

出版信息

Dement Geriatr Cogn Disord. 2017;43(5-6):259-268. doi: 10.1159/000464281. Epub 2017 Apr 19.

DOI:10.1159/000464281

PMID:28420004

Abstract

AIM

To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases).

METHODS

Cross-sectional and longitudinal analyses of baseline and follow-up data were performed in a population-based cohort. The baseline sample of 2,599 adults aged ≥55 included 1,515 cognitively normal subjects who were followed up to 8 years. Hearing loss at baseline was determined by the whispered voice test, and MCI and dementia by Mini-Mental State Examination screening, Clinical Dementia Rating scale, neurocognitive tests, MRI, and panel consensus diagnosis.

RESULTS

Hearing impairment was associated with increased prevalence of dementia (odds ratio = 3.63, 95% confidence interval [CI] 1.16-11.4, p = 0.027) but not MCI alone or all cases of MCI or dementia, adjusted for sex, age, ethnicity, education, central obesity, hypertension, diabetes, dyslipidemia, smoking, alcohol, leisure time activity, cardiac diseases, and depressive symptoms. Among participants who were cognitively normal at baseline, those with hearing impairment were more likely to develop MCI or dementia (hazard ratio [HR] = 2.30, 95% CI 1.08-4.92, p = 0.032). Hearing loss was associated with elevated but statistically nonsignificant estimates of adjusted HR (1.85, 95% CI 0.78-4.40) for incident MCI alone.

CONCLUSIONS

Hearing loss is independently associated with prevalent dementia and incident MCI or dementia.

摘要

目的

研究听力损失与现患和新发轻度认知障碍（MCI）、痴呆以及MCI或痴呆（所有病例）之间的关联。

方法

对基于人群的队列中的基线和随访数据进行横断面和纵向分析。2599名年龄≥55岁的成年人的基线样本包括1515名认知正常的受试者，随访时间长达8年。基线时的听力损失通过耳语试验确定，MCI和痴呆通过简易精神状态检查表筛查、临床痴呆评定量表、神经认知测试、MRI以及专家小组共识诊断来确定。

结果

在对性别、年龄、种族、教育程度、中心性肥胖、高血压、糖尿病、血脂异常、吸烟、饮酒、休闲活动、心脏病和抑郁症状进行校正后，听力障碍与痴呆患病率增加相关（优势比=3.63，95%置信区间[CI]1.16 - 11.4，p = 0.027），但与单独的MCI或所有MCI或痴呆病例无关。在基线时认知正常的参与者中，有听力障碍的人更有可能发展为MCI或痴呆（风险比[HR]=2.30，95%CI 1.08 - 4.92，p = 0.032）。听力损失与单独新发MCI的校正后HR升高但无统计学意义的估计值相关（1.85，95%CI 0.78 - 4.40）。