Davies Hilary R, Cadar Dorina, Herbert Annie, Orrell Martin, Steptoe Andrew
Institute of Epidemiology and Public Health, University College London, London, United Kingdom.
Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.
J Am Geriatr Soc. 2017 Sep;65(9):2074-2081. doi: 10.1111/jgs.14986. Epub 2017 Jul 22.
To determine whether hearing loss is associated with incident physician-diagnosed dementia in a representative sample.
Retrospective cohort study.
English Longitudinal Study of Ageing.
Adults aged 50 and older.
Cross-sectional associations between self-reported (n = 7,865) and objective hearing measures (n = 6,902) and dementia were examined using multinomial-logistic regression. The longitudinal association between self-reported hearing at Wave 2 (2004/05) and cumulative physician-diagnosed dementia up to Wave 7 (2014/15) was modelled using Cox proportional hazards regression.
After adjustment for potential confounders, in cross-sectional analysis, participants who had self-reported or objective moderate and poor hearing were more likely to have a dementia diagnosis than those with normal hearing (self-reported: odds ratio OR = 1.6, 95% CI = 1.1-2.4 moderate hearing; OR = 2.6, 95% CI = 1.7-3.9 poor hearing, objective: OR = 1.6, 95% CI = 1.0-2.8 moderate hearing; OR = 4.4, 95% CI = 1.9-9.9 poor hearing). Longitudinally, the hazard of developing dementia was 1.4 (95% CI = 1.0-1.9) times as high in individuals who reported moderate hearing and 1.6 (95% CI = 1.1-2.0) times as high in those who reported poor hearing.
Older adults with hearing loss are at greater risk of dementia than those with normal hearing. These findings are consistent with the rationale that correction of hearing loss could help delay the onset of dementia, or that hearing loss itself could serve as a risk indicator for cognitive decline.
在一个代表性样本中确定听力损失是否与医生诊断的新发痴呆症相关。
回顾性队列研究。
英国老龄化纵向研究。
50岁及以上的成年人。
使用多项逻辑回归分析自我报告听力(n = 7865)和客观听力测量(n = 6902)与痴呆症之间的横断面关联。使用Cox比例风险回归模型分析第2波(2004/05年)自我报告听力与截至第7波(2014/15年)累计医生诊断痴呆症之间的纵向关联。
在对潜在混杂因素进行调整后,横断面分析显示,自我报告或客观测量为中度和重度听力损失的参与者比听力正常者更有可能被诊断为痴呆症(自我报告:中度听力损失的比值比OR = 1.6,95%置信区间CI = 1.1 - 2.4;重度听力损失的OR = 2.6,95% CI = 1.7 - 3.9;客观测量:中度听力损失的OR = 1.6,95% CI = 1.0 - 2.8;重度听力损失的OR = 4.4,95% CI = 1.9 - 9.9)。纵向来看,报告中度听力损失的个体患痴呆症的风险是正常人的1.4倍(95% CI = 1.0 - 1.9),报告重度听力损失的个体患痴呆症的风险是正常人的1.6倍(95% CI = 1.1 - 2.0)。
听力损失的老年人患痴呆症的风险高于听力正常者。这些发现与以下观点一致,即纠正听力损失可能有助于延缓痴呆症的发病,或者听力损失本身可能是认知衰退的风险指标。