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全国范围内自我报告的严重感觉障碍的流行情况及其与自我报告的认知和功能困难的关系。

Nationwide Prevalence of Self-Reported Serious Sensory Impairments and Their Associations with Self-Reported Cognitive and Functional Difficulties.

机构信息

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; University of California, San Diego, School of Medicine, La Jolla, California.

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Dana Center for Preventive Ophthalmology, Johns Hopkins University, Baltimore, Maryland.

出版信息

Ophthalmology. 2018 Apr;125(4):476-485. doi: 10.1016/j.ophtha.2017.11.003. Epub 2018 Jan 4.

Abstract

PURPOSE

To estimate the nationwide prevalence of self-reported serious vision impairment (SVI), serious hearing impairment (SHI), and serious dual sensory impairment (DSI; i.e., concomitant SVI and SHI) and to characterize their associations with self-reported cognitive, independent living, self-care, and ambulatory difficulties.

DESIGN

The American Community Survey (ACS) is a nationwide cross-sectional survey administered by the United States Census Bureau.

PARTICIPANTS

The 2011-2015 ACS sample contains data on 7 210 535 individuals 45 years of age or older.

METHODS

Descriptive statistics for each of the 4 mutually exclusive sensory impairment categories no sensory impairment (NSI), SVI, SHI, and serious DSI were calculated using the weighted sample. Adjusted odds ratios using several logistic regressions were calculated using the unweighted sample to measure the magnitude of associations between sensory impairment status and the outcome difficulties.

MAIN OUTCOME MEASURES

Self-reported cognitive, independent living, self-care, and ambulatory difficulty.

RESULTS

Among individuals 45 years of age or older, the estimated nationwide prevalence of self-reported SVI alone is 2.8%, that of SHI alone is 6.0%, and that of serious DSI is 1.6%. The prevalence of each sensory impairment increases with age. A greater proportion of American Indians or Alaskan Natives experience SVI (4.8%), SHI (8.5%), and serious DSI (3.7%) than any other race or ethnic group (P < 0.001). Individuals reporting serious DSI are more likely to report cognitive impairment, independent living difficulty, self-care difficulty, and difficulty ambulating than individuals with NSI across all age groups (all P < 0.001). Furthermore, serious DSI is associated with greater cognitive and functional difficulties than SVI or SHI alone, and SVI alone has a greater association with cognitive and functional difficulties than SHI alone.

CONCLUSIONS

The nationwide prevalence of self-reported serious sensory impairment increases with age and is distributed unequally among different racial and ethnic groups. Any sensory impairment is associated with greater cognitive and functional difficulties than NSI. Additionally, serious DSI is associated with greater difficulties than SVI or SHI alone, and SVI alone is more serious than SHI alone in each of the 4 cognitive and functional difficulties.

摘要

目的

估计全国范围内报告的严重视力障碍(SVI)、严重听力障碍(SHI)和严重双重感觉障碍(DSI;即同时存在 SVI 和 SHI)的流行率,并描述其与报告的认知、独立生活、自我护理和行动困难之间的关系。

设计

美国社区调查(ACS)是由美国人口普查局进行的一项全国性横断面调查。

参与者

2011-2015 年 ACS 样本包含 45 岁及以上的 7210535 个人的数据。

方法

使用加权样本计算每个 4 个相互排斥的感觉障碍类别(无感觉障碍[NSI]、SVI、SHI 和严重 DSI)的描述性统计数据。使用未加权样本计算多个逻辑回归的调整比值,以衡量感觉障碍状况与结果困难之间的关联程度。

主要结果测量

自我报告的认知、独立生活、自我护理和行动困难。

结果

在 45 岁及以上的人群中,全国范围内报告的 SVI 单独的患病率估计为 2.8%,SHI 单独的患病率为 6.0%,严重 DSI 的患病率为 1.6%。每种感觉障碍的患病率随年龄增长而增加。美洲印第安人或阿拉斯加原住民中 SVI(4.8%)、SHI(8.5%)和严重 DSI(3.7%)的比例高于任何其他种族或族裔(P<0.001)。与无感觉障碍(NSI)相比,报告严重 DSI 的个体在所有年龄组中更有可能报告认知障碍、独立生活困难、自我护理困难和行动困难(均 P<0.001)。此外,严重 DSI 与认知和功能障碍的关联大于 SVI 或 SHI 单独,而 SVI 单独与认知和功能障碍的关联大于 SHI 单独。

结论

全国范围内报告的严重感觉障碍的患病率随年龄增长而增加,并且在不同种族和族裔群体之间分布不均。任何感觉障碍都比 NSI 更与认知和功能障碍相关。此外,严重 DSI 与 SVI 或 SHI 单独相比,与更大的困难相关,而 SVI 单独在认知和功能障碍的 4 个方面比 SHI 单独更严重。

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