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老年人感觉障碍与痴呆的关系:来自中国的证据。

Association Between Sensory Impairment and Dementia in Older Adults: Evidence from China.

机构信息

Institute of Population Research, Peking University, Beijing, China.

APEC Health Science Academy, Peking University, Beijing, China.

出版信息

J Am Geriatr Soc. 2018 Mar;66(3):480-486. doi: 10.1111/jgs.15202. Epub 2018 Jan 10.

Abstract

OBJECTIVES

To determine the association between sensory impairment and dementia in Chinese older adults.

DESIGN

Cross-sectional.

SETTING

Older adults in 31 provinces of China.

PARTICIPANTS

Individuals aged 65 and older (N = 250,752).

MEASUREMENTS

Psychiatrists ascertained dementia based on the International Classification of Diseases, 10th Revision. Sensory impairment was measured as only hearing impairment, only vision impairment, and combined sensory impairment (combined hearing and vision impairment). Hearing impairment was defined as greater than 40 dB loss in the better ear according to the standard of the World Health Organization (WHO) Prevention of Deafness and Hearing Impairment (PDH) standard 97.3. Ophthalmologists assessed vision impairment according to the WHO best-corrected visual acuity (BCVA) criteria (low vision: 0.05≤BCVA ≤0.29; blindness: no light perception ≤ BCVA <0.05, visual field less than 10 degrees; the better-seeing eye).

RESULTS

The prevalence of dementia was 0.41% (95% CI = 0.39-0.44%) without sensory impairment, 0.83% (95% CI = 0.70-0.99%) with only visual impairment, 0.61 (95% CI = 0.53-0.71%) with only hearing impairment, and 1.27% (95% CI = 1.00-1.61%) with combined sensory impairments. After adjusting for sociodemographic characteristics, vision impairment (odds ratio (OR) = 1.58, 95% CI = 1.28-1.96) and combined sensory impairments (OR = 1.64, 95% CI = 1.23-2.20) were associated with greater risk of severe to extremely severe dementia. Hearing impairment was not significantly associated with dementia.

CONCLUSION

Sensory impairments are associated with greater risk of dementia in Chinese older adults. Studies are needed to further explore the pathway of this association in Chinese elderly adults and to provide suggestions to improve health status for this population.

摘要

目的

在中国老年人中确定感觉障碍与痴呆的关系。

设计

横断面研究。

地点

中国 31 个省的老年人。

参与者

年龄在 65 岁及以上的个体(N=250752)。

测量方法

精神病学家根据《国际疾病分类》第 10 版确定痴呆。感觉障碍仅作为听力障碍、视力障碍和联合感觉障碍(联合听力和视力障碍)进行测量。根据世界卫生组织(WHO)预防耳聋和听力障碍(PDH)标准 97.3,听力损失定义为较好耳的听力损失大于 40dB。眼科医生根据 WHO 最佳矫正视力(BCVA)标准评估视力障碍(低视力:0.05≤BCVA≤0.29;失明:无光感≤BCVA<0.05,视野小于 10 度;视力较好的眼睛)。

结果

无感觉障碍的痴呆患病率为 0.41%(95%CI=0.39-0.44%),仅有视力障碍为 0.83%(95%CI=0.70-0.99%),仅有听力障碍为 0.61%(95%CI=0.53-0.71%),联合感觉障碍为 1.27%(95%CI=1.00-1.61%)。在调整了社会人口统计学特征后,视力障碍(比值比(OR)=1.58,95%CI=1.28-1.96)和联合感觉障碍(OR=1.64,95%CI=1.23-2.20)与严重至极严重痴呆的风险增加相关。听力障碍与痴呆无显著相关性。

结论

感觉障碍与中国老年人痴呆的风险增加相关。需要进一步研究该关联在中国老年人中的途径,并为该人群的健康状况改善提供建议。

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