Department of Epidemiology and Biostatistics, University of California, San Francisco.
San Francisco VA Health Care System, California.
J Gerontol A Biol Sci Med Sci. 2019 May 16;74(6):890-896. doi: 10.1093/gerona/gly264.
Few studies have examined impairment in multiple senses (multisensory impairment) and risk of dementia in comparison to having a single or no sensory impairment.
We studied 1,810 black and white nondemented participants from Health, Aging, and Body Composition (Health ABC) Study aged 70-79 years at enrollment. Sensory impairment was determined at our study baseline (Year 3-5 of Health ABC) using established cut points for vision (Bailey-Lovie visual acuity and Pelli-Robson contrast sensitivity test), hearing (audiometric testing), smell (12-item Cross-Cultural Smell Identification Test), and touch (peripheral nerve function tests). Incident dementia over 10 years of follow-up was based on hospitalization records, dementia medications, or at least 1.5 SD decline in Modified Mini-Mental State Examination score (race-specific). Cox proportional hazard models with adjustment for demographics, health behaviors, and health conditions evaluated the relationship between risk of dementia and increasing number of sensory impairments.
Sensory impairments were common: 28% had visual impairment, 35% had hearing loss, 22% had poor smell, 12% had touch insensitivity; 26% had more than two impairments, and 5.6% had more than three sensory impairments. Number of impairments was associated with risk of dementia in a graded fashion (p < .001). Compared to no sensory impairments, the adjusted hazard ratio was 1.49 (95% CI: 1.12, 1.98) for one sensory impairment, 1.91 (95% CI: 1.39, 2.63) for two sensory impairments, and 2.85 (95% CI: 1.88, 4.30) for more than three sensory impairments.
Multisensory impairment was strongly associated with increased risk of dementia. Although, the nature of this relationship needs further investigation, sensory function assessment in multiple domains may help identify patients at high risk of dementia.
与仅有单一感官损伤或无感官损伤相比，很少有研究检查多种感官损伤（多感官损伤）与痴呆风险之间的关系。
我们研究了来自健康、老龄化和身体成分研究（Health ABC 研究）的 1810 名黑人和白人非痴呆参与者，他们在入组时年龄为 70-79 岁。在研究基线时（Health ABC 的第 3-5 年）使用已建立的视力（贝利-洛维视力和佩利-罗宾逊对比敏感度测试）、听力（听力测试）、嗅觉（12 项跨文化嗅觉识别测试）和触觉（周围神经功能测试）的截断值来确定感官损伤。在 10 年的随访期间，根据住院记录、痴呆症药物或改良简易精神状态检查评分至少下降 1.5 个标准差（种族特异性）来确定痴呆症的发生。在调整人口统计学、健康行为和健康状况后，使用 Cox 比例风险模型评估了随着感官损伤数量的增加，痴呆症风险的关系。
感官损伤很常见：28%有视力障碍，35%有听力损失，22%有嗅觉差，12%有触觉不敏感；26%有两种以上损伤，5.6%有三种以上感官损伤。损伤数量与痴呆风险呈梯度相关（p<0.001）。与无感官损伤相比，调整后的风险比为 1.49（95%可信区间：1.12，1.98）有 1 种感官损伤，1.91（95%可信区间：1.39，2.63）有 2 种感官损伤，2.85（95%可信区间：1.88，4.30）有 3 种以上感官损伤。
多感官损伤与痴呆风险增加密切相关。尽管这种关系的性质需要进一步研究，但在多个领域进行感官功能评估可能有助于识别痴呆风险高的患者。
