School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu, China.
Int J Geriatr Psychiatry. 2021 Aug;36(8):1197-1203. doi: 10.1002/gps.5511. Epub 2021 Feb 23.
Although hearing difficulty is associated with cognitive impairment, little is known about the potential mechanisms involved. This study assessed the mediating effects of leisure activities and psychological resilience on the association between hearing difficulty and cognitive impairment.
Two waves of Chinese Longitudinal Healthy Longevity Survey (2011-2014) were used in the current analysis. Hearing difficulty, leisure activities and psychological resilience were measured at baseline. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination. The data were analyzed using generalized structural equation modeling with adjustment for confounding factors.
Of the 4267 participants at baseline, 33.5% (1430) reported hearing difficulty. The incidence of cognitive impairment was 15.3% (651) during the 3-year follow-up. Hearing difficulty increased the risk of cognitive impairment (odds ratio [OR] = 1.59, 95% confidence intervals [CI]: 1.26-1.92). Leisure activities and psychological resilience partly mediated the association between hearing difficulty and cognitive impairment. Hearing difficulty was negatively related to leisure activities (β = -0.23, 95% CI: -0.41 to -0.05) and psychological resilience (β = -0.34, 95% CI: -0.57 to -0.11). Furthermore, leisure activities (OR = 0.92, 95% CI: 0.89-0.96) and psychological resilience (OR = 0.95, 95% CI: 0.93-0.98) would significantly decrease the risk of cognitive impairment.
Hearing difficulty was associated with the incidence of cognitive impairment in older adults. Leisure activities and psychological resilience mediated the relationship. Participation in leisure activity and promoting psychological resilience may be candidate interventions in preventing cognitive impairment among the individuals with hearing difficulty.
尽管听力障碍与认知障碍有关，但对于其中涉及的潜在机制知之甚少。本研究评估了休闲活动和心理弹性在听力障碍与认知障碍之间的关联中的中介作用。
本研究使用了中国健康长寿纵向研究的两个时间点的数据（2011-2014 年）。在基线时测量了听力障碍、休闲活动和心理弹性。使用中文版的简易精神状态检查评估认知功能。采用广义结构方程模型对数据进行分析，并对混杂因素进行了调整。
在基线时的 4267 名参与者中，有 33.5%（1430 人）报告有听力障碍。在 3 年的随访中，认知障碍的发生率为 15.3%（651 人）。听力障碍增加了认知障碍的风险（比值比[OR] = 1.59，95%置信区间[CI]：1.26-1.92）。休闲活动和心理弹性部分介导了听力障碍与认知障碍之间的关联。听力障碍与休闲活动（β = -0.23，95% CI：-0.41 至 -0.05）和心理弹性（β = -0.34，95% CI：-0.57 至 -0.11）呈负相关。此外，休闲活动（OR = 0.92，95% CI：0.89-0.96）和心理弹性（OR = 0.95，95% CI：0.93-0.98）显著降低了认知障碍的风险。
听力障碍与老年人认知障碍的发生有关。休闲活动和心理弹性介导了这种关系。参与休闲活动和促进心理弹性可能是预防听力障碍个体认知障碍的候选干预措施。
