Pabst Alexander, Bär Jonathan, Röhr Susanne, Löbner Margrit, Kleineidam Luca, Heser Kathrin, Hajek André, van der Leeden Carolin, Wiese Birgitt, Maier Wolfgang, Angermeyer Matthias C, Scherer Martin, Wagner Michael, König Hans-Helmut, Riedel-Heller Steffi G
Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany.
Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
J Am Geriatr Soc. 2021 Jun;69(6):1519-1528. doi: 10.1111/jgs.17074. Epub 2021 Mar 18.
Sensory impairments have been associated with dementia in older adults. However, the contribution of different impairments and how they interact in the development of dementia is not clear. We examined the independent and interaction effects of hearing impairment (HI) and visual impairment (VI) on incident dementia.
Multi-centric population-based prospective cohort study.
Data were taken from the AgeDifferent.de platform, pooling participants aged 75 and older from the German LEILA75+ and AgeCoDe/AgeQualiDe cohorts.
Older adults (N = 3497) with mean age 79.8 years, 67.2% female.
Standardized interviews and questionnaires were used to assess self-reported HI and VI at baseline and all-cause dementia in 9 follow-ups, spanning over 20 years.
Competing risk regression models were conducted to test the main and interaction effects of HI and VI on dementia incidence, adjusting for established risk factors of dementia and accumulated mortality.
HI and VI at baseline were reported by 30.3% and 16.6% of individuals, respectively. Adjusting for baseline information on sociodemographics, substance use, cognitive functioning and morbidity, and controlling for accumulated mortality risk, HI (sHR 1.16, 95% CI 1.04-1.30, p = 0.011) but not VI (sHR 1.07, 95% CI 0.90-1.28, p = 0.462) was significantly associated with incident dementia. There was no interaction between HI and VI (sHR 1.09, 95% CI 0.81-1.46, p = 0.567).
Hearing impairment is associated with an increased incidence of all-cause dementia in older adults. There is no excess risk or risk compensation through the additional presence or absence of visual impairment. Early prevention measures for hearing impairment might help to reduce the long-term risk of dementia.
感觉障碍与老年人痴呆症有关。然而，不同障碍的作用以及它们在痴呆症发展过程中如何相互作用尚不清楚。我们研究了听力障碍（HI）和视力障碍（VI）对新发痴呆症的独立影响和交互作用。
基于多中心人群的前瞻性队列研究。
数据取自AgeDifferent.de平台，汇总了来自德国LEILA75+和AgeCoDe/AgeQualiDe队列的75岁及以上参与者。
年龄较大的成年人（N = 3497），平均年龄79.8岁，女性占67.2%。
在基线时使用标准化访谈和问卷来评估自我报告的HI和VI，并在9次随访中评估全因性痴呆症，随访时间超过20年。
采用竞争风险回归模型来测试HI和VI对痴呆症发病率的主要影响和交互作用，同时对已确定的痴呆症风险因素和累积死亡率进行调整。
分别有30.3%和16.6%的个体报告在基线时有HI和VI。在对社会人口统计学、物质使用、认知功能和发病率的基线信息进行调整，并控制累积死亡风险后，HI（标准化风险比1.16，95%置信区间1.04 - 1.30，p = 0.011）与新发痴呆症显著相关，但VI（标准化风险比1.07，95%置信区间0.90 - 1.28，p = 0.462）并非如此。HI和VI之间没有交互作用（标准化风险比1.09，95%置信区间0.81 - 1.46，p = 0.567）。
听力障碍与老年人全因性痴呆症发病率增加有关。视力障碍的存在与否并不会增加额外风险或产生风险补偿。听力障碍的早期预防措施可能有助于降低痴呆症的长期风险。
