Toyota Josui Mental Clinic, 86-2 Minamidaira, Josui, Toyota, Aichi 470-0343, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
Department of Otorhinolaryngology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
Auris Nasus Larynx. 2022 Feb;49(1):18-25. doi: 10.1016/j.anl.2021.03.017. Epub 2021 Apr 15.
Hearing loss is a risk factor for cognitive impairment, and the use of a hearing aid (HA) may prevent cognitive decline alongside hearing loss. We aimed to elucidate the prevalence of self-reported HA usage in Japanese community-dwelling elders with hearing loss, and the effect of hearing and HA on cognitive impairment.
A total of 1193 participants, who had audiometric defined hearing loss and were aged 60 years or over, had their cumulative 3260 observations followed up for 10 years from a large cohort of a Japanese study. Association between hearing (pure-tone average threshold level at 500, 1000, 2000, and 4000 Hz from the better hearing ear: PTABHE) and HA usage with cognitive impairment (total score of Mini-Mental State Estimation was under 27 or diagnosed as dementia) was analyzed using generalized estimating equations.
The HA usage rate of the 1193 community-dwelling elders with hearing loss was 6% during the first involvement. The majority (59.2%) of HA users always used an HA. HA usage rate was 0.7% for the mild hearing loss group and 32.4% for the moderate or greater hearing loss group in the latest participating wave. PTABHE was significantly associated with cognitive impairment (odds ratio for every 10 dB 1.36; 95% CI 1.21-1.53, p<0.0001) after adjusting for age, sex, education, depressed mood, smoking status, alcohol intake, income, activity, obesity, histories of hypertension, dyslipidemia, ischemic heart disease, diabetes, stroke, ear disease, and occupational noise exposure. PTABHE was also significantly associated with cognitive impairment in the mild hearing loss group (odds ratio for every 10 dB 1.34; 95% CI 1.05-1.72, p = 0.020) and moderate hearing loss group (odds ratio for every 10 dB 1.82; 95% CI 1.27-2.61, p = 0.001). HA use showed a significant suppressive effect on cognitive impairment in those with moderate hearing loss who always use an HA (odds ratio 0.54; 95% CI 0.30-1.00, p = 0.049).
The prevalence of HA usage among Japanese community-dwelling elders with hearing loss is consistent, at around 10%. The hearing level remained a primary risk factor for cognitive impairment among elders with hearing loss after adjusting for several confounding factors. Regular HA use may have a protective effect on cognitive impairment in those with moderate hearing loss.
听力损失是认知障碍的一个风险因素，使用助听器（HA）可能会预防听力损失和认知能力下降。我们旨在阐明日本社区居住的听力损失老年人中自我报告的 HA 使用情况的流行率，以及听力和 HA 对认知障碍的影响。
共有 1193 名参与者，他们的听力损失在经过听力测试后被定义为听力损失，年龄在 60 岁或以上，他们的听力损失状况从一个日本研究的大型队列中进行了 10 年的累计 3260 次随访。使用广义估计方程分析听力（来自较好耳的 500、1000、2000 和 4000 Hz 的纯音平均阈值水平：PTABHE）和 HA 使用与认知障碍（简易精神状态评估的总分低于 27 或被诊断为痴呆）之间的关系。
在第一次参与研究时，1193 名听力损失的社区居住老年人的 HA 使用率为 6%。大多数（59.2%）HA 用户一直使用 HA。在最新的参与波中，轻度听力损失组的 HA 使用率为 0.7%，中度或更重度听力损失组的 HA 使用率为 32.4%。在调整年龄、性别、教育程度、抑郁情绪、吸烟状况、饮酒量、收入、活动、肥胖、高血压、血脂异常、缺血性心脏病、糖尿病、中风、耳部疾病和职业性噪声暴露等因素后，PTABHE 与认知障碍显著相关（每 10dB 的比值比为 1.36；95%可信区间为 1.21-1.53，p<0.0001）。PTABHE 与轻度听力损失组（每 10dB 的比值比为 1.34；95%可信区间为 1.05-1.72，p=0.020）和中度听力损失组（每 10dB 的比值比为 1.82；95%可信区间为 1.27-2.61，p=0.001）的认知障碍也显著相关。在那些一直使用 HA 的中度听力损失患者中，HA 使用对认知障碍有显著的抑制作用（比值比为 0.54；95%可信区间为 0.30-1.00，p=0.049）。
日本社区居住的听力损失老年人中 HA 使用的流行率保持在 10%左右。在调整了几个混杂因素后，听力水平仍然是听力损失老年人认知障碍的主要危险因素。对于中度听力损失患者，定期使用 HA 可能对认知障碍有保护作用。
