Liang Zheng, Li Ao, Xu Yuanyuan, Qian Xiaoyun, Gao Xia
Jiangsu Provincial Key Medical Discipline (Laboratory), Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
Department of Neurology, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Front Aging Neurosci. 2021 Jul 8;13:695117. doi: 10.3389/fnagi.2021.695117. eCollection 2021.
Consensus is lacking with regard to whether hearing loss is an independent risk factor for dementia. We therefore conducted a meta-analysis to clarify the relationship of hearing loss and dementia. Prospective cohort studies investigating the association between hearing loss and the incidence of dementia in a community-derived population were included by searching electronic databases that included PubMed, Embase, and Cochrane's Library. A random-effects model was adopted to combine the results. Fourteen cohorts including 726,900 participants were analyzed. It was shown that hearing loss was independently associated with dementia [adjusted hazard ratio (HR): 1.59, 95% confidence interval (CI): 1.37 to 1.86, < 0.001; = 86%]. Sensitivity analysis sequentially excluding any of the individual studies included showed similar results. Subgroup analysis according to the diagnostic methods for hearing loss, validation strategy for dementia, follow-up duration, and adjustment of apolipoprotein E genotype also showed consistent results (-values for subgroup differences all > 0.05). Meta-analysis with five studies showed that hearing loss was also connected to higher risk of Alzheimer's disease (adjusted HR: 2.24, 95% CI: 1.32 to 3.79, = 0.003; = 2%). Hearing loss may increase the risk of dementia in the adult population. Whether effective treatment for hearing loss could reduce the incidence of dementia should be explored in the future.
关于听力损失是否为痴呆症的独立危险因素，目前尚未达成共识。因此，我们进行了一项荟萃分析，以阐明听力损失与痴呆症之间的关系。通过检索包括PubMed、Embase和Cochrane图书馆在内的电子数据库，纳入了调查社区人群中听力损失与痴呆症发病率之间关联的前瞻性队列研究。采用随机效应模型合并结果。分析了包括726,900名参与者的14个队列。结果表明，听力损失与痴呆症独立相关[调整后的风险比（HR）：1.59，95%置信区间（CI）：1.37至1.86，<0.001；I² = 86%]。依次排除纳入的任何一项个体研究的敏感性分析显示了相似的结果。根据听力损失的诊断方法、痴呆症的验证策略、随访持续时间和载脂蛋白E基因型的调整进行的亚组分析也显示了一致的结果（亚组差异的P值均>0.05）。对五项研究的荟萃分析表明，听力损失也与患阿尔茨海默病的较高风险相关（调整后的HR：2.24，95%CI：1.32至3.79，P = 0.003；I² = 2%）。听力损失可能会增加成年人群患痴呆症的风险。未来应探索对听力损失的有效治疗是否能降低痴呆症的发病率。
