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中国老年社区居民中言语频率听力损失、高频听力损失与认知障碍的性别特异性关联。

Gender-specific associations of speech-frequency hearing loss, high-frequency hearing loss, and cognitive impairment among older community dwellers in China.

机构信息

Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, 1500 Zhouyuan Road, Shanghai, 201318, Pudong New District, China.

Shanghai University of Medicine and Health Sciences, 279 Zhouzhu Highway, Shanghai, 201318, Pudong New District, China.

出版信息

Aging Clin Exp Res. 2022 Apr;34(4):857-868. doi: 10.1007/s40520-021-01990-0. Epub 2021 Oct 18.

Abstract

BACKGROUND AND AIMS

This study aimed atinvestigating the relationship between speech-frequency hearing loss (SFHL), high-frequency hearing loss (HFHL), and cognitive impairment (CI) and then to determine whether there are any differences in gender among older community dwellers in China.

METHODS

1012 adults aged ≥ 60 years (428 males; average age, 72.61 ± 5.51 years) and living in Chongming District, Shanghai were enrolled in the study. We used the audiometric definition of hearing loss (HL) adopted by the World Health Organization (WHO). Speech-frequencies were measured at 0.5 kHz, 1 kHz, 2 kHz, and 4 kHz; high-frequencies were measured at 4 kHz and 8 kHz. Pure tone average (PTA) was measured as hearing sensitivity. Cognitive performance was measured using the mini mental state examination (MMSE).

RESULTS

Our studies demonstrated a 37.6% prevalence of HL in males and a 36.0% prevalence of HL in females. Adjusted for confounding variables, the results from a multivariate analysis showed that SFHL was associated with CI in females (OR = 2.922, 95% Confidence Interval = 1.666-5.124) and males (OR = 2.559, 95% Confidence Interval = 1.252-5.232). However, HFHL was associated with CI only in females (OR = 3.490, 95% Confidence Interval = 1.834-6.643). HL was associated with poorer cognitive scores (P < 0.05). "Registration" (P < 0.05) in MMSE was associated with speech- and high-frequency hearing sensitivity.

CONCLUSIONS

The associations between HL and CI varied according to gender in older community-dwellers, suggesting that different mechanisms are involved in the etiology of HL. Moreover, hearing sensitivity was negatively associated with cognition scores; therefore, early screening for HL and CI among older community-dwelling adults is advised.

摘要

背景与目的

本研究旨在探讨言语频率听力损失(SFHL)、高频听力损失(HFHL)与认知障碍(CI)之间的关系,然后确定在中国,老年社区居民中是否存在性别差异。

方法

本研究纳入了上海市崇明区年龄≥60 岁的 1012 名成年人(男性 428 名,平均年龄 72.61±5.51 岁)。我们使用世界卫生组织(WHO)采用的听力损失(HL)的听力学定义。言语频率在 0.5kHz、1kHz、2kHz 和 4kHz 处测量;高频在 4kHz 和 8kHz 处测量。纯音平均(PTA)作为听力敏感度进行测量。认知表现使用简易精神状态检查(MMSE)进行测量。

结果

本研究表明,男性 HL 的患病率为 37.6%,女性 HL 的患病率为 36.0%。在调整了混杂变量后,多变量分析的结果表明,SFHL 与女性(OR=2.922,95%置信区间 1.666-5.124)和男性(OR=2.559,95%置信区间 1.252-5.232)的 CI 相关。然而,HFHL 仅与女性的 CI 相关(OR=3.490,95%置信区间 1.834-6.643)。HL 与认知评分较差相关(P<0.05)。MMSE 中的“登记”(P<0.05)与言语和高频听力敏感度相关。

结论

在老年社区居民中,HL 与 CI 之间的关联因性别而异,这表明 HL 的病因学涉及不同的机制。此外,听力敏感度与认知评分呈负相关;因此,建议对老年社区成年居民进行早期 HL 和 CI 筛查。

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