School of Nursing, Tung Wah College, Homantin Kowloon, Hong Kong, Hong Kong.
Department of Statistics and Actuarial Science, The University of Hong Kong, Pok Fu Lam, Hong Kong, Hong Kong.
BMC Geriatr. 2022 Mar 16;22(1):216. doi: 10.1186/s12877-022-02895-x.
Hearing and vision impairments and the use of audio-visual aids are associated with cognitive decline in community-dwelling older people, but effects in long-term care facilities (LFCF) are unclear. We hypothesize that visual and hearing impairment are associated with cognitive decline and these relationships are mediated by using visual and hearing aids.
Secondary data analysis of a longitudinal study was conducted in the 7 government-subsidized LTCF operated by one of the largest non-governmental organizations in Hong Kong using data between 2005 and 2016. Eligible residents were ≥ 60 years of age without severe cognitive impairment at baseline who had stayed in the facilities for more than 3 years. All variables were measured by using the Minimum Data Set-Resident Assessment Instrument Version 2.0, Hong Kong version. The outcome was cognitive decline. Predictors were visual and hearing impairments. Mediators were the use of visual and hearing aids. General linear models were employed to test the hypotheses.
Results for 2,233 residents were analyzed, with a mean age of 82.1 ± 8.2 years and a mean follow-up period of 4.4 ± 0.8 years. Results showed that those who had visual impairment (p = 0.004) and hearing impairments (p = 0.022) had a higher risk of cognitive decline. Using hearing aids (coefficient = 0.0186, p < 0.05) positively mediates the effect of hearing impairment on cognitive decline. Using visual aids (coefficient = -0.0881, p < 0.05) negatively mediates the effects of visual impairment on cognitive decline.
In LTCF, hearing and visual impairments are associated with a higher risk of cognitive decline. Hearing aids often-users were associated with a higher risk of cognitive decline. LTCF residents with visual impairment did not use visual aids. Use of visual aids demonstrated potential effects in slowing cognitive decline. A future study with a larger and more diverse sample with attention to quality of devices is proposed to confirm its effects.
听力和视力障碍以及视听辅助设备的使用与社区居住的老年人认知能力下降有关，但在长期护理机构（LTCF）中的影响尚不清楚。我们假设视觉和听力障碍与认知能力下降有关，而这些关系是通过使用视觉和听觉辅助设备来介导的。
对香港最大的非政府组织之一运营的 7 家政府补贴的长期护理机构进行了纵向研究的二次数据分析，该研究使用了 2005 年至 2016 年的数据。合格的居民年龄在 60 岁以上，在入住设施前没有严重的认知障碍，且在设施中居住超过 3 年。所有变量均通过使用香港版的最小数据集居民评估工具 2.0 进行测量。结果是认知能力下降。预测因素是视觉和听力障碍。中介变量是视觉和听觉辅助设备的使用。采用一般线性模型检验假设。
对 2233 名居民进行了分析，平均年龄为 82.1±8.2 岁，平均随访时间为 4.4±0.8 年。结果表明，有视觉障碍（p=0.004）和听力障碍（p=0.022）的居民认知能力下降的风险更高。使用助听器（系数=0.0186，p<0.05）正向调节听力障碍对认知能力下降的影响。使用助视器（系数=-0.0881，p<0.05）负向调节视力障碍对认知能力下降的影响。
在 LTCF 中，听力和视力障碍与认知能力下降的风险增加有关。助听器的高频使用者与认知能力下降的风险增加有关。有视力障碍的 LTCF 居民没有使用助视器。助视器的使用显示出在减缓认知能力下降方面的潜在效果。建议进行一项具有更大和更多样本的未来研究，并关注设备的质量，以确认其效果。
