85 岁及以上人群中与认知功能障碍相关的并发视力和听力损害：乌拉尔非常老研究。
Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study.
机构信息
Ufa Eye Research Institute, Ufa, Bashkortostan, Russian Federation.
Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany.
出版信息
BMJ Open. 2022 Apr 26;12(4):e058464. doi: 10.1136/bmjopen-2021-058464.
OBJECTIVE
To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years.
METHODS
The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function.
SETTING
A rural and urban area in Bashkortostan, Russia.
PARTICIPANTS
Out of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated.
PRIMARY AND SECONDARY OUTCOME MEASURES
Prevalence of vision, hearing and DSI and cognitive dysfunction.
RESULTS
The study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85-98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001).
CONCLUSIONS
In this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.
目的
评估 85 岁及以上人群中视力障碍、听力障碍和双重感觉障碍（DSI）（视力和听力障碍的组合）与认知功能障碍的患病率。
方法
这项在俄罗斯巴什科尔托斯坦农村和城市进行的基于人群的 Ural 非常老研究于 2017 年至 2020 年期间进行，包括详细的眼部和全身检查，评估中度至重度视力障碍（MSVI）/失明（最佳矫正视力<6/18）、中度至重度听力损失（MSHL）和认知功能。
地点
俄罗斯巴什科尔托斯坦的农村和城市地区。
参与者
在符合条件的 1882 名 85 岁及以上的个体中，有 1526 名（81.1%）参加了研究。
主要和次要观察指标
视力、听力和 DSI 以及认知功能障碍的患病率。
结果
该研究纳入了 731 名（47.9%）接受 MSVI/失明、MSHL 和认知功能测量的个体（平均年龄 88.1±2.7 岁；中位数 87 岁，范围 85-98 岁）。MSVI/失明、MSHL、DSI 和痴呆的患病率分别为 51.8%（95%CI 48.2%至 55.5%）、33.1%（95%CI 29.7%至 36.5%）、20.5%（95%CI 17.8%至 23.5%）和 48.2%（95%CI 44.5%至 51.8%）。较低的认知功能评分与较低的视力（p<0.001）和较高的听力损失评分（p=0.03）相关，在调整了年龄较大（p=0.001）、居住在农村地区（p=0.003）、较低的教育水平（p<0.001）和较高的抑郁评分（p<0.001）后。较高的痴呆患病率与较高的 MSHL 患病率（OR 2.18，95%CI 1.59 至 2.98；p<0.001）、较高的 MSVI/失明患病率（OR 2.09，95%CI 1.55 至 2.81；p<0.001）和较高的 DSI 患病率（OR 2.80，95%CI 1.92 至 4.07；p<0.001）相关。
结论
在这项来自俄罗斯的非常老的、多种族的人群中，DSI（患病率 20.5%）与听力障碍（OR 2.18）和单独视力障碍（OR 2.09）相比，与痴呆的相关性更强（OR 2.80）。研究结果表明，在老年人群中，听力和视力障碍，特别是两者的共同发生，与痴呆的患病率有更强的关联。
Zotero 插件