Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, Massachusetts.
Department of Epidemiology, University of Washington, Seattle.
JAMA Netw Open. 2022 May 2;5(5):e2210734. doi: 10.1001/jamanetworkopen.2022.10734.
Hearing and vision problems are individually associated with increased dementia risk, but the impact of having concurrent hearing and vision deficits, ie, dual sensory impairment (DSI), on risk of dementia, including its major subtypes Alzheimer disease (AD) and vascular dementia (VaD), is not well known.
To evaluate whether DSI is associated with incident dementia in older adults.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study from the Cardiovascular Health Study (CHS) was conducted between 1992 and 1999, with as many as 8 years of follow-up. The multicenter, population-based sample was recruited from Medicare eligibility files in 4 US communities with academic medical centers. Of 5888 participants aged 65 years and older in CHS, 3602 underwent cranial magnetic resonance imaging and completed the modified Mini-Mental State Examination in 1992 to 1994 as part of the CHS Cognition Study. A total of 227 participants were excluded due to prevalent dementia, leaving a total of 3375 participants without dementia at study baseline. The study hypothesis was that DSI would be associated with increased risk of dementia compared with no sensory impairment. The association between the duration of DSI with risk of dementia was also evaluated. Data analysis was conducted from November 2019 to February 2020.
Hearing and vision impairments were collected via self-report at baseline and as many as 5 follow-up visits.
All-cause dementia, AD, and VaD, classified by a multidisciplinary committee using standardized criteria.
A total of 2927 participants with information on hearing and vision at all available study visits were included in the analysis (mean [SD] age, 74.6 [4.8] years; 1704 [58.2%] women; 455 [15.5%] African American or Black; 2472 [85.5%] White). Compared with no sensory impairment, DSI was associated with increased risk of all-cause dementia (hazard ratio [HR], 2.60; 95% CI, 1.66-2.06; P < .001), AD (HR, 3.67; 95% CI, 2.04-6.60; P < .001) but not VaD (HR, 2.03; 95% CI, 1.00-4.09; P = .05).
In this cohort study, DSI was associated with increased risk of dementia, particularly AD. Evaluation of hearing and vision in older adults may help to identify those at high risk of developing dementia.
听力和视力问题单独与痴呆风险增加相关，但同时存在听力和视力缺陷（即双重感觉障碍，DSI）对痴呆风险的影响，包括其主要亚型阿尔茨海默病（AD）和血管性痴呆（VaD），尚不清楚。
评估 DSI 是否与老年人的痴呆症发生有关。
设计、地点和参与者：这是一项来自心血管健康研究（CHS）的前瞻性队列研究，于 1992 年至 1999 年进行，最多可进行 8 年的随访。该多中心、基于人群的样本是从美国 4 个有学术医疗中心的社区的医疗保险资格档案中招募的。CHS 认知研究中，共有 5888 名年龄在 65 岁及以上的 CHS 参与者接受了颅磁共振成像检查，并于 1992 年至 1994 年完成了改良的迷你精神状态检查。共有 227 名参与者因前期痴呆症而被排除在外，因此在研究开始时没有痴呆症的参与者共有 3375 名。研究假设 DSI 与无感觉障碍相比，与痴呆风险增加相关。还评估了 DSI 持续时间与痴呆风险之间的关系。数据分析于 2019 年 11 月至 2020 年 2 月进行。
听力和视力损伤通过基线和多达 5 次随访时的自我报告收集。
所有原因的痴呆症、AD 和 VaD，由一个使用标准化标准的多学科委员会进行分类。
在所有可用的研究访视中，共有 2927 名参与者提供了听力和视力信息（平均[标准差]年龄为 74.6[4.8]岁；1704[58.2%]名女性；455[15.5%]名非裔美国人或黑人；2472[85.5%]名白人）。与无感觉障碍相比，DSI 与全因痴呆症（风险比[HR]，2.60；95%置信区间[CI]，1.66-2.06；P<0.001）、AD（HR，3.67；95%CI，2.04-6.60；P<0.001）但不是 VaD（HR，2.03；95%CI，1.00-4.09；P=0.05）的风险增加有关。
在这项队列研究中，DSI 与痴呆风险增加相关，尤其是 AD。对老年人的听力和视力进行评估可能有助于识别那些患痴呆症风险较高的人群。
