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评估助听器与听力障碍老年患者认知能力下降减缓的关联性。

Evaluation of the Association Between Hearing Aids and Reduced Cognitive Decline in Older Adults with Hearing Impairment.

机构信息

Nishitokyo Medical Association, Nishitokyo City, Tokyo, Japan.

出版信息

Otol Neurotol. 2023 Jun 1;44(5):425-431. doi: 10.1097/MAO.0000000000003885. Epub 2023 May 1.

Abstract

OBJECTIVE

We investigated whether hearing aids (HAs) for hearing impairment may reduce cognitive decline in older adults.

STUDY DESIGN

Retrospective cohort.

SETTING

Ambulatory for medical checkup.

PATIENTS

Comprised 1,453 older adults aged 65 to 90 years.

INTERVENTION

HAs were recommended for hearing impairment with thresholds of ≥40 dB.

MAIN OUTCOME MEASURES

The Mini-Mental State Examination (MMSE) and pure-tone audiometry were performed. Over 2 years, multivariate logistic regression analysis was used to assess the effects of sex, age, hearing, HAs, hypertension, diabetes, cerebrovascular disease, smoking, and drinking on MMSE scores.

RESULTS

Of 1,453 participants who underwent MMSE, 1,320 who underwent audiometry in the first-year included 99 HA users. Of the 1,320 participants, 858 (89 HA users) were followed longitudinally for 1 year and 672 (66 HA users) for 2 years. In the first-year cross-sectional study, the risk ratios (RRs) for hearing impairment (≥25 dB) when the MMSE scores were ≤23 and ≤27 points were 2.97 (1.40-6.28) and 1.34 (1.01-1.79), respectively. For moderate (40-<70 dB) and moderate to severe (≥40 dB) hearing impairment, the RRs for HA use were 0.30 (0.11-0.86) and 0.50 (0.22-1.13), respectively, when the MMSE scores were ≤23. A 2-year follow-up of participants with moderate hearing impairment yielded hazard ratios for MMSE score decrease of 0.30 (0.11-0.82) after 1 year and 0.16 (0.04-0.64) after 2 years in HA users.

CONCLUSIONS

HA use may be associated with reducing MMSE score decrease in older adults with moderate hearing impairment.

摘要

目的

我们研究了听力障碍的助听器(HA)是否可以降低老年人的认知能力下降。

研究设计

回顾性队列研究。

设置

门诊体检。

患者

年龄在 65 至 90 岁之间的 1453 名老年人。

干预措施

为听力阈值≥40dB 的听力障碍者推荐使用 HA。

主要观察指标

采用简易精神状态检查表(MMSE)和纯音测听评估。在 2 年期间,采用多变量逻辑回归分析评估性别、年龄、听力、HA、高血压、糖尿病、脑血管疾病、吸烟和饮酒对 MMSE 评分的影响。

结果

在 1453 名接受 MMSE 测试的参与者中,有 1320 名在第一年接受了听力测试,其中包括 99 名 HA 用户。在 1320 名参与者中,有 858 名(89 名 HA 用户)进行了为期 1 年的纵向随访,672 名(66 名 HA 用户)进行了为期 2 年的随访。在第一年的横断面研究中,当 MMSE 评分≤23 和≤27 分时,听力障碍(≥25dB)的风险比(RR)分别为 2.97(1.40-6.28)和 1.34(1.01-1.79)。对于中度(40-<70dB)和中重度(≥40dB)听力障碍,当 MMSE 评分≤23 时,HA 使用的 RR 分别为 0.30(0.11-0.86)和 0.50(0.22-1.13)。在中度听力障碍的参与者中,进行了 2 年的随访,在 1 年后,HA 使用者的 MMSE 评分下降的危险比为 0.30(0.11-0.82),在 2 年后为 0.16(0.04-0.64)。

结论

HA 的使用可能与降低中度听力障碍老年人的 MMSE 评分下降有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d71a/10184821/039f33200a6b/on-44-0425-g001.jpg

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