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评估不同类型听力损失对认知能力下降的影响,以及听力损失和抑郁对中国老年人认知能力下降的联合影响。

Estimating the impact of different types hearing loss on cognitive decline and the joint effect of hearing loss and depression on cognitive decline among older adults in China.

机构信息

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China.

Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; National Health Commission (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, Shandong 250012, China; Center for Health Economics Experiment and Public Policy Research, Shandong University, Jinan, Shandong 250012, China.

出版信息

J Affect Disord. 2024 Apr 15;351:58-65. doi: 10.1016/j.jad.2024.01.203. Epub 2024 Jan 28.

Abstract

BACKGROUND

Current research lacks examination of the relationship between different subtypes of hearing loss (HL) and cognitive decline (CD). Additionally, the co-effects of HL and depression on CD remain unexplored. This study aims to investigate the relationship between HL, various types of HL, and CD, as well as the combined impact of HL and depression on CD.

METHODS

Data from a total of 5218 older adults who participated in the most recent three waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2011-2012, 2014, and 2018) were included. HL was assessed through self-report and objective measures. CD was defined as a decrease in MMSE score of≥3 between any two survey periods for older adults. Cox proportional hazards model was applied to analyzed.

RESULTS

Among Chinese older adults, bilateral HL (HR = 1.202, 95%CI = 1.093-1.322, P < 0.001), onset of HL after the age of 40 (HR = 1.155, 95%CI = 1.056-1.264, P = 0.002), and chronic HL (HR = 1.143, 95%CI = 1.040-1.255, P = 0.005) posed a greater risk. HL (HR = 1.146, 95%CI = 1.048-1.254, P = 0.003) and depression (HR = 1.162, 95%CI = 1.038-1.301, P = 0.009) were independently or jointly associated with CD. Participants who were simultaneously exposed to both HL and depression experienced the highest risk of CD (HR = 1.314, 95%CI = 1.117-1.545, P = 0.001).

LIMITATIONS

Given the observational design, unidentified confounding variables may still be present, such as whether to wear a hearing aid.

CONCLUSION

This study emphasizes the high risk of specific types of HL for CD and the importance of implementing health interventions that address both physiological and psychological aspects to enhance cognitive function and prevent CD in older adults.

摘要

背景

目前的研究缺乏对不同类型听力损失(HL)与认知能力下降(CD)之间关系的研究。此外,HL 和抑郁对 CD 的共同影响仍未得到探索。本研究旨在探讨 HL、各种类型的 HL 与 CD 之间的关系,以及 HL 和抑郁对 CD 的综合影响。

方法

本研究纳入了总共 5218 名参加了最近三次中国长寿纵向研究(CLHLS)(2011-2012 年、2014 年和 2018 年)的老年人的数据。HL 通过自我报告和客观测量进行评估。CD 被定义为老年人在任何两个调查期间 MMSE 评分下降≥3 分。采用 Cox 比例风险模型进行分析。

结果

在中国老年人中,双侧 HL(HR=1.202,95%CI=1.093-1.322,P<0.001)、40 岁以后发生 HL(HR=1.155,95%CI=1.056-1.264,P=0.002)和慢性 HL(HR=1.143,95%CI=1.040-1.255,P=0.005)风险更高。HL(HR=1.146,95%CI=1.048-1.254,P=0.003)和抑郁(HR=1.162,95%CI=1.038-1.301,P=0.009)与 CD 独立或共同相关。同时患有 HL 和抑郁的参与者患 CD 的风险最高(HR=1.314,95%CI=1.117-1.545,P=0.001)。

局限性

鉴于观察性设计,可能仍存在未识别的混杂因素,例如是否佩戴助听器。

结论

本研究强调了特定类型的 HL 对 CD 的高风险,以及实施同时解决生理和心理方面的健康干预措施的重要性,以增强认知功能并预防老年人的 CD。

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