Open Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark; The OPEN Research Unit, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark.
Research Unit for General Practice, Department of Public Health, University of Southern Denmark, 6700 Esbjerg-Odense, Denmark.
Arch Gerontol Geriatr. 2024 Dec;127:105584. doi: 10.1016/j.archger.2024.105584. Epub 2024 Jul 26.
In aging populations, understanding predictors of cognitive decline is essential. We aimed to investigate the risk of cognitive decline and dementia by sensory impairments across sex, age, and European regions, and examined the mediating role of activities of daily living (ADL), physical activity, and depressive symptoms.
A cohort study of 72,287 Europeans aged 50+ participating in at least two waves of the Survey of Health, Ageing and Retirement in Europe. We employed mixed-effects and time-to-event models, incorporating sex interactions, and adjusting for socio-demographic factors and medical history.
Compared to individuals with good vision and hearing, lower cognitive function was found for people with vision impairment (VI) (males: coef. -0.70, 95 % CI -0.95; -0.46; females: coef. -1.12, 95 % CI -1.33; -0.92), hearing impairment (HI) (males: coef. -0.64, 95 % CI -0.93; -0.35; females: coef. -0.96, 95 % CI -1.27; -0.65) and dual sensory impairment (DSI, i.e. VI and HI) (males: coef. -1.81, 95 % CI -2.16; -1.46; females: coef. -2.71, 95 % CI -3.05; -2.38), particularly among females. Moreover, higher dementia risk was observed among participants with VI (hazard ratio (HR) 1.29, 95 % CI 1.17; 1.43), HI (HR 1.18, 95 % CI 1.05; 1.34), and DSI (HR 1.62, 95 % CI 1.45; 1.81) with no sex-interactions. Findings were overall consistent across age and European regions.
The results suggest the necessity of preventing sensory impairments to maintain good cognitive function. Mitigating depressive symptoms, ADL limitations, and physical inactivity could potentially reduce a significant portion of the total effect of sensory impairments on cognitive decline.
在老龄化人口中，了解认知能力下降的预测因素至关重要。我们旨在研究不同性别、年龄和欧洲地区的感官障碍对认知能力下降和痴呆的风险，并探讨日常生活活动（ADL）、体育活动和抑郁症状的中介作用。
这是一项对参加欧洲健康老龄化和退休调查（Survey of Health, Ageing and Retirement in Europe）至少两波调查的 72287 名 50 岁以上欧洲人的队列研究。我们采用混合效应和时间事件模型，纳入性别交互作用，并调整社会人口统计学因素和病史。
与视力和听力良好的人相比，视力障碍（VI）（男性：系数 -0.70，95%置信区间 -0.95；-0.46；女性：系数 -1.12，95%置信区间 -1.33；-0.92）、听力障碍（HI）（男性：系数 -0.64，95%置信区间 -0.93；-0.35；女性：系数 -0.96，95%置信区间 -1.27；-0.65）和双重感官障碍（DSI，即 VI 和 HI）（男性：系数 -1.81，95%置信区间 -2.16；-1.46；女性：系数 -2.71，95%置信区间 -3.05；-2.38）的人群认知功能较差，尤其是女性。此外，VI（危险比（HR）1.29，95%置信区间 1.17；1.43）、HI（HR 1.18，95%置信区间 1.05；1.34）和 DSI（HR 1.62，95%置信区间 1.45；1.81）的参与者痴呆风险更高，且无性别交互作用。研究结果在年龄和欧洲地区总体上一致。
研究结果表明，有必要预防感官障碍以保持良好的认知功能。减轻抑郁症状、ADL 受限和缺乏体育活动可能会降低感官障碍对认知能力下降的总影响的很大一部分。
