Department of Biostatistics, Peking University First Hospital, No.8 Xi Shi Ku Road, Xicheng District, Beijing, China.
Department of Global Health, Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.
J Affect Disord. 2025 Jan 15;369:16-24. doi: 10.1016/j.jad.2024.09.140. Epub 2024 Sep 23.
Globally, over 2.2 billion people have a vision impairment and over 1.5 billion live with hearing impairment, which are significant public health concerns given the meaningful impacts on individual and society. We aimed to investigate whether long-term average visual, hearing, and dual sensory impairment was independently associated with cognitive impairment, incident dementia, and incident depressive symptoms.
We used data from the Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), two nationally representative and prospective cohorts of community middle aged and older adults. Average sensory impairment was calculated using the area under the curve divided by follow-up time from wave 3 (1996) to wave 15 (2020) in HRS and wave 1 (2011) to wave 4 (2018) in CHARLS. Cox regression models adjusted for multiple covariates were used to estimate adjusted hazard ratios (HRs) and 95 % confidence intervals (95 % CIs).
For each one standard deviation (SD) increment in average visual impairment, the risk of developing cognitive impairment, incident dementia, and incident depressive symptoms increased by 12 %, 34 %, and 39 % in CHARLS and 11 %, 14 % and 10 % in HRS. Similar results were found for each SD increment in average hearing impairment and dual sensory impairment. Nonlinear dose-response relationships were identified between visual impairment and dementia, as well as dual sensory impairment and dementia in both cohorts.
The diagnosis of cognitive impairment, dementia, and depression were based on subjective assessment.
Multi-level approaches aimed at improving access to sensory care are needed to improve middle-aged and older adults' visual and auditory functions.
在全球范围内，有超过 22 亿人视力受损，超过 15 亿人听力受损，这是一个重大的公共卫生问题，因为这对个人和社会都有重大影响。我们旨在研究长期平均视觉、听觉和双重感官损伤是否与认知障碍、新发痴呆和新发抑郁症状独立相关。
我们使用了来自健康与退休研究（HRS）和中国健康与退休纵向研究（CHARLS）的数据，这两项研究是具有全国代表性和前瞻性的社区中年及以上成年人队列研究。平均感官损伤是通过从 HRS 的第 3 波（1996 年）到第 15 波（2020 年）和 CHARLS 的第 1 波（2011 年）到第 4 波（2018 年）期间的曲线下面积除以随访时间计算得出的。使用调整了多个协变量的 Cox 回归模型来估计调整后的风险比（HR）和 95%置信区间（95%CI）。
在 CHARLS 中，每增加一个标准差（SD）的平均视觉损伤，认知障碍、新发痴呆和新发抑郁症状的风险分别增加 12%、34%和 39%；在 HRS 中，每增加一个 SD 的平均听力损伤和双重感官损伤，风险分别增加 11%、14%和 10%。在两个队列中，平均听力损伤和双重感官损伤与痴呆之间也存在类似的非线性剂量-反应关系。
认知障碍、痴呆和抑郁的诊断是基于主观评估的。
需要采取多层次的方法来改善对感官护理的获取，以改善中年及以上成年人的视觉和听觉功能。
