Samelli Alessandra Giannella, Gonçalves Natalia Gomes, Padilha Fernanda Yasmin Odila Maestri Miguel, Guesser Vitor Martins, Matas Carla Gentile, Rabelo Camila Maia, Moreira Renata Rodrigues, Santos Itamar S, Lotufo Paulo Andrade, Bensenõr Isabela J, Gilsanz Paola, Suemoto Claudia Kimie
Department of Physical Therapy, Speech-Language-Hearing Pathology Sciences, and Occupational Therapy, Faculty of Medicine (FMUSP), University of São Paulo, São Paulo, Brazil.
Division of Geriatrics, Faculty of Medicine (FMUSP), University of São Paulo, São Paulo, Brazil.
J Alzheimers Dis. 2025 Mar;104(1):283-293. doi: 10.1177/13872877251315043. Epub 2025 Feb 9.
BackgroundHearing loss (HL) of moderate or higher grades is common in older adults with increasing prevalence as people age, rising from 12% at the age of 60 years to over 58% at 90 years. HL in midlife is one of the main potentially modifiable risk factors for dementia. It is estimated that 7% of dementia cases globally could be avoided if this risk factor was eliminated. However, much of the research conducted has been in high-income countries even though low- and middle-income countries have the highest prevalence of dementia.ObjectiveTo study the association between HL and cognitive decline during eight years of follow-up in a Brazilian sample.MethodsParticipants from the São Paulo center of the Brazilian Longitudinal Study of Adult Health were evaluated in three study waves (2008-10, 2012-14, and 2017-19). HL was defined as pure-tone audiometry above 25 dB in the better ear. Cognitive performance was evaluated with six tests related to memory, verbal fluency, and trail-making tests. A global cognitive z-score was derived from these tests. The association between HL and cognitive decline was evaluated with linear mixed-effects models adjusted for sociodemographic, lifestyle, and clinical factors.ResultsOf 805 participants (mean age 51 ± 9 years, 52% women, 60% White), 62 had HL. During follow-up, HL was associated with faster global cognitive decline (β = -0.012, 95% CI = -0.023; 0.000, = 0.039).ConclusionsHL was significantly associated with a faster rate of global cognitive decline after a median follow-up of eight years in a sample of middle-income country.
中度或更严重程度的听力损失（HL）在老年人中很常见，且随着年龄增长患病率不断上升，从60岁时的12%升至90岁时的超过58%。中年HL是痴呆症主要的潜在可改变风险因素之一。据估计，如果消除这一风险因素，全球7%的痴呆症病例是可以避免的。然而，尽管低收入和中等收入国家痴呆症患病率最高，但大部分相关研究是在高收入国家开展的。
在一个巴西样本中研究八年随访期间HL与认知衰退之间的关联。
来自巴西成人健康纵向研究圣保罗中心的参与者在三个研究阶段（2008 - 10年、2012 - 14年和2017 - 19年）接受评估。HL定义为较好耳纯音听力测定阈值高于25分贝。通过六项与记忆、语言流畅性和连线测验相关的测试评估认知表现。从这些测试得出一个总体认知z分数。使用针对社会人口统计学、生活方式和临床因素进行调整的线性混合效应模型评估HL与认知衰退之间的关联。
在805名参与者（平均年龄51±9岁，52%为女性，60%为白人）中，62人患有HL。在随访期间，HL与更快的总体认知衰退相关（β = -0.012，95%置信区间 = -0.023；0.000，P = 0.039）。
在一个中等收入国家样本中，经过八年中位随访期后，HL与更快的总体认知衰退显著相关。
