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听力损失与痴呆风险:韩国国民健康保险服务高龄队列的纵向分析

Hearing loss and the risk of dementia: A longitudinal analysis of the Korean National Health Insurance Service Senior Cohort.

作者信息

Jang Jae-Won, Lee Seung-Hwan, Kim Taesu, Lee Eunju, Park Sang Won, Yeo Na Young, Kim Young-Ju

机构信息

Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.

School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.

出版信息

J Alzheimers Dis. 2025 Mar;104(2):364-373. doi: 10.1177/13872877251316805. Epub 2025 Feb 9.

Abstract

BackgroundHearing loss is a potentially modifiable risk factor implicated in dementia, with recent research suggesting an association between age-related hearing degradation and dementia.ObjectiveThis study aims to elucidate the relationship between hearing decline and dementia risk.MethodsWe analyzed data from 511,953 subjects from the Korean National Health Insurance Service-Senior Cohort (2002-2008). After excluding those diagnosed with dementia in 2002, 511,935 subjects were included. Subjects with hearing loss between 2002 and 2008 were selected and matched with a control group without hearing impairment based on age and gender. Statistical analyses, including Pearson's chi-squared test and the Cox proportional hazards model, were conducted, controlling for confounding variables such as household income and residential area. Subgroup analysis was also performed for Alzheimer's disease and vascular dementia.ResultsSubjects with hearing loss had a 1.245 times higher risk of all-cause dementia compared to those without hearing loss (adjusted hazard ratio over 3 years, 95% CI = 1.201-1.290), adjusting for gender, age, residence, and income. The adjusted hazard ratios for Alzheimer's disease over 3, 5, 7, and 10 years from the index date were 1.259 (95% CI = 1.211-1.308), 1.258 (95% CI = 1.208-1.310), 1.269 (95% CI = 1.215-1.325), and 1.235 (95% CI = 1.170-1.304), respectively. No significant association was found for vascular dementia, except for 3 years.ConclusionsHearing loss consistently increased the risk of all-cause dementia and Alzheimer's disease across timespans, suggesting a complex link between hearing loss and neurodegenerative diseases. These findings highlight the importance of early intervention and cognitive monitoring for individuals with hearing loss.

摘要

背景

听力损失是痴呆症中一个潜在可改变的风险因素,最近的研究表明年龄相关性听力衰退与痴呆症之间存在关联。

目的

本研究旨在阐明听力下降与痴呆症风险之间的关系。

方法

我们分析了来自韩国国民健康保险服务老年队列(2002 - 2008年)的511,953名受试者的数据。在排除2002年被诊断为痴呆症的患者后,纳入了511,935名受试者。选取2002年至2008年有听力损失的受试者,并根据年龄和性别与无听力障碍的对照组进行匹配。进行了包括Pearson卡方检验和Cox比例风险模型在内的统计分析,同时控制家庭收入和居住地区等混杂变量。还对阿尔茨海默病和血管性痴呆进行了亚组分析。

结果

与无听力损失的受试者相比,有听力损失的受试者全因痴呆症风险高1.245倍(3年调整后风险比,95%置信区间 = 1.201 - 1.290),对性别、年龄、居住和收入进行了调整。从索引日期起3、5、7和10年的阿尔茨海默病调整后风险比分别为1.259(95%置信区间 = 1.211 - 1.308)、1.258(95%置信区间 = 1.208 - 1.310)、1.269(95%置信区间 = 1.215 - 1.325)和1.235(95%置信区间 = 1.170 - 1.304)。除3年外,未发现血管性痴呆有显著关联。

结论

听力损失在不同时间段持续增加全因痴呆症和阿尔茨海默病的风险,表明听力损失与神经退行性疾病之间存在复杂联系。这些发现凸显了对听力损失个体进行早期干预和认知监测的重要性。

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