Brenowitz Willa D, Sheppler Christina R, Leng Yue, Yaffe Kristine
Kaiser Permanente Center for Health Research, Portland, Oregon, USA.
Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA.
J Am Geriatr Soc. 2025 Jun 6. doi: 10.1111/jgs.19547.
Impairment in multiple senses (multisensory impairment) is common in older adults but the underlying mechanisms are unclear. We evaluated whether common blood-based markers of inflammation (e.g., Interleukin 6 (IL-6), C-Reactive Protein (CRP), and Tumor Necrosis Factor Alpha (TNF-α)) were associated with multisensory impairment.
We analyzed data from 1674 participants in the Health, Aging, and Body Composition Study, a prospective cohort study of Black and White older adults who were aged 70-79 at enrollment. IL-6, CRP, and TNF-α were assayed from blood samples at Year 1. Sensory function in 4 domains was assessed in Years 3-5; impairment was defined with clinical cut-points. Vision was measured by visual acuity and contrast sensitivity; hearing by pure tone audiometry (500, 1000, 2000, and 4000 Hz); smell by the 12-item Cross Cultural Smell Identification Test; and touch by vibration detection threshold and monofilament of the big toe. A previously developed multisensory impairment score (0-12) was calculated based on sample quartiles and summed across sensory domains. Regression models evaluated the associations of inflammation markers with individual and multiple sensory impairments (as separate outcomes) with adjustment for demographics, health conditions, and health behaviors.
Higher CRP (ß = 0.07; 95% CI: 0.01-0.12; p = 0.01) and IL-6 (ß = 0.11; 95% CI: 0.04-0.18; p = 0.003) levels were associated with the number of sensory impairments. Participants with the highest quartile of IL-6 (OR = 1.45; 95% CI: 1.09-1.92; p = 0.01) and TNF-α (OR = 1.46; 95% CI: 1.12-1.91; p = 0.005) had higher odds of a poor multisensory impairment score. High CRP was associated with impaired vision (OR = 1.45; 95% CI:1.08-1.93; p = 0.01) and high TNF-α was associated with touch impairment (OR = 1.63; 95% CI:1.15-2.30; p = 0.006). Having multiple high markers was also associated with multisensory (OR: 1.76; 95% CI: 1.20-2.58; p = 0.004) and vision impairment (OR: 1.55; 95% CI: 1.13-2.13; p = 0.004).
Markers of inflammation were associated with multisensory impairment, but there were fewer associations with individual sensory impairments.
多种感官功能受损（多感官损伤）在老年人中很常见，但潜在机制尚不清楚。我们评估了常见的血液炎症标志物（如白细胞介素6（IL-6）、C反应蛋白（CRP）和肿瘤坏死因子α（TNF-α））是否与多感官损伤有关。
我们分析了健康、衰老和身体成分研究中1674名参与者的数据，这是一项针对黑人和白人老年人的前瞻性队列研究，入组时年龄为70 - 79岁。在第1年从血样中检测IL-6、CRP和TNF-α。在第3 - 5年评估4个领域的感觉功能；根据临床切点定义损伤情况。视力通过视力和对比敏感度测量；听力通过纯音听力测定（500、1000、2000和4000赫兹）；嗅觉通过12项跨文化嗅觉识别测试；触觉通过振动检测阈值和大脚趾单丝测量。根据样本四分位数计算先前开发的多感官损伤评分（0 - 12），并在各感觉领域求和。回归模型评估炎症标志物与个体和多种感觉损伤（作为单独结果）之间的关联，并对人口统计学、健康状况和健康行为进行调整。
较高的CRP（β = 0.07；95%置信区间：0.01 - 0.12；p = 0.01）和IL-6（β = 0.11；95%置信区间：0.04 - 0.18；p = 0.003）水平与感觉损伤的数量有关。IL-6（OR = 1.45；95%置信区间：1.09 - 1.92；p = 0.01）和TNF-α（OR = 1.46；95%置信区间：1.12 - 1.91；p = 0.005）最高四分位数的参与者多感官损伤评分较差的几率更高。高CRP与视力受损有关（OR = 1.45；95%置信区间：1.08 - 1.93；p = 0.01），高TNF-α与触觉损伤有关（OR = 1.63；95%置信区间：1.15 - 2.30；p = 0.006）。具有多个高标志物也与多感官（OR：1.76；95%置信区间：1.20 - 2.58；p = 0.004）和视力损伤（OR：1.55；95%置信区间：1.13 - 2.13；p = 0.004）有关。
炎症标志物与多感官损伤有关，但与个体感觉损伤的关联较少。
