Davoudi Anis, Agrawal Yuri, Wang Hang, Dougherty Ryan J, Wanigatunga Amal A, Reed Nicholas S, Ehrlich Joshua R, Gross Alden L, Schrack Jennifer A
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
BMC Geriatr. 2025 Aug 12;25(1):617. doi: 10.1186/s12877-025-06082-6.
Impairments in sensory and motor function are common in older adults and have been linked with higher prevalence of dementia. However, their independent associations with dementia have not been examined in a nationally representative population.
Cross-sectional analysis of the National Health and Aging Trends Study (NHATS; Round 11/2021) of U.S. Medicare beneficiaries. Dementia was classified per NHATS protocol as none, possible, or probable dementia. Vision measures included presenting binocular distance visual acuity, near visual acuity, and contrast sensitivity. Hearing measures included the pure tone average of the better ear. Motor function measures included gait speed, chair stands time, balance score, and grip strength. Dichotomized or categorized presence of impairment in each sensory and motor function was defined and used as the main exposures. Multivariable survey-weighted logistic regression was used to assess the independent associations of sensory and motor function impairments with dementia status.
Our final analytic sample included 2,379 participants with 36.6% aged 80 years, 56.2% female, 82.9% non-Hispanic White, and 9.8% having possible or probable dementia. In adjusted models including visual, hearing, and motor function variables, participants with impairment in gait (odds ratio (OR), 2.18; 95% CI, 1.32-3.6; p = 0.004), chair stand performance (OR, 1.69; 95% CI, 1.17-2.44; p < 0.01), or visual contrast sensitivity (OR, 1.52; 95% CI, 1.04-2.22; p = 0.03) had higher odds of dementia. Impaired standing balance, grip strength, hearing, and near visual acuity were not associated with higher odds of dementia (p > 0.05).
Findings suggest current impairment in vision or motor function may be strong indicators of prevalent dementia in older adults.
感觉和运动功能障碍在老年人中很常见，并且与痴呆症的较高患病率有关。然而，它们与痴呆症的独立关联尚未在具有全国代表性的人群中进行研究。
对美国医疗保险受益人的国家健康与老龄化趋势研究（NHATS；2021年第11轮）进行横断面分析。根据NHATS方案，痴呆症被分类为无、可能或疑似痴呆症。视力测量包括双眼远视力、近视力和对比敏感度。听力测量包括较好耳朵的纯音平均值。运动功能测量包括步态速度、从椅子上站起的时间、平衡分数和握力。定义了每种感觉和运动功能障碍的二分法或分类存在情况，并将其用作主要暴露因素。使用多变量调查加权逻辑回归来评估感觉和运动功能障碍与痴呆症状态的独立关联。
我们的最终分析样本包括2379名参与者，其中36.6%的年龄在80岁及以上，56.2%为女性，82.9%为非西班牙裔白人，9.8%患有可能或疑似痴呆症。在包括视觉、听力和运动功能变量的调整模型中，步态受损（比值比（OR），2.18；95%置信区间，1.32 - 3.6；p = 0.004）、从椅子上站起的表现受损（OR，1.69；95%置信区间，1.17 - 2.44；p < 0.01）或视觉对比敏感度受损（OR，1.52；95%置信区间，1.04 - 2.22；p = 0.03）的参与者患痴呆症的几率更高。站立平衡、握力、听力和近视力受损与患痴呆症的较高几率无关（p > 0.05）。
研究结果表明，目前的视力或运动功能障碍可能是老年人中普遍存在的痴呆症的有力指标。
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