Tanaka Saki, Katayose Ryo, Kawasaki Teruaki, Akiguchi Ichiro, Ogita Mihoko
Department of Clinical Nursing, Shiga University of Medical Science, Shiga, Japan.
Department of Nursing, Kyoto College of Nursing, Kyoto, Japan.
Psychogeriatrics. 2025 Sep;25(5):e70090. doi: 10.1111/psyg.70090.
Behavioural and psychological symptoms of dementia (BPSD), encompassing disturbances in perception, thought, mood and behaviour, are prevalent among individuals with dementia and can substantially affect their quality of life. Although prior research has suggested that hearing impairment (HI) may exacerbate BPSD due to communication difficulties and diminished social engagement, the relationship between HI and specific BPSD manifestations remains insufficiently explored. This study aims to examine the association between HI and distinct BPSD in individuals with cognitive decline attending a memory clinic.
This study included 179 individuals with cognitive decline and their accompanying persons who visited a memory clinic between July 2023 and March 2024. Pure-tone audiometry and a questionnaire survey were conducted. HI was defined as an average hearing level of 40 dB or higher. BPSD was assessed using a questionnaire derived from the BPSD25Q, a 25-item questionnaire designed to evaluate BPSD. The association between HI and BPSD was analyzed using modified Poisson regression, with adjusted risk ratios (aRR) and 95% confidence intervals (CI) calculated.
A total of 144 individuals were included in the analysis, with a mean age of 82.7 years, approximately 70% of whom were female. The aRR (95% CI) for the presence of specific BPSD among individuals with HI were as follows: anxiety, 2.08 (1.09-3.99); irritability, 1.73 (1.05-2.86); verbally aggressive behaviour, 3.41 (1.24-9.40); physically aggressive behaviour, 5.54 (1.31-23.40); leaving home unannounced, 4.22 (1.25-14.16); hoarding behaviour, 1.83 (1.06-3.16); resistance to care, 2.12 (1.02-4.40); and carelessness with fire, 4.46 (1.12-17.83). No significant association was observed between HI and other BPSD.
These findings suggest that HI may contribute to the presence of specific BPSD. Tailored interventions incorporating communication strategies and environmental modifications may help mitigate BPSD in individuals with cognitive decline and HI.
痴呆症的行为和心理症状（BPSD），包括感知、思维、情绪和行为方面的障碍，在痴呆症患者中很普遍，会严重影响他们的生活质量。尽管先前的研究表明，听力障碍（HI）可能由于沟通困难和社交参与减少而加剧BPSD，但HI与特定BPSD表现之间的关系仍未得到充分探索。本研究旨在调查在记忆门诊就诊的认知功能下降个体中，HI与不同BPSD之间的关联。
本研究纳入了2023年7月至2024年3月期间到记忆门诊就诊的179名认知功能下降个体及其陪同人员。进行了纯音听力测定和问卷调查。HI定义为平均听力水平40分贝或更高。使用源自BPSD25Q的问卷评估BPSD，BPSD25Q是一份旨在评估BPSD的25项问卷。使用修正泊松回归分析HI与BPSD之间的关联，并计算调整风险比（aRR）和95%置信区间（CI）。
共有144名个体纳入分析，平均年龄82.7岁，其中约70%为女性。HI个体中特定BPSD存在的aRR（95%CI）如下：焦虑，2.08（1.09 - 3.99）；易怒，1.73（1.05 - 2.86）；言语攻击行为，3.41（1.24 - 9.40）；身体攻击行为，5.54（1.31 - 23.40）；未经通知离家，4.22（1.25 - 14.16）；囤积行为，1.83（1.06 - 3.16）；抗拒护理，2.12（1.02 - 4.40）；用火粗心，4.46（1.12 - 17.83）。未观察到HI与其他BPSD之间存在显著关联。
这些发现表明，HI可能导致特定BPSD的出现。采用沟通策略和环境改造的针对性干预措施可能有助于减轻认知功能下降且有HI个体的BPSD。
