Relationship of hearing loss and dementia: a prospective, population-based study.
Relationship of hearing loss and dementia: a prospective, population-based study.
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DOI：
10.1097/mao.0000000000000313
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发表时间：
2014-06
期刊：
影响因子：
--
通讯作者：
Tschanz JT
中科院分区：
文献类型：
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作者：
Gurgel RK;Ward PD;Schwartz S;Norton MC;Foster NL;Tschanz JT
确定基线听力损失是否会增加老年人人群中认知能力下降和全因痴呆的风险。纵向队列研究以社区为基础的门诊男性和女性，年龄65岁或以上，基线时无痴呆。所有受试者在基线和超过3个三年期随访访视时完成改良简易精神状态检查（3 MS-R）。基线听力损失（HL）基于测试或访谈期间观察到的听力困难。痴呆事件由临床评估和专家共识确定。痴呆和3 MS-R评分。在基线时，4，463名受试者没有痴呆，其中836名患有HL。在HL患者中，16.3%发展为痴呆，而无HL患者为12.1%（p<0.001）。HL组至痴呆的平均时间为10.3年，而非HL组为11.9年（对数秩检验p<0.001）。在控制性别、APOE- ε4等位基因存在、教育和基线年龄以及心血管风险因素的考克斯回归分析中，HL是发生痴呆的独立预测因子（风险比= 1.27，p=0.026（95% CI = 1.03，1.56））。控制相似协变量的线性混合模型显示，HL与3 MS-R的更快下降相关，比无HL的患者差0.26分/年。与非听力受损的老年人相比，HL老年人发生痴呆的比率增加，3 MS-R评分下降更快。这些发现表明，听力障碍可能是65岁及以上成年人认知功能障碍的标志。
To determine whether baseline hearing loss increases cognitive decline and risk for all-cause dementia in a population of elderly individuals. Longitudinal cohort study Community-based, outpatient Men and women aged 65 years or older without dementia at baseline All subjects completed the Modified Mini-Mental Status Exam (3MS-R) at baseline and over 3 triennial follow-up visits. Hearing loss (HL) at baseline was based on observation of hearing difficulties during testing or interview. Incident dementia was determined by clinical assessment and expert consensus. Dementia and 3MS-R score. At baseline 4,463 subjects were without dementia, 836 of whom had HL. Of those with HL, 16.3% developed dementia, compared to 12.1% of those without HL (p<0.001). Mean time to dementia was 10.3 years in the HL group vs. 11.9 years for non-HL (Log Rank test p<0.001). In Cox regression analyses controlling for gender, presence of APOE- ε4 allele, education, and baseline age, and cardiovascular risk factors, HL was an independent predictor of developing dementia (Hazard ratio = 1.27, p=0.026 (95% CI = 1.03, 1.56). Linear mixed models controlling for similar covariates showed HL was associated with faster decline on the 3MS-R, at a rate of 0.26 points/year worse than those without HL. Elderly individuals with HL have an increased rate of developing dementia and more rapid decline on 3MS-R scores than their non-hearing impaired counterparts. These findings suggest that hearing impairment may be a marker for cognitive dysfunction in adults age 65 and older.