Hearing loss and cognitive decline in older adults.
Hearing loss and cognitive decline in older adults.
复制标题
DOI：
10.1001/jamainternmed.2013.1868
复制
发表时间：
2013-02-25
影响因子：
39
通讯作者：
Simonsick, Eleanor M.
中科院分区：
文献类型：
--
作者：
Lin, Frank R.;Yaffe, Kristine;Xia, Jin;Xue, Qian-Li;Harris, Tamara B.;Purchase-Helzner, Elizabeth;Satterfield, Suzanne;Ayonayon, Hilsa N.;Ferrucci, Luigi;Simonsick, Eleanor M.
听力损失是否与老年人认知能力的加速下降独立相关尚不清楚。我们研究了1984名参加HealthABC研究的老年人（平均年龄77.4岁），这是一项始于1997-98年的前瞻性观察性研究。我们的基线队列由在第5年接受听力测试的无普遍认知障碍（改良简易精神状态[3 MS]评分≥ 80）的受试者组成。参与者被跟踪了6年。听力在基线时使用听力较好的耳朵在0.5 - 4 kHz的纯音平均阈值（PTA）定义。在5、8、10和11年级进行认知测试，包括3 MS（测量整体功能）和数字符号替代测试（DSS，测量执行功能）。偶发性认知障碍定义为3 MS评分< 80 or a decline in 3MS >较基线5分。混合效应回归和考克斯模型根据人口统计学和心血管危险因素进行调整。基线听力损失患者（PTA > 25 dB，n = 1162）的3 MS和DSS评分下降率分别比听力正常者高41%和32（3 MS：−0.65点/年[95%CI：−0.73 - −0.56]对比−0.46点/年[95%CI：−0.55 - −0.36]，p= 0.004; DSS：−0.83点/年[95%CI：-0.94--0.73] vs.-0.63点/年[95% CI：-0.75--0.51]，p= 0.015）。与听力正常者相比，听力损失者发生认知功能障碍的风险增加24%（风险比：1.24 [95% CI：1.05 - 1.48]）。认知能力下降的比率和认知能力受损的风险与个体基线听力损失的严重程度呈线性相关。听力损失与社区居住老年人的加速认知衰退和偶发性认知障碍独立相关。需要进一步研究这种关联的机制基础以及听力康复干预是否会影响认知能力下降。
Whether hearing loss is independently associated with accelerated cognitive decline in older adults is unknown. We studied 1984 older adults (mean age 77.4 years) enrolled in the HealthABC study, a prospective observational study begun in 1997–98. Our baseline cohort consisted of participants without prevalent cognitive impairment (Modified Mini-Mental State [3MS] scores ≥ 80) who underwent audiometric testing in Year 5. Participants were followed for 6 years. Hearing was defined at baseline using a pure-tone average (PTA) of thresholds at 0.5 – 4 kHz in the better-hearing ear. Cognitive testing was performed in Years 5, 8, 10, and 11 and consisted of the 3MS (measuring global function) and the Digit Symbol Substitution test (DSS, measuring executive function). Incident cognitive impairment was defined as a 3MS score < 80 or a decline in 3MS > 5 points from baseline. Mixed-effects regression and Cox models were adjusted for demographic and cardiovascular risk factors. Individuals with baseline hearing loss (PTA > 25 dB, n = 1162) had rates of decline in 3MS and DSS scores that were 41% and 32% greater, respectively, than those in normal hearing individuals (3MS: −0.65 points/year [95% CI: −0.73 – −0.56] vs. −0.46 points/year [95% CI: −0.55 – −0.36], p=.004; DSS: −0.83 points/year [95% CI: −0.94 – −0.73] vs. −0.63 points/year [95% CI: −0.75 – −0.51], p=.015). Compared to those with normal hearing, individuals with hearing loss had a 24% (Hazard ratio: 1.24 [95% CI: 1.05 – 1.48]) increased risk of incident cognitive impairment. Rates of cognitive decline and the risk of incident cognitive impairment were linearly associated with the severity of an individual’s baseline hearing loss. Hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults. Further studies investigating the mechanistic basis of this association and whether hearing rehabilitative interventions could affect cognitive decline are needed.
登录
查看更多内容
影响因子：
--
作者：
Lin, Frank R.;Metter, E. Jeffrey;O'Brien, Richard J.;Resnick, Susan M.;Zonderman, Alan B.;Ferrucci, Luigi
通讯作者：
Ferrucci, Luigi
影响因子：
7.2
作者：
Gussekloo, J;de Craen, AJM;Westendorp, RGJ
通讯作者：
Westendorp, RGJ
影响因子：
168.9
作者：
Fratiglioni, L;Wang, HX;Winblad, B
通讯作者：
Winblad, B
DOI：
10.1093/gerona/glr115
发表时间：
2011-10-01
影响因子：
5.1
作者：
Lin, Frank R.
通讯作者：
Lin, Frank R.
DOI：
10.1682/jrrd.2005.01.0006
发表时间：
2005-07-01
影响因子：
--
作者：
Gordon-Salant, S
通讯作者：
Gordon-Salant, S