The Population Attributable Fraction of Dementia From Audiometric Hearing Loss Among a Nationally Representative Sample of Community-Dwelling Older Adults
The Population Attributable Fraction of Dementia From Audiometric Hearing Loss Among a Nationally Representative Sample of Community-Dwelling Older Adults
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DOI：
10.1093/gerona/glad117
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发表时间：
2023-05-04
影响因子：
5.1
通讯作者：
Deal, Jennifer A.
中科院分区：
文献类型：
--
作者：
Smith, Jason R.;Huang, Alison R.;Deal, Jennifer A.
背景资料：当纳入自我报告的听力损失（HL）指标时，美国听力损失（HL）所致痴呆的人群归因分数（PAF）与2%相似。然而，自我报告可能低估了老年人中具有临床意义的听力HL。在这里，我们量化了美国社区居住老年人的全国代表性样本中听力HL总体和年龄，性别和种族/种族组的痴呆PAF。我们使用了国家健康和老龄化趋势研究第11轮（2021年）的横截面数据，一项代表65岁以上美国医疗保险人群（N = 2470）的前瞻性队列研究。我们通过听力测定HL（纯音平均值：正常听力，= 41 dB HL）估计了流行性痴呆的模型校正PAF。结果：在符合条件的参与者中（34.8%年龄≥ 80岁; 55.3%女性; 82.4%非西班牙裔白色人），37.5%有轻度HL，28.8%有中度或更高HL。总体痴呆患病率为10.6%，PAF主要由中度或重度HL引起（PAF = 16.9%; 95%置信区间[CI]：4.1-28.7%）。任何程度HL的PAF较大，但CI较宽（PAF = 18.7%，95% CI：-5.3%至40.1%）。有证据表明，相关性因性别而异，但与年龄或人种/种族无关;中度或重度HL在男性中表现出更强的相关性（PAF = 40.5%; 95%CI：19.5%至57.2%）（PAF = 3.2%; 95% CI：-12.7%至17.9%）。在美国社区居住老年人的全国代表性样本中，17%的痴呆病例可归因于中度或重度听力HL，这一估计是仅依靠自我报告听力测量的研究的八倍。
Background: The population attributable fraction (PAF) of dementia from hearing loss (HL) in the United States is similar to 2% when incorporating self-reported HL measures. However, self-report might underestimate clinically significant audiometric HL among older adults. Here, we quantified PAFs of dementia from audiometric HL overall and by age, sex, and race/ethnicity groups among a nationally representative sample of community-dwelling older adults in the United States.Methods: We used cross-sectional data from Round 11 (2021) of the National Health and Aging Trends Study, a prospective cohort study representing the U.S. Medicare population aged 65+ years (N = 2 470). We estimated model-adjusted PAFs of prevalent dementia by audiometric HL (pure-tone averages: normal hearing, = 41 dB HL).Results: Among eligible participants (34.8% aged >= 80 years; 55.3% female; 82.4% non-Hispanic White), 37.5% had mild, and 28.8% had moderate or greater HL. Dementia prevalence overall was 10.6%, with the PAF predominately driven by moderate or greater HL (PAF = 16.9%; 95% confidence interval [CI]: 4.1-28.7%). The PAF from any degree of HL was larger but with a wider CI (PAF = 18.7%, 95% CI: -5.3% to 40.1%). There was evidence associations differed by sex but not age or race/ethnicity; moderate or greater HL exhibited stronger associations among males (PAF = 40.5%; 95% CI: 19.5% to 57.2%) than females (PAF = 3.2%; 95% CI: -12.7% to 17.9%).Conclusions: In a nationally representative sample of community-dwelling older adults in the United States, 17% of dementia cases were attributable to moderate or greater audiometric HL, an estimate that is eightfold higher relative to studies relying on self-reported hearing measures only.