社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性

Association of dual olfactory and hearing impairment with cognitive impairment among community⁃dwelling adults aged 65 years and above

目的探讨社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性。方法从湖北老年记忆队列纳入8370名65岁及以上老年人,根据嗅觉和听觉功能状况将研究对象分为4组:无嗅觉和听觉障碍(no olfactory and hearing impairment,NOHI)组、仅嗅觉障碍(olfactory impairment only,OI)组、仅听觉障碍(hearing impairment only,HI)组及嗅觉和听觉双重障碍(dual olfactory and hearing impairment,DOHI)组。认知障碍包括轻度认知障碍及痴呆。采用logistic回归分析模型分析老年人不同感觉功能状况与认知障碍的关系。结果一般社区老年人群嗅觉障碍、听觉障碍、DOHI和认知障碍患病率分别为24.1%(95%CI:23.2%~25.0%)、44.5%(95%CI:43.4%~45.5%)、20.0%(95%CI:19.1%~20.8%)和26.3%(95%CI:25.4%~27.3%)。OI、HI和DOHI组认知障碍患病率均高于NOHI组,且DOHI组认知障碍患病率高于其他3组。调整社会人口学、生活方式和慢病因素后,DOHI组认知障碍的患病风险分别为NOHI、OI和HI组的1.402倍、1.437倍和1.403倍。结论中国社区患嗅觉和听觉双重障碍的老年人群患认知障碍的风险高于无感觉障碍人群,也高于仅单纯一种感觉障碍人群。双重感觉障碍是患认知障碍的高风险因素。

Objective To investigate the association between dual olfactory and hearing impairment and cognitive impairment in community⁃dwelling adults aged≥65 years.Methods A total of 8370 elderly people aged≥65 years from the Hubei Memory and Aging Cohort Study were included.The participants were grouped by no olfactory and hearing impairment(NOHI),olfactory impairment only(OI),hearing impairment only(HI),and dual olfactory and hearing impairment(DOHI).Cognitive impairment includes mild cognitive impairment and dementia.Logistic regression was used to analyze the association between cognitive impairment and sensory function.Results The prevalence of olfactory impairment,hearing impairment,DOHI and cognitive impairment were 24.1%(95%CI:23.2%-25.0%),44.5%(95%CI:43.4%-45.5%),20.0%(95%CI:19.1%-20.8%)and 26.3%(95%CI:25.4%-27.3%)respectively,in community⁃dwelling old adults.All sensory impairment groups had significantly higher rates of cognitive impairment than those without sensory loss,and the prevalence of cognitive impairment in DOHI group was significantly higher than that in the other three groups.The DOHI individuals had increased odds of cognitive impairment than NOHI(OR=1.402),OI(OR=1.437)and HI(OR=1.403),after adjusting for sociodemographic factors,lifestyle and chronic diseases.Conclusions The risk of cognitive impairment in older people with dual olfactory and hearing impairment in the Chinese community is significantly higher than that of people without sensory impairment,and also higher than those with only one sensory impairment.Dual sensory impairment is a high risk factor for cognitive impairment.