抑郁在老年人听力减退与语言功能中的中介效应

Mediating Effects of Depression in Hearing Loss and Language Function in the Elderly

目的研究老年人听力减退对语言功能的影响及抑郁在听力减退与语言功能中的中介效应,为老年人语言功能损害的干预提供参考。方法收集2018~2022年湖北老年记忆队列(HAMCS)中6002名≥65岁老年人语言功能筛查的相关数据,采用多因素Logistic回归模型分析听力减退对语言功能的影响,采用Bootstrap法分析抑郁评分在听力减退影响语言功能中的中介效应。结果6002名≥65岁老年人中,轻度听力减退1137例(18.94%),中-重度听力减退264例(4.40%),语言功能损害2611例(43.50%);在控制了年龄、受教育年限、婚姻状况、居住地、体育锻炼、智力活动、高血压、冠心病和脑血管病等混杂因素后,多因素Logistic回归分析结果显示:轻度听力减退、中-重度听力减退老年人语言功能损害的患病风险分别为听力正常老年人的1.33倍(95%CI:1.13~1.56,P=0.001)、1.77倍(95%CI:1.29~2.42,P<0.001);中介效应分析结果显示:抑郁在听力减退和语言功能损害之间起部分中介作用,中介效应量为-0.021(95%CI:-0.027~-0.015,P<0.001),占总效应的12.96%。结论老年人听力减退可增加语言功能损害的患病风险,其中抑郁在听力减退和语言功能损害之间起部分中介作用。

Objective To study the effect of hearing loss on language function and the mediating effect of depression on hearing loss and language function,to provide a reference for the intervention of language function impairment in the elderly.Methods Data of 6002 older adults≥65 years old from the Hubei Aging and Memory Cohort Study(HAMCS)were collected from 2018 to 2022.A multivariate logistic regression model was used to analyze the effect of hearing loss on language function,and a Bootstrap method was used to analyze the mediating effect of depression score on hearing loss on language function.Results Among 6002 older adults≥65 years old,1137(18.94%)had mild hearing loss,264(4.40%)had moderate and severe hearing loss,and 2611(43.50%)had language function impairment.After controlling for related factors such as age,years of education,marital status,place of residence,physical exercise,intellectual activity,hypertension,coronary heart disease and cerebrovascular disease,multivariate logistic regression analysis showed that the risk of speech function impairment in the elderly with mild hearing loss and moderate to severe hearing loss was 1.33 times(95%CI:1.13~1.56,P=0.001)and 1.77 times(95%CI:1.29~2.42,P<0.001)respectively.The mediating effect showed that depression played a partial mediating role between hearing loss and language function,and the mediating effect was-0.021(95%CI:-0.027~-0.015,P<0.001),accounting for 12.96%of the total effects.Conclusion Hearing loss increases the risk of language impairment,and depression playing a partial mediating role between hearing loss and language function in the elderly.