社会隔离在老年人听力损失与认知功能间的中介效应

Social Isolation in Mediating Relationship Between Hearing Loss and Cognitive Function in Older Adults

目的分析老年人听力损失、社会隔离与认知功能的相关性,探索社会隔离在老年人听力损失与认知功能间的中介效应。方法采用方便抽样法选取山西省10个地级市453例老年人为调查对象。采用听力障碍筛查量表、社会隔离量表和简易智力状态检查量表进行问卷调查。结果老年人听力损失,社会隔离及认知功能得分分别为6(0,20)分,15(11,19)分,27(22,29)分。听力损失得分与社会隔离(r=-0.413,P<0.01)、认知功能得分(r=-0.342,P<0.01)均呈负相关。听力损失可直接影响认知功能,还可通过社会隔离间接影响认知功能;社会隔离的中介效应占总效应的31.0%。结论听力损失是老年人认知功能下降的重要风险因素,且社会隔离是这一影响的重要解释机制。听力损失可直接影响或通过社会隔离间接影响老年人认知功能。因此,社区卫生服务工作中应重视老年人的听力保健促进,改善其听力状况,使老年人能够融入社会活动中,从而降低认知功能障碍发生率,实现积极老龄化。

Objective To identify correlation between hearing loss,social isolation and cognitive function in older adults,and the mediating effect of social isolation between hearing loss and cognitive function.Methods A cross-sectional study was conducted using convenience sampling to include 453 older adults in 10 prefecture-level cities in Shanxi.The subjects were surveyed using the Hearing Handicap Inventory for the Elderly-Screening,the Lubben Social Network Scale and the Mini-mental State Examination.Results The hearing loss score was 6(0,20),social isolation score was 15(11,19),and cognitive function score was 27(22,29).The hearing loss score was negatively correlated with the social isolation score(r=-0.413,P<0.01)and cognitive function scores(r=-0.342,P<0.01).Hearing loss demonstrated a direct influence on cognitive function and an indirect impact(accounting for 31.0%of the total effect)via social isolation.Conclusion Hearing loss is an important risk factor for declining cognitive function in older adults,and social isolation contributes to the explanation of cognitive dysfunction.Nursing staff should improve their hearing health care knowledge,and encourage them to actively participate in social activities,which should reduce the incidence of cognitive dysfunction and to ultimately promote healthy aging.