老年听力水平与认知功能的关联研究

The Relationship between Hearing Loss and Cognitive Function in the Older Adults

目的探究老年人听力水平与总体认知和各分认知域功能的关联。方法2020至2021年从记忆障碍门诊和社区招募≥50岁的受试者进行听力测试和认知功能评估。采用纯音听力测试评估受试者听力水平;采用华山版成套神经心理测验评估受试者的认知功能;神经心理测试的粗分经标准转化为各认知领域z分。单因素和多因素(校正年龄、性别、受教育年限和ApoEε4等位基因)线性回归模型用于分析纯音听阈均值(PTA)和各认知域评分之间的关系。结果279例受试者中,认知正常者82例(29.4%),轻度认知损害者124例(44.4%),痴呆者73例(26.2%)。纯音听力测试结果:正常听力60例(21.5%),听力轻度下降139例(49.8%),听力中重度下降80例(28.7%)。经校正年龄、性别、受教育年限和ApoEε4后发现,PTA和总体认知功能(β=-0.021,P<0.001)、执行功能(β=-0.019,P=0.013)、视空间功能(β=-0.018,P=0.039)、语言(β=-0.018,P=0.033)和注意力(β=-0.020,P=0.003)呈显著负相关,但与记忆(β=-0.010,P=0.301)无相关性。结论老年听力下降与总体认知功能、执行功能、视空间功能、语言和注意功能受损显著相关。

Aim To investigate the correlations of hearing level and global and domain-specific cognitions in the older adults.Methods From 2020 to 2021,participants aged more than 50 years old were recruited from the cognitive impairment outpatient and community.Pure tone audiometer was used to measure the individual's hearing function.Cognitive function was evaluated by a battery of neuropsychological tests(Huashan version).Neuropsychological raw scores in each domain were converted to z scores.Univariate and multivariate(adjusted for age,sex,years of education,and APOEe4 allele)linear regression models were used to fit the correlation of pure tone average(PTA)and scores of cognitive domains.Results Among 279 participants who underwent the pure tone audiometry.82(29.4%),124(44.4%),and 73(26.2%)participants were diagnosed as cognitive normal,MCI,and dementia,respectively.60(21.5%),139(49.8%),and 80(28.7%)participants were tested as normal hearing,mild hearing loss,and moderate-to-severe hearing loss,respectively.After adjusting for age,sex,education,and APOEe4 allele,PTA was found to be correlated negatively with global cognitive function(β=-0.021,P<0.001),executive function(β=-0.019,P=0.013),visuospatial function(β=-0.018,P=0.039),language(β=-0.018,P=0.033),and attention(β=-0.020,P=0.003).However,there was no significant correlation between PTA and memory(β=-0.010,P=0.301).Conclusion Hearing loss is correlated with the deterioration in global cognition,executive function,visuospatial function,language,and attention among older adults.