Hearing Loss and Cognitive Decline in Older Adults

作者：Frank R. Lin, Kristine Yaffe, Jin Xia, Qian-Li Xue, Tamara B. Harris, Elizabeth Purchase-Helzner, Suzanne Satterfield, Hilsa N. Ayonayon, Luigi Ferrucci, Eleanor M. Simonsick, for the Health ABC Study Group · 发表于：JAMA Internal Medicine · 年份：2013 · DOI：10.1001/jamainternmed.2013.1868 · 被引用次数：3847 · 研究领域：Hearing Loss and Rehabilitation、Noise Effects and Management、Hearing, Cochlea, Tinnitus, Genetics

BACKGROUND Whether hearing loss is independently associated with accelerated cognitive decline in older adults is unknown. METHODS We studied 1984 older adults (mean age, 77.4 years) enrolled in the Health ABC Study, a prospective observational study begun in 1997-1998. Our baseline cohort consisted of participants without prevalent cognitive impairment (Modified Mini-Mental State Examination [3MS] score, ≥80) who underwent audiometric testing in year 5. Participants were followed up for 6 years. Hearing was defined at baseline using a pure-tone average of thresholds at 0.5 to 4 kHz in the better-hearing ear. Cognitive testing was performed in years 5, 8, 10, and 11 and consisted of the 3MS (measuring global function) and the Digit Symbol Substitution test (measuring executive function). Incident cognitive impairment was defined as a 3MS score of less than 80 or a decline in 3MS score of more than 5 points from baseline. Mixed-effects regression and Cox proportional hazards regression models were adjusted for demographic and cardiovascular risk factors. RESULTS In total, 1162 individuals with baseline hearing loss (pure-tone average >25 dB) had annual rates of decline in 3MS and Digit Symbol Substitution test scores that were 41% and 32% greater, respectively, than those among individuals with normal hearing. On the 3MS, the annual score changes were -0.65 (95% CI, -0.73 to -0.56) vs -0.46 (95% CI, -0.55 to -0.36) points per year (P = .004). On the Digit Symbol Substitution t...