老年性听力损失与认知障碍的相关研究  

Study on the relationship between age-related hearing loss and cognitive impairment

作　　者：刁桐湘 韩秋宏 山海军 吴晓琴 林蕴娟 李蔷[1] 王更慧[1] 静媛媛[1] 马鑫[1] 沈明[4] 余力生[1] 韩琳[1] 王宜旭 Diao Tongxiang;Han Qiuhong;Shan Haijun;Wu Xiaoqin;Lin Yunjuan;Li Qiang;Wang Genghui;Jing Yuanyuan;Ma Xin;Shen Ming;Yu Lisheng;Han Lin;Wang Yixu(Department of Otorhinolaryngology, Peking University People′s Hospital, Beijing 100044, China;Department of Otorhinolaryngology, Qinhuangdao Workers′ Hospital, Qinhuangdao 066200, China;Department of Otorhinolaryngology, Peking University International Hospital, Beijing 102206, China;Department of Neurology, Peking University People′s Hospital, Beijing 100044, China)

机构地区：[1]北京大学人民医院耳鼻咽喉科,100044 [2]秦皇岛市工人医院耳鼻咽喉科,066200 [3]北京大学国际医院耳鼻咽喉科,102206 [4]北京大学人民医院神经内科,100044

出　　处：《中华耳鼻咽喉头颈外科杂志》2019年第2期110-115,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京大学人民医院研究与发展基金(RDC2015-29).

摘　　要：目的研究老年性听力损失与认知障碍的相关性,分析其相关影响因素。方法采用听力筛查与蒙特利尔认知评估量表对2017年3月1—31日北京大学人民医院耳鼻咽喉科爱耳日义诊活动期间接诊的201例老年患者进行调查,其中女101例,男100例,年龄60~90岁。以认知水平为因变量,以年龄、性别、教育年限、职业、婚姻状况、居住情况、平均听力损失程度(500、1000、2000、4000Hz的平均听阈)、自觉听力下降时长等为自变量,采用单因素分析及多元线性回归分析进行统计处理,筛选影响老年人认知水平的主要因素。结果201例老年患者中听力正常者39例,轻度听力损失65例,中度听力损失80例,重度听力损失16例,极重度听力损失1例。平均听力损失程度为认知障碍的影响因素,且主要影响认知域亚项中的定向力及抽象能力(P值均<0.05);年龄、自觉听力下降时长、教育年限、婚姻状况、既往耳部疾病、高血压为认知水平的相对独立影响因素(P值均<0.05)。结论老年性听力损失为认知障碍的影响因素,主要通过定向力及抽象能力影响认知水平,而自觉听力下降年限为认知功能障碍的独立影响因素。ObjectiveTo investigate the correlation between age-related hearing loss and cognitive impairment. Methods201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly. ResultsOf the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05);The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05). ConclusionsAge-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.

关 键 词：听觉丧失 认知障碍 老年人 

分 类 号：R764[医药卫生—耳鼻咽喉科] R749.1[医药卫生—临床医学]