社区老年人群听力损失与认知功能下降及焦虑抑郁情绪的相关性分析  

The Relationship Among Hearing loss,Cognitive Decline,Anxiety and Depression in Community-Dwelling Older Adults

作　　者：傅新星[1] 陈雪清[1] 王硕[1] 陈静[1] 刘辉[1] 于逢春[2] 刘博[1] FU Xin-xing;CHEN Xue-qing;WANG Shuo;CHEN Jing;LIU-Hui;YU Feng-chun;LIU Bo

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科/北京市耳鼻咽喉科研究所,北京100005 [2]北京市海淀医院神经内科,北京100048

出　　处：《中国听力语言康复科学杂志》2022年第4期246-251,共6页Chinese Scientific Journal of Hearing and Speech Rehabilitation

摘　　要：目的分析老年人群听力损失与认知功能下降及精神健康指标的相关性。方法采用纯音测听、自我听力损失报告、简明智力状态量表、广泛性焦虑障碍和患者健康问卷等工具,对北京市某社区434例60岁以上老年人群进行调查。将年龄、性别、文化程度、听力损失、吸烟、饮酒、慢病等因素作为自变量,认知功能下降和焦虑抑郁指标设为因变量,进行Logistic回归和多元线性回归分析。结果434例受试者中,以较好耳500~4000 Hz平均听阈大于25 dB HL为准,286例(65.9%)存在听力损失。50例(11.5%)存在认知功能下降,60例(13.8%)和58例(13.4%)分别存在焦虑和抑郁。听力损失者的认知功能评分极显著低于听力正常者(P<0.001),听力损失者的焦虑和抑郁指标高于听力正常者,但无显著差异。Logistic回归表明,听力损失与认知功能下降(OR为1.98,95%CI为1.64~2.31)、抑郁和焦虑(OR分别为3.22和1.03,95%CI分别为1.72~6.05和1.01~1.05)存在独立相关。多重线性回归表明,纯音听阈与认知量表得分存在负相关(相关系数β=-0.03,95%CI为-0.06~-0.01),与焦虑量表得分存在正相关(相关系数β=0.03,95%CI为0.00~-0.06)。结论社区老年人群的听力损失与认知功能下降和焦虑抑郁存在独立相关性,受教育程度是保护性因素。Objective This study aimed to explore the associations of hearing loss with cognitive impairment,anxiety,and depression in a group of community-dwelling older adults.Methods Pure-tone audiometry,self-reported hearing loss,Mini-Mental State Examination(MMSE),Generalized Anxiety Disorder(GAD-7)and Patient Health Questionnaire(PHQ-9)were used to investigate 434 cases of an elderly population aged 60 years or above in a community in Beijing.Age,gender,education level,hearing loss,smoking,alcohol consumption and chronic illness were used as independent variables,and indicators of cognitive decline and anxiety and depression were set as dependent variables,respectively,and logistic regression and multiple linear regression analyses were performed.Results Of the 434 adults,286(65.9%)had hearing loss,based on the averaged threshold of 500 to 4000 Hz in the better ear(>25 dB HL).50(11.5%)had cognitive impairment,and 60(13.8%)and 58(13.4%)had anxiety and depression,respectively.Logistic regression showed that hearing loss was associated with decreased cognitive function(OR 1.98,95%CI 1.64-2.31)and anxiety and depression(OR 3.22 and 1.03,95%CI 1.72 to 6.05 and 1.01 to 1.05,respectively).Multiple linear regression showed a negative correlation between pure-tone hearing threshold and MMSE scores(correlation coefficientβ=-0.03,95%CI-0.06 to-0.01)and a positive correlation with anxiety scores(correlation coefficientβ=0.03,95%CI 0.00 to-0.06).Conclusion Hearing loss was independently associated with both cognitive decline and anxiety and depression in the community-based elderly population,with education level as a protecting factor.

关 键 词：年龄相关性听力损失 认知功能下降 焦虑 抑郁 纯音测听 

分 类 号：R764[医药卫生—耳鼻咽喉科]