中国老年人基线认知功能与听力损失和认知轨迹组别归属的关联：一项纵向轨迹分析
Association of baseline cognitive function and hearing loss with cognitive trajectory group membership among Chinese older adults: A longitudinal trajectory analysis.
文献信息
| PMID | 42753934 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xixing Xu |
| 作者单位 | Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, China. |
| 期刊 | Experimental gerontology |
| SCI 分区 | Q1 |
| IF | 4.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 认知老化具有异质性，但听力损失在特定认知轨迹中的作用仍不清楚。我们研究了中国老年人中听力损失与认知轨迹归属的关联，以及其对基线认知与随后认知变化之间关联的修饰作用。
方法： 数据来自中国老年健康影响因素跟踪调查。我们纳入了6650名65-99岁成年人，他们在2008年至2018年间至少完成了两次有效的简易精神状态检查（MMSE）评估。采用增长混合模型识别认知轨迹，并使用多项logistic回归检验基线听力损失和MMSE评分与轨迹组别归属的关联，并检验其交互作用。
结果： 识别出三种轨迹：高稳定型（83.3%）、中度下降型（11.2%）和快速下降型（5.5%）。较高的基线MMSE评分与中度下降（RRR 0.875，95% CI 0.859-0.892）和快速下降（RRR 0.920，95% CI 0.898-0.942）的相对可能性较低相关。听力损失与中度下降（RRR 1.262，95% CI 1.018-1.565）和快速下降（RRR 1.551，95% CI 1.188-2.025）的相对可能性较高相关。MMSE与听力的交互作用对中度下降具有显著性（RRR 1.252，95% CI 1.079-1.453），表明在听力损失参与者中，基线MMSE与中度下降归属之间的负向关联较弱。
结论： 听力损失与不良认知轨迹归属相关，并修饰了基线认知功能与中度下降之间的关联。与快速下降的关联在敏感性分析中尤其一致。这些发现支持在评估认知老化风险时考虑听力状况，同时进一步研究应确定听力干预是否会改变认知轨迹。
英文摘要
BACKGROUND: Cognitive aging is heterogeneous, but the role of hearing loss in distinct cognitive trajectories remains unclear. We examined associations of hearing loss with cognitive trajectory membership and its modification of the association between baseline cognition and subsequent cognitive change among Chinese older adults.
METHODS: Data were from the Chinese Longitudinal Healthy Longevity Survey. We included 6650 adults aged 65-99 years with at least two valid Mini-Mental State Examination (MMSE) assessments between 2008 and 2018. Growth mixture modelling identified cognitive trajectories, and multinomial logistic regression examined associations of baseline hearing loss and MMSE score with trajectory group membership and tested their interaction.
RESULTS: Three trajectories were identified: high-stable (83.3%), moderate decline (11.2%), and rapid decline (5.5%). Higher baseline MMSE scores were associated with lower relative likelihoods of moderate decline (RRR 0.875, 95% CI 0.859-0.892) and rapid decline (RRR 0.920, 95% CI 0.898-0.942). Hearing loss was associated with higher relative likelihoods of moderate decline (RRR 1.262, 95% CI 1.018-1.565) and rapid decline (RRR 1.551, 95% CI 1.188-2.025). The MMSE-by-hearing interaction was significant for moderate decline (RRR 1.252, 95% CI 1.079-1.453), indicating a weaker inverse association between baseline MMSE and moderate-decline membership among participants with hearing loss.
CONCLUSIONS: Hearing loss was associated with adverse cognitive trajectory membership and modified the association between baseline cognitive function and moderate decline. The association with rapid decline was particularly consistent across sensitivity analyses. These findings support considering hearing status when assessing cognitive aging risk, while further studies should determine whether hearing interventions alter cognitive trajectories.