老年人姿势平衡、听力损失与认知执行功能：它们相关吗？

文献信息

中文摘要

背景： 听力损失（HL）与认知表现或姿势失衡之间可能存在显著关联，但它们之间的相互关系仍不清楚。本研究旨在理解这些关系。方法：一项观察性前瞻性研究，受试者年龄≥55岁，分为正常听力组（A组）、未治疗的HL＞20分贝听力级（dBHL）组（B组）和已治疗的HL＞20 dBHL组（C组）。在初次就诊和随访时，参与者接受了评估听力、平衡和认知的测试和问卷。使用Stata 17进行统计分析，包括相对风险、Spearman's Rho相关、交互作用和调整模型；p值＜0.05被认为具有统计学显著性。结果：最初共招募714名受试者：A组210名，B组302名，C组202名。101名个体完成了平均3.6年的随访。与正常听力组相比，听力损失使B组不稳的概率增加1.4倍，C组增加4.1倍。计时起立行走（TUG）测试表现较差可由两项认知执行功能测试得分较低预测，相关性分别为-0.4和0.34（p＜0.001）。关于混杂因素，认知表现在年龄和教育方面存在统计学显著差异；TUG结果在年龄方面存在差异；HL在性别、心血管危险因素（CVRF）和教育方面存在差异。结论：姿势失衡和认知执行功能与HL相关。然而，没有证据将头晕与认知执行功能联系起来，尽管发现其与TUG结果存在关联。因此，HL与平衡和认知均相关，而认知也与平衡相关。

英文摘要

Background: There might be a significant association between hearing loss (HL) and cognitive performance or postural imbalance, but how they relate to each other remains unknown. The aim of this study is to gain an understanding of these relationships. Methods: An observational prospective study with subjects ≥ 55 years old divided into groups: normal hearing (group A), untreated HL > 20 decibel hearing level (dBHL) (group B), and patients with treated HL > 20 dBHL (group C). At the initial visit and follow-up, participants underwent tests and questionnaires evaluating hearing, balance, and cognition. Statistical analyses-including relative risk, Spearman's Rho correlation, interaction, and adjusted models-were performed using Stata 17; a p-value < 0.05 was considered statistically significant. Results: In total, 714 subjects were initially recruited: 210 in group A, 302 in group B, and 202 in group C. A mean follow-up time of 3.6 years was completed by 101 individuals. Compared with the normal-hearing group, hearing loss increased the probability of unsteadiness by 1.4-fold in group B and 4.1-fold in group C. Poorer performance on the Timed Up and Go (TUG) test was predicted by lower scores on both cognitive executive function tests, with correlations of -0.4 and 0.34 (p < 0.001). Regarding confounding factors, statistically significant differences were found for age and education in cognitive performance; age in the TUG results; and sex, cardiovascular risk factors (CVRF), and education in HL. Conclusions: Postural imbalance and cognitive executive function are related to HL. However, there is no evidence linking dizziness to cognitive executive function, although an association with TUG results was found. Therefore, HL is correlated with both balance and cognition, and cognition is also related to balance.