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社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性

万红 许浪 李琳 程桂荣 刘丹 余亚夫 韩刚斌 黄琳雅 张晶晶 曾燕

万红, 许浪, 李琳, 程桂荣, 刘丹, 余亚夫, 韩刚斌, 黄琳雅, 张晶晶, 曾燕. 社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性[J]. 中华疾病控制杂志, 2023, 27(8): 901-906. doi: 10.16462/j.cnki.zhjbkz.2023.08.006
引用本文: 万红, 许浪, 李琳, 程桂荣, 刘丹, 余亚夫, 韩刚斌, 黄琳雅, 张晶晶, 曾燕. 社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性[J]. 中华疾病控制杂志, 2023, 27(8): 901-906. doi: 10.16462/j.cnki.zhjbkz.2023.08.006
WAN Hong, XU Lang, LI Lin, CHENG Guirong, LIU Dan, YU Yafu, HAN Gangbin, HUANG Linya, ZHANG Jingjing, ZENG Yan. Association of dual olfactory and hearing impairment with cognitive impairment among community-dwelling adults aged 65 years and above[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(8): 901-906. doi: 10.16462/j.cnki.zhjbkz.2023.08.006
Citation: WAN Hong, XU Lang, LI Lin, CHENG Guirong, LIU Dan, YU Yafu, HAN Gangbin, HUANG Linya, ZHANG Jingjing, ZENG Yan. Association of dual olfactory and hearing impairment with cognitive impairment among community-dwelling adults aged 65 years and above[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2023, 27(8): 901-906. doi: 10.16462/j.cnki.zhjbkz.2023.08.006

社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性

doi: 10.16462/j.cnki.zhjbkz.2023.08.006
基金项目: 

国家重点研发计划 2020YFC2006000

国家自然科学基金 72174159

详细信息
    通讯作者:

    曾燕,E-mail: zengyan68@wust.edu.cn

  • 中图分类号: R181.2

Association of dual olfactory and hearing impairment with cognitive impairment among community-dwelling adults aged 65 years and above

Funds: 

National Key Research and Development Program of China 2020YFC2006000

National Natural Science Foundation of China 72174159

More Information
  • 摘要:   目的  探讨社区65岁及以上居民嗅觉和听觉双重障碍与认知障碍的关联性。  方法  从湖北老年记忆队列纳入8 370名65岁及以上老年人,根据嗅觉和听觉功能状况将研究对象分为4组:无嗅觉和听觉障碍(no olfactory and hearing impairment, NOHI)组、仅嗅觉障碍(olfactory impairment only, OI)组、仅听觉障碍(hearing impairment only, HI)组及嗅觉和听觉双重障碍(dual olfactory and hearing impairment,DOHI)组。认知障碍包括轻度认知障碍及痴呆。采用logistic回归分析模型分析老年人不同感觉功能状况与认知障碍的关系。  结果  一般社区老年人群嗅觉障碍、听觉障碍、DOHI和认知障碍患病率分别为24.1% (95% CI:23.2%~25.0%)、44.5% (95% CI:43.4%~45.5%)、20.0% (95% CI:19.1%~20.8%)和26.3% (95% CI:25.4%~27.3%)。OI、HI和DOHI组认知障碍患病率均高于NOHI组,且DOHI组认知障碍患病率高于其他3组。调整社会人口学、生活方式和慢病因素后,DOHI组认知障碍的患病风险分别为NOHI、OI和HI组的1.402倍、1.437倍和1.403倍。  结论  中国社区患嗅觉和听觉双重障碍的老年人群患认知障碍的风险高于无感觉障碍人群,也高于仅单纯一种感觉障碍人群。双重感觉障碍是患认知障碍的高风险因素。
  • 表  1  不同感觉功能组研究对象的一般特征

    Table  1.   General characteristics of subjects in different sensory functional groups

    特征  Characteristic 合计[人数(占比/%)]
    Total[Number of people (proportion /%)] (n=8 370)
    NOHI组[人数(占比/%)]
    [Number of people (proportion /%)] (n=4 305)
    OI组[人数(占比/%)]
    [Number of people (proportion /%)] (n=342)
    HI组[人数(占比/%)]
    [Number of people (proportion /%)] (n=2 050)
    DOHI组[人数(占比/%)]
    [Number of people (proportion /%)] (n=1 673)
    χ2/H
    value
    P
    value
    性别  Sex 7.66 0.054
      男  Male 3 831(45.8) 1 908(44.3) 164(48.0) 964(47.0) 795(47.5)
      女  Female 4 539(54.2) 2 397(55.7) 178(52.0) 1 086(53.0) 878(52.5)
    年龄/岁, [M(P25, P75)]
    Age/years, [M(P25, P75)]
    71(67, 75) 70(67, 74) 71(68, 76) 71(68, 76) 72(68, 77) 137.87 < 0.001
    年龄组/岁  Age group/years 152.40 < 0.001
      ≥65~<70 3 493(41.7) 1 987(46.2) 132(38.6) 790(38.5) 584(34.9)
      ≥70~<75 2 564(30.6) 1 345(31.2) 111(32.5) 600(29.3) 508(30.4)
      ≥75~<80 1 311(15.7) 593(13.8) 51(14.9) 376(18.3) 291(17.4)
      ≥80 1 002(12.0) 380(8.8) 48(14.0) 284(13.9) 290(17.3)
    教育年限/年, [M(P25, P75)]
    Education/year, [M(P25, P75)]
    9(4, 12) 9(6, 12) 9(3, 12) 9(3, 12) 5(0, 9) 628.62 < 0.001
    文化程度  Education level 568.99 < 0.001
      小学及以下  Primary school or below 3 370(40.3) 1 303(30.3) 151(44.2) 853(41.6) 1 063(63.5)
      中学  Middle school 3 675(43.9) 2 183(50.7) 139(40.6) 866(42.3) 487(29.1)
      大学及以上  University or above 1 325(15.8) 819(19.0) 52(15.2) 331(16.1) 123(7.4)
    居住地  Residence location 698.28 < 0.001
      农村  Rural 3 050(36.4) 1 061(24.6) 151(44.2) 826(40.3) 1 012(60.5)
      城市  Urban 5 320(63.6) 3 244(75.4) 191(55.8) 1 224(59.7) 661(39.5)
    独居  Living alone 87.19 < 0.001
      是  Yes 1 008(12.0) 392(9.1) 45(13.2) 278(13.6) 293(17.5)
      否  No 7 362(88.0) 3 913(90.9) 297(86.8) 1 772(86.4) 1 380(82.5)
    吸烟  Smoking 20.76 < 0.001
      是  Yes 2 379(28.4) 1 130(26.2) 102(29.8) 630(30.7) 517(30.9)
      否  No 5 991(71.6) 3 175(73.8) 240(70.2) 1 420(69.3) 1 156(69.1)
    饮酒  Drinking 103.27 < 0.001
      是  Yes 2 566(30.7) 1 110(25.8) 127(37.1) 704(34.3) 625(37.4)
      否  No 5 804(69.3) 3 195(74.2) 215(62.9) 1 346(65.7) 1 048(62.6)
    高血压  Hypertension 15.72 0.001
      是  Yes 4 837(57.8) 2 445(56.8) 190(55.6) 1 164(56.8) 1 038(62.0)
      否  No 3 533(42.2) 1 860(43.2) 152(44.4) 886(43.2) 635(38.0)
    糖尿病  Diabetes 4.38 0.223
      是  Yes 1 417(16.9) 710(16.5) 60(17.5) 336(16.4) 311(18.6)
      否  No 6 953(83.1) 3 595(83.5) 282(82.5) 1 714(83.6) 1 362(81.4)
    冠心病  Coronary heart disease 29.00 < 0.001
      是  Yes 1 363(16.3) 618(14.4) 59(17.3) 354(17.3) 332(19.8)
      否  No 7 007(83.7) 3 687(85.6) 283(82.7) 1 696(82.7) 1 341(80.2)
    脑血管疾病  Cerebrovascular disease 39.92 < 0.001
      是  Yes 1 736(20.7) 778(18.1) 73(21.3) 495(24.1) 390(23.3)
      否  No 6 634(79.3) 3 527(81.9) 269(78.7) 1 555(75.9) 1 283(76.7)
    认知障碍  Cognitive impairment 309.04 < 0.001
      是  Yes 2 202(26.3) 855(19.9) 94(27.5) 548(26.7) 705(42.1)
      否  No 6 168(73.7) 3 540(80.1) 248(72.5) 1 502(73.3) 968(57.9)
    注: NOHI,无嗅觉和听觉障碍;OI, 仅嗅觉障碍;HI, 仅听觉障碍;DOHI, 嗅觉和听觉双重障碍。
    Notes: NOHI, no olfactory and hearing impairment; OI, olfactory impairment only; HI, hearing impairment only; DOHI, dual olfactory and hearing impairment.
    下载: 导出CSV

    表  2  不同感觉功能组认知障碍患病率的两两比较

    Table  2.   Pairwise comparison of the prevalence of cognitive impairment in four groups

    组别
    Group
    认知障碍患病率/%
    Prevalence of cognitive impairment/%
    95% CI χ2
    value
    P
    value
    组别
    Group
    χ2
    value
    P
    value
    NOHI 19.9 18.7~21.1
    OI 27.5 22.7~32.2 11.33 0.001 HI 0.09 0.770
    HI 26.7 24.8~28.6 38.11 < 0.001 DOHI 25.48 < 0.001
    DOHI 42.1 39.8~44.5 310.08 < 0.001 DOHI 97.95 < 0.001
    合计 26.3 25.4~27.3 309.04 < 0.001
    注: 1. NOHI,无嗅觉和听觉障碍;OI, 仅嗅觉障碍;HI, 仅听觉障碍;DOHI, 嗅觉和听觉双重障碍。
    2. 两两比较检验水准为α=0.008 3。
    ①表示与NOHI组比较;②表示与OI组比较;③表示与HI组比较; ④表示总χ2值和总P值。
    Notes: 1. NOHI, no olfactory and hearing impairment; OI, olfactory impairment only; HI, hearing impairment only; DOHI, dual olfactory and hearing impairment.
    2. Pairwise comparison test level α=0.008 3.
    ① Indicates comparison with NOHI; ② Indicates comparison with OI; ③ Indicates comparison with HI; ④ Indicates the total χ2 value and the total P value.
    下载: 导出CSV

    表  3  不同感觉功能组与认知障碍的logistic回归分析

    Table  3.   Logistic regression analysis of cognitive impairment and different sensory function groups

    组别
    Group
    模型1  Model 1 模型2  Model 2 模型3  Model 3 模型4  Model 4
    OR值(95% CI)
    OR value (95% CI)
    P
    value
    OR值(95% CI)
    OR value (95% CI)
    P
    value
    OR值(95% CI)
    OR value (95% CI)
    P
    value
    OR值(95% CI)
    OR value (95% CI)
    P
    value
    OI 1.529(1.192~1.962) 0.001 1.014(0.770~1.334) 0.923 0.973(0.738~1.283) 0.846 0.975(0.739~1.287) 0.859
    HI 1.472(1.302~1.665) < 0.001 1.018(0.887~1.167) 0.803 0.986(0.859~1.133) 0.844 0.980(0.853~1.126) 0.775
    DOHI 2.939(2.600~3.322) < 0.001 1.436(1.248~1.652) < 0.001 1.426(1.238~1.641) < 0.001 1.402(1.216~1.615) < 0.001
    DOHI 1.921(1.487~2.483) < 0.001 1.391(1.042~1.856) 0.025 1.452(1.086~1.942) 0.012 1.437(1.074~1.923) 0.015
    DOHI 1.996(1.739~2.291) < 0.001 1.362(1.163~1.595) < 0.001 1.405(1.198~1.647) < 0.001 1.403(1.196~1.646) < 0.001
    注: OI, 仅嗅觉障碍;HI, 仅听觉障碍;DOHI, 嗅觉和听觉双重障碍。
    ①表示以NOHI组为对照; ②表示以OI组为对照; ③表示以HI组为对照。
    Notes: OI, olfactory impairment only; HI, hearing impairment only; DOHI, dual olfactory and hearing impairment.
    ① Indicates NOHI group as the reference; ② Indicates OI group as the reference; ③ Indicates HI group as the reference.
    下载: 导出CSV
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  • 收稿日期:  2022-07-20
  • 修回日期:  2022-10-01
  • 网络出版日期:  2023-09-02
  • 刊出日期:  2023-08-10

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