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目的 探讨老年性耳聋(Presbycusis, PC)患者听力水平不同程度下降对认知能力的影响，分析PC与认知障碍的关系。方法 选取2023年1月-2024年5月新疆医科大学第一附属医院耳鼻喉科就诊的300名60岁以上老年人，收集患者的听力学检查结果。Logistic回归模型分析认知状态的影响因素，Spearman相关性分析听力水平与认知状态的关系。结果 年龄、文化程度、经济状况、职业性质、高血压、日常娱乐时间、听力损失程度均为认知状态的影响因素(P<0.05);多因素Logistic回归分析结果显示，高血压病史、文化程度是认知功能降低的独立危险因素(P<0.05),高血压病史、文化程度、日常娱乐时间和听力损失是痴呆的独立危险因素(P<0.05);Spearman相关性分析结果显示，听力损失与简易精神状态量表(MMSE)评分呈负相关(r=-0.247,P<0.01);单因素分析结果显示，PTA受损程度与定向力、记忆力、注意力和计算力、回忆能力、语言能力(包括命名能力、复述能力、三步命令、阅读能力、结构能力)差异有统计学意义(P<0.01)。结论 PC患者听力水平不同程度下降是痴呆的危险因素，PC与认知障碍呈负相关，老年人听力下降应及早干预从而防治痴呆的发生。
Abstract：Objective To explore the effect of decreased hearing level in presbycusis patients on cognitive ability, and to analyze the relationship between presbycusis and cognitive impairment. Methods 300 elderly people over 60 years old treated in the hospital from January 2023 to May 2024 were selected to collect the audiological examination results. Logistic regression model analyzed the factors affecting cognitive status, and Spearman correlation analyzed the relationship between hearing level and cognitive status. Results Age, educational level, economic status, occupational nature, hypertension, daily entertainment time and hearing loss were all influencing factors of cognitive status(P<0.05). The results of the multivariate Logistic regression analysis showed that, history of hypertension and educational level were independent risk factors for reduced cognitive function(P<0.05); history of hypertension, educational level, daily recreational time and hearing loss were the independent risk factors for dementia(P<0.05). The results of the Spearman-correlation analysis showed that, hearing loss was negatively associated with MMSE(r=-0.247, P<0.01). The results of the univariate analysis showed that, the difference between the impaired PTA and orientation power, memory, attention and computing power, recall ability, language ability(including naming ability, retelling ability, 3-step command, reading ability and structural ability) was statistically significant(P<0.01). Conclusion Different decrease of hearing level in PC patients is a risk factor for dementia, and PC is negatively associated with cognitive impairment. Hearing loss in the elderly should prevent the occurrence of dementia as soon as possible.
[1] REIS L R,ESCADA P.Presbycusis:do we have a third ear?[J].Braz J Otorhinolaryngol,2016,82(6):710-714.
[2] LEE K Y.Pathophysiology of age-related hearing loss (peripheral and central)[J].Korean J Audiol,2013,17(2):45-49.
[3] PARHAM K,MCKINNON B J,EIBLING D,et al.Challenges and opportunities in presbycusis[J].Otolaryngol Head Neck Surg,2011,144(4):491-495.
[4] MAHARANI A,DAWES P,NAZROO J,et al.Longitudinal relationship between hearing aid use and cognitive function in older Americans[J].J Am Geriatr Soc,2018,66(6):1130-1136.
[5] 雷鸣祺，陈佳文，李岑菲，等.老年性聋与睡眠、情绪、认知功能相关性研究[J].中华耳科学杂志，2024,22(6):912-916.
[6] 赵春蓉，杨森，石敏，等.老年性聋患者认知功能初探[J].中国听力语言康复科学杂志，2024,22(5):471-474,504.
[7] 彭红祎，何钰峰，钟时勋.老年性聋和认知功能障碍的研究进展[J].中华耳科学杂志，2024,22(1):159-162.
[8] 黄海波，陈兴明，樊悦，等.基于听力损失分级的老年人听阈参考值范围研究[J].中华耳科学杂志，2024,22(4):684-688.
[9] MITCHELL A J.A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment[J].J Psychiatr Res,2009,43(4):411-431.
[10] VAISBUCH Y,SANTA MARIA P L.Age-related hearing loss:innovations in hearing augmentation[J].Otolaryngol Clin North Am,2018,51(4):705-723.
[11] 陈艾婷，韩莹，兰兰，等.60岁以上门诊老年听力障碍患者听力损失分布的初步研究[J].中华耳科学杂志，2018,16(4):445-450.
[12] NIXON G K,SARANT J Z,TOMLIN D.Peripheral and central hearing impairment and their relationship with cognition:a review[J].Int J Audiol,2019,58(9):541-552.
[13] 赵斐斐，朱宏伟，李筱贺，等.不同月龄SD大鼠年龄相关性听力减退发病机制探讨[J].临床和实验医学杂志，2018,17(22):2389-2392.
[14] JOHNSON K R,TIAN C,GAGNON L H,et al.Effects of Cdh23 single nucleotide substitutions on age-related hearing loss in C57BL/6 and 129S1/Sv mice and comparisons with congenic strains[J].Sci Rep,2017,7:44450.
[15] SOLDAN A,PETTIGREW C,CAI Q,et al.Cognitive reserve and long-term change in cognition in aging and preclinical Alzheimer′s disease[J].Neurobiol Aging,2017,60:164-172.
[16] 肖朕旭，梁小妞，吴婉清，等.老年听力水平与认知功能的关联研究[J].中国临床神经科学，2024,32(04):391-399,436.
[17] FEINKOHL I,WINTERER G,SPIES C D,et al.Cognitive reserve and the risk of postoperative cognitive dysfunction[J].Dtsch Arztebl Int,2017,114(7):110-117.
[18] 白旭晶，曲成毅，马菲，等.太原市城市社区中老年人听力障碍影响因素研究[J].现代预防医学，2008,(14):2609-2612.
[19] LEGRIS E,HENRIQUES J,AUSSEDAT C,et al.Emotional prosody perception in presbycusis patients after auditory rehabilitation[J].Eur Ann Otorhinolaryngol Head Neck Dis,2021,138(3):163-168.
[20] GAO J,ARMSTRONG N M,DEAL J A,et al.Hearing loss and cognitive function among Chinese older adults:the role of participation in leisure activities[J].BMC Geriatr,2020,20(1):215.
[21] TANEJA MK.Prevention and rehabilitation of old age deafness[J].Indian J Otolaryngol Head Neck Surg,2020,72(4):524-531.
[22] PANZA F,QUARANTA N,LOGROSCINO G.Sensory changes and the hearing loss-cognition link:the cognitive ear[J].JAMA Otolaryngol Head Neck Surg,2018,144(2):127-128.
[23] XING C,CHEN Y C,TONG Z,et al.Aberrant brain functional hubs and causal connectivity in presbycusis[J].Brain Imaging Behav,2021,15(1):453-463.
基本信息:
中图分类号:R764.436;R749.1
引用信息:
[1]管萌欢,冯娟,李林格,等.老年性耳聋与认知障碍的相关性分析[J].新疆医科大学学报,2025,48(03):338-343.
基金信息:
国家重点研发计划重点专项(2023YFC3604200,2023YFC3604203)
2025-03-15
2025-03-15