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Xu Y, Aung HL, Hesam-Shariati N, Keay L, Sun X, Phu J, Honson V, Tully PJ, Booth A, Lewis E, Anderson CS, Anstey KJ, Peters R. Contrast Sensitivity, Visual Field, Color Vision, Motion Perception, and Cognitive Impairment: A Systematic Review. J Am Med Dir Assoc 2024; 25:105098. [PMID: 38908397 DOI: 10.1016/j.jamda.2024.105098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 02/07/2024] [Accepted: 05/12/2024] [Indexed: 06/24/2024]
Abstract
OBJECTIVES To examine relationships between visual function (ie, contrast sensitivity, visual field, color vision, and motion perception) and cognitive impairment, including any definition of "cognitive impairment," mild cognitive impairment, or dementia. DESIGN Systematic review and meta-analyses. SETTING AND PARTICIPANTS Any settings; participants with (cases) or without (controls) cognitive impairment. METHODS We searched 4 databases (to January 2024) and included published studies that compared visual function between cases and controls. Standardized mean differences (SMD) with 95% CIs were calculated where data were available. Data were sufficient for meta-analyses when cases were people with dementia. The Joanna Briggs Institute checklists were used for quality assessment. RESULTS Fifty-one studies/69 reports were included. Cross-sectional evidence shows that people with dementia had worse contrast sensitivity function and color vision than controls: measured by contrast sensitivity (log units) on letter charts, SMD -1.22 (95% CI -1.98, -0.47), or at varied spatial frequencies, -0.92 (-1.28, -0.57); and by pseudoisochromatic plates, -1.04 (-1.59, -0.49); color arrangement, -1.30 (-2.31, -0.29); or matching tests, -0.51 (-0.78, -0.24). They also performed more poorly on tests of motion perception, -1.20 (-1.73, -0.67), and visual field: mean deviation, -0.87 (-1.29, -0.46), and pattern standard deviation, -0.69 (-1.24, -0.15). Results were similar when cases were limited to participants with clinically diagnosed Alzheimer disease. Sources of bias included lack of clarity on study populations or settings and definitions of cognitive impairment. The 2 included longitudinal studies with follow-ups of approximately 10 years were of good quality but reported inconsistent results. CONCLUSIONS AND IMPLICATIONS In the lack of longitudinal data, cross-sectional studies indicate that individuals with cognitive impairment have poorer visual function than those with normal cognition. Additional longitudinal data are needed to understand whether poor visual function precedes cognitive impairment and the most relevant aspects of visual function, dementia pathologies, and domains of cognition.
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Affiliation(s)
- Ying Xu
- Neuroscience Research Australia, Sydney, Australia; School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia; The George Institute for Global Health, UNSW Sydney, Sydney, Australia; Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Htein Linn Aung
- Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Negin Hesam-Shariati
- Neuroscience Research Australia, Sydney, Australia; School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia; School of Optometry and Vision Science, UNSW Sydney, Sydney, Australia
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Fundus Diseases, Shanghai, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China; National Clinical Research Center for Ophthalmic Diseases, Shanghai, China
| | - Jack Phu
- School of Optometry and Vision Science, UNSW Sydney, Sydney, Australia; Center for Eye Health, UNSW Sydney, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; Concord Clinical School, Concord Repatriation General Hospital, Sydney, Australia
| | - Vanessa Honson
- School of Optometry and Vision Science, UNSW Sydney, Sydney, Australia
| | - Phillip J Tully
- School of Psychology, The University of New England, Armidale, Australia
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Ebony Lewis
- Neuroscience Research Australia, Sydney, Australia; School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia; Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia
| | - Craig S Anderson
- The George Institute for Global Health, UNSW Sydney, Sydney, Australia; Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; The George Institute China, Peking University Health Science Center, Beijing, China; Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, Australia; School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia
| | - Ruth Peters
- Neuroscience Research Australia, Sydney, Australia; School of Psychology, Faculty of Science, UNSW Sydney, Sydney, Australia; The George Institute for Global Health, UNSW Sydney, Sydney, Australia; Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia; School of Public Health, Imperial College London, London, United Kingdom
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Marmamula S, Kumbham TR, Ehrlich JR, Alladi S, Bloom DE, Friedman DS. Cross-sectional study of cognitive impairment and visual impairment among the elderly population in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES). BMJ Open 2024; 14:e084348. [PMID: 39038860 DOI: 10.1136/bmjopen-2024-084348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVE To report the relationship between visual impairment (VI) and cognitive impairment (CI) among the older population living in residential care homes in Hyderabad, India. STUDY DESIGN Cross-sectional study. SETTING 41 homes for the aged centres in the Hyderabad region. PARTICIPANTS 965 participants aged ≥60 years from homes for the aged centres. PRIMARY OUTCOME MEASURES Visual impairment and cognitive impairment. METHODS The Hindi mini-Mental Status Examination (HMSE) questionnaire was used to assess the cognitive function. The final HMSE score was calculated after excluding vision-dependent tasks (HMSE-VI). A detailed eye examination was conducted, including visual acuity (VA) measurement for distance and near vision, using a standard logarithm of the minimum angle of resolution chart under good illumination. CI was defined as having a HMSE-VI score of ≤17. VI was defined as presenting VA worse than 6/12 in the better-seeing eye. Near VI (NVI) was defined as binocular presenting near vision worse than N8 and distance VA of 6/18 or better in the better-seeing eye. Multiple logistic regression was done to assess the association between VI and CI. RESULTS The mean age (±SD) was 74.3 (±8.3) years (range: 60-97 years). There were 612 (63.4%) women, and 593 (61.5%) had a school education. In total, 260 (26.9%; 95% confidence intervals: 24.2 to 29.9) participants had CI. The prevalence of CI among those with VI was 40.5% compared with 14.6% among those without VI (p<0.01). The logistic regression analysis showed that the participants with VI for distance vision had three times higher odds of having CI (OR 3.09; 95% confidence intervals: 2.13 to 4.47; p<0.01). Similarly, participants with NVI had two times higher odds of having CI (OR 2.11; 95% confidence intervals: 1.36 to 3.29; p<0.01) after adjusting for other covariates. CONCLUSIONS CI was highly prevalent among those with distance and near VI. VI was independently and positively associated with CI after adjusting for potential confounders. Interventions can be planned to address VI in this vulnerable population which could have a ripple effect in preventing cognitive decline.
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Affiliation(s)
- Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Institute of Optometry and Vision Sciences, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
- Department of Biotechnology / Wellcome Trust India Alliance, L V Prasad Eye Institute, Hyderabad, India
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Thirupathi Reddy Kumbham
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, L V Prasad Eye Institute, Hyderabad, India
| | - Joshua R Ehrlich
- Department of Ophthalmology & Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Survey Research Centre, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Suvarna Alladi
- National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - David S Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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Ge S, Wu KC, Chien SY, Jin X, Park S, Belza B. Urinary concerns among older adults: a qualitative analysis in the context of healthy aging. BMC Geriatr 2024; 24:605. [PMID: 39009962 PMCID: PMC11251362 DOI: 10.1186/s12877-024-05191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Urinary concerns increase with age impacting health and quality of life. The aims of this study were to describe: (1) urinary concerns as an age-related change (ARC); (2) the challenges of urinary concerns; (3) adaptation strategies used to manage urinary concerns; and (4) the value of engaging with aging (EWA) as a framework to promote self-management of urinary concerns. METHODS Data was used from semi-structured interviews with 29 older adults (mean age 77 years). An iterative coding process was used. A codebook was developed based on a-priori themes derived from the EWA framework, our previous publication, and a line-by-line coding of one of the transcripts. As the analysis progressed, additional codes emerged, enriching the codebook. RESULTS Six themes emerged: (1) the participants' experiences; (2) responses to urinary concerns, (3) adaptation and management strategies; (4) knowledge and understanding of urinary concerns; (5) available capacities and resources; and (6) the impact of the COVID-19 pandemic on urinary concerns. Participants tended to address their urinary concerns by adjusting routines, medication schedules, or diet patterns. They tried to secure restroom locations or use tools or reminders to resolve their urinary concerns. COVID-19 led to increased inconvenience for older adults to engage in outdoor activities due to the closure of public restrooms. CONCLUSIONS Our in-depth qualitative analysis found that participants developed personalized adjustments to address their needs and abilities to their urinary concerns. These findings offer insights into the individual aging experience, which will further enhance our understanding and advancement of person-centered care.
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Affiliation(s)
- Shaoqing Ge
- School of Nursing, University of Texas at Austin, Austin, TX, USA.
| | - Kuan-Ching Wu
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Shao-Yun Chien
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Xianglan Jin
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Suah Park
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Basia Belza
- School of Nursing, University of Washington, Seattle, WA, USA
- de Tornyay Center for Healthy Aging, University of Washington School of Nursing, Seattle, WA, USA
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Kuang L, Hu H, Xiang S, Zhang H, Liu G, Tai R, Wang L, Sheng Y. Social network and related factors in older people with sensory impairment in the community: Using principal component analysis. Geriatr Nurs 2024; 57:109-116. [PMID: 38621312 DOI: 10.1016/j.gerinurse.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/03/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024]
Abstract
AIM Older people with sensory impairment are more likely to have smaller and weaker social network due to their reduced ability, which lowers their quality of life. However, there is little research on the social network in older people with sensory impairment, especially the related factors. The aim of the study was to explore the related factors of social network and to provide evidence for the improvement of social network to promote successful aging in older people with sensory impairment. METHODS A cross-sectional study was conducted among 374 participants for hearing and vision assessment and questionnaire survey in a community, Beijing. Data were collected and analyzed by principal component analysis (PCA) and multiple logistic regression using IBM SPSS 25.0 software. RESULTS PCA showed that there were six risk factors whose eigenvalues >1 were extracted, with a total variance of 56.555%. Multiple logistic regression analysis of principal component indicated that five factors including physical health factor, social interaction factor, psychological status factor, lifestyle factor, and family condition factor, were statistically significant (p < 0.05). CONCLUSIONS The social network of older people with sensory impairment is relatively poor. Physical health factor, social interaction factor, psychological status factor, lifestyle factor, and family condition factor may be related factors. Medical staff should pay attention to physical, psychological and social characteristics of older people, especially with sensory impairment, to carry out necessary measures to improve social network and avoid social isolation.
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Affiliation(s)
- Li Kuang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hanyu Hu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shule Xiang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangnan Liu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Rui Tai
- Department of Nursing, Shanghai General Hospital, Shanghai, China
| | - Lingyun Wang
- Beijing Desheng Community Health Service Center, Beijing, China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Du X, Gu S, Wu Y, Zhao J, Liao H, Li S, Han D, Zhang M, Wang J. The association between dual sensory loss and healthcare expenditure: Mediating effect of depression. J Affect Disord 2024; 349:462-471. [PMID: 38199408 DOI: 10.1016/j.jad.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Previous studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous. OBJECTIVES The current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above. METHODS We first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE. RESULTS Depression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05). LIMITATIONS The DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias. CONCLUSION Significant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.
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Affiliation(s)
- Xinnan Du
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Shiping Gu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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Dhanda N, Hall A, Martin J. Does social isolation mediate the association between hearing loss and cognition in adults? A systematic review and meta-analysis of longitudinal studies. Front Public Health 2024; 12:1347794. [PMID: 38292910 PMCID: PMC10824982 DOI: 10.3389/fpubh.2024.1347794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Background There has been extensive research on the relationship between hearing and cognitive impairment in older adults but little examination of the role of mediating factors. Social isolation is a potential mediator, occurring because of hearing loss, and contributing to accelerated cognitive decline. Previous systematic reviews on this topic area have not considered the temporal nature of hearing loss and cognitive impairment exclusively or examined potential mediators within a longitudinal study design. Methods A systematic review was conducted. Electronic searches were performed in Web of Science, PubMed (Medline), Scopus, EMBASE, PsychInfo, and ProQuest (PsychArticles and ProQuest Dissertation and Theses) based on a search string of keywords relating to hearing loss, social isolation, and cognitive impairment/dementia in June 2023. Papers were critically appraised using the CASP checklists for cohort studies. Risk of bias in the selected studies was assessed using the Item Bank for Assessment of Risk of Bias and Precision for Observational Studies of Interventions or Exposures. Results Eleven of the 15 included studies provide evidence of a dose-dependent association between hearing threshold (40 dB HL or greater) and later cognitive impairment or incident dementia. Only one study included social isolation as a mediator, which was found to not be a significant contributing factor. The meta-analysis of 5 studies pooled hazard ratio for cognitive impairment due to hearing loss is 1.11 (95% CI: 1.06 to 1.15, p < 0.001). The pooled hazard ratio for incident dementia due to hearing loss was HR 1.21 (95% CI: 1.11 to 1.31, p = 0.002). Conclusion The analysis of included studies indicate that hearing threshold level affects later cognitive status or dementia diagnosis. There is not enough evidence to determine the role of social isolation as a mediator. Future epidemiology studies need to measure different elements of social isolation and ensure that hearing and cognition are measured at multiple time points.
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Affiliation(s)
- Nisha Dhanda
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Amanda Hall
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - James Martin
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Conceição Santos de Oliveira D, Gomes-Filho IS, Araújo EM, Xavier Ramos MDS, Freitas Coelho JM, Marques AA, Hintz AM, Firmino Rabelo D, Figueiredo ACMG, da Cruz SS. Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study. PLoS One 2023; 18:e0288099. [PMID: 37943811 PMCID: PMC10635537 DOI: 10.1371/journal.pone.0288099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/19/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship. METHOD The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: β) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies. RESULTS 5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: β = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: β = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant. CONCLUSION The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.
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Affiliation(s)
| | | | - Edna Maria Araújo
- Department of Health, Feira de Santana State University, Bahia, Brazil
| | | | | | - Adan Araújo Marques
- Health Sciences Center, Federal University of Recôncavo of Bahia, Bahia, Brazil
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Huang AR, Rebok GW, Swenor BK, Reed N, Griswold M, Zhu X, Deal JA. Concurrent hearing and vision impairment and 8-year memory decline in community-dwelling older adults. Alzheimers Dement 2023; 19:2307-2316. [PMID: 36462211 PMCID: PMC10238672 DOI: 10.1002/alz.12887] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Hearing and vision impairments are risk factors for cognitive decline; less is known about dual sensory impairment. This study quantifies the association between dual sensory impairment and 8-year change in memory among older adults. METHODS Data (N = 5552) were from the National Health and Aging Trends Study. Memory (immediate/delayed word recall, subjective memory) was measured annually (2011 to 2019). Hearing and vision impairments were measured by self-report. Association between dual sensory impairment and 8-year change in memory was assessed using multivariate linear mixed effect models and generalized logistic mixed models. RESULTS Rate of memory decline was most accelerated among participants with dual sensory impairment. For example, 8-year decline in delayed word recall was -1.03 (95% confidene interval: -1.29, -0.77) for dual sensory impairment versus -0.79 (-0.92, -0.67) for single and -0.56 (-0.63, -0.48) for no impairment. CONCLUSION Older adults with dual sensory impairment may be at particularly higher risk for cognitive decline.
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Affiliation(s)
- Alison R. Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - George W. Rebok
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Bonnielin K. Swenor
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD
- The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
- Johns Hopkins School of Nursing, Baltimore, MD
| | - Nicholas Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - Xiaoqian Zhu
- University of Mississippi Medical Center, Jackson, MS
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD
- Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD
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Guo R, Li X, Sun M, Wang Y, Wang X, Li J, Xie Z, Yao N, Yang Y, Li B, Jin L. Vision impairment, hearing impairment and functional Limitations of subjective cognitive decline: a population-based study. BMC Geriatr 2023; 23:230. [PMID: 37060058 PMCID: PMC10103414 DOI: 10.1186/s12877-023-03950-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/03/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The association between sensory impairment including vision impairment (VI), hearing impairment (HI), dual impairment (DI) and the functional limitations of SCD (SCD-related FL) are still unclear in middle-aged and older people. METHODS 162,083 participants from BRFSS in 2019 to 2020 was used in this cross-sectional study. After adjusting the weights, multiple logistic regression was used to study the relationship between sensory impairment and SCD or SCD-related FL. In addition, we performed subgroup analysis on the basis of interaction between sensory impairment and covariates. RESULTS Participants who reported sensory impairment were more likely to report SCD or SCD-related FL compared to those without sensory impairment (p < 0.001). The association between dual impairment and SCD-related FL was the strongest, the adjusted odds ratios (aORs) and 95% confidence interval (95% CI) were [HI, 2.88 (2.41, 3.43); VI, 3.15(2.61, 3.81); DI, 6.78(5.43, 8.47)] respectively. In addition, subgroup analysis showed that men with sensory impairment were more likely to report SCD-related FL than women, the aORs and 95% CI were [HI, 3.15(2.48, 3.99) vs2.69(2.09, 3.46); VI,3.67(2.79, 4.83) vs. 2.86(2.22, 3.70); DI, 9.07(6.67, 12.35) vs. 5.03(3.72, 6.81)] respectively. The subject of married with dual impairment had a stronger association with SCD-related FL than unmarried subjects the aOR and 95% CI was [9.58(6.69, 13.71) vs. 5.33(4.14, 6.87)]. CONCLUSIONS Sensory impairment was strongly associated with SCD and SCD-related FL. Individuals with dual impairment had the greatest possibility to reported SCD-related FL, and the association was stronger for men or married subjects than other subjects.
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Affiliation(s)
- Ruirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Yuxiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Xuhan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Zechun Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
| | - Lina Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 1163 Xinmin Avenue, Changchun, 130021, P. R. China.
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Ding Y, Yan Y, Tian Y, Du W, Fan L. Health-related quality of life associated with sensory impairment in Chinese middle-aged and older adults: a cohort study. J Epidemiol Community Health 2023; 77:258-264. [PMID: 36725347 DOI: 10.1136/jech-2022-219728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND The impact of sensory impairment (SI) on individual multidimensional health has not been adequately explored in developing countries. This study examined the association of hearing or/and visual impairment with health-related quality of life (HRQoL) in the Chinese middle-aged and older population, and further explored potential discrepancies in associations by gender and rural-urban residence. METHODS This cohort study used four-wave data during 2011-2018 from the China Health and Retirement Longitudinal Study, and enrolled 13 342 community-dwelling adults aged 45 years or older. We employed linear mixed effects models to estimate the longitudinal associations between SI and HRQoL, and conducted interaction tests to assess gender or rural-urban differences in above associations. RESULTS Hearing impairment (HI) and visual impairment (VI) were separately and jointly associated with deteriorated overall HRQoL and decreased physical/mental component of HRQoL (all β<0, all p<0.05), and in particular, dual sensory impairment (DSI) exhibited greater impacts on HRQoL than either HI or VI alone. The impacts of SI on HRQoL were more evident among women or rural population than their counterparts (all p for interaction<0.05). CONCLUSION This study observed decreased HRQoL in association with SI. The greater impact of DSI underlines the need for integrated care for comorbid sensory conditions. Our findings also indicate the necessity to reduce the burden of SI among more vulnerable populations such as females and rural adults.
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Affiliation(s)
- Yue Ding
- Department of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Yuhan Yan
- Department of Geriatrics, General Hospital of Eastern Theater Command, Nanjing, Jiangsu, China
| | - Yong Tian
- Department of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Wei Du
- Department of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Lijun Fan
- Department of Public Health, Southeast University, Nanjing, Jiangsu, China
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11
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Jia S, Zhao W, Ge M, Xia X, Hu F, Hao Q, Zhang Y, Yang M, Yue J, Dong B. Associations between transitions of intrinsic capacity and frailty status, and 3-year disability. BMC Geriatr 2023; 23:96. [PMID: 36788484 PMCID: PMC9930336 DOI: 10.1186/s12877-023-03795-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The trajectory of frailty and intrinsic capacity (IC) often overlap in older adults. Longitudinal analyses of transitions of frailty and IC, and their associations with incident functional decline are limited. The present study aimed to identify transitions of frailty status and IC, and explore associations between transitions of frailty and IC, and future disability among community-dwelling older adults. METHODS In the West China and Aging Trend Study, 808 participants aged ≥ 60 years completed baseline and three years follow-up (frailty, IC and disability assessments). Physical frailty was measured based on Fried phenotype. IC was evaluated by five domains (cognition, locomotion, sensory, psychological, and vitality). Disability was defined as a need for assistance in any items in activity of daily living (ADL) or the instrumental activity of daily living (IADL). Logistic regressions were performed to examine their relationships. RESULTS Four transitions of IC status (kept well: 27.4%, improved: 8.4%, worsened: 35.4%, and kept poor: 28.8%), and two transitions of frailty status (kept not-frail/improved: 93.2%, kept frail/worsened: 6.8%) were identified. Impaired locomotion and vitality at baseline were significantly associated with kept frail or worsened frail. However, impaired sensory and vitality at baseline not frailty status was significantly associated with transitions of IC. Adjusted for covariates and transitions of frailty, kept poor IC was associated with ADL (OR = 2.26, 95%CI = 1.17,4.34) and IADL disability (OR = 3.74, 95%CI = 1.79, 7.82). CONCLUSIONS Transitions of IC, but not frailty were associated with higher risk of incident disability. Baseline locomotion and vitality impairment were associated with worsened or kept frail. Our findings support the WHO's notion of monitoring and optimizing IC to delay deterioration of IC and preventing frailty and disability. CLINICAL TRIAL NUMBER ChiCTR1800018895.
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Affiliation(s)
- Shuli Jia
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Wanyu Zhao
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Meiling Ge
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Xin Xia
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Fengjuan Hu
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Qiukui Hao
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.25073.330000 0004 1936 8227School of Rehabilitation Science, McMaster University, Hamilton, ON Canada
| | - Yan Zhang
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Mei Yang
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Jirong Yue
- grid.412901.f0000 0004 1770 1022National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China ,grid.412901.f0000 0004 1770 1022Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041 Sichuan China
| | - Birong Dong
- National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China. .,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu, Chengdu, 610041, Sichuan, China.
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12
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Ge S, Pan W, Wu B, Plassman BL, Dong X, McConnell ES. Sensory impairment and cognitive decline among older adults: An analysis of mediation and moderation effects of loneliness. Front Neurosci 2023; 16:1092297. [PMID: 36699540 PMCID: PMC9869267 DOI: 10.3389/fnins.2022.1092297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Background Multiple studies have reported that hearing and vision impairment are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory impairment and cognitive decline. This study examined if loneliness mediates or moderates the impact of sensory impairment on cognitive decline as individuals age. Methods This was a longitudinal study using data from the Health and Retirement Study (HRS) and The Aging, Demographics, and Memory Study (ADAMS) (N = 243). We used one timepoint of hearing and vision (ADAMS 2006-2008), one timepoint of loneliness (HRS 2006-2008), and five waves of cognition (HRS 2006-2014). Hearing impairment was defined by an inability to hear pure-tone stimuli of 25 dB at frequencies between 0.5 and 4.0 kHz in either ear. Visual impairment was defined as having corrected binocular vision worse than 20/40. Longitudinal parallel-process (LPP) analysis was conducted at a significance level of α = 0.05 (one-tailed). Results Loneliness moderated but did not mediate the association between visual impairment and the rate of cognitive decline (standardized β =-0.108, p < 0.05). No moderation or mediation effect of loneliness was found for the association between hearing impairment and cognitive decline. Both vision and hearing impairment were significantly associated with increased severity of loneliness. Conclusion Visual impairment combined with an elevated level of loneliness may produce a more synergistic, deleterious impact on older adults' cognitive function than visual impairment alone. This study highlights the importance of promoting a healthy social and psychological status for older adults with sensory impairment.
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Affiliation(s)
- Shaoqing Ge
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States,Duke University School of Nursing, Durham, NC, United States,*Correspondence: Shaoqing Ge,
| | - Wei Pan
- Duke University School of Nursing, Durham, NC, United States,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, NY, United States
| | - Brenda L. Plassman
- Department of Psychiatry and Neurology, Duke University School of Medicine, Durham, NC, United States
| | - XinQi Dong
- Rutgers University Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ, United States
| | - Eleanor S. McConnell
- Duke University School of Nursing, Durham, NC, United States,Geriatric Research Education and Clinical Center (GRECC), Durham Department of Veterans Affairs (VA) Healthcare System, Durham, NC, United States
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13
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Marino FR, Jiang K, Smith JR, Chen D, Tzuang M, Reed NS, Swenor BK, Deal JA, Rebok GW, Huang A. Inclusion of hearing and vision impairments in cognitive training interventions. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12374. [PMID: 36873925 PMCID: PMC9983145 DOI: 10.1002/trc2.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/05/2023] [Accepted: 01/10/2023] [Indexed: 02/23/2023]
Abstract
Introduction Cognitive training can potentially reduce risk of cognitive decline and dementia in older adults. To support implementation of cognitive training in the broader population of older adults, it is critical to evaluate intervention implementation and efficacy among representative samples, particularly those at highest risk of cognitive decline. Hearing and vision impairments are highly prevalent among older adults and confer increased risk of cognitive decline/dementia. Whether cognitive training interventions enroll and are designed to include this important subgroup is unknown. Methods A scoping review of PubMed and PsycINFO was conducted to examine the inclusion of older adults with hearing and vision impairment in cognitive training interventions. Two independent reviewers completed a full-text review of eligible articles. Eligible articles included cognitive training and multimodal randomized controlled trials and a study population that was cognitively unimpaired, aged ≥55-years, and community dwelling. Articles were primary outcome papers published in English. Results Among the 130 articles included in the review, 103 were cognitive training interventions (79%) and 27 were multimodal interventions (21%). More than half the trials systematically excluded participants with hearing and/or vision impairment (n = 60, 58%). Few studies reported hearing and vision measurement (cognitive: n = 16, 16%; multimodal: n = 3, 11%) or incorporated universal design and accessibility into intervention design (cognitive: n = 7, 7%; multimodal: n = 0, 0%). Discussion Older adults with hearing and vision impairment are underrepresented in cognitive training interventions. Reporting of hearing and vision measurement, proper justification of exclusions, and inclusion of accessibility and universal intervention design are also lacking. These findings raise concerns about whether current trial findings apply to those with hearing and vision impairment and generalize to the broader population of older adults. It is critical to include more diverse study populations and integrate accessibility into intervention design to include and better represent older adults with hearing and vision impairment. Highlights Cognitive training interventions underrepresent hearing and vision impairment.Sensory measurement and proper justification of exclusions are rarely reported.Interventions lack inclusion of accessibility and universal intervention design.More diverse study populations are needed in cognitive training interventions.Integration of accessibility into cognitive training intervention design is needed.
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Affiliation(s)
- Francesca R. Marino
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Kening Jiang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Jason R. Smith
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Diefei Chen
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Marian Tzuang
- Department of Community Health SystemsSchool of NursingUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Nicholas S. Reed
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Bonnielin K. Swenor
- The Wilmer Eye InstituteJohns Hopkins UniversityBaltimoreMarylandUSA
- Johns Hopkins Disability Health Research CenterJohns Hopkins UniversityBaltimoreMarylandUSA
- Johns Hopkins School of NursingBaltimoreMarylandUSA
| | - Jennifer A. Deal
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - George W. Rebok
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Alison Huang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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Cognitive and behavioral effects of hearing loss. Curr Opin Otolaryngol Head Neck Surg 2022; 30:339-343. [PMID: 36004783 DOI: 10.1097/moo.0000000000000825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Hearing loss is one of the largest modifiable risk factors for developing dementia, accounting for up to 9% of the overall modifiable risk. The neuropsychologic and psychosocial impacts of hearing loss are becoming increasingly appreciated. The objective of this review is to explore the recent literature regarding the cognitive and behavioral effects of hearing loss and the role of hearing rehabilitation, particularly in older adults. RECENT FINDINGS Cognitive decline may begin while patients have subclinical hearing loss, earlier than previously thought. Hearing rehabilitation, either via hearing amplification, middle ear surgery, or cochlear implantation, likely plays a role in preventing or slowing the rate of cognitive decline in patients with hearing loss. Hearing loss can increase the likelihood of social isolation, loneliness and depression in older adults, but it is unclear at this time what effect hearing rehabilitation has on these domains. SUMMARY Hearing loss is one of the largest modifiable risk factors for cognitive decline, and hearing rehabilitation can play a significant role in preserving cognitive function. Understanding the cognitive and psychosocial impact of hearing loss can help facilitate the development of approaches for prevention and treatment.
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15
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Wan H, Zhang Y, Hua Q. Cellular autophagy, the compelling roles in hearing function and dysfunction. Front Cell Neurosci 2022; 16:966202. [PMID: 36246522 PMCID: PMC9561951 DOI: 10.3389/fncel.2022.966202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 09/14/2022] [Indexed: 11/21/2022] Open
Abstract
Sensorineural hearing loss (SNHL) is currently a major health issue. As one of the most common neurodegenerative diseases, SNHL is associated with the degradation of hair cells (HCs), spiral ganglion neurons (SGNs), the stria vascularis, supporting cells and central auditory system cells. Autophagy is a highly integrated cellular system that eliminates impaired components and replenishes energy to benefit cellular homeostasis. Etiological links between autophagy alterations and neurodegenerative diseases, such as SNHL, have been established. The hearing pathway is complex and depends on the comprehensive functions of many types of tissues and cells in auditory system. In this review, we discuss the roles of autophagy in promoting and inhibiting hearing, paying particular attention to specific cells in the auditory system, as discerned through research. Hence, our review provides enlightening ideas for the role of autophagy in hearing development and impairment.
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Affiliation(s)
- Huanzhi Wan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuanyuan Zhang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- *Correspondence: Yuanyuan Zhang,
| | - Qingquan Hua
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
- Qingquan Hua,
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Ge S, Wu KC, Frey H, Saudagaran M, Welsh D, Primomo J, Belza B. Engaging With Aging: A Qualitative Study of Age-Related Changes and Adaptations. Innov Aging 2022; 6:igac054. [DOI: 10.1093/geroni/igac054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background and Objectives
In the context of global aging, there is a need to better understand how older adults adapt to their changing health status. Engaging with aging (EWA) is an emerging framework proposed by Carnevali, which provides a new lens to understand an active, conscious daily-living process of managing age-related changes (ARCs) taken on by older adults. Study aims were to (a) describe the ARCs experienced by community-dwelling older adults and (b) identify the strategies and resources used by older adults to accommodate the daily-living challenges caused by the associated ARCs.
Research Design and Methods
We conducted semistructured interviews using a virtual card sort to gather qualitative data about ARCs and strategies to manage ARCs. Interviews were conducted virtually due to coronavirus disease 2019 (COVID-19) restrictions.
Results
Participants included 19 females and 10 males. The mean age was 77.45 years old (range from 64 to 98). Sixteen ARCs (e.g., changes in hearing, changes in stability, changes in sleep, etc.) were mentioned by participants, and their corresponding adaptations were discussed. Participants linked their adaptations to their ARCs based on their changing capacities and needs. Examples of commonly used adaptations included, for example, conserving energy, utilizing tools or technology, and being more conscious before and while taking actions. The challenges caused by COVID-19 in implementing the adaptations were also discussed.
Discussion and Implications
Findings from this study demonstrate how older adults explore, generate, and utilize adaptive behaviors to address their ARCS. This study substantiates the EWA framework by showing common patterns among older adults in linking ARCs with adaptations. Implications for clinicians include using EWA to help older adults identify personalized health solutions that fit their capacities. Researchers may use EWA to design and test interventions by considering the specific ARCs older adults encounter and the attitudes they hold towards the ARCs.
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Affiliation(s)
- Shaoqing Ge
- School of Nursing Department of Biobehavioral Nursing and Health Informatics, University of Washington , Seattle, WA , USA
| | - Kuan-Ching Wu
- School of Nursing Department of Biobehavioral Nursing and Health Informatics, University of Washington , Seattle, WA , USA
| | - Hillary Frey
- University of Washington Medical Center—Northwest , Seattle, Washington , USA
| | - Maryam Saudagaran
- School of Nursing Department of Biobehavioral Nursing and Health Informatics, University of Washington , Seattle, WA , USA
| | - Derick Welsh
- Providence Regional Medical Center Everett , Everett, Washington , USA
| | - Janet Primomo
- School of Nursing and Healthcare Leadership, University of Washington Tacoma , Tacoma, Washington , USA
| | - Basia Belza
- School of Nursing Department of Biobehavioral Nursing and Health Informatics, University of Washington , Seattle, WA , USA
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Brain structural alterations and clinical features of cognitive frailty in Japanese community-dwelling older adults: the Arao study (JPSC-AD). Sci Rep 2022; 12:8202. [PMID: 35581389 PMCID: PMC9114363 DOI: 10.1038/s41598-022-12195-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 05/04/2022] [Indexed: 11/08/2022] Open
Abstract
Cognitive frailty (CF) is a clinical condition defined by the presence of both mild cognitive impairment (MCI) and physical frailty (PF). Elderly with CF are at greater risk of dementia than those with MCI or PF alone, but there are few known clinical or neuroimaging features to reliably distinguish CF from PF or MCI. We therefore conducted a population-based cross-sectional study of community elderly combining physical, cognitive, neuropsychiatric, and multisequence magnetic resonance imaging (MRI) evaluations. The MRI evaluation parameters included white matter (WM) lesion volumes, perivascular and deep subcortical WM lesion grades, lacunar infarct prevalence, microbleed number, and regional medial temporal lobe (MTL) volumes. Participants were divided into 4 groups according to the presence or absence of MCI and PF-(1) no MCI, PF (n = 27); (2) no PF, MCI (n = 119); (3) CF (MCI + PF) (n = 21), (4) normal controls (n = 716). Unique features of CF included shorter one-leg standing time; severe depressive symptoms; and MRI signs of significantly more WM lesions, lacunar infarcts, small-vessel disease lesions, microbleeds, and reduced MTL volumes. These unique deficits suggest that interventions for CF prevention and treatment should focus on motor skills, depressive symptoms, and vascular disease risk factor control.
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Feldman A, Patou F, Baumann M, Stockmarr A, Waldemar G, Maier AM, Vogel A. Listen Carefully protocol: an exploratory case-control study of the association between listening effort and cognitive function. BMJ Open 2022; 12:e051109. [PMID: 35264340 PMCID: PMC8915370 DOI: 10.1136/bmjopen-2021-051109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI). METHODS AND ANALYSIS 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials. ETHICS AND DISSEMINATION Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.
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Affiliation(s)
- Alix Feldman
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - François Patou
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Research and Technology Group, Oticon Medical, Smørum, Denmark
| | - Monika Baumann
- Centre for Applied Audiology Research, Oticon, Smørum, Denmark
| | - Anders Stockmarr
- Statistics and Data Analysis, Department of Mathematics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja M Maier
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Department of Design, Manufacturing and Engineering Management, Faculty of Engineering, University of Strathclyde, Glasgow, UK
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Guan L, Liu Q, Chen D, Chen C, Wang Z. Hearing loss, depression, and medical service utilization among older adults: evidence from China. Public Health 2022; 205:122-129. [PMID: 35278783 DOI: 10.1016/j.puhe.2022.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/05/2021] [Accepted: 01/21/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To acquire a better understanding of the mechanisms underlying the association between hearing loss and medical service utilization, this study examined the relationship between hearing loss, depression, and medical service utilization. STUDY DESIGN Using the methods of probability proportional to size, a survey conducted in 28 provinces, 150 countries/districts, 450 villages/urban communities, 11,628 households, and 19,816 individuals of China in 2018. METHODS The data for this article were derived from the 2018 China Health and Retirement Longitudinal Study, which enrolled 14,455 people aged 50-80 years. Hearing loss was determined using self-reported hearing status. Self-reported outpatient visits in the last month and hospitalization within the last year were used to determine medical service utilization. Depression was obtained from the CES-D-10 scale. Logistic regression and stepwise regression methods were used. RESULTS Older adults with hearing loss problems used significantly more outpatient care services (odds ratio [OR] = 1.292, 95% confidence interval [CI] 1.152, 1.449; P < 0.001) and inpatient care services (OR = 1.238, 95% CI 1.021, 1.501; P < 0.05) than those without hearing loss problems. Following that, individuals with hearing loss problems were more likely to experience depressive symptoms (OR = 1.467, 95% CI 1.345, 1.599; P < 0.001) than those without. Moreover, respondents with depressive symptoms used outpatient care services at a significantly higher rate (OR = 1.292, 95% CI 1.152, 1.449; P < 0.001) and inpatient care service at a significantly higher rate (OR = 1.238, 95% CI 1.021, 1.501; P < 0.05) compared with those without depressive symptom. CONCLUSION This article discovered that depression acted as a mediation variable in the relationship between hearing loss and medical service utilization. This research provided possible interventions for reducing the burden of the healthcare system and society that older adults with hearing loss imposed.
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Affiliation(s)
- Liding Guan
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Qing Liu
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Deshan Chen
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Chen Chen
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
| | - Zengwen Wang
- The Center for Social Security Studies of Wuhan University, Wuhan, 430072, China.
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20
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Prell T, Wassermann A, Zipprich HM, Finn S, Axer H. Impact of Common Dizziness Associated Symptoms on Dizziness Handicap in Older Adults. Front Neurol 2022; 12:801499. [PMID: 34975741 PMCID: PMC8718649 DOI: 10.3389/fneur.2021.801499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background: A cross-sectional observational study was designed to determine the impact of dizziness associated symptoms on the dizziness handicap inventory (DHI) in older adults (≥60 years). Methods: In total, 785 individuals referred to a multidisciplinary dizziness unit were assessed. Participants completed self-report questionnaires with general questions about symptoms of dizziness as well as the DHI. The DHI subscores (physical, functional, emotional) were calculated. Medical diagnoses were collected from the medical records of the patients. One-way MANOVA and networking analysis were used to analyze the impact of dizziness associated symptoms on dizziness handicap. Results: Most patients reported swaying dizziness (60.6%) and feeling of unsteadiness (59.8%) with substantial overlap between the types of dizziness. Most frequent dizziness associated symptoms were ear noise/tinnitus, visual problems, and nausea/vomiting. Network analysis revealed that visual disturbances, headache, and hearing impairment were associated with higher DHI and explained 12% of the DHI variance in the linear regression. In the one-way MANOVA visual problems and headache had an effect on all three DHI subscores, while hearing impairment was associated with the functional and emotional subscores of DHI. Conclusion: Distinct dizziness associated symptoms have substantial impact on dizziness handicap in older adults. A multifactorial assessment including these symptoms may assist in tailoring therapies to alleviate dizziness handicap in this group.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Alexander Wassermann
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hannah M Zipprich
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany.,Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Sigrid Finn
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hubertus Axer
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
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21
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Yuan J, Sang S, Pham J, Kong WJ. Gender Modifies the Association of Cognition With Age-Related Hearing Impairment in the Health and Retirement Study. Front Public Health 2021; 9:751828. [PMID: 34976918 PMCID: PMC8718684 DOI: 10.3389/fpubh.2021.751828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Despite growing recognition of hearing loss as a risk factor for late life cognitive disorders, sex and gender analysis of this association has been limited. Elucidating this is one means to advocate for holistic medicine by considering the psychosocial attributes of people. With a composite Gender Score (GS), we aimed to assess this among aging participants (50+) from the 2016 Health and Retirement Study (HRS) cohort. Methods: The GS was derived from gender-related variables in HRS by factor analyses and logistic regression, ranging from 0 (toward masculinity) to 100 (toward femininity). GS tertiles were also used to indicate three gender types (GS tertile 1: lower GS indicates masculinity; GS tertile 2: middle GS indicates androgyny; GS tertile 3: higher GS indicates femininity). Univariate followed by multiple logistic regressions were used to estimate the Odds Ratio (OR) and 95% confidence intervals (CI) of cognitive impairment (assessed by adapted Telephone Interview for Cognitive Status) from hearing acuity, as well as to explore the interactions of sex and gender with hearing acuity. The risk of cognitive impairment among hearing-impaired participants was assessed using multivariable models including sex and gender as exposure variables. Results: Five variables (taking risks, loneliness, housework, drinking, and depression) were retained to compute the GS for each participant. The distribution of GS between sexes partly overlapped. After adjusting for confounding factors, the OR for cognitive impairment associated with hearing impairment was significantly higher (OR = 1.65, 95% CI: 1.26, 2.15), and this association was not modified by female sex (OR = 0.77, 95% CI: 0.46, 1.27), but by androgynous gender (OR = 0.44, 95% CI: 0.24, 0.81). In the multivariable models for participants with hearing impairment, androgynous and feminine gender, as opposed to female sex, was associated with lower odds of cognitive impairment (OR of GS tertile 2 = 0.59, 95% CI: 0.41, 0.84; OR of GS tertile 3 = 0.60, 95% CI: 0.41, 0.87; OR of female sex = 0.78, 95% CI: 0.57, 1.08). Conclusions: Hearing impairment was associated with cognitive impairment among older people, and this association may be attenuated by a more feminine GS.
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Affiliation(s)
- Jing Yuan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuping Sang
- School of Medicine, Yunnan University, Kunming, China
| | - Jessica Pham
- School of Medicine, Case Western Reserve University, Cleveland, OH, United States
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Wei-Jia Kong
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22
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Grant A, Aubin MJ, Buhrmann R, Kergoat MJ, Li G, Freeman EE. Visual Impairment, Eye Disease, and 3-Year Cognitive Decline: The Canadian Longitudinal Study on Aging. Ophthalmic Epidemiol 2021; 29:545-553. [PMID: 34486480 DOI: 10.1080/09286586.2021.1974494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine the longitudinal association between vision-related variables and the 3-year change in cognitive test scores in a community-dwelling sample of adults and to explore whether sex, education, or hearing loss act as effect modifiers. METHODS Data came from two waves of a 3-year population-based prospective cohort study (Canadian Longitudinal Study on Aging), which consisted of 30,097 randomly selected people aged 45-85 years from 7 Canadian provinces. Visual impairment (VI) was defined as binocular presenting visual acuity worse than 20/40. Participants were asked if they had ever had a diagnosis of age-related macular degeneration (AMD), glaucoma, or cataract. Cognitive change over 3 years was examined by calculating the difference between baseline and follow-up scores for the Rey Auditory Verbal Learning Test (RAVLT) and the RAVLT delayed test (memory tests), the Controlled Oral Word Association Test (COWAT) and the Animal Naming Test (ANT) (verbal fluency tests), and the Mental Alternation Test (MAT) (processing speed test). Multiple linear regression was used. RESULTS VI, AMD, and cataract were not associated with 3-year changes on any of the 5 cognitive tests after adjusting for age, sex, ethnicity, education, income, smoking, diabetes, stroke, heart disease, and province. A report of glaucoma was associated with greater declines in MAT scores (β = -0.60, 95% CI -1.03, -0.18). No effect modification was detected. CONCLUSIONS Glaucoma was associated with worsening processing speed. Further research to confirm this finding and to understand the possible reason is necessary.
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Affiliation(s)
- Alyssa Grant
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Marie-Josée Aubin
- Department of Ophthalmology, Université de Montréal, Montreal, Canada.,Centre Universitaire d'ophtalmologie de l'Hôpital Maisonneuve-Rosemont, Montreal, Canada.,Department of Social and Preventive Medicine, Espum, Université de Montréal, Montréal, Canada
| | - Ralf Buhrmann
- Department of Ophthalmology, University of Ottawa, Ottawa, Canada
| | - Marie-Jeanne Kergoat
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Canada.,Department of Medicine, Université de Montréal, Canada
| | - Gisele Li
- Department of Ophthalmology, Université de Montréal, Montreal, Canada.,Centre Universitaire d'ophtalmologie de l'Hôpital Maisonneuve-Rosemont, Montreal, Canada
| | - Ellen E Freeman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Ottawa Hospital Research Institute, Ottawa, Canada
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