Background

Previous studies identifying hearing loss as a promising modifiable risk factor for cognitive decline mostly adjusted for baseline age solely. As such a faster cognitive decline at a higher age, which is expected considering the non-linear relationship between cognition and age, may have been overlooked. Therefore it remains uncertain whether effects of hearing loss on cognitive decline extend beyond age-related declines of cognitive function.

Methods

3,590 non-demented participants were eligible for analysis at baseline, and a maximum of 837 participants were eligible for the longitudinal analysis. Hearing loss was defined at baseline. Cognitive function was measured at baseline and at follow-up (4.4 years [SD: 0.2]). Multivariable linear regression analysis was used for the cross-sectional analysis. Linear mixed models were used to assess the longitudinal association between hearing loss and cognitive decline over time while adjusting for confounders and the interaction of age and follow-up time.

Results

Hearing loss was associated with lower cognitive function at baseline. Moreover, hearing loss was associated with accelerated cognitive decline over time on a memory test. After additionally adjusting for the interaction between age and follow-up time, we found that hearing loss did not accelerate cognitive decline anymore.

Conclusions

Hearing loss was associated with lower cognitive function at baseline and accelerated cognitive decline on a memory test. The association between hearing loss and accelerated cognitive decline was non-significant after additional adjustment for non-linear age effects. More evidence is needed to ensure the role of hearing loss as a modifiable risk factor for cognitive decline.

中文翻译：

---

普通人群的听力丧失和认知能力下降：一项前瞻性队列研究。

背景

先前的研究将听力损失确定为认知能力下降的有前途的可修正危险因素，但大多仅根据基线年龄进行了调整。因此，考虑到认知与年龄之间的非线性关系，预期在较高年龄的较快认知衰退可能已被忽略。因此，尚不确定听力损失对认知能力下降的影响是否会超出年龄相关的认知功能下降。

方法

3,590名非痴呆型参与者符合基线分析的条件，最多837名参与者符合纵向分析的条件。听力损失是在基线时定义的。在基线和随访时（4.4年[SD：0.2]）测量认知功能。多变量线性回归分析用于横截面分析。线性混合模型用于评估随着时间的推移听力损失和认知能力下降之间的纵向关联，同时调整混杂因素以及年龄和随访时间之间的相互作用。

结果

听力下降与基线时认知功能下降有关。此外，在记忆力测试中，听力下降与随着时间的推移认知加速下降有关。在对年龄和随访时间之间的相互作用进行了额外的调整之后，我们发现听力下降不再能够加速认知功能下降。

结论

听力下降与基线时的认知功能低下和记忆力测试中加速的认知能力下降有关。进一步调整非线性年龄效应后，听力损失与认知加速衰退之间的关联不显着。需要更多的证据来确保听力下降作为认知功能下降的可改变危险因素的作用。