Initiation of Hearing Aids Use and Incident Dementia Among Mid-to-late Life Adults: The Health and Retirement Study 2010-2018.

IF 2.9 4区 医学 Q2 CLINICAL NEUROLOGY
Jingkai Wei, Kun Li, Youngran Kim, Rahul Ghosal, Donglan Zhang, Anwar T Merchant, Casey Crump
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Abstract

Background and objectives: Hearing aids may reduce the risk of dementia among individuals with hearing loss. However, no evidence is available from randomized controlled trials (RCTs) on the effectiveness of hearing aids use in reducing incident dementia. Using target trial emulation, we leveraged an existing longitudinal cohort study to estimate the association between hearing aids initiation and risk of dementia.

Research design and methods: The Health and Retirement Study was used to emulate target trials among non-institutionalized participants aged ≥50 years with self-reported hearing loss, without dementia at baseline, and without use of hearing aids in the previous 2 years. Intention-to-treat analysis was conducted to estimate the risk of dementia associated with hearing aids initiation vs controls who did not initiate hearing aids. Pooled logistic regression models with inverse-probability of treatment and censoring weights were applied to estimate risk ratios, and 95% confidence intervals were calculated using 1000 sets of bootstrapping.

Results: Among 2314 participants (328 in the intervention group and 1986 in the control group; average age: 72.3 ± 9.7 years, 49% women, and 81% White), after 8 years of follow-up, risk of dementia was significantly lower among individuals who initiated hearing aids (risk difference (RD): -0.05, 95% confidence interval (CI): -0.08, -0.01). A lower risk was observed particularly among adults aged 50-74 years, men, and individuals with cardiovascular disease.

Discussion and implications: Hearing aids use was associated with a significant reduction of incident dementia. Future interventional studies are needed to further assess the effectiveness of hearing aids in preventing dementia.

中晚年成年人开始使用助听器与痴呆症的发生:2010-2018年健康与退休研究》。
背景和目的:助听器可降低听力损失患者患痴呆症的风险。然而,目前还没有随机对照试验(RCT)的证据表明使用助听器对减少痴呆症的发生具有效果。通过目标试验仿真,我们利用现有的纵向队列研究来估计助听器的使用与痴呆症风险之间的关系:研究设计与方法:我们利用健康与退休研究(Health and Retirement Study)对年龄≥50 岁、自述有听力损失、基线时未患痴呆症且在过去两年中未使用助听器的非住院参与者进行了目标试验模拟。我们进行了意向治疗分析,以估算开始使用助听器与未开始使用助听器的对照组相比患痴呆症的风险。采用带有反向治疗概率和删减权重的汇总逻辑回归模型来估算风险比,并使用1000组引导法计算95%置信区间:在2314名参与者中(干预组328人,对照组1986人;平均年龄:72.3 ± 9.7岁,49%为女性,81%为白人),经过8年的随访,开始使用助听器的人患痴呆症的风险显著降低(风险差异(RD):-0.05,95%置信区间(CI):-0.08,-0.01)。特别是在 50-74 岁的成年人、男性和患有心血管疾病的人中观察到了较低的风险:助听器的使用与痴呆症发病率的显著降低有关。未来需要进行干预性研究,以进一步评估助听器在预防痴呆症方面的效果。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
40
审稿时长
>12 weeks
期刊介绍: Journal of Geriatric Psychiatry and Neurology (JGP) brings together original research, clinical reviews, and timely case reports on neuropsychiatric care of aging patients, including age-related biologic, neurologic, and psychiatric illnesses; psychosocial problems; forensic issues; and family care. The journal offers the latest peer-reviewed information on cognitive, mood, anxiety, addictive, and sleep disorders in older patients, as well as tested diagnostic tools and therapies.
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