Association between sensory impairment and cognitive frailty among older people: Evidence from four nationwide cohort studies

IF 4 3区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Nutrition Health & Aging Pub Date : 2025-05-28 DOI:10.1016/j.jnha.2025.100590

Xiaoming Zhang , Rui Zeng , Aizhang Zhu , Fayi Xie , Dongmei Ye , Lihuan Chen , Yi Xiao , Ke Zhu , Tenghui Fan , Wan Zhu , Zhigang Wu , Mengxia Shi , Yuxu Huang , Jiahui Bian , Shixuan Wang , Ziyun Lv , Ruzhao Chen , Yufei Zeng , Jiang Wang , Qingli Dou , Wenwu Zhang

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Abstract

Background

Sensory impairment, including hearing and vision impairment, are prevalent in older adults and may significantly contribute to cognitive frailty. However, the longitudinal association between sensory impairment and cognitive frailty has not been fully explored. The aim of our study was to examine such associations in four nationally representative cohorts to inform strategies for preventing cognitive frailty and promoting healthy aging.

Methods

Data were pooled from four large, longitudinal cohorts: the Health and Retirement Study (HRS), the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the Survey of Health, Ageing and Retirement in Europe (SHARE), and the English Longitudinal Study of Ageing (ELSA). The analysis included 37,076 older adults from these cohorts, with comparable measures of sensory impairment and cognitive frailty across studies. Sensory impairments were assessed via self-reported hearing impairment and vision impairment. The outcome was the incidence of cognitive frailty, assessed using self-reported cognitive function and frailty indicators. Cox regression models were used to evaluate the association between hearing impairments, vision impairments and dual sensory impairment with cognitive frailty risk, adjusting for potential confounders.

Results

The cohort had a mean (SD) age of 74.60 (6.61) years for HRS (41.41% male), 81.87 (10.50) years for CLHLS (48.10% male), 72.99 (6.12) years for SHARE (44.27% male), and 73.03 (6.22) years for ELSA (46.59%% male). The prevalence of cognitive frailty was 10.58% for HRS, 6.26% for CLHLS, 12.16% for SHARE, and 5.81% for ELSA. The prevalence of dual sensory impairment was 8.05% for HRS, 3.06% for CLHLS, 10.94% for SHARE, and 4.06% for ELSA. Cox regression revealed a significant synergistic effect between hearing impairment and vision impairment on cognitive frailty risk. Compared to no sensory impairments individuals, those with hearing impairments or vision impairments had a higher risk of cognitive frailty across all cohorts, with individuals with dual sensory impairment exhibiting the highest risk: HRS (Hazard Ratio [HR] = 2.10, 95% CI, 1.71–2.56), CLHLS (HR = 2.08, 95% CI, 1.37–3.15), SHARE (HR = 1.52, 95% CI, 1.35–1.71), and ELSA (HR = 2.77, 95% CI, 1.78–4.31).

Conclusions

This study identifies an association between combined hearing and vision impairments and an increased risk of cognitive frailty. These findings suggest that assessing sensory impairments, particularly dual sensory impairment, in older adults may help identify individuals at higher risk of cognitive frailty. Further research, including longitudinal studies and randomized controlled trials, is needed to explore the potential benefits of early sensory interventions for supporting healthy aging.

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老年人感觉障碍和认知衰弱之间的关系：来自四项全国性队列研究的证据

背景：感觉障碍，包括听力和视力障碍，在老年人中普遍存在，并可能显著导致认知衰弱。然而，感觉障碍和认知脆弱之间的纵向联系尚未得到充分的探讨。我们研究的目的是在四个具有全国代表性的队列中检查这种关联，以提供预防认知衰弱和促进健康老龄化的策略。方法数据来自四个大型纵向队列：健康与退休研究（HRS）、中国纵向健康寿命调查（CLHLS）、欧洲健康、老龄化和退休调查（SHARE）和英国老龄化纵向研究（ELSA）。该分析包括来自这些队列的37,076名老年人，在不同的研究中具有可比较的感觉障碍和认知脆弱的测量。感觉障碍通过自我报告的听力障碍和视力障碍进行评估。结果是认知衰弱的发生率，使用自我报告的认知功能和衰弱指标进行评估。采用Cox回归模型评估听力障碍、视力障碍和双重感觉障碍与认知衰弱风险之间的关系，并对潜在混杂因素进行调整。结果HRS组（41.41%男性）、CLHLS组（48.10%男性）、SHARE组（44.27%男性）、ELSA组（46.59%男性）的平均SD年龄分别为74.60（6.61）岁、81.87（10.50）岁、72.99（6.12）岁和73.03（6.22）岁。HRS的认知衰弱患病率为10.58%，CLHLS为6.26%，SHARE为12.16%，ELSA为5.81%。双感觉障碍的患病率HRS为8.05%，CLHLS为3.06%，SHARE为10.94%，ELSA为4.06%。Cox回归分析显示，听力障碍和视力障碍对认知衰弱风险有显著的协同作用。与没有感觉障碍的个体相比，听力障碍或视力障碍的个体在所有队列中都有更高的认知衰弱风险，双重感觉障碍的个体表现出最高的风险：HRS（风险比[HR] = 2.10, 95% CI, 1.71-2.56）， CLHLS（风险比[HR] = 2.08, 95% CI, 1.37-3.15）， SHARE（风险比[HR] = 1.52, 95% CI, 1.35-1.71）和ELSA（风险比= 2.77,95% CI, 1.78-4.31）。结论：本研究确定了听觉和视觉障碍与认知衰弱风险增加之间的联系。这些发现表明，评估老年人的感觉障碍，特别是双重感觉障碍，可能有助于识别认知衰弱风险较高的个体。需要进一步的研究，包括纵向研究和随机对照试验，来探索早期感官干预对支持健康老龄化的潜在益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Nutrition Health & Aging 医学-老年医学

CiteScore

7.80

自引率

3.40%

发文量

136

审稿时长

4-8 weeks

期刊介绍： There is increasing scientific and clinical interest in the interactions of nutrition and health as part of the aging process. This interest is due to the important role that nutrition plays throughout the life span. This role affects the growth and development of the body during childhood, affects the risk of acute and chronic diseases, the maintenance of physiological processes and the biological process of aging. A major aim of "The Journal of Nutrition, Health & Aging" is to contribute to the improvement of knowledge regarding the relationships between nutrition and the aging process from birth to old age.