痴呆症患者的听力损失、助听器使用和神经精神症状：来自NACC的发现

IF 3.8 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry Pub Date : 2025-08-05 DOI:10.1016/j.jagp.2025.07.007

Ahjeetha Shankar B.S. , Emmanuel E. Garcia Morales Ph.D. , Jeannie-Marie Leoutsakos Ph.D., M.H.S. , Valerie T. Cotter Dr.N.P., C.R.N.P. , Milap A. Nowrangi M.D. , Sevil Yasar M.D., Ph.D. , Constantine G. Lyketsos M.D., M.H.S. , Esther S. Oh M.D., Ph.D. , Carrie L. Nieman M.D., M.P.H.

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引用次数: 0

摘要

目的：听力损失是老年痴呆症患者的常见合并症，影响了90%的患者。感觉障碍与神经精神症状（NPS）的风险增加有关，而助听器的使用可能具有保护作用。方法我们分析了来自国家阿尔茨海默病协调中心统一数据集的横截面数据。我们在负二项回归中估计了功能性听力损失与NPS数量或严重程度之间的关联，并根据人口统计学和临床特征进行了稳健方差调整。在听力损失的子样本中，我们估计了助听器使用与NPS数量或严重程度之间的关系。使用基于被调查者人口学特征的最近邻匹配（NNM）来解决助听器使用的选择偏差。结果10054名参与者入组，平均年龄75岁（SD 8）。2416例（24%）自报功能性听力损失，平均NPS总数3.4例（标准差[SD] 2.5），平均NPS严重程度5.1例（SD 4.9）。在完全调整的模型中，听力损失与更多的NPS无关(预测患病率差异（PPD）：0.09；95%置信区间（CI）：-0.06,0.25)或更严重（PPD = 0.25; 95% CI:-0.06,0.56） NPS。在报告听力损失的PLWD中，1325人（54.8%）报告使用助听器。经过良好的平衡匹配后，在调整后的模型中，助听器的使用与较低的NPS （PPD:-0.71; 95% CI:-0.93,-0.50）和较轻的NPS （PPD:-1.79; 95% CI:-2.23,-1.34）相关。结论使用助听器可能是一种未充分利用的非药物干预措施。这些发现表明，听力保健可能是一种有前途的非药物治疗NPS的策略。

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Hearing Loss, Hearing Aid Use, and Neuropsychiatric Symptoms Among Persons Living With Dementia: Findings From NACC

Objective

Hearing loss is a common comorbidity among persons living with dementia (PLWD), affecting >90% of individuals. Sensory impairments have been associated with an increased risk of neuropsychiatric symptoms (NPS), while hearing aid use may be protective.

Method

We analyzed cross sectional data from the National Alzheimer’s Coordinating Center’s Uniform Data Set. We estimated the association between functional hearing loss and number or severity of NPS in a negative binomial regression with robust variance adjusting for demographic and clinical characteristics. In the subsample with hearing loss, we estimated the association between hearing aid use and number or severity of NPS. Selection bias for hearing aid use was addressed using nearest neighbor matching (NNM) based on respondent demographic characteristics.

Result

10,054 participants were included with a mean age of 75 (SD 8) years. 2,416 (24%) self-reported functional hearing loss with 3.4 (standard deviation [SD] 2.5) mean total number of NPS and mean NPS severity of 5.1 (SD 4.9). In fully adjusted models, hearing loss was not associated with more NPS (predicted prevalence difference (PPD):0.09; 95% confidence interval (CI):-0.06,0.25) or more severe (PPD = 0.25; 95% CI:-0.06,0.56) NPS. In PLWD reporting hearing loss, 1,325 (54.8%) reported hearing aid use. After well-balanced matching, in adjusted models, hearing aid use was associated with fewer (PPD:-0.71; 95% CI:-0.93,-0.50) and less severe NPS (PPD:-1.79; 95% CI:-2.23,-1.34).

Conclusion

Hearing aid use may represent an underutilized, nonpharmacological intervention to address NPS. These findings suggest that hearing care may represent a promising nonpharmacological strategy to explore in managing NPS.

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来源期刊

American Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

13.00

自引率

4.20%

发文量

381

审稿时长

26 days

期刊介绍： The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.