Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study

Abstract

ObjectiveTo assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years.MethodsThe cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function.SettingA rural and urban area in Bashkortostan, Russia.ParticipantsOut of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated.Primary and secondary outcome measuresPrevalence of vision, hearing and DSI and cognitive dysfunction.ResultsThe study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85–98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001).ConclusionsIn this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.

Sensorineural hearing loss and cognitive impairment: three hypotheses

“…RNA sequencing analysis has revealed that ARHL shares a common causative gene with Alzheimer’s disease (AD; Xue et al, 2021 ). Numerous experimental studies have identified multiple mechanisms by which SNHL can lead to CI ( Loughrey et al, 2018 ; Choi et al, 2021 ; Bikbov et al, 2022 ). In response to these findings, researchers have proposed three hypotheses on how SNHL brings about CI: the cognitive load (CL) hypothesis, the co-morbidity hypothesis, and the sensory deprivation hypothesis ( Slade et al, 2020 ; Figure 1 ).…”

The interaction between instrumental activities of daily living and dual sensory function on cognition among the elderly in China: A cross‐sectional survey

“…Sensory function decline is also caused by aging, in which vision and hearing especially affect the daily life of the elderly. Studies 13–15 have shown that visual and hearing difficulties in seniors can negatively influence their cognitive function. The elderly with visual difficulty would have problems with seeing objects, which further affects their perception and understanding of the surrounding environment 16 .…”

“…In addition, visual and hearing difficulties of the elderly may affect their mental health, leading to problems such as loneliness and depression, which further affect their cognitive function. It has been examined that difficulty in dual sensory (vision and hearing) has greater negative effects on their cognitive function 13–15,17 …”

“…It has been examined that difficulty in dual sensory (vision and hearing) has greater negative effects on their cognitive function. [13][14][15]17 To our knowledge, there was no research that has included IADLs, dual sensory difficulty, and cognitive function into one model to explore the correlation and further interaction. On this basis, this study focused on the analysis of the relationship between IADLs, dual sensory, and cognition of the elderly, and further explored whether they have interactive effects on cognition.…”

“…It has been examined that difficulty in dual sensory (vision and hearing) has greater negative effects on their cognitive function. 13 , 14 , 15 , 17 …”