A comprehensive evaluation on the associations between hearing and vision impairments and risk of all-cause and cause-specific dementia: results from cohort study, meta-analysis and Mendelian randomization study.

IF 7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL BMC Medicine Pub Date : 2024-11-07 DOI:10.1186/s12916-024-03748-7
Fan Jiang, Qiuyue Dong, Sijia Wu, Xinhui Liu, Alimu Dayimu, Yingying Liu, Hanbing Ji, Le Wang, Tiemei Liu, Na Li, Xiaofei Li, Peipei Fu, Qi Jing, Chengchao Zhou, Hongkai Li, Lei Xu, Shanquan Chen, Haibo Wang
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Abstract

Background: Epidemiological studies show inconsistent links between hearing/vision impairment and dementia risk. Using multisource data, we investigated how single or combined sensory impairments relate to risks of all-cause and specific types of dementia.

Methods: We employed a triangulation approach combining three methodologies. We analyzed 90,893 UK Biobank (UKB) adults to explore single and joint effects of hearing and vision impairments on all-cause and Alzheimer's disease (AD), vascular dementia (VD) and non-AD non-VD (NAVD). A meta-analysis of prospective studies involving 937,908 participants provided stronger evidence. Finally, we conducted Mendelian randomization (MR) analysis using genome-wide association studies from UKB (361,194 participants) and FinnGen (412,181 participants) to validate relationships between sensory impairments and dementia occurrence.

Results: In the UKB cohort study, compared to participants with normal hearing, those in the mild and severe hearing impairment groups had progressively and significantly higher risk of all-cause dementia (mild: HR1.52, 95%CI 1.31-1.77; severe: HR1.80, 95%CI 1.36-2.38), AD (mild: HR1.63, 95%CI 1.30-2.04; severe: HR2.18, 95%CI 1.45-3.27), VD (mild: HR1.68, 95%CI 1.19-2.37; severe: HR1.47, 95%CI 1.22-1.78), and NAVD (mild: HR1.47, 95%CI 1.22-1.78; severe: HR1.98, 95%CI 1.43-2.75). Besides, vision impairment was associated with an increased risk of all-cause dementia (HR1.55, 95%CI 1.18-2.04) and NAVD (HR1.51, 95%CI 1.07-2.13). Furthermore, dual sensory impairment was associated with stepwise increased risks of all-cause and cause-specific dementia than single hearing or vision impairment. In the meta-analysis of 31 prospective cohort studies, risks of all-cause dementia and AD were elevated in participants with single hearing impairment (all-cause dementia: HR1.30, 95%CI 1.21-1.40; AD: HR1.30, 95%CI 1.21-1.40) and dual sensory impairment (all-cause dementia: HR1.63, 95%CI1.14-2.12; AD: HR 2.55, 95%CI 1.19-3.91), while single vision impairment only associated with higher risk of all-cause dementia (HR1.43, 95%CI 1.16-1.71) but not AD. Finally, the MR analysis revealed a significant association between hearing impairment and all-cause dementia (OR1.74, 95%CI 1.01-2.99), AD (OR1.56, 95%CI 1.09-2.23), and NAVD (OR1.14, 1.02-1.26), as well as vision impairment and NAVD (OR1.62, 95%CI 1.13-2.33).

Conclusions: Our findings showed significant associations between hearing and vision impairments and increased risks of all-cause and cause-specific dementia. Standardized hearing and vision assessment and intervention should be emphasized in dementia prevention strategies.

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听力和视力障碍与全因痴呆症和特定原因痴呆症风险之间关系的综合评估:队列研究、荟萃分析和孟德尔随机研究的结果。
背景:流行病学研究显示,听力/视力障碍与痴呆症风险之间的联系并不一致。利用多源数据,我们调查了单一或综合感官障碍与全因痴呆症和特定类型痴呆症风险之间的关系:我们采用了结合三种方法的三角测量法。我们分析了90,893名英国生物库(UKB)成人,探讨了听力和视力障碍对全因痴呆症(AD)、血管性痴呆症(VD)和非AD非VD(NAVD)的单一和联合影响。对涉及 937,908 名参与者的前瞻性研究进行的荟萃分析提供了更有力的证据。最后,我们利用UKB(361,194名参与者)和FinnGen(412,181名参与者)的全基因组关联研究进行了孟德尔随机化(MR)分析,以验证感官障碍与痴呆发生之间的关系:在UKB队列研究中,与听力正常的参与者相比,轻度和重度听力障碍组的参与者罹患全因痴呆症的风险逐渐显著升高(轻度:HR1.52,95%CI 1.31-1.77;重度:HR1.80,95%CI 1.36-2.38)、AD(轻度:HR1.63,95%CI 1.30-2.04;重度:HR2.18,95%CI 1.45-3.27)、VD(轻度:HR1.68,95%CI 1.19-2.37;重度:HR1.47,95%CI 1.22-1.78)和 NAVD(轻度:HR1.47,95%CI 1.22-1.78;重度:HR1.98,95%CI 1.43-2.75)。此外,视力障碍与全因痴呆(HR1.55,95%CI 1.18-2.04)和非全因痴呆(HR1.51,95%CI 1.07-2.13)的风险增加有关。此外,与单一听力或视力损伤相比,双重感官损伤导致全因痴呆和特定原因痴呆的风险逐步增加。在对 31 项前瞻性队列研究进行的荟萃分析中,有单一听力障碍的参与者患全因痴呆症和注意力缺失症的风险较高(全因痴呆症:HR1.30,95%CI 1.21-1.40;注意力缺失症:HR1.30,95%CI 1.21-1.40),而有双重感官障碍的参与者患全因痴呆症和注意力缺失症的风险较低(HR1.30,95%CI 1.21-1.40)。40)和双重感觉障碍(全因痴呆:HR1.63,95%CI1.14-2.12;AD:HR 2.55,95%CI 1.19-3.91),而单一视力障碍仅与较高的全因痴呆风险相关(HR1.43,95%CI 1.16-1.71),但与 AD 无关。最后,磁共振分析显示,听力损伤与全因痴呆(OR1.74,95%CI 1.01-2.99)、AD(OR1.56,95%CI 1.09-2.23)和非全因痴呆(OR1.14,1.02-1.26)以及视力损伤与非全因痴呆(OR1.62,95%CI 1.13-2.33)之间存在显著关联:我们的研究结果表明,听力和视力损伤与全因痴呆症和特定原因痴呆症的风险增加之间存在明显关联。在痴呆症预防策略中应强调标准化听力和视力评估及干预。
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来源期刊
BMC Medicine
BMC Medicine 医学-医学:内科
CiteScore
13.10
自引率
1.10%
发文量
435
审稿时长
4-8 weeks
期刊介绍: BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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