生活方式以及血管和代谢健康及炎症因素与老年人感音神经-神经认知老化有关

Natascha Merten, Mary E. Fischer, A. A. Pinto, Richard J. Chappell, Carla R. Schubert
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摘要

本研究旨在确定与老年人感音神经和神经认知功能(大脑老化)相关的风险因素。我们对 1,478 名听力损失流行病学研究参与者(年龄在 64-100 岁之间,59% 为女性)进行了感音神经和认知测试,并使用主成分分析法(PCA)将这些测试结果合并为一个综合指标。PCA得分<-1个标准差(SD)的参与者被视为脑老化。基线时 PCA 得分≥-1 标准差的参与者中,随访 5 年时 PCA 得分<-1 标准差者定义为出现脑老化。逻辑回归和泊松模型分别用于估计生活方式、血管和代谢健康以及炎症等基线风险因素与流行性或偶发性脑老化之间的关系。在经年龄-性别调整的多变量模型中,不饮酒(几率比(OR)= 1.77,95% 置信区间(CI)= 1.18,2.66)、白细胞介素-6 水平较高(OR = 1.30,95% CI = 1.03,1.64)和抑郁症状(OR = 2.44,95% CI = 1.63,3.67)与较高的脑老化几率相关,而较高的教育程度则具有保护作用(OR = 0.55,95% CI = 0.33,0.94)。中风史、动脉僵化和肥胖与五年随访期间脑老化风险增加有关。生活方式、血管、新陈代谢和炎症因素与老年人大脑老化有关,这进一步证明了感音神经和神经认知衰退的共同途径。针对这些共同的中枢处理病因因素采取干预措施,可能会使神经功能得到改善,从而使听觉、嗅觉和认知等多个系统受益,最终帮助老年人更长久地保持独立和更高的生活质量。
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Lifestyle and factors of vascular and metabolic health and inflammation are associated with sensorineural-neurocognitive aging in older adults
This study's aim was to identify risk factors associated with sensorineural and neurocognitive function (brain aging) in older adults. In N = 1,478 Epidemiology of Hearing Loss Study participants (aged 64–100 years, 59% women), we conducted sensorineural and cognitive tests, which were combined into a summary measure using Principal Component Analysis (PCA). Participants with a PCA score <−1 standard deviation (SD) were considered to have brain aging. Incident brain aging was defined as PCA score <−1 SD at 5-year follow-up among participants who had a PCA score ≥−1 SD at baseline. Logistic regression and Poisson models were used to estimate associations between baseline risk factors of lifestyle, vascular and metabolic health, and inflammation and prevalent or incident brain aging, respectively. In an age-sex adjusted multivariable model, not consuming alcohol (odds ratio(OR) = 1.77, 95% confidence Interval (CI) = 1.18,2.66), higher interleukin-6 levels (OR = 1.30, 95% CI = 1.03,1.64), and depressive symptoms (OR = 2.44, 95% CI = 1.63,3.67) were associated with a higher odds of having brain aging, while higher education had protective effects (OR = 0.55, 95% CI = 0.33,0.94). A history of stroke, arterial stiffness, and obesity were associated with an increased risk of developing brain aging during the five years of follow-up. Lifestyle, vascular, metabolic and inflammatory factors were associated with brain aging in older adults, which adds to the evidence of shared pathways for sensorineural and neurocognitive declines in aging. Targeting these shared central processing etiological factors with interventions may lead to retention of better neurological function, benefiting multiple systems, i.e., hearing, smell, and cognition, ultimately helping older adults retain independence and higher quality of life longer.
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