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Cognitive reserve regulates the association between hearing difficulties and incident cognitive impairment evidence from a longitudinal study in China

Published online by Cambridge University Press:  20 November 2019

L. Chen Open the ORCID record for L. Chen [Opens in a new window]  and
B. Lu
L. Chen*
Affiliation:
School of Social and Behavioral Sciences, Nanjing University, Jiangsu210023, China
B. Lu
Affiliation:
Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai200032, China
*
Correspondence should be addressed to: Lele Chen, School of Social and Behavioral Sciences, Nanjing University, Jiangsu Province 210023, China. Email: lelechen0514@163.com.
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Abstract

Background:

Cognitive reserve (CR) can prevent the risk of incident cognitive impairment in the elderly. However, the moderator effects of CR on the link between hearing difficulties (HDs) and the risk of incident cognitive impairment are not well understood.

Methods:

This cohort study obtained data from the Chinese Longitudinal Healthy Longevity Survey from 2008 to 2014. The baseline samples included 6309 participants aged 65 years and older at baseline. Cognitive impairment was assessed using the Chinese version of the Mini Mental State Examination. A composite measure of CR was calculated based on education, occupational complexity, and leisure activities of the participants. The marginal structural model was utilized to investigate whether CR moderates the association between HD and incident cognitive impairment. Odds ratios (ORs) and accompanying 95% confidence intervals (CIs) were calculated.

Results:

Of the 6309 participants at baseline, 1936 (30.7%) developed cognitive impairment during the 6-year follow-up period and 2562 (40.6%) reported HD. The risk of incident cognitive impairment was 1.90-fold (95% CI 1.69–2.14) for participants developing HD compared to those without. Those with middle CR had lower OR (0.72, 95% CI 0.62–0.82) that further decreased to 0.58 (95% CI 0.49–0.69) for those with high CR. Participants with HD with low CR showed the highest OR (4.32, 95% CI 3.42–5.47). In addition, individuals with HD with low education levels or low complex occupations had the highest risk of incident cognitive impairment.

Conclusions:

CR moderates the negative association between HD and cognitive function. Education and occupation complexity may be more sensitive proxies for CR.

Keywords

hearing difficultiescognitive reserveincident cognitive impairmentmarginal structural modelChinese Longitudinal Healthy Longevity Survey (CLHLS)
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 5: Issue Theme: Challenges and Facilitators for Diagnosis and Treatment of Dementia , May 2020 , pp. 635 - 643
Copyright
© International Psychogeriatric Association 2019

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