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Abstract：
BACKGROUND: Hearing loss (HL) and mild behavioral impairment (MBI) are non-cognitive markers of dementia. This study investigated the relationship between hearing and MBI and explored the influence of hearing aid use on the treatment of hearing loss, both cross-sectionally and longitudinally.
METHODS: Data were analyzed from National Alzheimer\'s Coordinating Center participants, age ≥50, dementia-free at baseline, collected between 2005 and 2022. Three self-report questions were used to generate a three-level categorical hearing variable: No-HL, Untreated-HL, and Treated-HL. MBI status was derived from the informant-rated Neuropsychiatric Inventory Questionnaire (NPI-Q) using a published algorithm. At baseline (n = 7080), logistic regression was used to examine the association between hearing status (predictor) and the presence of global and domain-specific MBI (outcome), adjusting for age, sex, cognitive diagnosis, and apolipoprotein E4 (APOE4). Cox proportional hazard models with time-dependent covariates were used to examine the effect of (1) hearing status as exposure on the rate of incident MBI (n = 5889); and (2) MBI as exposure on the rate of incident HL in those with no HL at baseline (n = 6252).
RESULTS: Cross-sectionally, participants with Untreated-HL were more likely to exhibit global MBI (adjusted odds ratio (aOR) = 1.66, 95% CI: 1.24-2.21) and individual MBI domains of social inappropriateness (aOR = 1.95, 95% CI: 1.06-3.39), affective dysregulation (aOR = 1.71, 95% CI: 1.21-2.38), and impulse dyscontrol (aOR = 1.71, 95% CI: 1.21-2.38), compared to those with No-HL. Participants with Treated-HL (i.e., hearing aid use) did not differ from No-HL for odds of global or most MBI domains, except for impulse dyscontrol (aOR = 1.38, 95% CI: 1.05-1.81). Longitudinally, we found relationships between Treated-HL and incident MBI (adjusted hazard ratio (aHR) = 1.29, 95% CI: 1.01-1.63) and between MBI and incident Untreated-HL (aHR = 1.51, 95% CI: 1.19-1.94).
CONCLUSIONS: Our cross-sectional results support that hearing aid use is associated with lower odds of concurrent global MBI in dementia-free participants. Longitudinally, relationships were found between MBI and HL. The severity of HL was not assessed, however, and may require further exploration.
UNASSIGNED: Hearing Loss (HL) and mild behavioral impairment (MBI) are markers of dementiaCross-sectionally: Untreated-HL was associated with global MBI burden, butHL treated with hearing aids was notWe found associations between MBI and incident Untreated-HL.
METHODS: Data were analyzed from National Alzheimer\'s Coordinating Center participants, age ≥50, dementia-free at baseline, collected between 2005 and 2022. Three self-report questions were used to generate a three-level categorical hearing variable: No-HL, Untreated-HL, and Treated-HL. MBI status was derived from the informant-rated Neuropsychiatric Inventory Questionnaire (NPI-Q) using a published algorithm. At baseline (n = 7080), logistic regression was used to examine the association between hearing status (predictor) and the presence of global and domain-specific MBI (outcome), adjusting for age, sex, cognitive diagnosis, and apolipoprotein E4 (APOE4). Cox proportional hazard models with time-dependent covariates were used to examine the effect of (1) hearing status as exposure on the rate of incident MBI (n = 5889); and (2) MBI as exposure on the rate of incident HL in those with no HL at baseline (n = 6252).
RESULTS: Cross-sectionally, participants with Untreated-HL were more likely to exhibit global MBI (adjusted odds ratio (aOR) = 1.66, 95% CI: 1.24-2.21) and individual MBI domains of social inappropriateness (aOR = 1.95, 95% CI: 1.06-3.39), affective dysregulation (aOR = 1.71, 95% CI: 1.21-2.38), and impulse dyscontrol (aOR = 1.71, 95% CI: 1.21-2.38), compared to those with No-HL. Participants with Treated-HL (i.e., hearing aid use) did not differ from No-HL for odds of global or most MBI domains, except for impulse dyscontrol (aOR = 1.38, 95% CI: 1.05-1.81). Longitudinally, we found relationships between Treated-HL and incident MBI (adjusted hazard ratio (aHR) = 1.29, 95% CI: 1.01-1.63) and between MBI and incident Untreated-HL (aHR = 1.51, 95% CI: 1.19-1.94).
CONCLUSIONS: Our cross-sectional results support that hearing aid use is associated with lower odds of concurrent global MBI in dementia-free participants. Longitudinally, relationships were found between MBI and HL. The severity of HL was not assessed, however, and may require further exploration.
UNASSIGNED: Hearing Loss (HL) and mild behavioral impairment (MBI) are markers of dementiaCross-sectionally: Untreated-HL was associated with global MBI burden, butHL treated with hearing aids was notWe found associations between MBI and incident Untreated-HL.
摘要：
背景：听力损失（HL）和轻度行为障碍（MBI）是痴呆的非认知标志物。这项研究调查了听力与MBI之间的关系，并探讨了助听器的使用对听力损失治疗的影响。横截面和纵向。
方法：分析了来自国家阿尔茨海默氏症协调中心参与者的数据，年龄≥50岁，基线无痴呆，在2005年至2022年之间收集。使用三个自我报告问题来生成三级分类听力变量：No-HL，未处理的HL,和处理-HL。MBI状态是使用已发布的算法从受人评估的神经精神清单问卷（NPI-Q）得出的。在基线（n=7080），使用逻辑回归检查听力状态（预测因子）与全局和特定领域MBI（结果）之间的关联，调整年龄，性别,认知诊断,和载脂蛋白E4（APOE4）。使用具有时间依赖性协变量的Cox比例风险模型来检查（1）听力状态作为暴露对MBI发生率的影响（n=5889）；（2）MBI作为暴露对基线时没有HL的人的HL发生率的影响（n=6252）。
结果：横截面，未治疗HL的参与者更有可能表现出整体MBI(调整后比值比(aOR)=1.66,95%CI:1.24-2.21)和个体MBI领域的社会不适当(aOR=1.95,95%CI:1.06-3.39)，情感失调（aOR=1.71，95%CI：1.21-2.38），和冲动控制异常(aOR=1.71，95%CI：1.21-2.38)，与那些没有HL相比。患有治疗过的HL的参与者(即，助听器使用)在全球或大多数MBI领域的几率方面与No-HL没有区别，除冲动控制异常外（aOR=1.38，95%CI：1.05-1.81）。纵向,我们发现治疗后的HL与事件MBI(校正后的风险比(aHR)=1.29,95%CI:1.01~1.63)之间以及MBI与事件未治疗后的HL(aHR=1.51,95%CI:1.19~1.94)之间的关系.
结论：我们的横断面结果支持使用助听器与无痴呆参与者并发全球MBI的几率较低有关。纵向,发现MBI和HL之间存在关系。未评估HL的严重程度，然而,可能需要进一步探索。
听力损失(HL)和轻度行为障碍(MBI)是痴呆的标志。但是用助听器治疗的HL没有。我们发现MBI和未治疗的HL之间存在关联。
方法：分析了来自国家阿尔茨海默氏症协调中心参与者的数据，年龄≥50岁，基线无痴呆，在2005年至2022年之间收集。使用三个自我报告问题来生成三级分类听力变量：No-HL，未处理的HL,和处理-HL。MBI状态是使用已发布的算法从受人评估的神经精神清单问卷（NPI-Q）得出的。在基线（n=7080），使用逻辑回归检查听力状态（预测因子）与全局和特定领域MBI（结果）之间的关联，调整年龄，性别,认知诊断,和载脂蛋白E4（APOE4）。使用具有时间依赖性协变量的Cox比例风险模型来检查（1）听力状态作为暴露对MBI发生率的影响（n=5889）；（2）MBI作为暴露对基线时没有HL的人的HL发生率的影响（n=6252）。
结果：横截面，未治疗HL的参与者更有可能表现出整体MBI(调整后比值比(aOR)=1.66,95%CI:1.24-2.21)和个体MBI领域的社会不适当(aOR=1.95,95%CI:1.06-3.39)，情感失调（aOR=1.71，95%CI：1.21-2.38），和冲动控制异常(aOR=1.71，95%CI：1.21-2.38)，与那些没有HL相比。患有治疗过的HL的参与者(即，助听器使用)在全球或大多数MBI领域的几率方面与No-HL没有区别，除冲动控制异常外（aOR=1.38，95%CI：1.05-1.81）。纵向,我们发现治疗后的HL与事件MBI(校正后的风险比(aHR)=1.29,95%CI:1.01~1.63)之间以及MBI与事件未治疗后的HL(aHR=1.51,95%CI:1.19~1.94)之间的关系.
结论：我们的横断面结果支持使用助听器与无痴呆参与者并发全球MBI的几率较低有关。纵向,发现MBI和HL之间存在关系。未评估HL的严重程度，然而,可能需要进一步探索。
听力损失(HL)和轻度行为障碍(MBI)是痴呆的标志。但是用助听器治疗的HL没有。我们发现MBI和未治疗的HL之间存在关联。
