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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: [email protected].
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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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References

Amieva, H., Ouvrard, C., Giulioli, C., Meillon, C., Rullier, L. and Dartigues, J. F. (2015). Self-reported hearing loss, hearing aids, and cognitive decline in elderly adults: a 25-year study. Journal of the American Geriatrics Society, 63, 2099–2104. doi:10.1111/jgs.13649.CrossRefGoogle ScholarPubMed
Amieva, H., Ouvrard, C., Meillon, C., Rullier, L. and Dartigues, J. F. (2018). Death, depression, disability, and dementia associated with self-reported hearing problems: a 25-year study. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 73, 1383–1389. doi:10.1093/gerona/glx250.CrossRefGoogle ScholarPubMed
An, R. and Liu, G. G. (2016). Cognitive impairment and mortality among the oldest-old Chinese. International Journal of Geriatric Psychiatry, 31, 1345–1353. doi:10.1002/gps.4442.CrossRefGoogle ScholarPubMed
Bennett, D. A., Schneider, J. A., Tang, Y., Arnold, S. E. and Wilson, R. S. (2006). The effect of social networks on the relation between Alzheimer’s disease pathology and level of cognitive function in old people: a longitudinal cohort study. The Lancet Neurology, 5, 406–412. doi:10.1016/S1474-4422(06)70417-3.CrossRefGoogle ScholarPubMed
Boyle, P., Wilson, R., Schneider, J., Bienias, J. and Bennett, D. (2008). Processing resources reduce the effect of Alzheimer pathology on other cognitive systems. Neurology, 70, 1534–1542. doi:10.1212/01.wnl.0000304345.14212.38.CrossRefGoogle ScholarPubMed
Cole, S. R. and Hernan, M. A. (2008). Constructing inverse probability weights for marginal structural models. American Journal of Epidemiology, 168, 656–664. doi:10.1093/aje/kwn164.CrossRefGoogle ScholarPubMed
Correa Ribeiro, P. C., Lopes, C. S. and Lourenco, R. A. (2013). Complexity of lifetime occupation and cognitive performance in old age. Occupational Medicine, 63, 556–562. doi:10.1093/occmed/kqt115.CrossRefGoogle ScholarPubMed
Cruickshanks, K. J.et al. (2010). Education, occupation, noise exposure history and the 10-yr cumulative incidence of hearing impairment in older adults. Hearing Research, 264, 3–9. doi:10.1016/j.heares.2009.10.008.CrossRefGoogle ScholarPubMed
Dawes, P.et al. (2015). Hearing loss and cognition: the role of hearing AIDS, social isolation and depression. PLoS ONE, 10, e0119616. doi:10.1371/journal.pone.0119616.CrossRefGoogle ScholarPubMed
Donovan, N. J., Wu, Q., Rentz, D. M., Sperling, R. A., Marshall, G. A. and Glymour, M. M. (2017). Loneliness, depression and cognitive function in older US adults. International Journal of Geriatric Psychiatry, 32, 564–573. doi:10.1002/gps.4495.CrossRefGoogle Scholar
Gu, D. (2008). General data quality assessment of the CLHLS. In: Zeng, Y., Gu, D., Purser, J., Hoenig, H., and Christakis, N. (Eds.), Healthy longevity in China (pp. 39–60). New York: Springer.10.1007/978-1-4020-6752-5_3CrossRefGoogle Scholar
Gu, D., Yang, F. and Sautter, J. (2016). Socioeconomic status as a moderator between frailty and mortality at old ages. BMC Geriatrics, 16, 151. doi:10.1186/s12877-016-0322-2.CrossRefGoogle ScholarPubMed
Gurgel, R. K., Ward, P. D., Schwartz, S., Norton, M. C., Foster, N. L. and Tschanz, J. T. (2014). Relationship of hearing loss and dementia: a prospective, population-based study. Otology & Neurotology, 35, 775–781. doi:10.1097/MAO.0000000000000313.CrossRefGoogle ScholarPubMed
Harrison, S. L., Sajjad, A., Bramer, W. M., Ikram, M. A., Tiemeier, H. and Stephan, B. C. (2015). Exploring strategies to operationalize cognitive reserve: a systematic review of reviews. Journal of Clinical and Experimental Neuropsychology, 37, 253–264. doi:10.1080/13803395.2014.1002759.CrossRefGoogle ScholarPubMed
Hu, X.et al. (2018). Cognitive and physical function of people older than 80 years in China from 1998 to 2014. Journal of International Medical Research, 46, 2810–2827. doi:10.1177/0300060518773211.CrossRefGoogle ScholarPubMed
Ji, F., Chen, A. -T. and Wang, Q. -J. (2015). Hearing loss in the aged: status and interventions in China. Hearing, Balance and Communication, 13, 51–57. doi:10.3109/21695717.2015.1032719.CrossRefGoogle Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged - the index of adl - a standardized measure of biological and psychosocial function. Jama-Journal of the American Medical Association, 185, 914–919. doi:10.1001/jama.1963.03060120024016.CrossRefGoogle Scholar
Kiely, K. M., Gopinath, B., Mitchell, P., Luszcz, M. and Anstey, K. J. (2012). Cognitive, health, and sociodemographic predictors of longitudinal decline in hearing acuity among older adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 67, 997–1003. doi:10.1093/gerona/gls066.CrossRefGoogle ScholarPubMed
Lin, F.et al. (2014). Association of hearing impairment with brain volume changes in older adults. Neuroimage, 90, 84–92. doi:10.1016/j.neuroimage.2013.12.059.CrossRefGoogle ScholarPubMed
Lin, F. R., Metter, E. J., O’brien, R. J., Resnick, S. M., Zonderman, A. B. and Ferrucci, L. (2011). Hearing loss and incident dementia. Archives of Neurology, 68, 214–220. doi:10.1001/archneurol.2010.362.CrossRefGoogle ScholarPubMed
Lin, F. R., et al. (2013). Hearing loss and cognitive decline in older adults. JAMA Internal Medicine, 173, 293–299. doi:10.1001/jamainternmed.2013.1868.CrossRefGoogle ScholarPubMed
Lin, H. -C., Chao, P. -Z. and Lee, H. -C. (2008). Sudden sensorineural hearing loss increases the risk of stroke: a 5-year follow-up study. Stroke, 39, 2744–2748. doi:10.1161/strokeaha.108.519090.CrossRefGoogle ScholarPubMed
Loughrey, D. G., Kelly, M. E., Kelley, G. A., Brennan, S. and Lawlor, B. A. (2018). Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis. JAMA Otolaryngology–Head & Neck Surgery, 144, 115–126. doi:10.1001/jamaoto.2017.2513.CrossRefGoogle ScholarPubMed
Meng, X. and D’Arcy, C. (2012). Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS ONE, 7, e38268. doi:10.1371/journal.pone.0038268.CrossRefGoogle ScholarPubMed
Mitchell, P.et al. (2009). Relationship of type 2 diabetes to the prevalence, incidence and progression of age-related hearing loss. Diabetic Medicine, 26, 483–488. doi:10.1111/j.1464-5491.2009.02710.x.CrossRefGoogle ScholarPubMed
Opdebeeck, C., Martyr, A. and Clare, L. (2016). Cognitive reserve and cognitive function in healthy older people: a meta-analysis. Aging, Neuropsychology, and Cognition, 23, 40–60. doi:10.1080/13825585.2015.1041450.CrossRefGoogle ScholarPubMed
Opdebeeck, C., Matthews, F. E., Wu, Y. -T., Woods, R. T., Brayne, C. and Clare, L., (2018). Cognitive reserve as a moderator of the negative association between mood and cognition: evidence from a population-representative cohort. Psychological Medicine, 48, 61–71. doi:10.1017/S003329171700126X.CrossRefGoogle ScholarPubMed
Placek, K.et al. (2016). Cognitive reserve in frontotemporal degeneration: neuroanatomic and neuropsychological evidence. Neurology, 87, 1813–1819. doi:10.1212/WNL.0000000000003250.CrossRefGoogle ScholarPubMed
Richards, M. and Deary, I. J. (2005). A life course approach to cognitive reserve: a model for cognitive aging and development? Annals of Neurology, 58, 617–622. doi:10.1002/ana.20637.CrossRefGoogle Scholar
Robins, J. M., Hernan, M. A. and Brumback, B. (2000). Marginal structural models and causal inference in epidemiology. Epidemiology, 11, 550–560. doi:10.1097/00001648-200009000-00011.CrossRefGoogle ScholarPubMed
Rönnberg, J.et al. (2013). The Ease of Language Understanding (ELU) model: theoretical, empirical, and clinical advances. Frontiers in Systems Neuroscience, 7, 31. doi:10.3389/fnsys.2013.00031.CrossRefGoogle ScholarPubMed
Singh-Manoux, A., Marmot, M. G., Glymour, M., Sabia, S., Kivimäki, M. and Dugravot, A. (2011). Does cognitive reserve shape cognitive decline? Annals of Neurology, 70, 296–304. doi:10.1002/ana.22391.CrossRefGoogle ScholarPubMed
Sinha, U. K., Hollen, K. M., Rodriguez, R. and Miller, C. A. (1993). Auditory system degeneration in Alzheimer’s disease. Neurology, 43, 779–779. doi:10.1212/WNL.43.4.779.CrossRefGoogle ScholarPubMed
Stern, Y. (2011). Elaborating a hypothetical concept: comments on the special series on cognitive reserve. Journal of the International Neuropsychological Society, 17, 639–642. doi:10.1017/S1355617711000579.CrossRefGoogle ScholarPubMed
Stern, Y. (2012). Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurology, 11, 1006–1012. doi:10.1016/S1474-4422(12)70191-6.CrossRefGoogle ScholarPubMed
Yi, Z. (2008). Introduction to the chinese longitudinal healthy longevity survey (CLHLS). In: Zeng, Y., Gu, D., Purser, J., Hoenig, H., and Christakis, N. (Eds.), Healthy longevity in China (pp. 23–38). New York: Springer.CrossRefGoogle Scholar
Yi, Z., Vaupel, J. W., Zhenyu, X., Chunyuan, Z. and Yuzhi, L. (2002). Sociodemographic and health profiles of the oldest old in China. Population and Development Review, 28, 251–273. doi:10.1111/j.1728-4457.2002.00251.x.CrossRefGoogle Scholar
Zeng, Y., Gu, D., Purser, J., Hoenig, H. and Christakis, N. (2010). Associations of environmental factors with elderly health and mortality in China. American Journal of Public Health, 100, 298–305. doi:10.2105/AJPH.2008.154971.CrossRefGoogle ScholarPubMed
Zhang, Z. (2006). Gender differentials in cognitive impairment and decline of the oldest old in China. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61, S107–S115. doi:10.1093/geronb/61.2.S107.CrossRefGoogle ScholarPubMed
Zhu, X., Qiu, C., Zeng, Y. and Li, J. (2017). Leisure activities, education, and cognitive impairment in Chinese older adults: a population-based longitudinal study. International Psychogeriatrics, 29, 727–739. doi:10.1017/S1041610216001769.CrossRefGoogle ScholarPubMed