Abstract: Background　Hearing loss is one of the common health problems among the elderly，which seriously affects their physical and mental health.Previous studies have shown that hearing loss affects cognitive level in older adults.There are few studies on the relationship between hearing loss and cognition in the elderly cohort in China.Objective　To explore the correlation between hearing loss and cognitive impairment in an elderly cohort from Rugao，Jiangsu Province，providing a theoretical basis for delivering early interventions for cognitive impairment prevention via improving hearing loss.Methods　From November 13 to December 21，2014，by use of random stratified sampling，from the name list of 11 198 elderly residents（aged 70-84 years） living in 31 villages of Jiangan Town，Rugao City，Jiangsu Province，provided by Jiangan Town Health Bureau，we selected 1 960 cases，and 1 788 of them were enrolled as the baseline sample.Then we conducted two rounds of surveys with them 1.5 years（from April to June 2016） and 3 years（from November to December 2017） after the baseline survey，respectively.Of the 1 375 cases participating in all the surveys，1 117 with complete self-assessment hearing data evaluated in 2014 and cognitive status evaluated by the MMSE in 2017 were finally enrolled.We collected and analyzed their general information，self-assessment hearing status and cognitive status.Results　Among the 1 117 subjects，916（82.0%） had good hearing，and 201（18.0%） had hearing loss，575（51.5%） had cognitive impairment，and 542（48.5%） had normal cognitive function.Compared with those with normal hearing，hearing-impaired participants showed greater mean age，and lower mean MMSE score（P<0.05）.There were significant differences in sex ratio，distributions of age，occupation，marital status，education level，smoking status，drinking status，self-rated health status，and self-rated hearing status，and proportion of diabetes mellitus between those with and without cognitive impairment（P<0.05）.Logistic regression analysis showed that hearing level was the influencing factor of cognitive impariment〔OR=1.51，95%CI（1.06，2.15），P=0.022〕.Conclusion　Elderly people with hearing loss are more likely to develop cognitive impairment.Timely detection of hearing loss and giving intervention measures may reduce or delay the occurrence of cognitive impairment in the elderly.

Key words: 基金项目：国家重点研发计划项目（SQ2018YFC200162, SQ2018YFC200194）；国家自然科学基金资助项目（81771414, 81571372, 81670465）

摘要： 背景　听力下降是老年人普遍存在的健康问题之一，严重影响老年人的身心健康。既往研究表明，听力下降影响老年人的认知水平。目前，国内听力下降与认知关系在老年队列人群中研究较少。目的　探讨江苏省如皋市长寿及衰老队列中听力下降和认知障碍的相关关系，以期为认知障碍在听力方面的早期预防与干预提供理论依据。方法　于2014-11-13至2014-12-21，从江苏省如皋市江安镇卫生局提供的11 198例老年人（70~84岁）名单中采用随机分层抽样法抽取1 960例，共包括江安镇31个自然村，共1 788例组成基线样本。分别于基线调查1.5年后（2016年4—6月）和3年后（2017年11—12月）进行了第一次和第二次重复调查。本研究人群为同时参加基线调查和第二次重复调查的参与者，共1 375例。其中，1 117例具有完整的2014年自评听力数据和2017年简易精神状态评价量表（MMSE）评估的认知障碍数据，最终被纳入本研究。收集受试者的一般资料，听力水平为受试者对自身听力情况进行自我评价，采用MMSE对受试者的认知情况进行评估。结果　1 117例受试者中听力较好916例（82.0%），听力下降201例（18.0%）；认知障碍575例（51.5%），无认知障碍542例（48.5%）。听力下降者年龄高于听力较好者，MMSE评分低于听力较好者（P<0.05）。无认知障碍和认知障碍者性别、年龄、职业、婚姻状况、教育程度、吸烟状况、饮酒状况、自评健康状况、糖尿病所占比例、听力水平比较，差异均有统计学意义（P<0.05）。Logistic回归分析结果显示，听力水平是认知障碍的影响因素〔OR=1.51，95%CI（1.06，2.15），P=0.022〕。结论　听力下降的老年人易发生认知障碍。及时发现老年人听力下降并给予干预措施，可能减少或延缓老年人认知障碍的发生。

关键词: 听觉减退, 认知障碍, 老年人, 队列研究