Table 1. The characters of the participants. (N=1012)
|
Variables
|
ALL
|
|
Male
|
|
Female
|
Normal
|
HL
|
P
|
|
Normal
|
HL
|
P
|
|
Normal
|
HL
|
P
|
(N=641)
|
(N=371)
|
(N=267)
|
(N=161)
|
(N=374)
|
(N=210)
|
Age(y)
|
70.99±4.71
|
75.38±6.25
|
<0.001
|
71.42±4.77
|
74.57±6.08
|
<0.001
|
70.68±4.65
|
76.00±6.32
|
<0.001
|
Male(%)
|
267(41.65)
|
161(43.40)
|
0.589
|
/
|
/
|
/
|
/
|
/
|
/
|
Speech-PTA(dB HL)
|
37.14±7.43
|
56.75±9.05
|
<0.001
|
37.03±7.10
|
56.54±8.66
|
<0.001
|
37.21±7.67
|
56.92±9.36
|
<0.001
|
High-PTA(dB HL)
|
37.23±7.70
|
60.72±9.86
|
<0.001
|
37.50±7.48
|
61.52±9.69
|
<0.001
|
37.07±7.83
|
60.02±9.94
|
<0.001
|
BMI(kg/m2)
|
23.77±3.38
|
23.50±3.76
|
0.246
|
23.40±3.28
|
23.14±3.79
|
0.457
|
24.04±3.44
|
23.77±3.72
|
0.379
|
SBP(mmHg)
|
129.66±18.90
|
133.00±21.16
|
0.012
|
127.54±17.88
|
130.97±19.47
|
0.065
|
131.19±19.48
|
134.57±22.29
|
0.068
|
DBP(mmHg)
|
73.17±10.45
|
73.40±11.54
|
0.741
|
74.26±10.26
|
75.19±10.81
|
0.373
|
72.38±10.53
|
72.02±11.92
|
0.709
|
Marital status
|
|
|
<0.001
|
|
|
0.533
|
|
|
<0.001
|
Married(%)
|
529(82.53)
|
254(68.4)
|
|
243(91.01)
|
141(87.58)
|
|
286(76.47)
|
113(53.81)
|
|
Windowed(%)
|
109(17.00)
|
115(30.99)
|
|
22(8.24)
|
19(11.8)
|
|
87(23.26)
|
96(45.71)
|
|
Single(%)
|
1(0.16)
|
2(0.54)
|
|
1(0.37)
|
1(0.62)
|
|
0(0.00)
|
1(0.48)
|
|
Divorced(%)
|
2(0.31)
|
0(0.00)
|
|
1(0.37)
|
0(0.00)
|
|
1(0.27)
|
0(0.00)
|
|
Living alone(%)
|
92(14.40)
|
86(23.20)
|
<0.001
|
28(10.50)
|
24(14.90)
|
0.175
|
64(17.10)
|
62(29.50)
|
<0.001
|
Monthly income
|
|
|
0.030
|
|
|
0.081
|
|
|
0.226
|
<1000(%)
|
54(8.40)
|
44(11.90)
|
|
17(6.39)
|
13(8.13)
|
|
37(9.89)
|
31(14.83)
|
|
1000-3000(%)
|
367(57.30)
|
229(62.10)
|
|
134(50.38)
|
98(61.25)
|
|
233(62.3)
|
131(62.68)
|
|
3000-5000(%)
|
97(15.20)
|
44(11.90)
|
|
51(19.17)
|
22(13.75)
|
|
46(12.3)
|
22(10.53)
|
|
>5000(%)
|
122(19.10)
|
52(14.10)
|
|
64(24.00)
|
27(16.88)
|
|
58(15.51)
|
25(11.96)
|
|
Education
|
|
|
<0.001
|
|
|
0.411
|
|
|
<0.001
|
Illiteracy(%)
|
70(10.92)
|
84(22.64)
|
|
15(5.62)
|
10(6.21)
|
|
55(14.71)
|
74(35.24)
|
|
Primary(%)
|
375(58.50)
|
200(53.91)
|
|
135(50.56)
|
91(56.52)
|
|
240(64.17)
|
109(51.90)
|
|
≥High school(%)
|
196(30.58)
|
87(23.45)
|
|
117(43.82)
|
60(37.27)
|
|
79(21.12)
|
27(12.86)
|
|
Smoking
|
|
|
0.682
|
|
|
0.650
|
|
|
0.288
|
Current(%)
|
99(15.47)
|
54(14.59)
|
|
98(36.7)
|
52(32.3)
|
|
1(0.27)
|
2(0.96)
|
|
Never(%)
|
440(68.75)
|
250(67.57)
|
|
69(25.84)
|
45(27.95)
|
|
371(99.46)
|
205(98.09)
|
|
Former(%)
|
101(15.78)
|
66(17.84)
|
|
100(37.45)
|
64(39.75)
|
|
1(0.27)
|
2(0.96)
|
|
Drinking
|
|
|
0.086
|
|
|
0.402
|
|
|
0.010
|
Daily(%)
|
88(13.77)
|
55(14.86)
|
|
75(28.2)
|
37(23.13)
|
|
13(3.49)
|
18(8.57)
|
|
Occasional(%)
|
95(14.87)
|
52(14.05)
|
|
56(21.05)
|
32(20.00)
|
|
39(10.46)
|
20(9.52)
|
|
Former(%)
|
67(10.49)
|
58(15.67)
|
|
54(20.30)
|
43(26.88)
|
|
13(3.49)
|
15(7.14)
|
|
Never(%)
|
389(60.88)
|
205(55.41)
|
|
81(30.45)
|
48(30.00)
|
|
308(82.57)
|
157(74.76)
|
|
Disease history
|
|
|
|
|
|
|
|
|
|
Diabetes(%)
|
130(21.74)
|
77(22.92)
|
0.678
|
48(19.12)
|
41(27.52)
|
0.051
|
82(23.63)
|
36(19.25)
|
0.245
|
Hypertension(%)
|
457(71.2)
|
279(75.41)
|
0.157
|
191(71.54)
|
111(69.38)
|
0.635
|
266(71.12)
|
168(80.00)
|
0.018
|
Hyperlipidemia(%)
|
305(54.17)
|
167(52.68)
|
0.670
|
97(42.17)
|
58(41.43)
|
0.888
|
208(62.46)
|
109(61.58)
|
0.845
|
Stroke(%)
|
32(5.09)
|
32(8.79)
|
0.022
|
23(8.75)
|
10(6.29)
|
0.363
|
9(2.46)
|
22(10.73)
|
<0.001
|
MMSE
|
25.73±4.04
|
22.77±5.55
|
<0.001
|
26.54±3.67
|
24.58±4.03
|
<0.001
|
25.16±4.19
|
21.38±6.13
|
<0.001
|
IPAQ(Met/week)
|
4746(1680,9786)
|
4620(1606,9786)
|
0.985
|
4053(1440,8022)
|
5040(1533,10733)
|
0.061
|
5239(2140,10600)
|
4155(1621,9056)
|
0.023
|
ADL
|
99.49±2.19
|
98.91±3.76
|
0.006
|
99.64±1.49
|
98.79±4.46
|
0.020
|
99.38±2.57
|
99±3.12
|
0.131
|
IADL
|
7.71±0.74
|
7.34±1.34
|
<0.001
|
7.69±0.76
|
7.51±1.15
|
0.085
|
7.73±0.72
|
7.21±1.46
|
<0.001
|
Abbreviation: PTA, pure-tone average; High PTA was defined as pure tone average of the threshold at 4, and 8 kHz in the better ear; Speech PTA was defined as pure tone average of the threshold at 0.5, 1, 2, and 4 kHz in the better ear; HL, hearing loss, and was defined as more than 40 dB loss in the better ear; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic pressure; IPAQ, international physical activity questionnaire; ADL, activity of daily living; IADL, instrumental activity of daily living; MMSE, mini-mental status examination.
Table 2. logistic regression between hearing loss and cognitive impairment, stratified by gender.
|
Variables
|
Model 1
|
Model 2
|
Model 3
|
OR(95%CI)
|
P
|
OR(95%CI)
|
P
|
OR(95%CI)
|
P
|
ALL
|
|
|
|
|
|
|
HFHL
|
3.851(2.508,5.914)
|
<0.001
|
2.524(1.608,3.961)
|
<0.001
|
2.128(1.286,3.521)
|
0.003
|
SFHL
|
3.842(2.706,5.457)
|
<0.001
|
2.498(1.708,3.652)
|
<0.001
|
2.300(1.470,3.597)
|
<0.001
|
Male
|
|
|
|
|
|
|
HFHL
|
1.875(0.926,3.794)
|
0.081
|
1.544(0.749,3.179)
|
0.239
|
1.327(0.599,2.944)
|
0.486
|
SFHL
|
2.6(1.411,4.791)
|
0.002
|
2.071(1.091,3.933)
|
0.026
|
2.189(1.033,4.638)
|
0.041
|
Female
|
|
|
|
|
|
|
HFHL
|
6.093(3.53,10.518)
|
<0.001
|
3.447(1.923,6.181)
|
<0.001
|
2.943(1.505,5.754)
|
0.002
|
SFHL
|
4.872(3.154,7.526)
|
<0.001
|
2.757(1.702,4.466)
|
<0.001
|
2.400(1.313,4.385)
|
0.004
|
Note: HFHL, high-frequency hearing loss; HFHL was defined as more than 40 dB loss in the better ear.
SFHL, speech-frequency hearing loss; SFHL was defined as more than 40 dB loss in the better ear.
Model 1: unadjusted model.
Model 2: adjusted for age.
Model 3: adjusted for age, BMI, marital status, living alone, monthly income, education, drinking, smoking, IPAQ, ADL, IADL, diabetes, hypertension, hyperlipidemia, and stroke.
Table 3. linear regression between hearing sensitivity and cognitive impairment.
|
Variables
|
Model 1
|
Model 2
|
β(95%CI)
|
P
|
β(95%CI)
|
P
|
High PTA
|
|
|
|
|
MMSE
|
-0.084(-0.102,-0.066)
|
<0.001
|
-0.038(-0.055,-0.022)
|
<0.001
|
time
|
-0.014(-0.018,-0.010)
|
<0.001
|
-0.004(-0.009,0.000)
|
0.065
|
place
|
-0.010(-0.013,-0.006)
|
<0.001
|
-0.003(-0.007,0.001)
|
0.099
|
registration
|
-0.008(-0.011,-0.006)
|
<0.001
|
-0.007(-0.009,-0.004)
|
<0.001
|
recall
|
-0.013(-0.018,-0.009)
|
<0.001
|
-0.008(-0.014,-0.003)
|
0.002
|
attention/calculation
|
-0.021(-0.027,-0.014)
|
<0.001
|
-0.012(-0.019,-0.003)
|
0.001
|
language
|
-0.019(-0.023,-0.014)
|
<0.001
|
-0.004(-0.009,0.000)
|
0.050
|
Speech PTA
|
|
|
|
|
MMSE
|
-0.131(-0.151,-0.111)
|
<0.001
|
-0.061(-0.081,-0.042)
|
<0.001
|
time
|
-0.021(-0.026,-0.016)
|
<0.001
|
-0.008(-0.014,-0.003)
|
0.003
|
place
|
-0.017(-0.021,-0.013)
|
<0.001
|
-0.007(-0.011,-0.002)
|
0.003
|
registration
|
-0.012(-0.014,-0.009)
|
<0.001
|
-0.009(-0.012,-0.005)
|
<0.001
|
recall
|
-0.019(-0.025,-0.014)
|
<0.001
|
-0.011(-0.017,-0.004)
|
0.001
|
attention/calculation
|
-0.033(-0.040,-0.026)
|
<0.001
|
-0.020(-0.028,-0.012)
|
<0.001
|
language
|
-0.029(-0.035,-0.023)
|
<0.001
|
-0.007(-0.013,-0.002)
|
0.010
|
Note: PTA, pure-tone average; High PTA was defined as pure tone average of the threshold at 4, and 8 kHz in the better ear; Speech PTA was defined as pure tone average of the threshold at 0.5, 1, 2, and 4 kHz in the better ear.
Model 1: unadjusted.
Model 2: adjusted for age, BMI, marital status, living alone, monthly income, education, drinking, smoking, IPAQ, ADL, IADL, diabetes, hypertension, hyperlipidemia, and stroke.
Table 4. linear regression between hearing sensitivity and cognitive impairment in male.
|
Variables
|
Model 1
|
Model 2
|
β(95%CI)
|
P
|
β(95%CI)
|
P
|
High PTA
|
|
|
|
|
MMSE
|
-0.042(-0.064,-0.019)
|
<0.001
|
-0.027(-0.051,0.003)
|
0.027
|
time
|
-0.006(-0.012,0.000)
|
0.059
|
-0.002(-0.009,0.005)
|
0.539
|
place
|
-0.002(-0.005,0.001)
|
0.242
|
0.000(-0.003,0.004)
|
0.835
|
registration
|
-0.008(-0.011,-0.004)
|
<0.001
|
-0.007(-0.012,-0.003)
|
0.001
|
recall
|
-0.008(-0.015,-0.000)
|
0.037
|
-0.008(-0.016,0.000)
|
0.064
|
attention/calculation
|
-0.011(-0.020,-0.003)
|
0.011
|
-0.009(-0.018,0.001)
|
0.078
|
language
|
-0.007(-0.014,-0.001)
|
0.024
|
-0.002(-0.008,0.005)
|
0.577
|
Speech PTA
|
|
|
|
|
MMSE
|
-0.082(-0.108,-0.055)
|
<0.001
|
-0.066(-0.095,-0.037)
|
<0.001
|
time
|
-0.012(-0.019,-0.005)
|
0.001
|
-0.009(-0.018,-0.000)
|
0.025
|
place
|
-0.005(-0.009,-0.001)
|
0.021
|
-0.001(-0.006,0.003)
|
0.597
|
registration
|
-0.012(-0.016,-0.007)
|
<0.001
|
-0.011(-0.016,-0.006)
|
<0.001
|
recall
|
-0.017(-0.026,-0.008)
|
<0.001
|
-0.015(-0.025,-0.005)
|
0.003
|
attention/calculation
|
-0.022(-0.033,-0.012)
|
<0.001
|
-0.022(-0.033,-0.010)
|
<0.001
|
language
|
-0.014(-0.021,-0.006)
|
<0.001
|
-0.007(-0.015,0.001)
|
0.072
|
Note: PTA, pure-tone average; High PTA was defined as pure tone average of the threshold at 4, and 8 kHz in the better ear; Speech PTA was defined as pure tone average of the threshold at 0.5, 1, 2, and 4 kHz in the better ear.
Model 1: unadjusted.
Model 2: adjusted for age, BMI, marital status, living alone, monthly income, education, drinking, smoking, IPAQ, ADL, IADL, diabetes, hypertension, hyperlipidemia, and stroke.
Table 5. linear regression between hearing sensitivity and cognitive impairment in female.
|
Variables
|
Model 1
|
Model 2
|
β(95%CI)
|
P
|
β(95%CI)
|
P
|
High PTA
|
|
|
|
|
MMSE
|
-0.130(-0.155,-0.106)
|
<0.001
|
-0.047(-0.071,-0.024)
|
<0.001
|
time
|
-0.022(-0.027,-0.016)
|
<0.001
|
-0.004(-0.010,0.003)
|
0.158
|
place
|
-0.019(-0.024,-0.014)
|
<0.001
|
-0.007(-0.012,-0.001)
|
0.031
|
registration
|
-0.009(-0.013,-0.006)
|
<0.001
|
-0.007(-0.011,-0.002)
|
0.001
|
recall
|
-0.018(-0.023,-0.012)
|
<0.001
|
-0.009(-0.017,-0.002)
|
0.020
|
attention/calculation
|
-0.032(-0.041,-0.023)
|
<0.001
|
-0.015(-0.025,-0.004)
|
0.001
|
language
|
-0.031(-0.038,-0.024)
|
<0.001
|
-0.006(-0.013,0.000)
|
0.062
|
Speech PTA
|
|
|
|
|
MMSE
|
-0.165(-0.193,-0.137)
|
<0.001
|
-0.055(-0.082,-0.027)
|
<0.001
|
time
|
-0.027(-0.033,-0.020)
|
<0.001
|
-0.005(-0.012,0.003)
|
0.110
|
place
|
-0.026(-0.032,-0.020)
|
<0.001
|
-0.010(-0.017,-0.003)
|
0.003
|
registration
|
-0.012(-0.015,-0.008)
|
<0.001
|
-0.007(-0.012,-0.003)
|
0.003
|
recall
|
-0.021(-0.028,-0.014)
|
<0.001
|
-0.009(-0.018,-0.000)
|
0.053
|
attention/calculation
|
-0.040(-0.050,-0.030)
|
<0.001
|
-0.016(-0.028,-0.004)
|
0.003
|
language
|
-0.039(-0.047,-0.031)
|
<0.001
|
-0.007(-0.014,0.001)
|
0.117
|
Note: PTA, pure-tone average; High PTA was defined as pure tone average of the threshold at 4, and 8 kHz in the better ear; Speech PTA was defined as pure tone average of the threshold at 0.5, 1, 2, and 4 kHz in the better ear.
Model 1: unadjusted.
Model 2: adjusted for age, BMI, marital status, living alone, monthly income, education, drinking, smoking, IPAQ, ADL, IADL, diabetes, hypertension, hyperlipidemia, and stroke.