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Sensory impairments and subjective cognition (Smith et al., 2022)

posted on 2022-11-08, 22:16 authored by Jason R. Smith, Joshua F. Betz, Emmanuel E. Garcia, Kening Jiang, Bonnielin K. Swenor, Nicholas S. Reed, Jennifer A. Deal

Purpose: Subjective cognitive complaints (SCCs) are associated with poor quality of life, important for clinical care planning and management, and may predict dementia diagnosis. Dual sensory impairment (DSI) is a risk factor for dementia, but whether DSI is associated with SCCs is unknown. We evaluated whether self-reported DSI is associated with SCCs.

Method: We performed a cross-sectional analysis of 9,899 community-dwelling respondents aged 60+ years without dementia or depression in the 2019 National Health Interview Survey. Participants self-reported difficulty remembering or concentrating, seeing even when wearing corrective lenses, and hearing even when using a hearing aid. We defined SCCs and sensory impairment for each mode as reporting at least some difficulty. We categorized sensory impairment into no sensory impairment, vision impairment only, hearing impairment only, and DSI. We then estimated weighted prevalence ratios (PRs) of SCCs by impairment category.

Results: After weighting (9,899 participants representing a weighted n = 59,261,749), 12% of participants reported vision impairment only, 19% reported hearing impairment only, and 7% reported DSI. Relative to no impairment, after adjustment for potential confounders, vision impairment (PR = 2.07; 95% confidence interval [CI] [1.79, 2.39]), hearing impairment (PR = 2.26; 95% CI [2.00, 2.55]), and DSI (PR = 3.21; 95% CI [2.83, 3.63]) were associated with an increased prevalence of SCCs.

Conclusions: In this nationally representative survey of older Americans, DSI was associated with a threefold increased prevalence of SCCs. Although cross-sectional, these data underscore the importance of assessing multiple impairments as exposures when studying subjective cognition in older adults.

Supplemental Material S1. Description of variables derived from questions in the 2019 NHIS.

Supplemental Material S2. Interaction between impairment status and age category on subjective cognitive complaints among eligible participants in the 2019 NHIS.

Supplemental Material S3. Prevalence ratio of subjective cognitive complaints by impairment status after restricting sample to participants aged 60-85 years in the 2019 NHIS. 

Smith, J. R., Betz, J. F., Garcia, E. E., Jiang, K., Swenor, B. K., Reed, N. S., & Deal, J. A. (2022). Self-reported dual sensory impairment and subjective cognitive complaints among older adults in the 2019 National Health Interview Survey. American Journal of Audiology. Advance online publication.


This work was supported by the National Institutes of Health (Grants K01AG052640 [B.K.S.], K23AG065443 [N.S.R.], and K01AG054693 [J.A.D.]).