Influence of Sensory Impairments on Incidence of Dementia in the Korean Population

Abstract

Objective: Previous studies have shown the influence of visual and auditory sensory impairment on dementia incidence. In this study, we tested the hypothesis that the incidence of dementia will increase with visual and auditory impairments than with visual or auditory impairment.

Methods: Data from the Korea National Health Insurance Service database were used, including disease and medication codes from 2009 to 2018, and the 2011 national health check-up results. Participants were grouped based on their sensory abilities: normal, visual impairment, auditory impairment, and both visual and auditory impairments (dual sensory impairment). To compare the incidence of dementia, hazard ratios were calculated for each group, with reference to the normal sensory (NS) group. Sensitivity analyses were performed comparing dementia incidence from 2014 to 2018, excluding the onset of the disease in 2012 and 2013.

Results: We identified 8,289 cases of dementia during the seven-year follow-up. In the multiple Cox regression analysis, adjusted for sex, social economic status, age, comorbidities, smoking, alcohol consumption, and activity level, the auditory impairment (hazard ratio= 1.1908) and visual impairment (hazard ratio=1.3553) groups showed a significantly higher dementia incidence than the NS group. Dual sensory impairment (hazard ratio=1.5267) showed the highest incidence. The sensitivity analysis yielded similar results.

Conclusion: Visual and auditory impairments are associated with an increased risk of dementia, particularly in individuals with dual sensory impairment. Hence, visual and auditory impairments might have increased the risk of dementia through independent pathological processes. Therefore, preventing and correcting sensory impairment is necessary to reduce the risk of dementia.

Keywords: Dementia; Korea; Nationwide study; Sensory impairment; Visual and auditory impairment.

Figure 1.

Flow chart of the study. ASI, auditory sensory impairment; VSI, visual sensory impairment; DSI, dual sensory impairment; PSM, propensity score matching; SES, socioeconomic status.

Figure 2.

Cox regression plot. Adjusted with sex, SES, age, comorbidity, smoking, alcohol, and activity. NS, normal sensory; ASI, auditory sensory impairment; VSI, visual sensory impairment; DSI, dual sensory impairment; SES, socioeconomic status.