청력기능이 저하된 노인에게서 보청기 사용과 인지기능의 연관성
The Association of Hearing Aid Use With Cognitive Function in Hearing-Impaired Older Adults
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초록
본 연구는 2023년 노인실태조사(복합표본)를 활용해 청력 저하를 지닌 65세 이상 2,089명을 대상으로 보청기 사용과 인지기능(K-MMSE2)의 관련성을 살펴보았다. 이 가운데 보청기 사용자는 508명(26.6%)이었다. 설계기반 χ² 검정과 복합표본 로지스틱 회귀로 성별·연령·교육·소득·취업·운동·고혈압·당뇨·우울증을 통제했다. 그 결과 ‘불편한 편’(n=1,854) 에서는 보청기 사용이 정상 인지와 유의한 양의 관련을 보였다(OR=1.47, 95% CI 1.04-2.09; χ²=4.852, p=0.0306). 반면 ‘매우 불편’(n=235)한 집단에서는 유의하지 않았다(OR=1.11, 95% CI 0.51-2.38). 평소 운동 여부는 보호요인으로, 고혈압·우울증은 위험요인으로 나타났다. 단면 설계와 자기보고 측정의 제약에도, 초기 난청 단계에서의 조기 보급과 순응도· 청력기능재활을 통합한 지원의 필요성을 시사한다.
Abstract
This study examined whether hearing-aid use is associated with cognitive status among older adults with hearing difficulty. Using the nationally representative 2023 National Survey of Older Koreans, we analyzed 2,089 respondents aged 65 and over who reported hearing difficulty (“somewhat difficult,” n = 1,854; or “very difficult,” n = 235); 508 (24.3%) used hearing aids. Cognitive impairment was defined as K-MMSE-2 < 24. We applied design‑based chi‑square tests and complex‑sample logistic regression controlling for sex, age, education, household income quintile, employment, physical activity, hypertension, diabetes, and depression; multicollinearity was minimal (VIF<5). Among those with “somewhat” difficulty (n=1,854), hearing‑aid use was associated with higher odds of normal cognition (OR=1.525, 95% CI 1.058–2.199; χ²=4.852, p=0.0276). Among those with “very” difficulty (n=235), the association was null (OR=1.013, 95% CI 0.441–2.327). In the “somewhat” group, regular exercise was protective (OR=1.537, 95% CI 1.171–2.016), whereas hypertension (OR=0.714, 95% CI 0.525–0.971) and depression (OR=0.364, 95% CI 0.187–0.711) were associated with impairment; in the “very” group, female sex, older age, and lower education predicted impairment. As a cross‑sectional analysis relying on self‑reported hearing and without data on fitting or adherence, causal inference is limited. Even so, the pattern suggests that early identification and timely provision of hearing aids—paired with adherence support and aural rehabilitation—may help preserve cognition in older Koreans.