Sensory impairments and cognition in a diverse cohort: Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study

Abstract

AbstractBackgroundSensory impairments have been associated with poor cognition in primarily non‐Latino White cohorts. We used the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study to examine racial/ethnic differences in the association between sensory impairments and cognition.MethodKHANDLE includes diverse, community‐dwelling adults ages 65+ living in North California and aims to evaluate how race/ethnicity influence brain health. Analysis included 1,623 Asian (24%), Black (26%), Latino (18%), and White (32%) individuals. Participants rated their hearing and vision and were classified as impaired (self‐report of “Fair” or “Poor”) or not impaired (“Excellent,” “Very Good,” or “Good”) in hearing, vision, or both. Cognition was measured using the Spanish and English Neuropsychological Assessment Scales (SENAS). Cognitive test scores for executive function, semantic memory, and verbal episodic memory were z‐standardized and averaged for a global z‐score. Linear regression was used to estimate the associations between sensory impairments and cognition, adjusted for age, gender, race, education, income, waist circumference, physical activity, alcohol consumption, and ever smoking tobacco. Race/ethnicity interaction terms were tested.ResultParticipants had a mean age of 76 (SD=7). Whites (23.9%) were the most likely to report hearing impairment followed by Latinos (19.4%), Asians (18.0%), and Blacks (11.6%). Latinos (13.2%) were the most likely to report vision impairment followed by Blacks (12.5%), Asians (10.3%), and Whites (8.6%). Blacks (16.0%) were the most likely to report concurrent vision and hearing impairment followed by Latinos (11.8%), Asians (11.3%), and Whites (9.8%). Associations between sensory impairments and cognition did not differ by race/ethnicity. Associations remained consistent across the cognitive domains but were strongest for semantic memory. Hearing impairment was not associated with global cognition [β(95% CI):‐0.04(‐0.12, 0.05)]. Participants with visual impairments had worse global cognition than those without visual impairment [β:‐0.18(‐0.27, ‐0.09)]. Compared to those with no impairments, global cognition did not differ for participants with one impairment [β:‐0.03(‐0.12, 0.05)], but was significantly worse in those with dual sensory impairments [β:‐0.20(‐0.33, ‐0.08)].ConclusionWe found no racial/ethnic differences in the association between sensory impairments and cognition. Self‐reported vision impairment was associated with poor cognition, but self‐reported hearing impairment was not.