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Article(id=1311350496154186591, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202510241, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1760976000000, receivedDateStr=2025-10-21, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579921996, onlineDateStr=2026-09-28, pubDate=1787587200000, pubDateStr=2026-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579921996, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579921996, creator=13701087609, updateTime=1790579921996, updator=13701087609, issue=Issue{id=1311350363295417204, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='16', pageStart='2881', pageEnd='3072', issueExtLink='null', onlineDate='null', pubDate='1787587200000', pubDateStr='2026-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1790579890321, creator='13701087609', updateTime=1790584112451, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311368072267653663, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311368072267653664, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2962, endPage=2968, ext={EN=ArticleExt(id=1311350496359707488, articleId=1311350496154186591, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Effects of the number of teeth and hearing difficulty on mild cognitive impairment among the elderly people, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the association of teeth number and hearing difficulty with mild cognitive impairment (MCI) among community-dwelling older adults (≥60 years) in Henan Province, and to analyze their independent and joint effects on MCI.

Methods

Data were obtained from the 2023 Henan Healthy Aging Survey, which used a multistage stratified probability-proportional-to-size (PPS) sampling method to recruit 9 180 residents aged ≥60 years across 17 cities in Henan Province. Information was collected via questionnaires, physical examinations, and biochemical tests. Weighted multivariate logistic regression models were used to analyze the independent effects of tooth number and hearing difficulty on MCI. Multiplicative and additive interactions between the two factors were assessed using the multiplicative interaction term, along with relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI).

Results

Among 9 147 older adults, totally 24.6% was with MCI. The results revealed a significant association between the number of teeth and MCI. Compared to older adults with <10 teeth, those with more teeth had successively lower odds of MCI: 10-19 teeth (OR=0.76, 95%CI:0.60-0.95,P=0.015), 20-27 teeth (OR=0.71, 95%CI=0.58-0.88,P=0.001), and ≥28 teeth (OR=0.66, 95%CI: 0.53-0.83,P<0.001). Hearing difficulty was also significantly associated with MCI. Compared to older adults without hearing difficulties, those with hearing difficulties have a higher likelihood of developing MCI, with this association being more pronounced in individuals with bilateral hearing difficulties (unilateral: OR=1.41, 95%CI: 1.15-1.75,P=0.001; bilateral: OR=1.78, 95%CI: 1.50-2.11,P<0.001). The interaction results showed that there was no multiplicative interaction between the number of teeth and hearing difficulty on MCI (OR=0.83, 95%CI: 0.62-1.11,P=0.203), nor an additive interaction (RERI, API, and SI of the interaction were -0.17 (95%CI:-0.56-0.21), -0.09(95%CI: -0.29-0.10), 0.83 (95%CI: 0.60-1.26), respectively).

Conclusion

Maintaining more teeth and no hearing difficulty contributed to improve cognitive function. It is recommended to conduct simultaneous screening for oral and hearing health, enhance health education and encourage regular check among the elderly population, and the inclusion of early screening in basic public health services is recommended for decelerating the progression of cognitive decline.

, authors=Hui LI1, Han-xue ZHANG1, Shu-xian YANG1, Lei FAN1, Yan GAO1, Jian-bin LI2, Yan HUANG3, Kai KANG1, Lin-qi DIAO1, authorsList=Hui LI, Han-xue ZHANG, Shu-xian YANG, Lei FAN, Yan GAO, Jian-bin LI, Yan HUANG, Kai KANG, Lin-qi DIAO, authorCompany=null, correspAuthors=Lin-qi DIAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350498792403815, articleId=1311350496154186591, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=牙齿数量与听力困难对老年人轻度认知功能障碍的影响研究, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

分析河南省≥60岁社区老年人牙齿数量、听力困难与轻度认知功能障碍（Mild Cognitive Impairment，MCI）的独立及共同影响。

方法

数据来源于2023年河南省健康老龄化水平调查，采用多阶段分层概率成比例的抽样方法在全省17个省辖市抽取9 180名≥60岁常住老年人，通过问卷调查、体格检查及生化检测获取健康相关信息。采用基于权重的多因素logistic回归模型，分别分析牙齿数量、听力困难对MCI的独立作用；通过相乘交互项及相对超额危险度（RERI）、归因百分比（API）、协同指数（SI）评估二者的相乘与相加交互作用。

结果

9 147名老年人中，MCI的比例占24.6%。与0颗牙齿的老年人相比，10~19颗、20~27颗、≥28颗牙齿的老年人患MCI的可能性随之降低（OR=0.76，95%CI：0.60~0.95，P=0.015；OR=0.71，95%CI：0.58~0.88，P=0.001；OR=0.66，95%CI：0.53~0.83，P<0.001）。与无听力困难的老年人相比，有听力困难的老年人患MCI的可能性更高，这种关联在双侧听力困难者中更为明显（单侧：OR=1.41，95%CI：1.15~1.75，P=0.001；双侧：OR=1.78，95%CI：1.50~2.11，P<0.001）。交互作用结果显示，牙齿数量与听力困难对MCI无相乘交互作用(OR=0.83，95%CI：0.62~1.11，P=0.203)，也无相加交互作用：相对超额危险度(relative excess risk of interaction，RERI)、归因百分比(attributable proportion of interaction，API)、协同指数(synergy index，SI)分别为-0.17(95%CI：-0.56~0.21)、-0.09(95%CI：-0.29~0.10)、0.83(95%CI：0.60~1.26))。

结论

保持较多牙齿和无听力困难有助于改善认知功能。建议在公共卫生实践中对老年人开展常规口腔与听力筛查及并行干预，加强健康教育，鼓励定期检查，并将早期筛查纳入基本公共卫生服务，以延缓认知衰退。

, authors=李卉1, 张寒雪1, 杨淑显1, 范雷1, 高焱1, 李建彬2, 黄艳3, 康锴1, 刁琳琪1, authorsList=李卉, 张寒雪, 杨淑显, 范雷, 高焱, 李建彬, 黄艳, 康锴, 刁琳琪, authorCompany=null, correspAuthors=刁琳琪, authorNote=

李卉（1993—），女，硕士，主管医师，研究方向：老年人慢性流行病学

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刁琳琪，E-mail：
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李卉（1993—），女，硕士，主管医师，研究方向：老年人慢性流行病学

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李卉（1993—），女，硕士，主管医师，研究方向：老年人慢性流行病学

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Front Aging Neurosci, 2019, 11(5): 97., articleTitle=Cingulate cortex atrophy is associated with hearing loss in presbycusis with cochlear amplifier dysfunction, refAbstract=null)], funds=[Fund(id=1311350505335518133, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, awardId=252102311008, language=CN, fundingSource=河南省科技攻关项目(252102311008), fundOrder=null, country=null), Fund(id=1311350505394238390, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, awardId=HNCDCZD20250102; HNCDCYC202547, language=CN, fundingSource=河南省疾病预防控制中心科技攻关专项计划(HNCDCZD20250102; HNCDCYC202547), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1311350499010507624, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, xref=1., ext=[AuthorCompanyExt(id=1311350499027284841, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, companyId=1311350499010507624, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute for Chronic Non-communicable Disease Prevention and Control, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China), AuthorCompanyExt(id=1311350499039867754, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, companyId=1311350499010507624, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.河南省疾病预防控制中心慢性非传染性疾病防治研究所，河南 郑州 450016)]), AuthorCompany(id=1311350499098588011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, xref=2., ext=[AuthorCompanyExt(id=1311350499111170924, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, companyId=1311350499098588011, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.郑州市疾病预防控制中心)]), AuthorCompany(id=1311350499182474093, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, xref=3., ext=[AuthorCompanyExt(id=1311350499190862702, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, companyId=1311350499182474093, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.洛阳市疾病预防控制中心)])], figs=[ArticleFig(id=1311350503762654119, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Fig.1, caption=The association of the number of teeth and MCI, figureFileSmall=L/p6RoBzx/Re0eN0gBc3zA==, figureFileBig=sQ+P0FYvlW/tU+KrKZX63Q==, tableContent=null), ArticleFig(id=1311350503884288936, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=图1, caption=牙齿数量与MCI的关系, figureFileSmall=L/p6RoBzx/Re0eN0gBc3zA==, figureFileBig=sQ+P0FYvlW/tU+KrKZX63Q==, tableContent=null), ArticleFig(id=1311350504085615529, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Fig.2, caption=The association of hearing difficulty and MCI, figureFileSmall=0Ap6CzH1/Jaquiod69E44A==, figureFileBig=HX12SH5iwjsYJoHv5gjWog==, tableContent=null), ArticleFig(id=1311350504333079466, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=图2, caption=听力困难与MCI的关系, figureFileSmall=0Ap6CzH1/Jaquiod69E44A==, figureFileBig=HX12SH5iwjsYJoHv5gjWog==, tableContent=null), ArticleFig(id=1311350504400188331, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Table 1, caption=

The distribution of the score of MMSE scale in different characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群MMSE得分P值
<25%
分位数		25%~75%
分位数		>75%
分位数
合计9 147（100.0）1 936（21.2）4 771（52.2）2 440（26.7）
性别<0.001
男4 343(47.5)600(31.0)2 273(47.6)1 470(60.2)
女4 804(52.5)1 336(69.0）2 498(52.4)970(39.8)
年龄(岁)69.4(65.6,74.4)72.2(1.0,79.4)69.3(2.0,74.0)67.8(3.0,72.1)<0.001
城乡<0.001
城市2 022(22.1)311(16.1)956(20.0)755(30.9)
农村7 125(77.9)1 625(83.9)3 815(80.0)1 685(69.1)
民族0.110
汉族9 013(98.5)1 915(98.9)4 703(98.6)2 395(98.2)
其他民族134(1.5)21(1.1)68(1.4)45(1.8)
教育程度<0.001
文盲2 547(27.8)1 274(65.8)1 182(24.8)91(3.7)
小学2 937(32.1)538(27.8)1 790(37.5)609(25.0)
初中及以上3 663(40.0)124(6.4)1 799(37.7)1 740(71.3)
经济水平<0.001
低1 573(17.2)474(24.5)855(17.9)244(10.0)
中3 481(38.1)558(28.8)1 876(39.3)1 047(42.9)
高1 346(14.7)73(3.8)621(13.0)652(26.7)
婚姻状况<0.001
已婚7 338(80.2)1 383(71.4)3 857(80.8)2 098(86.0)
其他（未婚/同居/丧偶/离婚/分居）1 809(19.8)553(28.6)914(19.2)342(14.0)
高血压<0.001
是7 000(76.6)1 553(80.3)3 671(77.0)1 776(72.8)
否2 139(23.4)382(19.7)1 094(23.0)663(27.2)
糖尿病0.005
是3 296(38.8)743(41.7)1 659(37.4)894(39.5)
否5 188(61.2)1 040(58.3)2 781(62.6)1 367(60.5)
冠心病0.313
是1 314(14.4)261(13.5)709(14.9)344(14.1)
否7 833(85.6)1 675(86.5)4 062(85.1)2 096(85.9)
抑郁<0.001
是1 872(20.5)499(25.8)1 070(22.4)303(12.4)
否7 275(79.5)1 437(74.2)3 701(77.6)2 137(87.6)
BMI（Kg/m2）25.2(22.9,27.6)24.9(1.0,27.4)25.3(2.0,27.6)25.5(3.0,27.7)0.287
WC（cm）88.1(81.4,94.6)87.1(1.0,94.3)88.1(2.0,94.4)88.8(3.0,95.3)0.002
FPG(mmol/L)5.8(5.4,6.8)5.9(1.0,6.8)5.8(2.0,6.8)5.8(3.0,6.9)0.090
牙齿数（颗）<0.001
01 189(13.0)400(20.7)614(12.9)175(7.2)
1~91 494(16.4)455(23.6)767(16.1)272(11.2)
10~191 416(15.5)327(16.9)773(16.2)316(13.0)
20~272 909(31.9)466(24.1)1 518(31.9)925(38.1)
≥282 107(23.1)283(14.7)1 085(22.8)739(30.4)
听力困难<0.001
无6 988(76.4)1 275(65.9)3 681(77.2)2 032(83.3)
有（一耳）764(8.4)179(9.2)402(8.4)183(7.5)
有（两耳）1 395(15.3)482(24.9)688(14.4)225(9.2)
MCI<0.001
是2 253(24.6)1 511(78.0)742(15.6)0(0.0)
否6 894(75.4)425(22.0)4 029(84.4)2 440(100.0)
), ArticleFig(id=1311350504492463020, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=表1, caption=

不同特征老年人MMSE得分比较 ［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群MMSE得分P值
<25%
分位数		25%~75%
分位数		>75%
分位数
合计9 147（100.0）1 936（21.2）4 771（52.2）2 440（26.7）
性别<0.001
男4 343(47.5)600(31.0)2 273(47.6)1 470(60.2)
女4 804(52.5)1 336(69.0）2 498(52.4)970(39.8)
年龄(岁)69.4(65.6,74.4)72.2(1.0,79.4)69.3(2.0,74.0)67.8(3.0,72.1)<0.001
城乡<0.001
城市2 022(22.1)311(16.1)956(20.0)755(30.9)
农村7 125(77.9)1 625(83.9)3 815(80.0)1 685(69.1)
民族0.110
汉族9 013(98.5)1 915(98.9)4 703(98.6)2 395(98.2)
其他民族134(1.5)21(1.1)68(1.4)45(1.8)
教育程度<0.001
文盲2 547(27.8)1 274(65.8)1 182(24.8)91(3.7)
小学2 937(32.1)538(27.8)1 790(37.5)609(25.0)
初中及以上3 663(40.0)124(6.4)1 799(37.7)1 740(71.3)
经济水平<0.001
低1 573(17.2)474(24.5)855(17.9)244(10.0)
中3 481(38.1)558(28.8)1 876(39.3)1 047(42.9)
高1 346(14.7)73(3.8)621(13.0)652(26.7)
婚姻状况<0.001
已婚7 338(80.2)1 383(71.4)3 857(80.8)2 098(86.0)
其他（未婚/同居/丧偶/离婚/分居）1 809(19.8)553(28.6)914(19.2)342(14.0)
高血压<0.001
是7 000(76.6)1 553(80.3)3 671(77.0)1 776(72.8)
否2 139(23.4)382(19.7)1 094(23.0)663(27.2)
糖尿病0.005
是3 296(38.8)743(41.7)1 659(37.4)894(39.5)
否5 188(61.2)1 040(58.3)2 781(62.6)1 367(60.5)
冠心病0.313
是1 314(14.4)261(13.5)709(14.9)344(14.1)
否7 833(85.6)1 675(86.5)4 062(85.1)2 096(85.9)
抑郁<0.001
是1 872(20.5)499(25.8)1 070(22.4)303(12.4)
否7 275(79.5)1 437(74.2)3 701(77.6)2 137(87.6)
BMI（Kg/m2）25.2(22.9,27.6)24.9(1.0,27.4)25.3(2.0,27.6)25.5(3.0,27.7)0.287
WC（cm）88.1(81.4,94.6)87.1(1.0,94.3)88.1(2.0,94.4)88.8(3.0,95.3)0.002
FPG(mmol/L)5.8(5.4,6.8)5.9(1.0,6.8)5.8(2.0,6.8)5.8(3.0,6.9)0.090
牙齿数（颗）<0.001
01 189(13.0)400(20.7)614(12.9)175(7.2)
1~91 494(16.4)455(23.6)767(16.1)272(11.2)
10~191 416(15.5)327(16.9)773(16.2)316(13.0)
20~272 909(31.9)466(24.1)1 518(31.9)925(38.1)
≥282 107(23.1)283(14.7)1 085(22.8)739(30.4)
听力困难<0.001
无6 988(76.4)1 275(65.9)3 681(77.2)2 032(83.3)
有（一耳）764(8.4)179(9.2)402(8.4)183(7.5)
有（两耳）1 395(15.3)482(24.9)688(14.4)225(9.2)
MCI<0.001
是2 253(24.6)1 511(78.0)742(15.6)0(0.0)
否6 894(75.4)425(22.0)4 029(84.4)2 440(100.0)
), ArticleFig(id=1311350504731538349, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Table 2, caption=

Sensitivity analysis of the associations of tooth number and hearing difficulty with MCI

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1OR (95%CI)模型2OR(95%CI)
牙齿数量（颗）
01.00 (Ref)1.00 (Ref)
1~90.83（0.68~1.02）0.87（0.71~1.07）
10~190.61（0.50~0.76）0.69（0.56~0.86）
20~270.48（0.40~0.57）0.60（0.50~0.73）
≥280.41（0.34~0.50）0.53（0.43~0.65）
听力困难
无1.00(Ref)1.00(Ref)
有（一耳）1.49（1.22~1.84）1.39（1.13~1.70）
有（双耳）2.25（1.93~2.61）1.92（1.64~2.24）
), ArticleFig(id=1311350504807035822, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=表2, caption=

牙齿数量、听力困难与MCI关系的敏感性分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型1OR (95%CI)模型2OR(95%CI)
牙齿数量（颗）
01.00 (Ref)1.00 (Ref)
1~90.83（0.68~1.02）0.87（0.71~1.07）
10~190.61（0.50~0.76）0.69（0.56~0.86）
20~270.48（0.40~0.57）0.60（0.50~0.73）
≥280.41（0.34~0.50）0.53（0.43~0.65）
听力困难
无1.00(Ref)1.00(Ref)
有（一耳）1.49（1.22~1.84）1.39（1.13~1.70）
有（双耳）2.25（1.93~2.61）1.92（1.64~2.24）
), ArticleFig(id=1311350504882533295, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Table 3, caption=

The multiplicative interaction between the number of teeth and hearing difficulty on MCI

, figureFileSmall=null, figureFileBig=null, tableContent=
参数β值SEWald χ2值OR值（95%CI）P值
听力困难0.6030.1165.211.83(1.46~2.29)<0.001
牙齿数量<21颗0.2640.0813.271.30(1.11~1.52)0.001
听力困难×牙齿数量<21颗-0.1870.146-1.270.83(0.62~1.11)0.203
年龄0.3170.0506.321.37(1.24~1.51)<0.001
性别0.0970.0861.131.10(0.93~1.30)0.261
城乡-0.2550.108-2.360.78(0.63~0.96)0.018
民族0.4610.2731.691.59(0.93~2.71)0.091
教育程度-0.1860.046-4.040.83(0.76~0.91)<0.001
经济水平<0.001<0.0016.391.00(1.00~1.00)<0.001
婚姻状况-0.0200.083-0.240.98(0.83~1.15)0.814
吸烟-0.0530.010-5.290.95(0.93~0.97)<0.001
饮酒0.0030.0021.511.00(1.00~1.01)0.130
身体活动0.0010.0010.671.00(1.00~1.00)0.505
睡眠不足-0.0020.001-2.021.00(1.00~1.00)0.044
添加糖摄入量0.0000.0010.461.00(1.00~1.00)0.645
BMI-0.0030.088-0.041.00(0.84~1.18)0.972
WC-0.0050.003-1.711.00(0.99~1.00)0.087
抑郁0.0020.0012.121.00(1.00~1.00)0.034
高血压0.0010.0011.711.00(1.00~1.00)0.087
糖尿病<0.0010.0010.161.00(1.00~1.00)0.869
冠心病-0.0020.001-1.981.00(1.00~1.00)0.048
), ArticleFig(id=1311350504966419376, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=表3, caption=

牙齿数量与听力困难对MCI的相乘交互作用

, figureFileSmall=null, figureFileBig=null, tableContent=
参数β值SEWald χ2值OR值（95%CI）P值
听力困难0.6030.1165.211.83(1.46~2.29)<0.001
牙齿数量<21颗0.2640.0813.271.30(1.11~1.52)0.001
听力困难×牙齿数量<21颗-0.1870.146-1.270.83(0.62~1.11)0.203
年龄0.3170.0506.321.37(1.24~1.51)<0.001
性别0.0970.0861.131.10(0.93~1.30)0.261
城乡-0.2550.108-2.360.78(0.63~0.96)0.018
民族0.4610.2731.691.59(0.93~2.71)0.091
教育程度-0.1860.046-4.040.83(0.76~0.91)<0.001
经济水平<0.001<0.0016.391.00(1.00~1.00)<0.001
婚姻状况-0.0200.083-0.240.98(0.83~1.15)0.814
吸烟-0.0530.010-5.290.95(0.93~0.97)<0.001
饮酒0.0030.0021.511.00(1.00~1.01)0.130
身体活动0.0010.0010.671.00(1.00~1.00)0.505
睡眠不足-0.0020.001-2.021.00(1.00~1.00)0.044
添加糖摄入量0.0000.0010.461.00(1.00~1.00)0.645
BMI-0.0030.088-0.041.00(0.84~1.18)0.972
WC-0.0050.003-1.711.00(0.99~1.00)0.087
抑郁0.0020.0012.121.00(1.00~1.00)0.034
高血压0.0010.0011.711.00(1.00~1.00)0.087
糖尿病<0.0010.0010.161.00(1.00~1.00)0.869
冠心病-0.0020.001-1.981.00(1.00~1.00)0.048
), ArticleFig(id=1311350505037722545, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Table 4, caption=

Cross tabulation of MCI by the number of teeth and hearing difficulty

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR值 95%CIP值
牙齿数量≥21颗且无听力困难1.00
牙齿数量≥21颗且有听力困难1.37(1.12~1.68)0.002
牙齿数量<21颗且无听力困难1.65(1.23~2.20)0.001
牙齿数量<21颗且有听力困难1.85(1.45~2.37)<0.001
年龄1.47(1.30~1.66)<0.001
性别1.07(0.86~1.32)0.545
城乡0.82(0.63~1.07)0.143
民族1.26(0.69~2.31)0.454
教育程度0.88(0.78~0.98)0.020
经济水平1.00(1.00~1.00)<0.001
婚姻状况1.01(0.82~1.24)0.921
吸烟0.94(0.92~0.96)<0.001
饮酒1.00(1.00~1.01)0.168
身体活动1.00(1.00~1.00)0.695
睡眠不足1.00(1.00~1.00)0.053
添加糖摄入量1.00(1.00~1.00)0.714
BMI0.97(0.78~1.21)0.797
WC1.00(0.99~1.00)0.284
抑郁1.00(1.00~1.00)0.139
高血压1.00(1.00~1.00)0.130
糖尿病1.00(1.00~1.00)0.621
冠心病1.00(1.00~1.00)0.384
), ArticleFig(id=1311350505100637106, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=表4, caption=

牙齿数量与听力困难对MCI的交叉分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量OR值 95%CIP值
牙齿数量≥21颗且无听力困难1.00
牙齿数量≥21颗且有听力困难1.37(1.12~1.68)0.002
牙齿数量<21颗且无听力困难1.65(1.23~2.20)0.001
牙齿数量<21颗且有听力困难1.85(1.45~2.37)<0.001
年龄1.47(1.30~1.66)<0.001
性别1.07(0.86~1.32)0.545
城乡0.82(0.63~1.07)0.143
民族1.26(0.69~2.31)0.454
教育程度0.88(0.78~0.98)0.020
经济水平1.00(1.00~1.00)<0.001
婚姻状况1.01(0.82~1.24)0.921
吸烟0.94(0.92~0.96)<0.001
饮酒1.00(1.00~1.01)0.168
身体活动1.00(1.00~1.00)0.695
睡眠不足1.00(1.00~1.00)0.053
添加糖摄入量1.00(1.00~1.00)0.714
BMI0.97(0.78~1.21)0.797
WC1.00(0.99~1.00)0.284
抑郁1.00(1.00~1.00)0.139
高血压1.00(1.00~1.00)0.130
糖尿病1.00(1.00~1.00)0.621
冠心病1.00(1.00~1.00)0.384
), ArticleFig(id=1311350505176134579, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=EN, label=Table 5, caption=

Evaluation indicators of the additive interaction between the number of teeth and hearing difficulty on MCI

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评价指标OR(95%CI)
RERI(95%CI)-0.17(-0.56~0.21)
API(95%CI)-0.09(-0.29~0.10)
SI(95%CI)0.83(0.60~1.26)
), ArticleFig(id=1311350505243243444, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350496154186591, language=CN, label=表5, caption=

牙齿数量与听力困难对MCI的相加交互作用评价指标

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评价指标OR(95%CI)
RERI(95%CI)-0.17(-0.56~0.21)
API(95%CI)-0.09(-0.29~0.10)
SI(95%CI)0.83(0.60~1.26)
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牙齿数量与听力困难对老年人轻度认知功能障碍的影响研究
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李卉 1 , 张寒雪 1 , 杨淑显 1 , 范雷 1 , 高焱 1 , 李建彬 2 , 黄艳 3 , 康锴 1 , 刁琳琪 1
现代预防医学 | 基层卫生服务 2026,53(16): 2962-2968
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现代预防医学 |基层卫生服务 2026 , 53 (16) : 2962 -2968
牙齿数量与听力困难对老年人轻度认知功能障碍的影响研究
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李卉1, 张寒雪1, 杨淑显1, 范雷1, 高焱1, 李建彬2, 黄艳3, 康锴1, 刁琳琪1
作者信息
  • 1.河南省疾病预防控制中心慢性非传染性疾病防治研究所，河南 郑州 450016
  • 2.郑州市疾病预防控制中心
  • 3.洛阳市疾病预防控制中心
通讯作者:
刁琳琪，E-mail：
作者简介:

李卉（1993—），女，硕士，主管医师，研究方向：老年人慢性流行病学

Effects of the number of teeth and hearing difficulty on mild cognitive impairment among the elderly people
Hui LI1, Han-xue ZHANG1, Shu-xian YANG1, Lei FAN1, Yan GAO1, Jian-bin LI2, Yan HUANG3, Kai KANG1, Lin-qi DIAO1
Affiliations
  • Institute for Chronic Non-communicable Disease Prevention and Control, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan 450016, China
出版时间: 2026-08-25 doi: 10.20043/j.cnki.MPM.202510241
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摘要
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目的

分析河南省≥60岁社区老年人牙齿数量、听力困难与轻度认知功能障碍（Mild Cognitive Impairment，MCI）的独立及共同影响。

方法

数据来源于2023年河南省健康老龄化水平调查，采用多阶段分层概率成比例的抽样方法在全省17个省辖市抽取9 180名≥60岁常住老年人，通过问卷调查、体格检查及生化检测获取健康相关信息。采用基于权重的多因素logistic回归模型，分别分析牙齿数量、听力困难对MCI的独立作用；通过相乘交互项及相对超额危险度（RERI）、归因百分比（API）、协同指数（SI）评估二者的相乘与相加交互作用。

结果

9 147名老年人中，MCI的比例占24.6%。与0颗牙齿的老年人相比，10~19颗、20~27颗、≥28颗牙齿的老年人患MCI的可能性随之降低（OR=0.76，95%CI：0.60~0.95，P=0.015；OR=0.71，95%CI：0.58~0.88，P=0.001；OR=0.66，95%CI：0.53~0.83，P<0.001）。与无听力困难的老年人相比，有听力困难的老年人患MCI的可能性更高，这种关联在双侧听力困难者中更为明显（单侧：OR=1.41，95%CI：1.15~1.75，P=0.001；双侧：OR=1.78，95%CI：1.50~2.11，P<0.001）。交互作用结果显示，牙齿数量与听力困难对MCI无相乘交互作用(OR=0.83，95%CI：0.62~1.11，P=0.203)，也无相加交互作用：相对超额危险度(relative excess risk of interaction，RERI)、归因百分比(attributable proportion of interaction，API)、协同指数(synergy index，SI)分别为-0.17(95%CI：-0.56~0.21)、-0.09(95%CI：-0.29~0.10)、0.83(95%CI：0.60~1.26))。

结论

保持较多牙齿和无听力困难有助于改善认知功能。建议在公共卫生实践中对老年人开展常规口腔与听力筛查及并行干预，加强健康教育，鼓励定期检查，并将早期筛查纳入基本公共卫生服务，以延缓认知衰退。

老年人  /  牙齿数量  /  听力困难  /  轻度认知功能障碍  /  交互作用
Objective

To investigate the association of teeth number and hearing difficulty with mild cognitive impairment (MCI) among community-dwelling older adults (≥60 years) in Henan Province, and to analyze their independent and joint effects on MCI.

Methods

Data were obtained from the 2023 Henan Healthy Aging Survey, which used a multistage stratified probability-proportional-to-size (PPS) sampling method to recruit 9 180 residents aged ≥60 years across 17 cities in Henan Province. Information was collected via questionnaires, physical examinations, and biochemical tests. Weighted multivariate logistic regression models were used to analyze the independent effects of tooth number and hearing difficulty on MCI. Multiplicative and additive interactions between the two factors were assessed using the multiplicative interaction term, along with relative excess risk of interaction (RERI), attributable proportion of interaction (API), and synergy index (SI).

Results

Among 9 147 older adults, totally 24.6% was with MCI. The results revealed a significant association between the number of teeth and MCI. Compared to older adults with <10 teeth, those with more teeth had successively lower odds of MCI: 10-19 teeth (OR=0.76, 95%CI:0.60-0.95,P=0.015), 20-27 teeth (OR=0.71, 95%CI=0.58-0.88,P=0.001), and ≥28 teeth (OR=0.66, 95%CI: 0.53-0.83,P<0.001). Hearing difficulty was also significantly associated with MCI. Compared to older adults without hearing difficulties, those with hearing difficulties have a higher likelihood of developing MCI, with this association being more pronounced in individuals with bilateral hearing difficulties (unilateral: OR=1.41, 95%CI: 1.15-1.75,P=0.001; bilateral: OR=1.78, 95%CI: 1.50-2.11,P<0.001). The interaction results showed that there was no multiplicative interaction between the number of teeth and hearing difficulty on MCI (OR=0.83, 95%CI: 0.62-1.11,P=0.203), nor an additive interaction (RERI, API, and SI of the interaction were -0.17 (95%CI:-0.56-0.21), -0.09(95%CI: -0.29-0.10), 0.83 (95%CI: 0.60-1.26), respectively).

Conclusion

Maintaining more teeth and no hearing difficulty contributed to improve cognitive function. It is recommended to conduct simultaneous screening for oral and hearing health, enhance health education and encourage regular check among the elderly population, and the inclusion of early screening in basic public health services is recommended for decelerating the progression of cognitive decline.

Elderly  /  Teeth number  /  Hearing difficulty  /  Mild Cognitive impairment  /  Interaction
李卉, 张寒雪, 杨淑显, 范雷, 高焱, 李建彬, 黄艳, 康锴, 刁琳琪. 牙齿数量与听力困难对老年人轻度认知功能障碍的影响研究. 现代预防医学, 2026 , 53 (16) : 2962 -2968 . DOI: 10.20043/j.cnki.MPM.202510241
Hui LI, Han-xue ZHANG, Shu-xian YANG, Lei FAN, Yan GAO, Jian-bin LI, Yan HUANG, Kai KANG, Lin-qi DIAO. Effects of the number of teeth and hearing difficulty on mild cognitive impairment among the elderly people[J]. Modern Preventive Medicine, 2026 , 53 (16) : 2962 -2968 . DOI: 10.20043/j.cnki.MPM.202510241
正文
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随着全球人口老龄化加速，认知障碍带来的疾病负担日益严峻。痴呆已成为本世纪最重大的公共卫生挑战之一［1］。预计2050年，全球≥60岁人口达21亿，同期痴呆患者人数或将增长逾两倍，超过1.4亿人［2］。中国作为老年人口最多的国家［3］，阿尔茨海默病（痴呆最主要的类型）的患病率与死亡率迅速攀升，高居死因前列，给社会照护体系造成巨大压力［4-6］。
轻度认知功能障碍（Mild Cognitive Impairment，MCI）是正常衰老与痴呆之间的临床过渡状态，是痴呆的高危因素［7］。研究表明，15%的MCI患者会在两年内进展为痴呆［8］。鉴于痴呆目前难以治愈，在MCI阶段识别可干预危险因素并延缓其进展，已成为关键的防控策略。国内外研究发现，口腔健康（如牙齿缺失）与听力损失与认知功能下降显著关联［9-14］，但二者对MCI的联合效应尚不明确。因此，本研究基于2023年河南省健康老龄化水平调查数据，分析≥60岁老年人牙齿数量与听力困难对MCI的独立及交互作用，为制定多感官整合的早期干预策略提供科学依据。
1　资料与方法
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1.1　研究对象
本研究采用多阶段分层概率成比例（Probability-proportional-to-size，PPS）的抽样方法在全省17个省辖市抽取调查对象。第一阶段：根据城镇化率分别抽取城镇化率高的3个区和3个县、城镇化率低的6个区和5个县，共17个县区；第二阶段：每个抽中的县（区）采用与人口规模成比例（PPS）的整群抽样方法随机抽取3个乡镇/街道；第三阶段：每个乡镇/街道采用与人口规模成比例（PPS）的整群抽样方法随机抽取2个行政村/社区；第四阶段：每个抽中的行政村/社区采用简单随机抽样方法抽取≥60岁常住居民作为调查对象。本研究方案通过河南省疾病预防控制中心伦理委员会审查（2023-KY-006-02），所有调查对象均签署知情同意书。
1.2　样本量
样本量计算公式如下：
公式中，ɑ=0.05，u=1.96；参考国内研究，健康老龄化水平p取15.6%［15］；d为绝对容许误差，相对容许误差r=20%，d=20%×15.6%，设计效率deff=4，计算出每一层样本量为2 079人。根据河南省城镇化率水平分为4层，并考虑不超过10%的调查失访率，共需总样本量为9 148人。为便于分配，每个调查县/区抽取540人，总样本量为9 180人。
1.3　变量定义
1.3.1　MCI定义
采用中文版简易精神状况检查（Mini-mental State Examination，MMSE）量表评估MCI，该量表包括30道题目，涉及5个维度（定向力、即时回忆、注意力和计算力、延缓回忆、语言，理解和自我协调能力）［16］，得分从0到30，表示认知功能越来越强。考虑到量表得分与文化程度高度相关，因此文盲且得分≤17分、小学且得分≤20分、初中及以上且得分≤24分被定义为MCI［7］。
1.3.2　牙齿数量、听力困难分组
根据自报牙齿数量（不包括假牙）划分为五组：≥28颗、20~27颗、10~19颗、1~9颗、0颗［17］。根据自报是否有听力困难以及哪只耳朵有听力困难，分为无听力困难、一耳存在听力困难、两耳均存在听力困难。
1.3.3　协变量
①民族：汉族、其他民族。②教育程度：文盲、小学、初中及以上。③经济水平：根据家庭年收入划分为低（<5 000元/年）、中（5 000~50 000元/年）、高（>50 000元/年）。④婚姻状况：已婚、其他婚姻状态（未婚/同居/丧偶/离婚/分居）。⑤体质指数（Body Mass Index，BMI）=体重（Kg）/身高（m）2。⑥现在吸烟：每天都吸、不是每天都吸。⑦饮酒：过去12月内喝过酒。⑧身体活动：根据调查对象一周内参加的身体活动（高等、中等强度）及闲暇时娱乐活动的频率及持续时间，计算身体活动总时间，<150分钟/周定义为身体活动不足［18］。⑨睡眠不足：每天睡觉时间<6小时［19］。⑩添加糖摄入量：根据食物频率法问卷（Food Frequency Questionnaire，FFQ）获取调查对象过去一年里添加糖（白糖、红糖、糖果、巧克力等）的摄入频率及平均每次食用量，计算平均每天的摄入量。⑪高血压：收缩压≥140 mmHg和/或舒张压≥90 mmHg者，或已被乡镇（社区）及以上级别医院确诊为高血压且近2周服药者［20］。⑫糖尿病：空腹血糖≥7.0 mmol/L或餐后两小时血糖≥11.1 mmol/L者，或已被乡镇（社区）及以上级别医院诊断患有糖尿病者［21］。⑬冠心病：自报曾被县（区）级或以上级别医疗机构医生诊断为心绞痛或心肌梗死或房颤或做过心脏搭桥/支架手术。⑭抑郁：根据GDS-15量表，得分≥8分［22］。
1.4　调查方法
所有调查对象接受问卷调查、体格检查和实验室检测。
（1）问卷调查：均由经过统一培训的调查员采用集中或入户的方式进行面对面调查。问卷内容包括社会人口学信息、主要慢性病患病情况、生活方式及行为、饮食、抑郁状况、认知和躯体功能等。
（2）体格检查：包括身高、体重、腰围和血压。身高测量采用长度2.0 m，精确度0.1 cm的TZG型身高坐高计；体重及体成分采用智能体脂秤（华为3 Pro）测量；腰围（Waist circumference，WC）采用长度1.5 m、宽度1.5 cm、精确度为0.1 cm的火炬形腰围尺测量。血压测量采用欧姆龙血压计（HBP-1300/1320），测量调查者右侧手臂收缩压和舒张压，连续测量两次，间隔2分钟，取平均值。
（3）实验室检测：包括血常规、空腹血糖及餐后两小时血糖、血脂四项（TG/ TC/HDL-C/LDL-C）。所有结果均经过有资质的第三方检测公司出具。
1.5　统计学分析
采用SAS 9.4软件进行数据清理和分析，采用R 4.3.3软件绘制森林图。由于调查采用的复杂抽样，因此考虑了权重。定量资料采用M(Q1,Q3)表示，定性资料采用构成比(%)表示，组间差异采用方差分析或χ2检验。采用多因素logistic回归分别分析牙齿数量、听力困难与MCI的关系，所有模型均校正年龄、性别、城乡、民族、教育程度、经济水平、婚姻状况、吸烟、饮酒、身体活动不足、睡眠不足、添加糖摄入量、BMI、WC、抑郁、高血压、糖尿病及冠心病。对构建包含全部协变量的模型进行了多重共线性诊断，结果显示所有自变量的方差膨胀因子（VIF）均<5，表明共线性问题不严重。为评估年龄的混杂效应，采用比较模型1（未校正）、模型2（校正年龄）中效应估计值的变化进行敏感性分析。
采用相乘交互项和相加交互作用指标评估牙齿数量与听力困难对MCI的交互作用。将牙齿数量（按中位数二分类）与听力困难（是/否）作为哑变量纳入模型，采用相乘交互项评估相乘交互作用，校正的混杂因素同前。使用Bootstrap抽样方法计相对超额危险度(RERI)、归因百分比(API)、协同指数(SI)评估相加交互作用。公式计算：RERI=OR11-OR10-OR01+1；API=RERI/OR11；SI=(OR11-1)/(OR01-1)，其中，OR11为两种危险因素同时存在时的比值比，OR10、OR01分别为其中一个危险因素单独存在时的比值比，当RERI及API的95%CI不包含0且SI的95%CI不包含1时，表明两因素之间存在相加交互效应。双侧检验，检验水准α=0.05。
2　结果
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2.1　不同特征老年人MMSE得分比较
共9 147名有效调查对象纳入分析，年龄中位数为69.4岁，男性占47.5%。MCI筛查比例为24.6%，MMSE得分>75%分位数的共有2 440人（26.7%）。MMSE得分在不同性别、年龄、城乡、教育程度、经济水平、婚姻状况、高血压、糖尿病、抑郁、WC、牙齿数量及听力困难等特征方面的差异均有统计学意义（均P<0.05）。见表1。
2.2　牙齿数量、听力困难与MCI的关系
与0颗牙齿的老年人相比，10~19颗、20~27颗、≥28颗牙齿的老年人患MCI的可能性随之降低（OR=0.76，95%CI 0.60~0.95，P=0.015；OR=0.71，95%CI 0.58~0.88，P=0.001；OR=0.66，95%CI 0.53~0.83，P<0.001）。见图1。
与无听力困难的老年人相比，有听力困难的老年人患MCI的可能性更高，这种关联在双侧听力困难者中更为明显（双侧：OR=1.41，95%CI 1.15~1.75，P=0.001；单侧：OR=1.78，95%CI 1.50~2.11，P<0.001）。见图2。
敏感性分析结果显示，未校正年龄时，以0颗为参照，模型1中10~19颗、20~27颗、≥28颗的OR值（95%CI）分别为0.61（0.50~0.76）、0.48（0.40~0.57）、0.41（0.34~0.50）；模型2中相应OR值分别为0.69（0.56~0.86）、0.60（0.50~0.73）、0.53（0.43~0.65），提示年龄存在正向混杂作用，听力困难的分析结果呈现类似趋势。见表2。
2.3　牙齿数量与听力困难对MCI的相乘交互作用
校正混杂因素后，未发现牙齿数量和听力困难对MCI存在相乘交互作用(OR=0.83，95%CI 0.62~1.11，P=0.203)。见表3。
2.4　牙齿数量与听力困难对MCI的交叉分析
校正混杂因素后，与牙齿数量≥21颗且无听力困难的老年人相比，牙齿数量≥21颗且有听力困难、牙齿数量<21颗且无听力困难、牙齿数量<21颗且有听力困难的老年人发生MCI的风险分别增加了37%（OR=1.37，95%CI 1.12~1.68，P=0.002）、65%（OR=1.65，95%CI 1.23~2.20，P=0.001）和85%(OR=1.85，95%CI 1.12~1.68，P<0.001）。见表4。
2.5　牙齿数量与听力困难对MCI的相加交互作用
校正混杂因素后，牙齿数量与听力困难对MCI之间不存在相加交互作用，RERI、API、SI分别为-0.17(95%CI：-0.56~0.21)、-0.09(95%CI：0.29~0.10)、0.83(95%CI：0.60~1.26)。见表5。
3　讨论
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本研究基于河南省代表性的横断面调查数据发现，≥60岁老年人牙齿缺失与MCI流行情况严峻；牙齿缺失与听力困难均是MCI的独立危险因素，但未发现二者存在交互作用。
本研究发现，MCI风险随牙齿数量增加逐渐降低，与多项研究一致［17，23］。但日本的一项队列研究未发现显著关联［12］，这可能由于该人群牙齿缺失率较低，而本研究中牙齿缺失（<21颗）比例高达68.1%，使保护效应更易显现。听力困难同样是认知衰退的明确危险因素，多项研究表明，成人听力受损或不使用助听器的听力丧失人群发生老年痴呆的风险增加［24-25］。这一结论与美国NHATS结果一致，在70岁以上的老年人群中，与听力正常者相比，中度与重度听力损失者发生失智的风险分别增加了8%和61%［11］，而本研究发现，双耳与单耳听力困难者发生MCI的风险分别增加了81%和44%，两项研究存在差异的原因可能与人群差异、测量方式或混杂因素控制有关，但总体结论与以往研究一致。敏感性分析显示，校正年龄后牙齿数量与听力困难的效应值虽有所减弱，但关联仍具有统计学意义，进一步证实了二者与MCI的独立关联。
口腔健康可能通过多种机制影响认知功能，“营养途径”假说强调由于牙齿缺失导致咀嚼功能减退从而引发营养不良影响认知功能［26-27］；“炎症途径”假说则强调牙齿缺失导致口腔病原体增殖，产生的炎症因子随血行传播至大脑，增加大脑中β-淀粉样蛋白斑块的形成［28］；“生命历程”理论更加关注生命早期不健康生活方式（如吸烟、高糖饮食）对晚年不良口腔状况的累积效应［29-30］。听力受损增加痴呆风险，可能由于听力受损者费力理解他人言语时承受的“认知负荷”［31-32］；其次，听力受损会造成社交隔离，增加抑郁的风险，而抑郁是痴呆的危险因素［33］。更有研究直接表明，听力损失可能与大脑某些主导记忆区域（如海马体、颞叶）的加速萎缩有关［34］。
本研究首次探讨了河南省老年人牙齿数量与听力困难对MCI的交互作用。但未发现显著的相乘或相加交互作用。可能原因包括：牙齿缺失与听力困难可能通过不同机制独立影响认知功能；二者均已产生显著的独立效应，可能达到风险“天花板”；方法学上存在局限，如自报听力可能存在测量误差，认知评估未能涵盖特定认知域。尽管如此，结果仍提示口腔与听力健康是老年人认知功能的两个重要且可干预的独立因素。本研究采用多阶段分层抽样，样本代表性好，并控制了多个混杂因素。但存在以下局限：口腔与听力数据均为自报，可能存在信息偏倚；未考虑助听器使用的影响；横断面设计无法确定因果关系。
综上，保持较多牙齿和无听力困难有助于改善认知功能。建议在公共卫生实践中对老年人开展常规口腔与听力筛查及并行干预，加强健康教育，鼓励定期检查，并将早期筛查纳入基本公共卫生服务，以延缓认知功能衰退。
基金
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  • 河南省科技攻关项目(252102311008)
  • 河南省疾病预防控制中心科技攻关专项计划(HNCDCZD20250102; HNCDCYC202547)
文献
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doi: 10.20043/j.cnki.MPM.202510241
  • 接收时间：2025-10-21
  • 首发时间：2026-09-28
  • 出版时间：2026-08-25
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  • 收稿日期：2025-10-21
基金
河南省科技攻关项目(252102311008)
河南省疾病预防控制中心科技攻关专项计划(HNCDCZD20250102; HNCDCYC202547)
作者信息
    1.河南省疾病预防控制中心慢性非传染性疾病防治研究所，河南 郑州 450016
    2.郑州市疾病预防控制中心
    3.洛阳市疾病预防控制中心

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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