Chia Ee-Munn, Mitchell Paul, Rochtchina Elena, Foran Suriya, Golding Maryanne, Wang Jie Jin
Department of Ophthalmology, University of Sydney, Australia.
Arch Ophthalmol. 2006 Oct;124(10):1465-70. doi: 10.1001/archopht.124.10.1465.
To assess associations between age-related vision and hearing impairments and whether combined sensory losses magnify effects on health-related quality of life.
Seventy-five percent of survivors (n = 2334) were reexamined at Blue Mountains Eye Study 5-year examinations and 86.3% (2015) attended hearing assessments. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB (500-4000 Hz, better ear).
Persons with visual impairment, compared with those without visual impairment, had lower mean audiometric thresholds across all frequencies (P< or =.05). For each 1-line (5-letter) reduction in best-corrected visual acuity and presenting visual acuity, hearing loss prevalence increased by 18% and 13%, respectively. Cataract and age-related maculopathy were also associated with hearing loss (respectively, multivariate-adjusted odds ratio, 1.3 and 1.6; 95% confidence interval, 1.0-1.7 and 1.1-3.1). The association between age-related maculopathy and hearing loss was stronger at younger ages (<70 years). Combined impairments were associated with poorer health-related quality of life than were single impairments (multivariate-adjusted 36-Item Short-Form Health Survey mean physical and mental component scores; Ptrend = .001 and <.001, respectively).
Older persons with visual impairment were also more likely to have hearing loss in this study, which suggests that these sensory impairments could share common risk factors or biologic aging markers. Combined sensory impairments also cumulatively affect health-related quality of life.
评估与年龄相关的视力和听力损害之间的关联，以及联合感觉丧失是否会放大对健康相关生活质量的影响。
在蓝山眼研究5年检查中，75%的幸存者（n = 2334）接受了复查，86.3%（2015人）参加了听力评估。视力损害定义为视力低于20/40（较好眼），听力损害定义为平均纯音气导阈值大于25 dB（500 - 4000 Hz，较好耳）。
与无视力损害者相比，视力损害者在所有频率下的平均听力阈值较低（P≤0.05）。最佳矫正视力和现患视力每降低1行（5个字母），听力损失患病率分别增加18%和13%。白内障和年龄相关性黄斑病变也与听力损失相关（多变量调整后的优势比分别为1.3和1.6；95%置信区间为1.0 - 1.7和1.1 - 3.1）。年龄相关性黄斑病变与听力损失之间的关联在较年轻年龄组（<70岁）更强。与单一损害相比，联合损害与较差的健康相关生活质量相关（多变量调整后的36项简明健康调查的平均身体和心理成分得分；趋势P值分别为0.001和<0.001）。
在本研究中，视力损害的老年人也更有可能患有听力损失，这表明这些感觉损害可能有共同的危险因素或生物学衰老标志物。联合感觉损害也会累积影响健康相关生活质量。
