Viljanen Anne, Kaprio Jaakko, Pyykkö Ilmari, Sorri Martti, Pajala Satu, Kauppinen Markku, Koskenvuo Markku, Rantanen Taina
Department of Health Sciences, Finnish Centre for Interdisciplinary Gerontology, Finland.
J Gerontol A Biol Sci Med Sci. 2009 Feb;64(2):312-7. doi: 10.1093/gerona/gln015. Epub 2009 Jan 31.
The purpose of the present study was to examine, first, whether hearing acuity predicts falls and whether the potential association is explained by postural balance and, second, to examine whether shared genetic or environmental effects underlie these associations.
Hearing was measured using a clinical audiometer as a part of the Finnish Twin Study on Aging in 103 monozygotic and 114 dizygotic female twin pairs aged 63-76 years. Postural balance was indicated as a center of pressure (COP) movement in semi-tandem stance, and participants filled in a fall-calendar daily for an average of 345 days after the baseline.
Mean hearing acuity (better ear hearing threshold level at 0.5-4 kHz) was 21 dB (standard deviation [SD] 12). Means of the COP velocity moment for the best to the poorest hearing quartiles increased linearly from 40.7 mm(2)/s (SD 24.4) to 52.8 mm(2)/s (SD 32.0) (p value for the trend = .003). Altogether 199 participants reported 437 falls. Age-adjusted incidence rate ratios (IRRs) for falls, with the best hearing quartile as a reference, were 1.2 (95% confidence interval [CI] = 0.4-3.8) in the second, 4.1 (95% CI = 1.1-15.6) in the third, and 3.4 (95% CI = 1.0-11.4) in the poorest hearing quartiles. Adjustment for COP velocity moment decreased IRRs markedly. Twin analyses showed that the association between hearing acuity and postural balance was not explained by genetic factors in common for these traits.
People with poor hearing acuity have a higher risk for falls, which is partially explained by their poorer postural control. Auditory information about environment may be important for safe mobility.
本研究的目的，其一，是检验听力敏锐度是否能预测跌倒以及这种潜在关联是否可由姿势平衡来解释；其二，是检验这些关联是否存在共同的遗传或环境影响因素。
在芬兰老年双胞胎研究中，使用临床听力计对103对同卵和114对异卵63至76岁女性双胞胎进行听力测量。姿势平衡通过半串联站立时的压力中心（COP）移动来表示，参与者在基线后平均345天每天填写跌倒日历。
平均听力敏锐度（0.5至4kHz较好耳听力阈值水平）为21dB（标准差[SD]12）。从听力最好到最差的四分位数，COP速度矩的均值从40.7mm²/s（SD 24.4）线性增加到52.8mm²/s（SD 32.0）（趋势p值 = 0.003）。共有199名参与者报告了437次跌倒。以听力最好的四分位数为参照，年龄调整后的跌倒发病率比（IRR）在第二四分位数中为1.2（95%置信区间[CI]=0.4 - 3.8），在第三四分位数中为4.1（95%CI = 1.1 - 15.6），在听力最差的四分位数中为3.4（95%CI = 1.0 - 11.4）。对COP速度矩进行调整后，IRR显著降低。双胞胎分析表明，听力敏锐度与姿势平衡之间的关联不能由这些性状共有的遗传因素来解释。
听力敏锐度差的人跌倒风险更高，这部分可由其较差的姿势控制来解释。关于环境的听觉信息对于安全移动可能很重要。
