Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD 21205, United States.
Gait Posture. 2013 May;38(1):25-9. doi: 10.1016/j.gaitpost.2012.10.006. Epub 2012 Nov 22.
Previous studies have suggested that hearing loss, which is highly prevalent but undertreated in older adults, may be associated with gait and physical functioning. Determining if hearing loss is independently associated with gait speed is critical toward understanding whether hearing rehabilitative interventions could help mitigate declines in physical functioning in older adults.
We analyzed cross-sectional data from the 1999 to 2002 cycles of the National Health and Nutritional Examination Survey during which participants 50-69 years (n=1180) underwent hearing and gait speed assessments. Hearing was defined by a pure tone average of hearing thresholds at 0.5-4kHz tones in the better-hearing ear. Gait speed was obtained in a timed 20-ft (6.1m) walk. Linear and logistic regression models were used to examine the association between hearing loss and gait speed while adjusting for demographic and cardiovascular risk factors. Analyses incorporated sampling weights to yield results generalizable to the U.S. population.
In a model adjusted for demographic and cardiovascular risk factors, a hearing loss was associated with slower gait speed (-0.05m/s per 25dB of hearing loss [95% CI: -0.09 to -0.02]) and an increased odds of having a gait speed <1.0m/s (OR=2.0 per 25dB of hearing loss, 95% CI: 1.2-3.3). The reduction in gait speed associated with a 25dB hearing loss was equivalent to that associated with an age difference of approximately 12 years.
Greater hearing loss is independently associated with slower gait speed. Further studies investigating the mechanistic basis of this association and whether hearing rehabilitative interventions could affect gait and physical functioning are needed.
先前的研究表明,听力损失在老年人中普遍存在但治疗不足,可能与步态和身体功能有关。确定听力损失是否与步态速度独立相关,对于理解听力康复干预是否可以帮助减轻老年人身体功能下降至关重要。
我们分析了 1999 年至 2002 年全国健康和营养检查调查的横断面数据,在此期间,50-69 岁的参与者(n=1180)接受了听力和步态速度评估。听力通过较好耳的 0.5-4kHz 频段纯音平均听力阈值来定义。步态速度通过 20 英尺(6.1 米)定时行走获得。线性和逻辑回归模型用于检查听力损失与步态速度之间的关联,同时调整人口统计学和心血管危险因素。分析采用抽样权重,使结果可推广到美国人群。
在调整人口统计学和心血管危险因素的模型中,听力损失与较慢的步态速度相关(每 25dB 听力损失下降 0.05m/s [95%CI:-0.09 至 -0.02]),且步态速度<1.0m/s 的几率增加(每 25dB 听力损失增加 2.0 倍,95%CI:1.2-3.3)。与 25dB 听力损失相关的步态速度降低相当于与年龄差异约 12 年相关的降低。
听力损失越严重,与步态速度越慢独立相关。需要进一步研究该关联的机制基础以及听力康复干预是否可以影响步态和身体功能。