Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland.
National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland.
JAMA Otolaryngol Head Neck Surg. 2014 Apr;140(4):293-302. doi: 10.1001/jamaoto.2014.42.
Depression among hearing impaired US adults has not been studied previously.
To estimate the prevalence of and risk factors for depression among adults with hearing loss.
DESIGN, SETTING, AND PARTICIPANTS: Adults aged 18 years or older (N = 18 318) who participated in the National Health and Nutrition Examination Survey (NHANES), 2005-2010, a nationally representative sample.
Multistage probability sampling of US population.
Depression, assessed by the 9-item Patient Health Questionnaire (PHQ-9) scale, and hearing impairment (HI), assessed by self-report and audiometric examination for adults aged 70 years or older.
The prevalence of moderate to severe depression (PHQ-9 score, ≥10) was 4.9% for individuals reporting excellent hearing, 7.1% for those with good hearing, and 11.4% for participants who reported a little trouble or greater HI. Using excellent hearing as the reference, after adjusting for all covariates, multivariate odds ratios (ORs) for depression were 1.4 (95% CI, 1.1-1.8) for good hearing, 1.7 (1.3-2.2) for a little trouble, 2.4 (1.7-3.2) for moderate trouble, 1.5 (0.9-2.6) for a lot of trouble, and 0.6 (0.1-2.6) for deaf. Moderate HI (defined by better ear pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz within the range 35- to 49-dB hearing level) was significantly associated with depression among older women (OR, 3.9; 95% CI, 1.3-11.3), after adjusting for age, sex, race/ethnicity, lifestyle characteristics, and selected health conditions.
After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. Health care professionals should be aware of an increased risk for depression among adults with hearing loss.
之前尚未研究过美国失聪成年人的抑郁情况。
评估听力受损成年人中抑郁的患病率和危险因素。
设计、地点和参与者：年龄在 18 岁或以上（N=18318）的成年人参加了 2005-2010 年全国健康和营养调查（NHANES），这是一个具有全国代表性的样本。
美国人口的多阶段概率抽样。
抑郁，用 9 项患者健康问卷（PHQ-9）量表评估；听力障碍（HI），通过自我报告和 70 岁及以上成年人的听力测试来评估。
报告听力极好的个体中，中度至重度抑郁（PHQ-9 评分≥10）的患病率为 4.9%，报告听力良好的个体中为 7.1%，报告稍有困难或更严重 HI 的个体中为 11.4%。以听力极好作为参照，在调整所有协变量后，抑郁的多变量优势比（OR）为听力良好者（1.4[95%CI，1.1-1.8]）、稍有困难者（1.7[1.3-2.2]）、中度困难者（2.4[1.7-3.2]）、有很多困难者（1.5[0.9-2.6]）和聋人（0.6[0.1-2.6]）。在调整年龄、性别、种族/民族、生活方式特征和选定健康状况后，中度 HI（定义为更好耳的纯音平均听力阈值在 0.5、1、2 和 4 kHz 范围内为 35-49 dB 听力级）与老年女性的抑郁显著相关（OR，3.9；95%CI，1.3-11.3）。
在考虑健康状况和其他因素（包括视力问题）后，自我报告的 HI 和听力测试确定的 HI 与抑郁显著相关，尤其是在女性中。医疗保健专业人员应意识到听力受损成年人患抑郁症的风险增加。
