Jiam Nicole Tin-Lok, Li Carol, Agrawal Yuri
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Otolaryngology, New York-Presbyterian Hospital, New York, New York, U.S.A.
Laryngoscope. 2016 Nov;126(11):2587-2596. doi: 10.1002/lary.25927. Epub 2016 Mar 24.
Falls are a devastating condition in older individuals. Identifying potentially modifiable risk factors such as hearing loss would provide a substantial public health benefit.
To evaluate the current evidence for an association between hearing loss and falls risk.
A systematic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Web of Science, and Cochrane databases was performed in July 2014.
Studies were eligible for inclusion if they were published in the peer-reviewed literature. All studies used a predetermined definition of hearing loss. Main outcomes and measurements were fall hospitalization records or self-reports of falls by structured interview or validated questionnaires.
Two investigators independently reviewed the literature related to hearing loss, falls, and older adults. We pooled effect sizes from across the studies and performed a meta-analysis to compute an overall effect size.
Twelve eligible studies were identified. The odds of falling were 2.39 times greater among older adults with hearing loss than older adults with normal hearing (pooled odds ratio 2.39, 95% confidence interval [CI]: 2.11-2.68). In sensitivity analyses, we restricted the meta-analysis to studies where hearing loss was audiometrically defined (N = 6) and observed hearing loss to be associated with a 69% increase in the odds of falling (pooled odds ratio 1.69, 95% CI: 1.18-2.19). When we further limited to studies that also performed multivariate regression analyses (N = 4), the overall effect size did not appreciably change (pooled odds ratio 1.72, 95% CI: 1.07-2.37). We observed a potential positive publication bias in the literature. Limitations of the systematic review and meta-analysis are the cross-sectional designs of most studies and the heterogeneity across studies (Q = 631, P < .05, I = 98.1%).
In the published literature, hearing loss is associated with a significantly increased odds of falling in older adults. These findings need to be interpreted in light of the potential for positive publication bias in the literature on this topic.
NA Laryngoscope, 126:2587-2596, 2016.
跌倒在老年人中是一种极具破坏性的状况。识别诸如听力损失等潜在可改变的风险因素将带来巨大的公共卫生效益。
评估目前关于听力损失与跌倒风险之间关联的证据。
2014年7月对PubMed、护理学与健康相关文献累积索引、Embase、Scopus、科学引文索引和Cochrane数据库进行了系统检索。
若研究发表于同行评审文献，则有资格纳入。所有研究均采用了预先确定的听力损失定义。主要结局和测量指标为跌倒住院记录或通过结构化访谈或经过验证的问卷进行的跌倒自我报告。
两名研究者独立回顾了与听力损失、跌倒和老年人相关的文献。我们汇总了各项研究的效应量，并进行了荟萃分析以计算总体效应量。
共识别出12项符合条件的研究。听力损失的老年人跌倒几率比听力正常的老年人高2.39倍（汇总比值比2.39，95%置信区间[CI]：2.11 - 2.68）。在敏感性分析中，我们将荟萃分析限制在通过听力测定定义听力损失的研究（N = 6），并观察到听力损失与跌倒几率增加69%相关（汇总比值比1.69，95% CI：1.18 - 2.19）。当我们进一步限制在也进行了多变量回归分析的研究（N = 4）时，总体效应量没有明显变化（汇总比值比1.72，95% CI：1.07 - 2.37）。我们在文献中观察到潜在的正向发表偏倚。系统评价和荟萃分析的局限性在于大多数研究的横断面设计以及研究之间的异质性（Q = 631，P <.05，I = 98.1%）。
在已发表的文献中，听力损失与老年人跌倒几率显著增加相关。鉴于关于该主题的文献中存在正向发表偏倚的可能性，这些发现需要谨慎解读。
NA 喉镜，126:2587 - 2596，2016年。
