英国社区居住老年人自我报告的听力障碍与衰弱发生率：一项4年随访研究
Self-Reported Hearing Impairment and Incident Frailty in English Community-Dwelling Older Adults: A 4-Year Follow-Up Study.
作者信息
Liljas Ann E M, Carvalho Livia A, Papachristou Efstathios, Oliveira Cesar De, Wannamethee S Goya, Ramsay Sheena E, Walters Kate
机构信息
Department of Primary Care and Population Health, University College London, London, United Kingdom.
Department of Epidemiology and Public Health, University College London, London, United Kingdom.
出版信息
J Am Geriatr Soc. 2017 May;65(5):958-965. doi: 10.1111/jgs.14687. Epub 2016 Dec 19.
OBJECTIVES
To examine the association between hearing impairment and incident frailty in older adults.
DESIGN
Cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing.
SETTING
Community.
PARTICIPANTS
Community-dwelling individuals aged 60 and older with data on hearing and frailty status (N = 2,836).
MEASUREMENTS
Hearing impairment was defined as poor self-reported hearing. Having none of the five Fried frailty phenotype components (slow walking, weak grip, self-reported exhaustion, weight loss and low physical activity) was defined as not frail, having one or two as prefrail, and having three or more as frail. Participants who were not frail at baseline were followed for incident prefrailty and frailty. Participants who were prefrail at baseline were followed for incident frailty.
RESULTS
One thousand three hundred ninety six (49%) participants were not frail, 1,178 (42%) were prefrail, and 262 (9%) were frail according to the Fried phenotype. At follow-up, there were 367 new cases of prefrailty and frailty among those who were not frail at baseline (n = 1,396) and 133 new cases of frailty among those who were prefrail at baseline (n = 1,178). Cross-sectional analysis showed an association between hearing impairment and frailty (age- and sex-adjusted odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.37-2.01), which remained after further adjustments for wealth, education, cardiovascular disease, cognition, and depression. In longitudinal analyses, nonfrail participants with hearing impairment were at greater risk of becoming prefrail and frail at follow-up (OR = 1.43, 95% CI = 1.05-1.95), but the association was attenuated after further adjustment. Prefrail participants with hearing impairment had a greater risk of becoming frail at follow-up (OR = 1.64, 95% CI = 1.07-2.51) even after further adjustment.
CONCLUSION
Hearing impairment in prefrail older adults was associated with greater risk of becoming frail, independent of covariates, suggesting that hearing impairment may hasten the progression of frailty.
目的
研究老年人听力障碍与衰弱发生率之间的关联。
设计
采用英国老龄化纵向研究的数据进行横断面和纵向分析，并随访4年。
地点
社区。
参与者
60岁及以上的社区居住个体，有听力和衰弱状况的数据（N = 2836）。
测量方法
听力障碍定义为自我报告听力差。没有弗里德衰弱表型的五个组成部分（步行缓慢、握力弱、自我报告疲劳、体重减轻和身体活动少）被定义为非衰弱，有一个或两个被定义为衰弱前期，有三个或更多被定义为衰弱。在基线时非衰弱的参与者随访其衰弱前期和衰弱的发生情况。在基线时处于衰弱前期的参与者随访其衰弱的发生情况。
结果
根据弗里德表型，1396名（49%）参与者非衰弱，1178名（42%）处于衰弱前期，262名（9%）衰弱。在随访中，基线时非衰弱的参与者（n = 1396）中有367例新的衰弱前期和衰弱病例，基线时处于衰弱前期的参与者（n = 1178）中有133例新的衰弱病例。横断面分析显示听力障碍与衰弱之间存在关联（年龄和性别调整后的优势比（OR）= 1.66，95%置信区间（CI）= 1.37 - 2.01），在进一步调整财富、教育、心血管疾病、认知和抑郁因素后该关联仍然存在。在纵向分析中，有听力障碍的非衰弱参与者在随访时发展为衰弱前期和衰弱的风险更高（OR = 1.43，95% CI = 1.05 - 1.95），但在进一步调整后该关联减弱。有听力障碍的衰弱前期参与者在随访时发展为衰弱的风险更高（OR = 1.64，95% CI = 1.07 - 2.51），即使在进一步调整后也是如此。
结论
衰弱前期老年人的听力障碍与发展为衰弱的风险增加有关，独立于协变量，这表明听力障碍可能加速衰弱的进展。
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