Simpson Annie N, Simpson Kit N, Dubno Judy R
Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, USA; Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
Department of Healthcare Leadership and Management, Medical University of South Carolina, Charleston, SC, USA.
Healthy Aging Res. 2015;4. doi: 10.12715/har.2015.4.4. Epub 2015 Feb 3.
Recent findings on hearing loss (HL) and healthy aging have highlighted important clinical and policy implications concerning quality of life in older adults. Our objective was to explore the impact of HL on quality of life in older Americans, independent of survival, using the 2000 Medical Expenditure Panel Survey (MEPS) and 2010 Census data.
A retrospective cohort of 2,567 subjects aged 60-90 in the MEPS who provided information on self-reported HL, health-related quality of life and chronic conditions. The EQ-5D visual analog scale (VAS) transformation was used to estimate marginal utility decrements for 5-year age categories and conditions, including HL, hypertension, diabetes, angina, joint pain, asthma, emphysema, or blindness. The modeled decrements were applied to the 2010 US census population to estimate annual quality-adjusted life years (QALYs) lost.
Of the respondents, 15.4% had mild HL and 1.1% had moderate/severe hearing loss. Other conditions (utility decrement) included: joint pain 53% (.0643), hypertension 47.2% (.0292), diabetes 15.6% (.0577), angina 9.8% (.0352), asthma 7.9% (.0288), emphysema 4.5% (.1186), blindness 0.8% (.0836), and average age 71.0 with decrements .0033 per year. The decrement from hearing loss ranked 4th at 174,689 in the US population.
The substantial impact of hearing loss on healthy aging may not be obvious when quality of life decrements include survival or when diluted with younger populations. Careful consideration of clinical interventions for age-related HL is warranted and further research is needed on the effect of HL on quality of life in otherwise healthy older adults.
近期关于听力损失(HL)与健康老龄化的研究结果凸显了有关老年人生活质量的重要临床和政策意义。我们的目标是利用2000年医疗支出面板调查(MEPS)和2010年人口普查数据,探讨HL对美国老年人生活质量的影响,且不考虑生存因素。
对MEPS中2567名年龄在60 - 90岁的受试者进行回顾性队列研究,这些受试者提供了关于自我报告的HL、健康相关生活质量和慢性病的信息。使用EQ - 5D视觉模拟量表(VAS)转换来估计5年年龄组和各种疾病(包括HL、高血压、糖尿病、心绞痛、关节疼痛、哮喘、肺气肿或失明)的边际效用递减。将模拟的递减应用于2010年美国人口普查数据,以估计每年损失的质量调整生命年(QALY)。
在受访者中,15.4%有轻度HL,1.1%有中度/重度听力损失。其他疾病(效用递减)包括:关节疼痛53%(0.0643)、高血压47.2%(0.0292)、糖尿病15.6%(0.0577)、心绞痛9.8%(0.0352)、哮喘7.9%(0.0288)、肺气肿4.5%(0.1186)、失明0.8%(0.0836),平均年龄71.0岁,每年递减0.0033。在美国人群中,听力损失导致的效用递减排名第4,为174,689。
当生活质量递减包括生存因素或与年轻人群混合计算时,听力损失对健康老龄化的重大影响可能并不明显。有必要仔细考虑针对与年龄相关的HL的临床干预措施,并且需要进一步研究HL对其他方面健康的老年人生活质量的影响。