Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy; C. Golgi Geriatric Institute, Piazza Samek 5, 20081, Abbiategrasso, Italy.
Golgi Cenci Foundation, Corso San Martino 10, 20081, Abbiategrasso, Italy.
Maturitas. 2019 Mar;121:35-40. doi: 10.1016/j.maturitas.2018.12.009. Epub 2018 Dec 12.
Hearing loss is a common chronic condition in elderly people. The prevalence of disabling hearing loss among the elderly worldwide is 33% and in Italy ranges from 0.6% (profound hearing loss) to 39% (mild hearing loss). We investigated the relationship between self-reported hearing disability and clinician-evaluated hearing status, and its longitudinal consequences in relation to cognitive impairment and functional decline. We hypothesised that subjects who report that they have a hearing disability have a worse functional and cognitive profile than people who do not report having a hearing disability.
We analysed 1171 participants in the InveCe.Ab study, a longitudinal population-based study. We evaluated whether self-reported hearing disability was consistent with clinician-evaluated hearing status (using the Whispered Voice Test; WVT), categorizing this variable as: unaware of hearing loss (UHL), aware of hearing loss (AHL), only subjective hearing loss (OSHL), without hearing loss (noHL). We also examined its relationship with various population characteristics, and its long-term effects on functional and cognitive performance and depressive symptoms.
At baseline, hearing loss was found in 13.6% (95% CI: 11.7-15.7) of the participants [17.6% (95% CI: 12.0-24.4) AHL; 82.4% (95% CI: 75.6-88) UHL], while 2.3% (95% CI: 1.4-3.4) of the subjects with normal WVT hearing status had OSHL. Male gender, age, functional and cognitive performance, and depressive symptoms were associated with consistency between self-reported hearing disability and WVT hearing status. Longitudinal analysis revealed worsening functional performance and selective attention, global cognitive deterioration, and depressive symptoms in the AHL group.
Our results showed that awareness of hearing disability in the elderly has adverse cognitive and functional consequences over time. When clinicians inform those who are unaware of their hearing problems, they should arrange for prompt referral not only for audiometric evaluation but also for counselling in order to prevent a negative impact of awareness of hearing loss.
听力损失是老年人常见的慢性疾病。全球老年人失能性听力损失的患病率为 33%，意大利的患病率为 0.6%（极重度听力损失）至 39%（轻度听力损失）。我们研究了自我报告的听力障碍与临床医生评估的听力状况之间的关系，以及其与认知障碍和功能下降相关的纵向后果。我们假设，报告有听力障碍的受试者比没有报告有听力障碍的受试者具有更差的功能和认知特征。
我们分析了 InveCe.Ab 研究中的 1171 名参与者，这是一项纵向的基于人群的研究。我们评估了自我报告的听力障碍是否与临床医生评估的听力状况一致（使用 whispered voice test，WVT），并将该变量分类为：听力损失不自知（UHL）、听力损失自知（AHL）、仅有主观听力损失（OSHL）、无听力损失（noHL）。我们还研究了它与各种人群特征的关系，以及它对功能和认知表现和抑郁症状的长期影响。
在基线时，13.6%（95%CI：11.7-15.7）的参与者存在听力损失[17.6%（95%CI：12.0-24.4）为 AHL；82.4%（95%CI：75.6-88）为 UHL]，而 WVT 听力正常的受试者中有 2.3%（95%CI：1.4-3.4）患有 OSHL。男性性别、年龄、功能和认知表现以及抑郁症状与自我报告的听力障碍与 WVT 听力状况之间的一致性相关。纵向分析显示，在 AHL 组中，功能表现和选择性注意力恶化，整体认知能力下降，抑郁症状加重。
我们的研究结果表明，老年人对听力障碍的认知会随着时间的推移产生不利的认知和功能后果。当临床医生告知那些不知道自己听力问题的人时，他们应该及时安排转介，不仅进行听力评估，还要进行咨询，以防止对听力损失认知的负面影响。
