Department of Epidemiology and Biostatistics, George Washington University Milken Institute of Public Health, Washington, DC.
Department of Medicine, George Washington University Milken Institute of Public Health, Washington, DC.
J Am Geriatr Soc. 2019 Jul;67(7):1410-1416. doi: 10.1111/jgs.15849. Epub 2019 Mar 8.
BACKGROUND/OBJECTIVE: To evaluate the relationship between self-reported hearing loss and nonfatal fall-related injury in a nationally representative sample of community-dwelling adults living in the United States.
Cross-sectional analysis of national survey data.
National Health Interview Survey (2016).
A total of 30 994 community-dwelling adults in the United States, aged 18 years and older.
We evaluated the association between self-reported hearing loss and nonfatal injury resulting from a fall in the previous 3 months. We used multivariate logistic regression to calculate adjusted odds ratios (ORs) and evaluated effect measure modification by age.
The odds of nonfatal fall-related injury were 1.60 times higher among respondents with hearing loss compared to respondents without hearing loss (95% confidence interval [CI] = 1.20-2.12; P = .0012). Results were unchanged when adjusting for demographics (OR = 1.59; 95% CI = 1.18-2.15; P = .002). After adjustment for cardiovascular risk factors, cardiovascular disease, visual impairment, and limitation caused by nervous system/sensory organ conditions and depression, anxiety, or another emotional problem, the OR fell to 1.27 (95% CI = 0.92-1.74; P = .14). In the fully adjusted model, including adjustment for vestibular vertigo, there was little support to link hearing loss and fall-related injury (OR = 1.16; 95% CI = 0.84-1.60; P = .36). Effect modification by age was not observed.
Self-reported hearing loss may be a clinically useful indicator of increased fall risk, but treatment for hearing loss is unlikely to mitigate this risk, given that there is no independent association between self-reported hearing loss and nonfatal falls after accounting for vestibular function and other potential confounders.
背景/目的：评估美国社区居住的成年人中自我报告的听力损失与非致命性跌倒相关伤害之间的关系。
全国调查数据的横断面分析。
全国健康访谈调查（2016 年）。
美国共有 30994 名年龄在 18 岁及以上的社区居住成年人。
我们评估了自我报告的听力损失与前 3 个月内因跌倒导致的非致命性伤害之间的关联。我们使用多元逻辑回归来计算调整后的优势比（OR），并评估年龄的效果测量修饰作用。
与无听力损失的受访者相比，听力损失的受访者发生非致命性跌倒相关伤害的可能性高 1.60 倍（95%置信区间[CI] = 1.20-2.12；P =.0012）。当调整人口统计学因素（OR = 1.59；95%CI = 1.18-2.15；P =.002）时，结果保持不变。在调整心血管危险因素、心血管疾病、视力障碍以及神经系统/感觉器官疾病和抑郁、焦虑或其他情绪问题导致的限制后，OR 下降至 1.27（95%CI = 0.92-1.74；P =.14）。在完全调整的模型中，包括对前庭眩晕的调整，几乎没有证据表明听力损失与跌倒相关伤害之间存在关联（OR = 1.16；95%CI = 0.84-1.60；P =.36）。未观察到年龄的效果修饰作用。
自我报告的听力损失可能是增加跌倒风险的一个有用的临床指标，但考虑到在考虑前庭功能和其他潜在混杂因素后，自我报告的听力损失与非致命性跌倒之间没有独立关联，因此治疗听力损失不太可能降低这种风险。
