School of Nursing, University of California San Francisco.
School of Medicine and Public Health, University of Wisconsin-Madison.
J Gerontol A Biol Sci Med Sci. 2020 Feb 14;75(3):561-566. doi: 10.1093/gerona/glz166.
Ototoxicity may interact with the effects of aging, leading to a more severe hearing loss than that associated with age alone. The purpose of this study was to explore the associations between ototoxic medication use and the incidence and progression of hearing loss in older adults with a population-based longitudinal study.
Epidemiology of Hearing Loss Study participants (n = 3,753) were examined. Medication use was assessed using a standardized questionnaire by the examiners at each examination every 5 year. The ototoxic medications include loop diuretics, nonsteroidal anti-inflammatory drugs, antibiotics, chemotherapeutic agents, quinine, and acetaminophen in this study. Generalized estimating equations model was used as a proportional hazard discrete time analysis.
Number of ototoxic medications was associated with the risk of developing hearing loss during the 10-year follow-up period (hazard ratio [HR] = 1.15, 95% confidence interval [CI] = 1.06, 1.25) after adjusting for age, sex, smoking, and body mass index. Loop diuretics (HR = 1.40, 95% CI = 1.05, 1.87) were associated with the 10-year incidence of hearing loss. Nonsteroidal anti-inflammatory drugs (HR = 1.45, 95% CI = 1.22, 1.72) and loop diuretics (HR = 1.33 95% CI = 1.08, 1.63) were associated with risk of progressive hearing loss over 10 years.
These ototoxic medications are commonly used in older adults and should be considered as potentially modifiable contributors to the incidence and severity of age-related hearing loss.
耳毒性可能与衰老的影响相互作用，导致听力损失比单独与年龄相关的听力损失更严重。本研究的目的是通过一项基于人群的纵向研究，探讨老年患者使用耳毒性药物与听力损失的发生和进展之间的关系。
对听力损失流行病学研究的参与者（n=3753）进行了检查。在每次每 5 年的检查中，由检查人员使用标准化问卷评估药物使用情况。在这项研究中，耳毒性药物包括利尿剂、非甾体抗炎药、抗生素、化疗药物、奎宁和对乙酰氨基酚。使用广义估计方程模型作为比例风险离散时间分析。
在 10 年的随访期间，使用的耳毒性药物数量与发生听力损失的风险相关（危险比[HR]=1.15，95%置信区间[CI] = 1.06，1.25），调整年龄、性别、吸烟和体重指数后。利尿剂（HR=1.40，95%CI=1.05，1.87）与 10 年内听力损失的发生率相关。非甾体抗炎药（HR=1.45，95%CI=1.22，1.72）和利尿剂（HR=1.33，95%CI=1.08，1.63）与 10 年内听力损失的进展风险相关。
这些耳毒性药物在老年人中广泛使用，应被视为与年龄相关听力损失的发生和严重程度相关的潜在可改变因素。
