Population Health Unit, Salus in Apulia Study, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy.
Center for Neurodegenerative Diseases and the Aging Brain, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
JAMA Otolaryngol Head Neck Surg. 2021 Jun 1;147(6):561-571. doi: 10.1001/jamaoto.2020.5334.
The association between age-related hearing loss (ARHL) and physical or cognitive frailty has been poorly explored. These associations could define new perspectives for delaying frailty-related processes in older age.
To examine whether peripheral ARHL and age-related central auditory processing disorder (CAPD) are independently associated with physical or cognitive frailty.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed registry data from December 31, 2014, on 1929 older (≥65 years) participants of the Salus in Apulia Study (Southern Italy) who underwent audiologic, physical, and neuropsychological assessment. Data analysis was performed from December 12, 2019, to January 4, 2020.
Prevalence of peripheral ARHL in older individuals with physical and/or cognitive frailty and those without frailty assessed using the Fried criteria (physical) and the Mini-Mental State Examination (cognitive). Multivariable logistic regression models were used to assess associations of audiologic variables with frailty phenotype.
Data from 1929 participants (mean [SD] age, 73.6 [6.3] years; 974 male [50.5%]) were eligible for the analyses. The prevalence of peripheral ARHL was higher in the physical frailty group (96 [26.6%]) than in the nonfrail group (329 [21.0%]) (difference, 5.61 percentage points; 95% CI, 0.63-10.59 percentage points) and in the cognitive frailty group (40 [38.8%]) than in the nonfrail group (385 [21.1%]) (difference, 17.75 percentage points; 95% CI, 8.2-27.3 percentage points). Age-related CAPD was more prevalent in the physical frailty group (62 [17.2%]) than in the nonfrail group (219 [14.0%]) (difference, 3.21 percentage points; 95% CI, -1.04 to 7.46 percentage points) and in the cognitive frailty group (28 [27.2%]) than in the nonfrail group (253 [13.9%]) (difference, 13.33 percentage points; 95% CI, 4.10-22.21 percentage points). In the multivariable models, age-related CAPD was associated with cognitive frailty in the fully adjusted model (odds ratio [OR], 1.889; 95% CI, 1.094-3.311). There was also an inverse association between the unitary increase in Synthetic Sentence Identification With the Ipsilateral Competitive Message scores, indicating a lower likelihood of this disorder, and cognitive frailty (OR, 0.989; 95% CI, 0.988-0.999). Peripheral ARHL was associated with cognitive frailty only in the partially adjusted model (OR, 1.725; 95% CI, 1.008-2.937).
In this cross-sectional study of 1929 participants, age-related CAPD was independently associated with cognitive frailty. Whether the management of ARHL may help prevent the development of different frailty phenotypes or improve their clinical consequences should be addressed in longitudinal studies and, eventually, well-designed randomized clinical trials.
年龄相关性听力损失 (ARHL) 与身体或认知衰弱之间的关联尚未得到充分探索。这些关联可以为延缓老年相关衰弱过程提供新的视角。
研究外周性 ARHL 和与年龄相关的中枢听觉处理障碍 (CAPD) 是否与身体或认知衰弱独立相关。
设计、地点和参与者：这项横断面研究分析了 2014 年 12 月 31 日来自意大利南部萨卢斯研究 (Salus in Apulia Study) 的 1929 名年龄≥65 岁的参与者的登记数据，这些参与者接受了听力、身体和神经心理学评估。数据分析于 2019 年 12 月 12 日至 2020 年 1 月 4 日进行。
使用 Fried 标准（身体）和 Mini-Mental State Examination（认知）评估身体和/或认知衰弱以及无衰弱的老年人中周围性 ARHL 的患病率。多变量逻辑回归模型用于评估听力变量与衰弱表型的关联。
共有 1929 名参与者（平均[标准差]年龄，73.6[6.3]岁；男性 974 名[50.5%]）符合分析条件。与非衰弱组（329 名[21.0%]）相比，外周性 ARHL 在身体衰弱组（96 名[26.6%]）中的患病率更高（差异，5.61 个百分点；95%CI，0.63-10.59 个百分点），与认知衰弱组（40 名[38.8%]）相比，在非衰弱组（385 名[21.1%]）中的患病率更高（差异，17.75 个百分点；95%CI，8.2-27.3 个百分点）。与年龄相关的 CAPD 在身体衰弱组（62 名[17.2%]）中比非衰弱组（219 名[14.0%]）更常见（差异，3.21 个百分点；95%CI，-1.04 至 7.46 个百分点），与认知衰弱组（28 名[27.2%]）相比，在非衰弱组（253 名[13.9%]）中更常见（差异，13.33 个百分点；95%CI，4.10-22.21 个百分点）。在多变量模型中，与年龄相关的 CAPD 在完全调整的模型中与认知衰弱相关（优势比[OR]，1.889；95%CI，1.094-3.311）。综合句子识别与同侧竞争信息得分的单位增加也与认知衰弱呈负相关，表明这种障碍的可能性降低（OR，0.989；95%CI，0.988-0.999）。外周性 ARHL 仅在部分调整模型中与认知衰弱相关（OR，1.725；95%CI，1.008-2.937）。
在这项对 1929 名参与者的横断面研究中，与年龄相关的 CAPD 与认知衰弱独立相关。是否管理 ARHL 可以帮助预防不同衰弱表型的发展或改善其临床后果，这应该在纵向研究中得到解决，并最终在精心设计的随机临床试验中得到解决。
