Ruan Qingwei, Chen Jie, Zhang Ruxin, Zhang Weibin, Ruan Jian, Zhang Min, Han Chao, Yu Zhuowei
Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China.
Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Front Psychol. 2021 Feb 16;11:617610. doi: 10.3389/fpsyg.2020.617610. eCollection 2020.
Fried physical frailty, with mobility frailty and non-motor frailty phenotypes, is a heterogeneous syndrome. The coexistence of the two phenotypes and cognitive impairment is referred to as cognitive frailty (CF). It remains unknown whether frailty phenotype has a different association with hearing loss (HL) and tinnitus.
Of the 5,328 community-dwelling older adults, 429 participants aged ≥58 years were enrolled in the study. The participants were divided into robust, mobility, and non-mobility frailty, mobility and non-mobility CF (subdivided into reversible and potentially reversible CF, RCF, and PRCF), and cognitive decline [subdivided into mild cognitive impairment (MCI) and pre-MCI] groups. The severity and presentations of HL and/or tinnitus were used as dependent variables in the multivariate logistic or nominal regression analyses with forward elimination adjusted for frailty phenotype stratifications and other covariates.
Patients with physical frailty (mobility frailty) or who are robust were found to have lower probability of developing severe HL and tinnitus, and presented HL and/or tinnitus than those with only cognitive decline, or CF. Patients with RCF and non-mobility RCF had higher probability with less HL and tinnitus, and the presentation of HL and/or tinnitus than those with PRCF and mobility RCF. Other confounders, age, cognitive and social function, cardiovascular disease, depression, and body mass index, independently mediated the severity of HL and tinnitus, and presented HL and/or tinnitus.
Frailty phenotypes have divergent association with HL and tinnitus. Further research is required to understand the differential mechanisms and the personalized intervention of HL and tinnitus.
ClinicalTrials.gov identifier, NCT2017K020.
衰弱综合征是一种异质性综合征,包括行动迟缓型衰弱和非运动型衰弱表型。这两种表型与认知障碍同时存在被称为认知衰弱(CF)。目前尚不清楚衰弱表型与听力损失(HL)和耳鸣之间是否存在不同的关联。
在5328名社区居住的老年人中,429名年龄≥58岁的参与者被纳入研究。参与者被分为健康组、行动迟缓型衰弱组、非行动迟缓型衰弱组、行动迟缓型认知衰弱组和非行动迟缓型认知衰弱组(进一步分为可逆性和潜在可逆性认知衰弱,即RCF和PRCF)以及认知衰退组(进一步分为轻度认知障碍,即MCI和MCI前期)。在多因素逻辑回归或名义回归分析中,将HL和/或耳鸣的严重程度和表现作为因变量,并对衰弱表型分层和其他协变量进行向前逐步回归调整。
发现身体衰弱(行动迟缓型衰弱)或健康的患者发生严重HL和耳鸣的概率较低,且与仅存在认知衰退或CF的患者相比,出现HL和/或耳鸣的情况较少。与PRCF和行动迟缓型RCF患者相比,RCF和非行动迟缓型RCF患者出现较少HL和耳鸣以及HL和/或耳鸣表现的概率更高。其他混杂因素,如年龄、认知和社会功能、心血管疾病、抑郁症和体重指数,独立介导HL和耳鸣的严重程度,并导致HL和/或耳鸣的出现。
衰弱表型与HL和耳鸣存在不同的关联。需要进一步研究以了解其不同机制以及HL和耳鸣的个性化干预措施。
ClinicalTrials.gov标识符,NCT2017K020 。