National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
JAMA Netw Open. 2021 Apr 1;4(4):e215484. doi: 10.1001/jamanetworkopen.2021.5484.
Hearing loss may be a modifiable factor associated with decreased physical activity in older adults.
To examine the association of hearing loss with objectively measured physical activity, including moderate-to-vigorous physical activity, light-intensity physical activity, sedentary behavior, and pattern of physical activity (physical activity fragmentation).
DESIGN, SETTING, AND PARTICIPANTS: This population-based cross-sectional study used National Health and Nutrition Examination Survey (NHANES) data collected in the 2003 to 2004 cycle and analyzed in 2017 to 2020. Participants aged 60 to 69 years with complete audiometry, physical activity, and comorbidity data were included in the analysis. Data analysis was performed from January 2017 to December 2020.
Hearing defined by the pure tone average (PTA; range, 0.5-4 kHz) in the better ear, with normal PTA defined as less than 25 dB hearing loss, mild hearing loss defined as PTA 25 to less than 40 dB hearing loss, and moderate or greater hearing loss defined as a PTA greater than or equal to 40 dB hearing loss.
The primary outcomes were comprehensive metrics of objectively measured physical activity, including time spent in moderate-to-vigorous physical activity, light-intensity physical activity, and sedentary behavior, and physical activity fragmentation. Linear regression was used to model the association between hearing loss and physical activity.
Of the 291 participants (mean [SD] age, 64.53 [2.96] years), 139 (47.8%) were male, 48 (16.5%) had mild hearing loss, and 22 (7.6%) had moderate or greater hearing loss. After adjusting for age, sex, education, race/ethnicity, and comorbidities, hearing loss (vs normal hearing) was significantly associated with less time spent in moderate-to-vigorous physical activity by 5.53 minutes per day (95% CI, -10.15 to -0.90 minutes per day), less time spent in light-intensity physical activity by 28.55 minutes per day (95% CI, -53.07 to -4.02 minutes per day), more time spent in sedentary behaviors by 34.07 minutes per day (95% CI, 8.32 to 59.82 minutes per day), and more fragmented physical activity pattern by 0.38 SD higher in active-to-sedentary transition probability (95% CI, to 0.10 to 0.65). The magnitude of the association of hearing loss (vs normal hearing) with physical activity metrics was equivalent to 7.28 years (95% CI, 3.19 to 11.37 years) of accelerated age for moderate-to-vigorous physical activity, 5.84 years (95% CI, 1.45 to 10.23 years) of accelerated age for light-intensity physical activity, and 10.53 years (95% CI, 2.89 to 18.16 years) of accelerated age for degree of physical activity fragmentation.
These findings suggest that hearing loss is associated with a worse physical activity profile. Whether interventions to address hearing loss in adults could improve physical activity profiles will require further study.
听力损失可能是与老年人身体活动减少相关的可改变因素。
研究听力损失与客观测量的身体活动之间的关系，包括中等到剧烈的身体活动、低强度身体活动、久坐行为以及身体活动模式（身体活动碎片化）。
设计、设置和参与者：本基于人群的横断面研究使用了国家健康和营养检查调查（NHANES）2003 至 2004 周期的数据，并于 2017 年至 2020 年进行了分析。分析纳入了听力检查、身体活动和合并症数据完整的 60 至 69 岁参与者。数据分析于 2017 年 1 月至 2020 年 12 月进行。
听力通过纯音平均听力（PTA；范围，0.5-4 kHz）来定义，较好耳的正常 PTA 定义为听力损失小于 25 dB，轻度听力损失定义为 PTA 25 至小于 40 dB 听力损失，中度或更严重的听力损失定义为 PTA 大于或等于 40 dB 听力损失。
主要结局是客观测量身体活动的综合指标，包括中等到剧烈的身体活动、低强度身体活动和久坐行为的时间，以及身体活动碎片化。线性回归用于模型化听力损失与身体活动之间的关系。
在 291 名参与者（平均[标准差]年龄，64.53[2.96]岁）中，139 名（47.8%）为男性，48 名（16.5%）有轻度听力损失，22 名（7.6%）有中度或更严重的听力损失。调整年龄、性别、教育程度、种族/民族和合并症后，听力损失（与正常听力相比）每天少进行 5.53 分钟的中等到剧烈身体活动（95%置信区间，每天减少 10.15 至减少 0.90 分钟），每天少进行 28.55 分钟的低强度身体活动（95%置信区间，每天减少 53.07 至减少 4.02 分钟），每天多进行 34.07 分钟的久坐行为（95%置信区间，每天增加 8.32 至增加 59.82 分钟），活跃到久坐状态的转换概率的身体活动模式碎片化增加 0.38 个标准差（95%置信区间，0.10 至 0.65）。听力损失（与正常听力相比）与身体活动指标的关联程度相当于中等到剧烈身体活动的年龄加速 7.28 年（95%置信区间，3.19 年至 11.37 年），低强度身体活动的年龄加速 5.84 年（95%置信区间，1.45 年至 10.23 年），身体活动碎片化程度的年龄加速 10.53 年（95%置信区间，2.89 年至 18.16 年）。
这些发现表明听力损失与较差的身体活动模式相关。是否通过干预措施解决成年人的听力损失是否可以改善身体活动模式，这将需要进一步的研究。
