Zhang Weibin, Ruan Jian, Zhang Ruxin, Zhang Min, Hu Xiuhua, Yu Zhuowei, Han Zhao, Ruan Qingwei
Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Fudan University, Shanghai, China.
Department of Geriatrics, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Shanghai Institute of Geriatrics and Gerontology, Fudan University, Shanghai, China.
Front Med (Lausanne). 2021 Oct 21;8:762556. doi: 10.3389/fmed.2021.762556. eCollection 2021.
To investigate the impact of the severity of age-related hearing loss (ARHL) and tinnitus, presence of ARHL and/or tinnitus, and physical frailty on the health-related quality of life (HRQoL) and domain-specific HRQoL in Chinese community-dwelling older adults. This was a cross-sectional study of a community-based cohort. We evaluated Chinese older adults ( = 429, 183 men and 246 women) aged ≥ 58years. The severity of HL and tinnitus were measured using pure-tone audiometry and the Tinnitus Handicap Inventory (THI), respectively. Physical frailty was measured using the five-item Fried scale. HRQoL was assessed using the Assessment of Quality of Life-8-Dimension (AQoL-8D) multi-attribute utility instrument (35 HRQoL items and eight domain-specific HRQoL subcategories). Low HRQoL (HRQoL score or subscores in the highest quintile) was used as a dependent variable in logistic regression analyses adjusted for demographic (Model 1) and health-related (Model 2) and psychosocial (Model 3) confounders. Age-related hearing loss severity was an independent determinant of senses in the physical dimension of HRQoL after adjusting for all covariates. Tinnitus severity was significantly associated with HRQoL and with independent living, senses, and pain in the physical dimension after adjusting for demographic and health-related covariates and was still associated with independent living and senses after adjusting for all covariates. The presence of ARHL and/or tinnitus was significantly associated with independent living and senses in the physical dimension after adjusting for all the covariates. Physical frailty was an independent determinant of HRQoL, independent living, and pain in the physical dimension and with mental health, happiness, and coping in the psychosocial dimension after adjusting for demographic and health-related covariates. The association with HRQoL, independent living, and pain in the physical dimension, and with happiness and coping in the psychosocial dimension remained significant after adjusting for the covariates. Depressive symptoms, social dysfunction, and a number of comorbidities were critical determinants of psychosocial HRQoL. Physical frailty has a stronger and more profound effect on HRQoL, particularly on independent living and pain in the physical dimension and on happiness and coping in the psychosocial dimension. Domain-specific HRQoL should be considered in the management of patients with ARHL with tinnitus and physical frailty. www.ClinicalTrials.gov, identifier: NCT2017K020.
为研究年龄相关性听力损失(ARHL)和耳鸣的严重程度、ARHL和/或耳鸣的存在以及身体衰弱对中国社区居住老年人健康相关生活质量(HRQoL)及特定领域HRQoL的影响。这是一项基于社区队列的横断面研究。我们评估了年龄≥58岁的中国老年人(n = 429,男性183名,女性246名)。分别使用纯音听力测定法和耳鸣障碍量表(THI)测量听力损失和耳鸣的严重程度。使用五项Fried量表测量身体衰弱情况。使用生活质量评估-8维度(AQoL-8D)多属性效用工具(35项HRQoL项目和八个特定领域的HRQoL子类别)评估HRQoL。在针对人口统计学(模型1)、健康相关(模型2)和社会心理(模型3)混杂因素进行调整的逻辑回归分析中,将低HRQoL(HRQoL得分或子得分处于最高五分位数)用作因变量。在对所有协变量进行调整后,年龄相关性听力损失严重程度是HRQoL身体维度中感官方面的独立决定因素。在对人口统计学和健康相关协变量进行调整后,耳鸣严重程度与HRQoL以及身体维度中的独立生活、感官和疼痛显著相关,在对所有协变量进行调整后,仍与独立生活和感官相关。在对所有协变量进行调整后,ARHL和/或耳鸣的存在与身体维度中的独立生活和感官显著相关。在对人口统计学和健康相关协变量进行调整后,身体衰弱是HRQoL、身体维度中的独立生活和疼痛以及社会心理维度中的心理健康、幸福感和应对能力的独立决定因素。在对协变量进行调整后,与HRQoL、身体维度中的独立生活和疼痛以及社会心理维度中的幸福感和应对能力的关联仍然显著。抑郁症状、社会功能障碍和多种合并症是社会心理HRQoL的关键决定因素。身体衰弱对HRQoL有更强、更深远的影响,尤其是对身体维度中的独立生活和疼痛以及社会心理维度中的幸福感和应对能力。在管理伴有耳鸣和身体衰弱的ARHL患者时,应考虑特定领域的HRQoL。ClinicalTrials.gov,标识符:NCT2017K020。