Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York.
Department of Epidemiology, School of Public Health, University of Alabama at Birmingham.
JAMA Netw Open. 2022 Mar 1;5(3):e222983. doi: 10.1001/jamanetworkopen.2022.2983.
Lower physical activity (PA) levels have been proposed as a mechanism to explain the association between hearing loss and various adverse outcomes of aging. But whether hearing loss is associated with lower PA is poorly understood.
To evaluate whether hearing loss is associated with lower levels of PA.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional analysis was conducted in a representative sample of US adults (aged 30-69 years) who participated in the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES). Data analysis was conducted from July to September 2021.
Hearing was assessed, in dB, by pure-tone audiometry and summarized as the better hearing ear's pure-tone average (BPTA) of 4 speech frequencies (500, 1000, 2000, and 4000 kHz); a higher BTPA indicates worse hearing. Hearing was also categorized into normal (BPTA ≤25 dB), mild hearing impairment (>25 to 40 dB), and moderate or greater hearing impairment (>40 dB).
Total 24-hour movement activity was measured using wrist accelerometers worn at all times for 7 consecutive days and summarized in monitor-independent movement summary units (MIMS) units (higher MIMS units indicate more movement). The association between BPTA and MIMS units was evaluated using a multivariable-adjusted (demographic characteristics and chronic conditions) piecewise spline regression (knot at 15 dB). Mean differences in MIMS units across hearing categories compared with normal hearing were estimated.
The study included 2490 participants (mean [SE] age, 48.9 [0.3] years; 900 [weighted percentage, 69.3%] White individuals, 1248 [weighted percentage, 50.8%] female participants). Before the knot at 15 dB, we found that each 10-dB higher BPTA was associated with 860.4 (95% CI, 444.8-1276.1) higher MIMS units. Conversely, after the knot, each 10-dB higher BPTA was associated with 458.6 (95% CI, 27.7-889.4) lower MIMS units. The difference in MIMS units across hearing categories was not statistically significant.
In this cross-sectional study, in the range of hearing sensitivity of BPTA of 15 dB or greater, worse hearing was associated with lower MIMS units. Lower PA may be a mechanism contributing to the association between hearing impairment and adverse health.
较低的体力活动 (PA) 水平被认为是解释听力损失与衰老的各种不良后果之间关联的机制。但是，听力损失是否与较低的 PA 有关尚不清楚。
评估听力损失是否与较低水平的 PA 有关。
设计、地点和参与者：这是一项在美国成年人（年龄 30-69 岁）的代表性样本中进行的横断面分析，他们参加了 2011-2012 年全国健康和营养检查调查 (NHANES) 的循环。数据分析于 2021 年 7 月至 9 月进行。
通过纯音测听评估听力，以分贝 (dB) 表示，并总结为较好耳朵的纯音平均听力 (BPTA) 4 个语音频率（500、1000、2000 和 4000 kHz）；更高的 BTPA 表示听力更差。听力也分为正常（BPTA ≤25 dB）、轻度听力障碍（>25-40 dB）和中度或更严重听力障碍（>40 dB）。
使用佩戴在手腕上的连续 7 天的腕式加速度计测量 24 小时总运动活动量，并以监测独立运动总结单位 (MIMS) 单位表示（更高的 MIMS 单位表示更多的运动）。使用多变量调整（人口统计学特征和慢性疾病）分段样条回归（结在 15 dB 处）评估 BPTA 与 MIMS 单位之间的关联。与正常听力相比，估计听力类别之间 MIMS 单位的平均差异。
该研究纳入了 2490 名参与者（平均[SE]年龄 48.9[0.3]岁；900 名[加权百分比，69.3%]白人个体，1248 名[加权百分比，50.8%]女性参与者）。在 15 dB 的结之前，我们发现每增加 10 dB 的 BPTA 与 860.4（95%CI，444.8-1276.1）个更高的 MIMS 单位相关。相反，在结之后，每增加 10 dB 的 BPTA 与 458.6（95%CI，27.7-889.4）个更低的 MIMS 单位相关。听力类别之间的 MIMS 单位差异无统计学意义。
在这项横断面研究中，在 BPTA 听力敏感度为 15 dB 或更高的范围内，听力越差与 MIMS 单位越低相关。较低的 PA 可能是导致听力损伤与不良健康之间关联的机制之一。
