Department of Public Health, Southeast University, Nanjing, Jiangsu, China.
Department of Geriatrics, General Hospital of Eastern Theater Command, Nanjing, Jiangsu, China.
J Epidemiol Community Health. 2023 Apr;77(4):258-264. doi: 10.1136/jech-2022-219728. Epub 2023 Feb 1.
The impact of sensory impairment (SI) on individual multidimensional health has not been adequately explored in developing countries. This study examined the association of hearing or/and visual impairment with health-related quality of life (HRQoL) in the Chinese middle-aged and older population, and further explored potential discrepancies in associations by gender and rural-urban residence.
This cohort study used four-wave data during 2011-2018 from the China Health and Retirement Longitudinal Study, and enrolled 13 342 community-dwelling adults aged 45 years or older. We employed linear mixed effects models to estimate the longitudinal associations between SI and HRQoL, and conducted interaction tests to assess gender or rural-urban differences in above associations.
Hearing impairment (HI) and visual impairment (VI) were separately and jointly associated with deteriorated overall HRQoL and decreased physical/mental component of HRQoL (all β<0, all p<0.05), and in particular, dual sensory impairment (DSI) exhibited greater impacts on HRQoL than either HI or VI alone. The impacts of SI on HRQoL were more evident among women or rural population than their counterparts (all p for interaction<0.05).
This study observed decreased HRQoL in association with SI. The greater impact of DSI underlines the need for integrated care for comorbid sensory conditions. Our findings also indicate the necessity to reduce the burden of SI among more vulnerable populations such as females and rural adults.
在发展中国家,感官障碍(SI)对个体多维健康的影响尚未得到充分探讨。本研究调查了听力或/和视力障碍与中国中老年人群健康相关生活质量(HRQoL)的关联,并进一步探讨了性别和城乡居住差异对关联的潜在差异。
本队列研究使用了 2011 年至 2018 年期间中国健康与退休纵向研究的四轮数据,共纳入了 13342 名 45 岁及以上的社区居住成年人。我们采用线性混合效应模型估计 SI 与 HRQoL 之间的纵向关联,并进行了交互检验,以评估上述关联在性别或城乡差异方面的差异。
听力障碍(HI)和视力障碍(VI)分别和共同与整体 HRQoL 恶化和身体/精神成分 HRQoL 下降相关(所有β<0,均 p<0.05),特别是双重感官障碍(DSI)对 HRQoL 的影响大于 HI 或 VI 单独作用。SI 对 HRQoL 的影响在女性或农村人口中比在其对应人群中更为明显(所有交互检验 p<0.05)。
本研究观察到与 SI 相关的 HRQoL 下降。DSI 的更大影响强调了需要对合并的感官疾病进行综合护理。我们的研究结果还表明,有必要减轻女性和农村成年人等弱势群体的 SI 负担。