老年人听力损失与虚弱：社区动脉粥样硬化风险研究。
Hearing Loss and Frailty among Older Adults: The Atherosclerosis Risk in Communities Study.
机构信息
Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
出版信息
J Am Med Dir Assoc. 2023 Nov;24(11):1683-1689.e5. doi: 10.1016/j.jamda.2023.08.023. Epub 2023 Sep 23.
OBJECTIVES
Hearing loss may contribute to frailty through cognitive and physical decline, but population-based evidence using validated measures remains scarce. We investigated the association of hearing loss with phenotypic frailty and its individual components and explored the potential protective role of hearing aid use.
DESIGN
Cross-sectional study of community-dwelling older adults at visit 6 (2016-2017) of the Atherosclerosis Risk in Communities (ARIC) study, a cohort study of older adults from 4 U.S. communities (Washington County, MD; Forsyth County, NC; Jackson, MS; and Minneapolis, MN).
SETTING AND PARTICIPANTS
Population-based study of 3179 participants (mean age = 79.2 years, 58.9% female).
METHODS
Pure-tone audiometry at 0.5-4 kHz was used to assess unaided hearing, and the better-hearing ear's pure-tone average was categorized as follows: no [≤25 dB hearing level (HL)], mild (26-40 dB HL), and moderate or greater (>40 dB HL) hearing loss. Hearing aid use was self-reported. The Fried/physical frailty phenotype was used to categorize frailty status (robust, pre-frail, or frail). Multivariable multinomial and logistic regression models were used to study the association of hearing loss/hearing aid use with frailty status and individual frailty components, respectively.
RESULTS
In our sample, 40% had mild and 27% had moderate or greater hearing loss (12% and 55% reported hearing aid use, respectively). Moderate or greater hearing loss was associated with greater odds of being pre-frail [odds ratio (OR), 1.25; 95% CI, 1.01-1.57] and frail (OR, 1.62; 95% CI, 1.06-2.47) vs robust, and greater odds of having slow gait, low physical activity, and exhaustion, compared with no hearing loss. Among those with hearing loss (>25 dB HL), compared with hearing aid users, nonusers had greater odds of being frail vs robust, and having unintentional weight loss, slow gait, and low physical activity.
CONCLUSIONS AND IMPLICATIONS
Hearing loss is associated with pre-frailty and frailty. Longitudinal studies are warranted to establish if hearing aid use may prevent or delay frailty onset.
目的
听力损失可能通过认知和身体衰退导致虚弱，但使用经过验证的测量方法的基于人群的证据仍然很少。我们研究了听力损失与表型虚弱及其各个组成部分的关系，并探讨了助听器使用的潜在保护作用。
设计
横断面研究，来自美国 4 个社区（马里兰州华盛顿县、北卡罗来纳州福赛斯县、密西西比州杰克逊和明尼苏达州明尼阿波利斯）的 ARIC 研究（一项针对老年人的队列研究）中的社区居住的老年人在第 6 次就诊（2016-2017 年）时进行。
地点和参与者
一项基于人群的研究，共 3179 名参与者（平均年龄 79.2 岁，58.9%为女性）。
方法
使用 0.5-4 kHz 的纯音测听评估未助听听力，较好耳的纯音平均分为以下几类：无 [≤25 分贝听力水平 (HL)]、轻度（26-40 dB HL）和中度或更重度（>40 dB HL）听力损失。助听器使用情况为自我报告。使用 Fried/身体虚弱表型来分类虚弱状态（稳健、虚弱前期或虚弱）。多变量多项和逻辑回归模型分别用于研究听力损失/助听器使用与虚弱状态和个体虚弱成分的关系。
结果
在我们的样本中，40%有轻度听力损失，27%有中度或更重度听力损失（分别有 12%和 55%报告使用助听器）。中度或更重度听力损失与虚弱前期（优势比[OR]，1.25；95%置信区间[CI]，1.01-1.57）和虚弱（OR，1.62；95% CI，1.06-2.47）的几率增加相关，与稳健相比，且与较慢的步态、较低的体力活动和疲惫感的几率增加相关，与无听力损失相比。在有听力损失（>25 dB HL）的人群中，与助听器使用者相比，未使用者虚弱前期比稳健的几率更高，且有非故意体重减轻、较慢的步态和较低的体力活动。
结论和意义
听力损失与虚弱前期和虚弱有关。需要进行纵向研究以确定助听器的使用是否可以预防或延迟虚弱的发生。
Zotero 插件