Caruso Department of Otolaryngology-Head & Neck Surgery, University of Southern California, Los Angeles, CA, USA.
Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
Lancet Healthy Longev. 2024 Jan;5(1):e66-e75. doi: 10.1016/S2666-7568(23)00232-5.
Hearing loss has been identified as an independent risk factor for negative health outcomes and mortality. However, whether rehabilitation with hearing aid use is associated with lower mortality is currently unknown. This study aimed to examine the associations of hearing loss, hearing aid use, and mortality in the USA.
In this cross-sectional, follow-up study, we assessed 9885 adults (age 20 years and older) who participated in the National Health and Nutrition Examination Survey between 1999 and 2012 and completed audiometry and hearing aid use questionnaires (1863 adults with hearing loss). Main measures included hearing loss (speech-frequency pure-tone average) and hearing aid use (never users, non-regular users, and regular users). Mortality status of the cohort was linked to the National Death Index up to Dec 31, 2019. Cox proportional regression models were used to examine the association between hearing loss, hearing aid use, and mortality while adjusting for demographics and medical history.
The cohort consisted of 9885 participants, of which 5037 (51·0%) were female and 4848 (49·0%) were male with a mean age of 48·6 years (SD 18·1) at baseline. The weighted prevalence of audiometry-measured hearing loss was 14·7% (95% CI 13·3-16·3%) and the all-cause mortality rate was 13·2% (12·1-14·4) at a median 10·4 years of follow-up (range 0·1-20·8). The rate of regular hearing aid use among adults with hearing loss was 12·7% (95% CI 10·6-15·1). Hearing loss was an independent risk factor associated with higher mortality (adjusted hazard ratio [HR] 1·40 [95% CI 1·21-1·62]). Among individuals with hearing loss, the adjusted mortality risk was lower among regular hearing aid users in comparison with never users (adjusted HR 0·76 [0·60-0·95]) accounting for demographics, hearing levels, and medical history. There was no difference in adjusted mortality between non-regular hearing aid users and never users (adjusted HR 0·93 [0·70-1·24]).
Regular hearing aid use was associated with lower risks of mortality than in never users in US adults with hearing loss when accounting for age, hearing loss, and other potential confounders. Future research is needed to investigate the potential protective role of hearing aid use against mortality for adults with hearing loss.
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听力损失已被确定为负面健康结果和死亡率的独立危险因素。然而，目前尚不清楚使用助听器进行康复是否与更低的死亡率相关。本研究旨在检验美国听力损失、助听器使用和死亡率之间的关联。
在这项横断面、随访研究中，我们评估了 9885 名年龄在 20 岁及以上的成年人（1863 名有听力损失的成年人），他们参加了 1999 年至 2012 年的全国健康与营养调查，并完成了听力和助听器使用问卷。主要措施包括听力损失（言语频率纯音平均听力级）和助听器使用（从不使用者、非定期使用者和定期使用者）。队列的死亡率状态与截至 2019 年 12 月 31 日的国家死亡索引相关联。使用 Cox 比例风险回归模型，在调整人口统计学和病史的情况下，检验听力损失、助听器使用和死亡率之间的关联。
该队列由 9885 名参与者组成，其中 5037 名（51.0%）为女性，4848 名（49.0%）为男性，基线时的平均年龄为 48.6 岁（标准差 18.1）。经加权的听力计测量的听力损失患病率为 14.7%（95%CI 13.3-16.3%），在中位数为 10.4 年的随访（范围 0.1-20.8）期间，全因死亡率为 13.2%（12.1-14.4%）。听力损失成年人中定期使用助听器的比例为 12.7%（95%CI 10.6-15.1）。听力损失是与更高死亡率相关的独立危险因素（调整后的危害比[HR]1.40[95%CI 1.21-1.62]）。在有听力损失的人群中，与从不使用者相比，定期使用助听器者的调整后死亡率风险较低（调整后的 HR 0.76[0.60-0.95]），这与人口统计学、听力水平和病史有关。非定期使用助听器者与从不使用者的调整后死亡率无差异（调整后的 HR 0.93[0.70-1.24]）。
在美国有听力损失的成年人中，当考虑年龄、听力损失和其他潜在混杂因素时，与从不使用者相比，定期使用助听器与较低的死亡率风险相关。需要进一步研究以探讨助听器使用对听力损失成年人的死亡率的潜在保护作用。
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