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老年人与年龄相关的听力损失与步行和平衡:病例对照的横断面研究。

Walking and balance in older adults with age-related hearing loss: A cross-sectional study of cases and matched controls.

机构信息

Department of Health and Function, Western Norway University of Applied Science, Bergen, Norway.

Department of Health and Function, Western Norway University of Applied Science, Bergen, Norway.

出版信息

Gait Posture. 2024 Sep;113:398-406. doi: 10.1016/j.gaitpost.2024.07.301. Epub 2024 Jul 29.

Abstract

BACKGROUND

Hearing loss (HL) is prevalent in older individuals. It is suggested that there is an association between age-related HL, walking and balance, leading to poorer function and increased risk of falls in older individuals.

RESEARCH QUESTION

Is HL associated with physical performance, gait variability, and postural sway in older adults, and will additional dizziness moderate the effect of HL on balance?

METHODS

In this cross-sectional study we examined 100 older individuals (age ≥70 years, 60 % females), divided in two groups, with or without age-related HL. Physical function and balance were evaluated by the Short Physical Performance Battery (SPPB), postural sway measured on a force platform (posturography), and balance in walking (gait variability) measured with a body-worn sensor. Multiple linear regression was used to examine the relationships between the variables, with physical function and balance as outcomes and HL as a dichotomous exposure (>30 dB). For all analyses, we further tested if associations were modified by self-reported dizziness.

RESULTS

Multiple regression analysis with HL, age, sex, education, diabetes, and cardiovascular disease revealed a significant association between reduced SPPB and HL. Multiple linear regression analysis also showed that HL was associated with increased postural sway on firm surface with eyes open and closed after adjusting for age, sex, education, diabetes, and cardiovascular disease. There was significant association between HL and increased gait variability during dual task walking in all directions after adjusting for age, sex, education, diabetes, and cardiovascular disease. Further, we found that the association between HL and SPPB was significantly stronger in those with dizziness compared with those without dizziness. Dizziness also modified the association of HL with the other SPPB sub-scores but not for the other outcomes of postural sway or gait variability.

SIGNIFICANCE

In this study, age-related HL was associated with worse physical performance as measured by SPPB, postural sway, and gait variability. This relationship illustrates the importance of assessing physical performance in people with HL to prevent risk of falls and disability.

摘要

背景

听力损失(HL)在老年人中较为普遍。有研究表明,年龄相关性 HL 与行走和平衡之间存在关联,这会导致老年人功能下降和跌倒风险增加。

研究问题

HL 是否与老年人的身体机能、步态变异性和姿势摆动有关,而额外的头晕是否会减弱 HL 对平衡的影响?

方法

在这项横断面研究中,我们检查了 100 名年龄在 70 岁以上的老年人(60%为女性),分为有或无年龄相关性 HL 两组。使用短体适能表现测试(SPPB)评估身体机能和平衡,使用力平台(姿势描记法)测量姿势摆动,使用佩戴在身体上的传感器测量行走时的平衡(步态变异性)。使用多元线性回归分析来检验这些变量之间的关系,以身体机能和平衡为结果,HL 为二分类暴露(>30dB)。对于所有分析,我们进一步测试了如果关联是否因自我报告的头晕而改变。

结果

多元回归分析显示,HL、年龄、性别、教育程度、糖尿病和心血管疾病与 SPPB 降低显著相关。多元线性回归分析还表明,在调整年龄、性别、教育程度、糖尿病和心血管疾病后,HL 与睁眼和闭眼时在坚固表面上的姿势摆动增加有关。在调整年龄、性别、教育程度、糖尿病和心血管疾病后,HL 与所有方向的双重任务行走时的步态变异性增加显著相关。此外,我们发现,与没有头晕的人相比,HL 与 SPPB 的相关性在有头晕的人身上更强。头晕还改变了 HL 与 SPPB 其他子评分之间的关联,但对姿势摆动或步态变异性的其他结果没有影响。

意义

在这项研究中,年龄相关性 HL 与 SPPB、姿势摆动和步态变异性等身体机能的下降有关。这种关系说明了评估有 HL 的人的身体机能以预防跌倒和残疾的重要性。

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