听力干预与健康教育培训对照在疲劳方面的效果：ACHIEVE 研究的二次分析。
Effect of Hearing Intervention Versus Health Education Control on Fatigue: A Secondary Analysis of the ACHIEVE Study.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
出版信息
J Gerontol A Biol Sci Med Sci. 2024 Nov 1;79(11). doi: 10.1093/gerona/glae193.
BACKGROUND
Fatigue is a common complaint among older adults with hearing loss. The impact of addressing hearing loss on fatigue symptoms has not been studied in a randomized controlled trial. In a secondary analysis of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study, we investigated the effect of hearing intervention versus health education control on 3-year change in fatigue in community-dwelling older adults with hearing loss.
METHODS
Participants aged 70-84 years old with untreated hearing loss recruited across 4 study sites in the United States (Forsyth County, North Carolina; Jackson, Mississippi; Minneapolis, Minnesota; Washington County, Maryland) were randomized (1:1) to hearing intervention or health education control and followed for 3 years. Three-year change in fatigue symptoms was measured by 2 instruments (RAND-36 and PROMIS). We estimated the intervention effect as the difference in the 3-year change in fatigue between intervention and control groups using a linear mixed-effects model under the intention-to-treat principle.
RESULTS
Participants (n = 977) had a mean age (SD) of 76.8 (4.0) years, were 53.5% female and 87.8% White. Over 3 years, a beneficial effect of the hearing intervention versus health education control on fatigue was observed using the RAND-fatigue score (β = -0.12 [95% CI: -0.22, -0.02]). Estimates also suggested beneficial effect of hearing intervention on fatigue when measured by the PROMIS-fatigue score (β = -0.32 [95% CI: -1.15, 0.51]).
CONCLUSIONS
Our findings suggest that hearing intervention may reduce fatigue over 3 years among older adults with hearing loss.
背景
疲劳是听力损失老年人常见的主诉。在随机对照试验中，尚未研究解决听力损失对疲劳症状的影响。在老年人认知健康评估研究（ACHIEVE）的二次分析中，我们调查了听力干预与健康教育对照在 3 年内对听力损失的社区居住老年人疲劳症状的影响。
方法
我们在美国的 4 个研究地点（北卡罗来纳州福赛斯县、密西西比州杰克逊、明尼苏达州明尼阿波利斯、马里兰州华盛顿县）招募了年龄在 70-84 岁之间、未经治疗的听力损失的参与者，随机分为（1:1）听力干预组或健康教育对照组，并随访 3 年。疲劳症状的 3 年变化通过 2 种工具（RAND-36 和 PROMIS）进行测量。我们根据意向治疗原则，使用线性混合效应模型来估计干预效果，即干预组和对照组之间 3 年疲劳变化的差异。
结果
参与者（n=977）的平均年龄（SD）为 76.8（4.0）岁，53.5%为女性，87.8%为白人。在 3 年内，与健康教育对照组相比，听力干预对 RAND 疲劳评分（β=-0.12[95%CI：-0.22，-0.02]）的疲劳有有益作用。当使用 PROMIS 疲劳评分（β=-0.32[95%CI：-1.15，0.51]）测量时，也表明听力干预对疲劳有有益作用。
结论
我们的研究结果表明，听力干预可能会减少 3 年内听力损失老年人的疲劳感。
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