一般健康检查中的听力筛查标准能否作为老年人群体虚弱和认知缺陷的间接指标？——基于世界卫生组织听力损失分类更新的患病率估计

Can hearing screening criteria at general health checkups be an indirect indicator of frailty and cognitive deficit in the older population? - with prevalence estimates based on updated World Health Organization hearing loss classification.

作者信息

Uchida Yasue, Sugiura Saiko, Shimono Mariko, Suzuki Hirokazu, Ando Fujiko, Shimokata Hiroshi, Tange Chikako, Nishita Yukiko, Otsuka Rei

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Nagakute, Japan.

Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Japan.

出版信息

Geriatr Gerontol Int. 2025 Apr;25(4):504-510. doi: 10.1111/ggi.14992. Epub 2025 Jan 28.

DOI:10.1111/ggi.14992

PMID:39876659

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11973012/

Abstract

AIM

This study aimed to reestimate the prevalence of hearing loss based on the updated World Health Organization hearing loss classification and investigate whether existing hearing screening criteria could efficiently screen for frailty or cognitive deficit.

METHODS

Data collected from community dwellers aged 40-91 years included 2325 samples. Health checkup hearing screening used were as follows: (A) 30 dB both at 1 and 4 kHz and (B) 30 dB at 1 kHz and 40 dB at 4 kHz were used. For participants aged ≥60 years, frailty according to the modified Cardiovascular Health Study criteria and cognitive deficit defined by a Mini-Mental State Examination score <28 were assessed. Logistic regression was performed to obtain odds ratios for frailty and cognitive deficit.

RESULTS

The rates of hearing loss using the updated World Health Organization classification in men were 8.6, 24.1, 54.2, 79.0 and 96.0% in their 40s, 50s, 60s, 70s and 80s and 3.7, 12.7, 36.4, 72.1 and 90.4% in women, respectively. Failing hearing screening using criterion A was associated with an increased risk of frailty, a sex-adjusted odds ratio of 4.136 (95% confidence interval, 2.182-7.838) and an increased risk of cognitive deficit: 1.753 (95% confidence interval, 1.346-2.283). After adjusting for age and sex, the effects on frailty and cognitive deficit were no longer significant. The results were similar when criterion B was used.

CONCLUSION

Because of the high prevalence of hearing loss and the ability to utilize existing devices and methodologies, hearing screening for the elderly should be reviewed. Geriatr Gerontol Int 2025; 25: 504-510.

摘要

目的

本研究旨在根据世界卫生组织更新的听力损失分类重新估计听力损失的患病率，并调查现有的听力筛查标准能否有效筛查衰弱或认知缺陷。

方法

收集了年龄在40 - 91岁的社区居民的2325份样本数据。使用的健康检查听力筛查标准如下：(A) 1kHz和4kHz时均为30dB；(B) 1kHz时为30dB，4kHz时为40dB。对于年龄≥60岁的参与者，根据改良的心血管健康研究标准评估衰弱情况，并通过简易精神状态检查表得分<28定义认知缺陷。进行逻辑回归以获得衰弱和认知缺陷的比值比。

结果

根据世界卫生组织更新分类，40多岁、50多岁、60多岁、70多岁和80多岁男性的听力损失率分别为8.6%、24.1%、54.2%、79.0%和96.0%，女性分别为3.7%、12.7%、36.4%、72.1%和90.4%。使用标准A听力筛查未通过与衰弱风险增加相关，经性别调整后的比值比为4.136（95%置信区间，2.182 - 7.838），与认知缺陷风险增加相关：1.753（95%置信区间，1.346 - 2.283）。在调整年龄和性别后，对衰弱和认知缺陷的影响不再显著。使用标准B时结果相似。