Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years.
Declining Prevalence of Hearing Loss in US Adults Aged 20 to 69 Years.
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在20至69岁的美国成年人中，听力损失的患病率下降。
DOI：
10.1001/jamaoto.2016.3527
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发表时间：
2017-03-01
期刊：
影响因子：
--
通讯作者：
Flamme GA
中科院分区：
文献类型：
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作者：
Hoffman HJ;Dobie RA;Losonczy KG;Themann CL;Flamme GA
随着美国人口老龄化，有效的医疗保健计划需要了解听力损失患病率的变化。确定在过去十年中，成人听力损失的年龄和性别特异性患病率是否发生了变化。2011-2012年国家健康和营养检查调查（NHANES）听力数据与1999-2004年NHANES相比的分析。NHANES是一项对平民、非机构化人口进行的跨部门、具有全国代表性的访谈和检查调查。对3，831名年龄在20-69岁之间的成年人进行分层随机抽样测听和问卷调查。语频听力损伤（HI）定义为0.5-1-2-4 kHz范围内阈值的纯音平均值（PTA）大于25 dB听力水平（HL）;高频HI定义为3-4-6 kHz范围内PTA>25 dB HL。采用逻辑回归分析来检验未校正、年龄和性别校正以及多变量校正与人口统计学、噪声暴露和心血管危险因素的相关性。2011-2012年未校正的单侧和双侧言语频率HI成人患病率为14.1%，而1999-2004年为16%;在年龄和性别校正后，差异显著，比值比（OR）=0.70（95%置信区间[95%CI]：0.56-0.86）。男性的言语频率HI患病率为18.6%（1780万人），女性为9.6%（970万人）。对于60-69岁的人群，言语频率HI患病率为39.3%（95%CI：30.7%-48.7%）。在双侧言语频率HI的多变量分析中，年龄是主要的风险因素;然而，男性、非西班牙裔（NH）白色和NH亚裔、教育程度较低和大量使用枪支都有显著的相关性。高频HI的其他相关因素是墨西哥裔美国人和其他西班牙裔种族/民族，以及职业和工作以外的大声和非常大声的噪音暴露，OR=2.4（95% CI：1.4-4.2）。成人听力损失很常见，与年龄和其他人口统计学因素（性别，种族/民族，教育）密切相关。噪声暴露，这是可以预防的，是不太强烈的相关性。心血管危险因素--重度吸烟、高血压和糖尿病--仅在未校正的分析中有意义。年龄和性别特异性HI患病率继续下降。尽管HI的延迟发作有好处，但随着美国人口的增长和老龄化，听力保健需求将增加。
As the American population ages, effective healthcare planning requires understanding changes in hearing loss prevalence. Determine if age- and sex-specific prevalence of adult hearing loss changed during the past decade. Analysis of 2011–2012 National Health and Nutrition Examination Survey (NHANES) audiometric data compared to NHANES 1999–2004. NHANES is a cross-sectional, nationally-representative interview and examination survey of the civilian, non-institutionalized population. A stratified random sample of 3,831 adults aged 20–69 years Audiometry and questionnaires Speech-frequency hearing impairment (HI) defined by pure-tone average (PTA) of thresholds across 0.5–1–2–4 kHz greater than 25 dB hearing level (HL); high-frequency HI defined by PTA across 3–4–6 kHz >25 dB HL. Logistic regression was used to examine unadjusted, age- and sex-adjusted, and multivariable-adjusted associations with demographic, noise exposure, and cardiovascular risk factors. The 2011–2012 unadjusted adult prevalence of unilateral and bilateral speech-frequency HI was 14.1%, compared to 16% for 1999–2004; after age- and sex-adjustment, the difference was significant, odds ratio (OR)=0.70 (95% confidence interval [95% CI]: 0.56–0.86). Men had nearly twice the prevalence of speech-frequency HI, 18.6% (17.8 million), compared to women, 9.6% (9.7 million). For 60–69 year-olds, speech-frequency HI prevalence was 39.3% (95% CI: 30.7%–48.7%). In multivariable analyses for bilateral speech-frequency HI, age was the major risk factor; however, men, non-Hispanic (NH) white and NH Asian race, lower educational attainment, and heavy use of firearms all had significant associations. Additional associations for high-frequency HI were Mexican-American and Other Hispanic race/ethnicity and the combination of loud and very loud noise exposure occupationally and outside of work, OR=2.4 (95% CI: 1.4–4.2). Adult hearing loss is common and strongly associated with age and other demographic factors (sex, race/ethnicity, education). Noise exposure, which is preventable, was less strongly associated. Cardiovascular risk factors – heavy smoking, hypertension, and diabetes – were significant only in unadjusted analyses. Age- and sex-specific HI prevalence continues to decline. Despite the benefit of delayed onset of HI, hearing healthcare needs will increase as the U.S. population grows and ages.