American Journal of Epidemiology Original Contribution Generational Differences in the Prevalence of Hearing Impairment in Older Adults
American Journal of Epidemiology Original Contribution Generational Differences in the Prevalence of Hearing Impairment in Older Adults
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通讯作者：
W. Zhan;K. Cruickshanks;B. Klein;R. Klein;Guan-Hua Huang;J. Pankow;R. Gangnon;T. Tweed
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作者：
W. Zhan;K. Cruickshanks;B. Klein;R. Klein;Guan-Hua Huang;J. Pankow;R. Gangnon;T. Tweed
在整个世纪，健康和生活方式发生了重大变化，这可能改变了成年人听力损伤的时间模式。在这项研究中，作者旨在评估出生队列对45-94岁成年人群听力损伤患病率的影响，使用1993年至2008年从听力损失流行病学研究的3个周期收集的数据。（n = 3，753;基线年龄48-92岁）和来自比弗坝后代研究的参与者样本（n = 2，173;年龄！45年）。听力损伤定义为0.5、1、2和4 kHz的纯音平均阈值大于25 dB HL [听力水平]。描述性分析，广义相加模型，交替逻辑回归模型被用来检查出生队列效应。控制年龄，出生年份每增加5岁，男性听力受损的几率降低13%（比值比：0.87，95%置信区间：0.83，0.92），女性降低6%（比值比：0.94，95%置信区间：0.89，0.98）。这些结果表明，1）老年人可能比前几代人保持良好的听力更长时间，2）可改变的因素导致成年人的听力受损。世纪见证了经济、技术和社会环境的深刻变化。这些变化极大地影响了人们的日常生活，因此可能重塑了一代又一代的疾病模式。世代之间的变化被称为出生队列效应。了解出生队列效应对公共卫生具有重要意义，因为它们在预测卫生保健需求和制定相应的预防战略方面发挥着关键作用，特别是在人口老龄化的慢性残疾领域（1，2）。听力障碍就是这样一种慢性残疾。作为美国第三大流行的慢性残疾，听力障碍估计影响2900万20-69岁的美国人（3）。听力障碍通常会导致理解言语的困难，而言语是沟通的一个非常重要的工具。听力障碍患者可能会进一步遭受心理，身体和社会后果，再加上其高患病率，使听力障碍成为一个主要的公共卫生问题。随着人口老龄化，听力障碍的人数预计会增加。然而，如果后代听力障碍的患病率较低，则数字可能会更低。据我们所知，还没有基于人口的代际差异研究。
There were significant changes in health and lifestyle throughout the 20th century which may have changed temporal patterns of hearing impairment in adults. In this study, the authors aimed to assess the effect of birth cohort on the prevalence of hearing impairment in an adult population aged 45–94 years, using data collected between 1993 and 2008 from 3 cycles of the Epidemiology of Hearing Loss Study (n ¼ 3,753; ages 48–92 years at baseline) and a sample of participants from the Beaver Dam Offspring Study (n ¼ 2,173; ages !45 years). Hearing impairment was defined as a pure-tone average of thresholds at 0.5, 1, 2, and 4 kHz greater than 25-dB HL [hearing level]. Descriptive analysis, generalized additive models, and alternating logistic regression models were used to examine the birth cohort effect. Controlling for age, with every 5-year increase in birth year, the odds of having hearing impairment were 13% lower in men (odds ratio ¼ 0.87, 95% confidence interval: 0.83, 0.92) and 6% lower in women (odds ratio ¼ 0.94, 95% confidence interval: 0.89, 0.98). These results suggest that 1) older adults may be retaining good hearing longer than previous generations and 2) modifiable factors contribute to hearing impairment in adults. The 20th century saw profound changes in the economic , technologic, and social environments. These changes greatly affected people's everyday lives and thus may have reshaped the pattern of disease from generation to generation. Changes across generations are referred to as the birth cohort effect. Understanding birth cohort effects has important implications for public health because of the key role they play in predicting health-care needs and developing corresponding prevention strategies, particularly in the field of chronic disability, with the aging of the population (1, 2). Hearing impairment is one such chronic disability. As the third-most-prevalent chronic disability in the United States, hearing impairment is estimated to affect 29 million Americans aged 20–69 years (3). Hearing impairment usually causes difficulty in understanding speech, an extremely important tool for communication. People with hearing impairment may further suffer psychological, physical, and social consequences, which, together with its high prevalence, make hearing impairment a major public health concern (4). The number of people with hearing impairment is expected to increase as the population ages. However, the numbers may be lower if later generations have lower prevalences of hearing impairment. To our knowledge, there have been no population-based studies of generational differences …