Association of Hearing Impairment with Declines in Physical Functioning and the Risk of Disability in Older Adults
Association of Hearing Impairment with Declines in Physical Functioning and the Risk of Disability in Older Adults
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DOI：
10.1093/gerona/glu207
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发表时间：
2015-05-01
影响因子：
5.1
通讯作者：
Lin, Frank R.
中科院分区：
文献类型：
--
作者：
Chen, David S.;Betz, Joshua;Lin, Frank R.
背景：鉴于人口老龄化，识别与老年人功能衰退相关的因素非常重要。我们调查了以社区为基础的老年人样本中听力障碍是否与客观测量的身体机能下降独立相关。方法：对来自健康、衰老和身体成分研究的 2,190 名个体进行前瞻性观察研究。每年对参与者进行最多 11 次随访。听力通过纯音测听法进行测量。使用短体力测试电池（SPPB）测量身体机能和步态速度。每半年通过自我报告评估事件残疾和护理需求。结果：在混合效应模型中，听力损伤程度与身体机能较差相关。在访视 1 和访视 11 时，轻度听力障碍 (10.14 [95% CI 10.04-10.25]，p < .01；7.35 [95% CI 7.12-7.58]，p < .05) 和中度或重度听力障碍 (10.04 [95% CI 9.90-10.19]，p < .05) 个体的 SPPB 评分较低.01；7.00 [95% 置信区间 6.69-7.32]，p < .01）高于正常听力个体的分数（10.36 [95% CI 10.26-10.46]；7.71 [95% CI 7.49-7.92]）。我们观察到，与听力正常的女性相比，中度或以上听力障碍的女性发生残疾的风险增加了 31%（风险比 [HR] = 1.31 [95% CI 1.08-1.60]，p < .01），发生护理需求的风险增加了 31%（HR = 1.31 [95% CI 1.05-1.62]，p = .02）。结论：听力损伤是独立的 与老年人客观身体机能较差有关，并且女性发生残疾和需要护理的风险增加 31%。
Background: Identifying factors associated with functional declines in older adults is important given the aging of the population. We investigated if hearing impairment is independently associated with objectively measured declines in physical functioning in a community-based sample of older adults.Methods: Prospective observational study of 2,190 individuals from the Health, Aging, and Body Composition study. Participants were followed annually for up to 11 visits. Hearing was measured with pure-tone audiometry. Physical functioning and gait speed were measured with the Short Physical Performance Battery (SPPB). Incident disability and requirement for nursing care were assessed semiannually through self-report.Results: In a mixed-effects model, greater hearing impairment was associated with poorer physical functioning. At both Visit 1 and Visit 11, SPPB scores were lower in individuals with mild (10.14 [95% CI 10.04-10.25], p < .01; 7.35 [95% CI 7.12-7.58], p < .05) and moderate or greater hearing impairment (10.04 [95% CI 9.90-10.19], p < .01; 7.00 [95% CI 6.69-7.32], p < .01) than scores in normal hearing individuals (10.36 [95% CI 10.26-10.46]; 7.71 [95% CI 7.49-7.92]). We observed that women with moderate or greater hearing impairment had a 31% increased risk of incident disability (Hazard ratio [HR] = 1.31 [95% CI 1.08-1.60], p < .01) and a 31% increased risk of incident nursing care requirement (HR = 1.31 [95% CI 1.05-1.62], p = .02) compared to women with normal hearing.Conclusions: Hearing impairment is independently associated with poorer objective physical functioning in older adults, and a 31% increased risk for incident disability and need for nursing care in women.