Associations Between Age-Related Hearing Loss, Cognitive Impairment, and Multiple Chronic Conditions in a Group Care Setting.
Associations Between Age-Related Hearing Loss, Cognitive Impairment, and Multiple Chronic Conditions in a Group Care Setting.
复制标题
团体护理环境中与年龄相关的听力损失、认知障碍和多种慢性病之间的关联。
DOI：
10.1044/2023_jslhr-23-00067
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Wheeler,KaraA
中科院分区：
文献类型：
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作者：
Mamo,SaraK;Pearlman,Jessica;Wheeler,KaraA
本研究的目的是探讨参加老年全纳护理计划的老年人在两年内听力损失、认知状态和一系列健康结果之间的关系。该计划是一项医疗保险/医疗补助受益计划，针对登记时符合疗养院条件但居住在社区的个人。方法样本(N=144)包括不同的成年人(47%的白人/非西班牙裔，35%的黑人/非裔美国人，16%的拉丁裔/拉美裔)，年龄从55岁到93岁。我们使用医疗表数据来衡量受访者的认知和健康状况，包括慢性病和医院使用情况。在为期两年的审查期开始时测量一次听力状况。我们使用Logistic回归和负二项障碍模型进行分析。我们使用潜在类别分析(LCA)来探索受访者在多大程度上聚集在一组以他们的听力、认知状况和健康状况为特征的健康档案中。结果我们发现听力损失与心脏病和糖尿病的相关性较弱，与脑血管疾病和跌倒有关；认知障碍也与脑血管疾病和跌倒次数有关。LCA表明，受访者聚集在不同的健康档案中，听力损失和抑郁的配对一致。结论该结果与流行病学研究中报告的包括年龄相关性听力损失的相关性基本一致。这项研究特别令人感兴趣的是LCA，它表明所有与听力损失高可能性相关的特征都包括抑郁症的高风险。这两个因素的共同出现突显了识别和治疗老年人听力损失的必要性，特别是作为有抑郁症状的个人治疗计划的一部分。
PurposeThe purpose of this study was to explore the relationships between hearing loss, cognitive status, and a range of health outcomes over a period of 2 years in a sample of older adults who are enrolled in Program of All-Inclusive Care for the Elderly, which is a Medicare/Medicaid beneficiary program for individuals who are nursing home eligible but living in the community at time of enrollment.MethodThe sample (N= 144) includes a diverse (47% White/non-Hispanic, 35% Black/African American, and 16% Latin/Hispanic) group of adults ranging from 55 to 93 years old. We used medical chart data to measure respondents' cognitive and health status, including chronic conditions and hospital use. Hearing status was measured once at the beginning of the 2-year review period. We used logistic regression and negative binomial hurdle models for analyses. We used latent class analysis (LCA) to explore the extent to which respondents cluster into a set of “health profiles” characterized by their hearing, cognitive status, and health conditions.ResultsWe found that hearing loss is weakly associated with heart disease and diabetes and associated with cerebrovascular disease and falls; cognitive impairment is also associated with cerebrovascular disease and the number of falls. LCA indicates that respondents cluster into a variety of health profiles with a consistent pairing of hearing loss and depression.ConclusionsThe results are largely consistent with associations reported in epidemiological studies that include age-related hearing loss. Of particular interest in this study is the LCA that suggested that all of the profiles associated with a high likelihood of hearing loss included a high risk of depression. The co-occurrence of these two factors highlights the need to identify and treat hearing loss in older adults, especially as part of the treatment plan for individuals with depressive symptoms.