Associations of Hearing Loss and Depressive Symptoms With Incident Disability in Older Adults: Health, Aging, and Body Composition Study
Associations of Hearing Loss and Depressive Symptoms With Incident Disability in Older Adults: Health, Aging, and Body Composition Study
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DOI：
10.1093/gerona/gly251
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发表时间：
2020-03-01
影响因子：
5.1
通讯作者：
Lin, Frank R.
中科院分区：
文献类型：
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作者：
Armstrong, Nicole M.;Deal, Jennifer A.;Lin, Frank R.
背景抑郁症状和听力损失(HL)与发生残疾的风险增加独立相关；增加的风险是否相加尚不清楚。方法使用COX比例风险模型评估HL(正常、轻度、中度/重度)和老年抑郁症状(由>；=8在10项流行病学研究中心-抑郁量表上)，出现行动不便(行走1/4英里和/或爬10步有很大困难或能力)和任何日常生活能力(ADL)障碍，在2,196名健康、老龄化和身体成分研究的参与者中，这是一组70-79岁的功能正常的老年人队列。结果与听力正常和无抑郁症状的受试者相比，无抑郁症状的轻、中、重度HL患者发生活动和ADL残疾的风险增加(活动障碍的危险比[HR]，轻度HL：1.34，95%可信区间[CI]：1.09，1.64；HR：1.37，95%CI：1.08，95%CI：1.08，1.75；ADL障碍的HR：1.32，轻度HL：1.32，ADL残疾的95%CI：1.08，1.63，HR，中重度HL：1.42，95%CI：1.11，1.82)。在有抑郁症状的参与者中，轻度HL(HR：1.71，95%CI：1.09，2.70)与发生活动障碍的风险增加相关。结论与抑郁症状无关，无论严重程度如何，老年HL患者发生活动障碍的风险都更大。对HL干预的进一步研究可能会推迟残疾的发生。
Background Depressive symptoms and hearing loss (HL) are independently associated with increased risk of incident disability; whether the increased risk is additive is unclear.Methods Cox Proportional Hazards models were used to assess joint associations of HL (normal, mild, moderate/severe) and late-life depressive symptoms (defined by a score of >= 8 on the 10-item Center for Epidemiologic Studies-Depression scale) with onset of mobility disability (a lot of difficulty or inability to walk 1/4 mile and/or climb 10 steps) and any disability in activities of daily living (ADL), among 2,196 participants of the Health, Aging and Body Composition Study, a cohort of well-functioning older adults aged 70-79 years. Models were adjusted for age, race, sex, education, diabetes, hypertension, and body mass index.Results Relative to participants with normal hearing and without depressive symptoms, participants without depressive symptoms who had mild or moderate/severe HL had increased risk of incident mobility and ADL disability (hazard ratio [HR] for mobility disability, mild HL:1.34, 95% confidence interval [CI]: 1.09, 1.64 and HR for mobility disability, moderate/severe HL: 1.37, 95% CI: 1.08, 1.75 and HR for ADL disability, mild HL: 1.32, 95% CI: 1.08, 1.63, and HR for ADL disability, moderate/severe HL: 1.42, 95% CI: 1.11, 1.82). Among participants with depressive symptoms, mild HL (HR: 1.71, 95% CI: 1.09, 2.70) was associated with increased risk of incident mobility disability.Conclusions Independent of depressive symptoms, risk of incident disability was greater in older adults with HL, regardless of severity. Further research into HL interventions may delay disability onset.