Longitudinal study of pure-tone thresholds in older persons
Longitudinal study of pure-tone thresholds in older persons
复制标题
DOI：
10.1097/00003446-200502000-00001
复制
发表时间：
2005-02-01
期刊：
影响因子：
3.7
通讯作者：
Mills, JH
中科院分区：
文献类型：
--
作者：
Lee, FS;Matthews, LJ;Mills, JH
目的：对188名老年人（91名女性，97名男性）的常规高频和扩展高频纯音阈值进行分析。目的是研究阈值的纵向变化，以及初始阈值水平、年龄、性别和噪声历史对这些纵向变化的影响。设计：入组时，受试者年龄60 ~ 81岁，平均年龄68岁。在3至11.5年（平均6.40年）期间，受试者进行了2至21次就诊（平均9.81次）。常规的纯音阈值在0.25至8 kHz测量在大多数访问。每2至3年测量9至18 kHz的扩展高频（EHF）阈值。线性回归的斜率用于估计每只耳朵在0.25至18 kHz的纯音阈值的变化率。使用问卷来确定那些有积极噪音史的受试者。结果：在0.25 kHz时，阈值的平均变化率为0.7 dB /年，在8 kHz时逐渐增加到1.2 dB /年，在12 kHz时增加到1.23 dB /年。阈值的变化率随着年龄的增长而显著增加，女性为0.25至3、10和11 kHz，男性为6 kHz。在调整年龄后，女性在1 kHz时的变化率明显慢于男性，而在6至12 kHz时的变化率明显快于男性。在0.25和1 kHz时，高频听力损失更严重的受试者在这些频率上的变化率更快，而在6和8 kHz时，中频和高频听力损失更严重的受试者在这些频率上的变化率更慢。阳性噪声史受试者的阈值变化率与阴性噪声史受试者的阈值变化率无统计学差异。结论：60岁及以上受试者的听力阈值平均每年增加约1 dB。年龄、性别和初始阈值水平可以影响阈值的变化率。老年女性受试者（大于或等于70岁）在0.25至3,10和11 kHz的变化率比年轻女性受试者（60至69岁）更快。老年男性受试者在6 kHz时的变化率比年轻男性受试者快。女性在1 kHz时的变化率比男性慢，而在6 ~ 12 kHz时的变化率比男性快。低频和中频初始阈值较高的受试者在接下来的几年中，在0.25 ~ 2 kHz的阈值变化率往往更快。在中高频率初始阈值较高的受试者在接下来的几年中，在6 ~ 8 kHz的变化率往往较慢。噪声历史对阈值变化率没有显著影响。
Objective: Pure-tone thresholds for conventional and extended high frequencies were analyzed for 188 older adult human subjects (91 females, 97 males). The objectives were to study longitudinal changes in thresholds as well as the effects of initial threshold levels, age, gender, and noise history on these longitudinal changes.Design: At the time of entry into the study, subjects' ages ranged from 60 to 81 years, with a mean age of 68 years. Subjects had between 2 and 21 visits (mean = 9.81 visits) over a period of 3 to 11.5 years (mean = 6.40 years). Conventional pure-tone thresholds at 0.25 to 8 kHz were measured during most visits. Extended high-frequency (EHF) thresholds at 9 to 18 kHz were measured every 2 to 3 years. The slope of a linear regression was used to estimate the rate of change in pure-tone thresholds at 0.25 to 18 kHz for each ear. A questionnaire was used to identify those subjects with a positive noise history.Results: The average rate of change in thresholds was 0.7 dB per year at 0.25 kHz, increasing gradually to 1.2 dB per year at 8 kHz and 1.23 dB per year at 12 kHz. The rate of change for thresholds increased significantly with age, at 0.25 to 3, 10, and 11 kHz for females and at 6 kHz for males. After adjusting for age, females had a significantly slower rate of change at 1 kHz but a significantly faster rate of change at 6 to 12 kHz than males. For 0.25 and 1 kHz, subjects with more hearing loss at higher frequencies had a faster rate of change at these frequencies, whereas for 6 and 8 kHz, subjects with more hearing loss at mid and high frequencies had a slower rate of change at these frequencies. The rates of threshold change for subjects with a positive noise history were not statistically different from those with a negative noise history.Conclusions: On average, hearing threshold increased approximately 1 dB per year for subjects age 60 and over. Age, gender, and initial threshold levels can affect the rate of change in thresholds. Older female subjects (greater than or equal to70 years) had faster rate of change at 0.25 to 3, 10, and 11 kHz than younger female subjects (60 to 69 years). Older male subjects had faster rate of change at 6 kHz than younger male subjects. Females had a slower rate of change at 1 kHz and a faster rate of change at 6 to 12 kHz than males. Subjects with higher initial thresholds at low and mid frequencies tended to have faster rate of threshold change at 0.25 to 2 kHz in the following years. Subjects with higher initial thresholds at mid and higher frequencies tended to have slower rate of change at 6 to 8 kHz in the following years. Noise history did not have a significant effect on the rate of threshold changes.