Epidemiology of Age-Related Hearing Loss

描述（由申请人提供）：这项拟议的流行病学研究的目的是重新检查一个大型的、以人群为基础的老年人队列，以确定10年听力损失的发病率和进展，并调查与年龄相关的听力变化的危险因素。基线检查（1993- 1995）的参与者（n=3753）年龄为48-92岁。他们将在2003-2005年使用相同的标准化方案进行耳镜检查、筛选鼓室测量、听力测量、文字识别测试和失真产品耳声发射。以访谈形式完成一份关于病史、噪音暴露、身体功能和健康相关生活质量的标准化问卷。在5年的随访检查中，增加了嗅觉测试以确定嗅觉障碍的患病率。将使用相同的嗅觉测试对该队列进行重新测试，以确定5年内嗅觉损伤的发生率。视力障碍、心血管疾病风险标志物（c反应蛋白）、亚临床外周血管疾病（踝-肱指数）和视网膜微血管变化（小动脉-静脉比率）的数据将从已批准的海狸坝眼科研究的15年随访中获得。在拟议的资助期内，将获得关于亚临床动脉粥样硬化的存在和严重程度的新数据。在5年的检查中获得的颈动脉b超扫描档案将根据内膜-内侧厚度进行分级，这是全身性动脉粥样硬化的标志。

DESCRIPTION (provided by applicant): The purpose of this proposed epidemiologic study is to re-examine a large, population-based cohort of older adults to determine the 10-yr incidence and progression of hearing loss and investigate risk factors for age-related changes in hearing. Participants (n=3753) in the baseline examination (1993-95) were 48-92 years of age. They will be reexamined in 2003-2005 using the same standardized protocols for otoscopy, screening tympanometry, audiometry, word recognition tests, and distortion product otoacoustic emissions. A standardized questionnaire about medical history, noise exposure, physical functioning, and health-related quality of life will be completed as an interview. At the five-yr follow-up examination, olfaction testing was added to determine the prevalence of olfactory impairment. The cohort will be re-tested using the same test of olfaction to determine the 5-yr incidence of olfactory impairment. Data on vision impairment, as well as markers of cardiovascular disease risk (C-reactive protein), subclinical peripheral vascular disease (ankle-brachial index), and retinal microvascular changes (arteriolar-venular ratio) will be available from the approved 15-yr follow-up for the Beaver Dam Eye Study. During the proposed grant period, new data will be obtained on the presence and severity of subclinical atherosclerosis. Archived B-mode ultrasound scans of the carotid arteries obtained at the 5-yr examination will be graded for intima-medial thickness, a marker of generalized atherosclerosis. This study will provide important new data about the associations of vascular factors, and other potentially modifiable risk factors, with the incidence and progression of hearing loss in older adults. It will provide the first population-based estimates of the 10-yr incidence and progression of hearing loss and the 5-yr incidence of olfactory impairments. Because of the links with an on-going epidemiologic study of age-related ocular disorders, this study has the opportunity to determine the relative contributions of impairments in three sensory systems, vision, hearing, and smell, to decrements in health-related quality of life and functional disability in older adults. It will provide data important for planning for the health-care needs of older adults and possible targets for intervention strategies to delay or diminish the impact of sensory impairments on quality of life in older adults.