听力损失作为合并症与死亡率之间关联的调节因素
Hearing Loss as a Modifier of the Association Between Comorbidities and Mortality.
文献信息
| PMID | 42728658 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Gypsyamber D'Souza |
| 作者单位 | Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. |
| 期刊 | Journal of the American Geriatrics Society |
| SCI 分区 | Q1 |
| IF | 5.2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 合并症会增加老年人的死亡风险。听力损失影响医疗保健沟通、利用和结果，可能影响这一关联，但据我们所知，迄今为止尚无研究探讨听力损失对合并症-死亡率关系的影响。
方法： 将2009-2010周期全国健康与营养调查的数据与截至2020年的全国死亡指数死亡率数据相关联。在年龄≥70岁且具有纯音气导听力测定数据的个体中，我们使用Cox比例风险模型评估听力、合并症数量与死亡率之间的关联。
结果： 在中位随访9.3年期间，46%（398/874）的个体死亡。65%（571/874）的参与者有听力损失，其中27%使用助听器。听力损失与死亡率增加相关，而在患有多种合并症且听力损失的个体中风险更高。在调整性别、年龄、婚姻状况和吸烟史后，听力损失和合并症仍然是死亡率的重要预测因素。死亡风险随听力损失独立增加（aHR=1.4，95%CI=1.0-2.0），以及高与低合并症数量（≥3 vs. <3；aHR=1.7，95%CI=0.9-3.1），在同时具有≥3种合并症和听力损失的个体中死亡风险最高（aHR=2.3，95%CI=1.7-3.2；交互作用p值=0.03）。
结论： 在这个具有全国代表性的70岁以上美国成年人样本中，听力测定确定的听力损失调节了合并症与死亡率之间的关联。需要进一步研究以调查治疗年龄相关性听力损失是否能改善有或无合并症的老年人的生存率。
英文摘要
BACKGROUND: Comorbidities increase mortality risk in older adults. Hearing loss impacts health care communication, utilization, and outcomes may influence this association, but to our knowledge, no study to-date has examined the impact of hearing loss on the comorbidity-mortality relationship.
METHODS: Data from the national health and nutrition examination survey 2009-2010 cycle was linked with mortality data from the national death index through 2020. In individuals ≥ 70 years with data for pure tone air conduction audiometry, we used cox proportional hazards model to evaluate the association between hearing, comorbidity count and mortality.
RESULTS: During an median follow-up of 9.3 years, 46% (398/874) individuals died. The 65% (571/874) of participants had hearing loss, of whom 27% used hearing aids. Hearing loss was associated with increased mortality, and risk was even higher in those with multiple comorbidities and hearing loss. After adjustment for sex, age, marital status, and smoking history, both hearing loss and comorbidity remained important predictors of mortality. Risk of mortality increased independently with hearing loss (aHR = 1.4 95% CI = 1.0-2.0 and with high vs. low comorbidity count ≥ 3 vs. < 3; aHR = 1.7 95% CI = 0.9-3.1), with the highest mortality risk among those with both ≥ 3 comorbidities and hearing loss (aHR = 2.3, 95% CI = 1.7-3.2; p value for interaction = 0.03).
CONCLUSIONS: In this nationally representative sample of US adults over the age of 70 years, audiometric hearing loss modified the association between comorbidity and mortality. Additional research is needed to investigate whether treating age-related hearing loss could improve survival among older adults with and without comorbidities.