更高的社会支持与机构化老年人中较低的耳鸣相关残疾相关：一项横断面研究。

文献信息

中文摘要

背景： 长期护理机构中老年人的耳鸣相关残疾可能不仅反映听觉症状，还反映功能和社会心理脆弱性。本研究探讨了患有慢性主观性耳鸣的老年长期护理居民中感知社会支持与耳鸣残疾量表（THI）定义的耳鸣相关残疾之间的关联。
方法： 我们在2025年7月至11月期间，对中国武汉市城市长期护理机构中390名年龄≥60岁、患有慢性主观性耳鸣的居民进行了一项横断面研究。感知社会支持使用针对老年人的13项简版社会支持评价量表测量，耳鸣相关残疾使用THI评估。主要结局是连续THI评分；严重/灾难性THI另外作为二分类结局进行分析。在敏感性分析中检查了序数THI严重程度和中度或更差THI。进行了多变量线性、逻辑回归、序数逻辑回归、基于四分位数、限制性立方样条、亚组和敏感性分析，并调整了人口学、社会经济、生活方式、机构、临床和耳鸣相关协变量。
结果： 平均年龄为79.85岁（SD 8.32），237名参与者（60.8%）为女性。在完全调整模型中包含的协变量中，高血压与更高的THI评分相关（调整后β=23.82，95% CI 19.00至28.65；p<0.001）。SSA-13评分每增加1个SD，完全调整后的THI总分降低5.24分（β=-5.24，95% CI -7.34至-3.14；p<0.001），严重/灾难性THI的比值比较低（OR=0.60，95% CI 0.45至0.80；p<0.001）。最高SSA-13四分位数的调整后THI评分低于最低四分位数（β=-12.11，95% CI -17.39至-6.84），但中间四分位数的估计值非单调；样条非线性检验显著（p<0.001）。
结论： 在长期护理机构中患有慢性主观性耳鸣的老年人中，更高的感知社会支持与较低的耳鸣相关残疾相关。由于横断面设计，这些发现应解释为关联证据而非因果关系。对感知社会支持的简要评估可能有助于识别长期护理环境中需要额外社会心理关注的居民。

英文摘要

BACKGROUND: Tinnitus-related disability among older adults in long-term care facilities may reflect not only auditory symptoms but also functional and psychosocial vulnerability. This study examined the association between perceived social support and Tinnitus Handicap Inventory (THI)-defined tinnitus-related disability among older long-term care residents with chronic subjective tinnitus.
METHODS: We conducted a cross-sectional study between July and November 2025 among 390 residents aged 60 years or older with chronic subjective tinnitus in long-term care facilities in urban Wuhan, China. Perceived social support was measured using the 13-item Short-form Social Support Appraisals Scale for older adults, and tinnitus-related disability was assessed using the THI. The primary outcome was continuous THI score; severe/catastrophic THI was additionally analyzed as a binary outcome. Ordinal THI severity and moderate-or-worse THI were examined in sensitivity analyses. Multivariable linear, logistic, ordinal logistic, quartile-based, restricted cubic spline, subgroup, and sensitivity analyses were performed with adjustment for demographic, socioeconomic, lifestyle, institutional, clinical, and tinnitus-related covariates.
RESULTS: The mean age was 79.85 years (SD 8.32), and 237 participants (60.8%) were female. Among the covariates included in the fully adjusted model, hypertension was associated with a higher THI score (adjusted β = 23.82, 95% CI 19.00 to 28.65; p < 0.001). Per 1-SD higher SSA-13 score, the fully adjusted THI total was 5.24 points lower (β = -5.24, 95% CI -7.34 to -3.14; p < 0.001), and the odds of severe/catastrophic THI were lower (OR = 0.60, 95% CI 0.45 to 0.80; p < 0.001). The highest SSA-13 quartile had a lower adjusted THI score than the lowest quartile (β = -12.11, 95% CI -17.39 to -6.84), but intermediate-quartile estimates were non-monotonic; the spline nonlinearity test was significant (p < 0.001).
CONCLUSION: Among older adults with chronic subjective tinnitus living in long-term care facilities, higher perceived social support was associated with lower tinnitus-related disability. Because of the cross-sectional design, these findings should be interpreted as evidence of association rather than causation. Brief assessment of perceived social support may help identify residents who need additional psychosocial attention within long-term care settings.