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. 2021 Jun 1;4(6):e2113742.
doi: 10.1001/jamanetworkopen.2021.13742.

Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US

Pablo Martinez-Amezcua  1   2   3 , Danielle Powell  1   2   3 , Pei-Lun Kuo  1   4 , Nicholas S Reed  1   3 , Kevin J Sullivan  5 , Priya Palta  6   7 , Moyses Szklo  1   8 , Richey Sharrett  1   8 , Jennifer A Schrack  1   2 , Frank R Lin  1   2   3 , Jennifer A Deal  1   2   3
Affiliations

Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US

Pablo Martinez-Amezcua et al. JAMA Netw Open. .

Abstract

Importance: Hearing impairment, a common treatable condition, may contribute to poorer physical function with aging.

Objective: To assess whether hearing impairment is associated with poorer physical function, reduced walking endurance, and faster decline in physical function.

Design, setting, and participants: In this cohort study, cross-sectional and longitudinal analyses were performed using data from the 2011 to 2019 period of the Atherosclerosis Risk in Communities study, a population-based study of community-dwelling adults at 4 sites in the US.

Exposures: Hearing thresholds (per 10 dB) assessed with pure tone audiometry and categorized as normal hearing or mild, moderate, or severe hearing impairment.

Main outcomes and measures: Physical function was assessed using the short physical performance battery (SPPB), with composite scores ranging from 0 to 12. A composite score of 6 or less and a score for each component (balance, gait speed, and chair stands) of 2 or less indicated poor performance. Walking endurance was assessed using a 2-minute fast-paced walk test. Tobit regression models adjusted for sociodemographic factors and medical history were used to calculate the mean differences in SPPB composite scores; logistic regression models, to estimate the odds ratios (ORs) of low SPPB composite and component scores; and linear mixed-effects models, to estimate the mean rate of change in SPPB composite scores over time.

Results: Of the 2956 participants (mean [SD] age, 79 [4.6] years) who attended study visit 6 between 2016 and 2017, 1722 (58.3%) were women, and 2356 (79.7%) were White. As determined by pure tone audiometry, 973 (33%) participants had normal hearing, 1170 (40%) had mild hearing impairment, 692 (23%) had moderate hearing impairment, and 121 (4%) had severe hearing impairment. In the Tobit regression model, severe hearing impairment was associated with a lower mean SPPB score (β, -0.82; 95% CI, -0.34 to -1.30) compared with normal hearing. In fully adjusted logistic regression models, hearing impairment was associated with higher odds of low physical performance scores (severe impairment vs normal hearing: OR for composite physical performance, 2.51 [95% CI, 1.47-4.27]; OR for balance, 2.58 [95% CI, 1.62-4.12]; OR for gait speed, 2.11 [95% CI, 1.03-4.33]). Over time (2 to 3 visits; maximum, 8.9 years), participants with hearing impairment had faster declines in SPPB compared with those with normal hearing (moderate hearing impairment × time interaction, -0.34 [-0.52 to -0.16]). In adjusted models for walking endurance, participants with moderate or severe hearing impairment walked a mean distance of -2.81 m (95% CI, -5.45 to -0.17 m) and -5.31 m (95% CI, -10.20 to -0.36 m) than those with normal hearing, respectively, during the 2-minute walk test.

Conclusions and relevance: In this cohort study, hearing impairment was associated with poorer performance, faster decline in physical function, and reduced walking endurance. The results of the longitudinal analysis suggest that hearing impairment may be associated with poorer physical function with aging. Whether management of hearing impairment could delay decline in physical function requires further investigation.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Martinez-Amezcua reported receiving sponsorship from the Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health during the conduct of the study. Dr Powell reported receiving sponsorship from the Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health during the conduct of the study. Dr Kuo reported receiving sponsorship through the Intramural Research Program from the National Institute on Aging (NIA), National Institutes of Health (NIH). Dr Reed reported receiving grants from the NIA, NIH and serving as a scientific advisory board member with no financial interest for Shoebox Inc and Good Machine Studio during the conduct of the study. Dr Palta reported receiving grants from the NIA, NIH during the conduct of the study. Dr Sharrett reported receiving grants from the NIH during the conduct of the study. Dr Schrack reported receiving grants from the NIA, NIH during the conduct of the study. Dr Lin reported receiving personal fees from Frequency Therapeutics and Caption Call outside the submitted work and being the director of a public health research center funded in part by a philanthropic gift from Cochlear Ltd to the Johns Hopkins Bloomberg School of Public Health. Dr Deal reported receiving grants from the NIA, NIH during the conduct of the study. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Adjusted Associations Between Hearing Categories and Low Vs High Short Physical Performance Battery (SPPB) Composite and Component Scores
Markers indicate log odds compared with normal hearing; horizontal lines indicate 95% CIs. The model was adjusted for covariates in model 2: age, sex, race–center site, body mass index, educational level, occupational noise exposure, smoking status, and multimorbidity index.
Figure 2.
Figure 2.. Estimated Mean Short Physical Performance Battery (SPPB) Composite Score Over Time Across Hearing Categories
Adjusted for covariates in model 2: age, sex, race–center site, body mass index, educational level, occupational noise exposure, smoking status, and multimorbidity index. Error bars indicate 95% CIs. ARIC indicates Atherosclerosis Risk in Communities.
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References

    1. Guralnik JM, Ferrucci L, Pieper CF, et al. . Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000;55(4):M221-M231. doi:10.1093/gerona/55.4.M221 - DOI - PubMed
    1. Newman AB, Simonsick EM, Naydeck BL, et al. . Association of long-distance corridor walk performance with mortality, cardiovascular disease, mobility limitation, and disability. JAMA. 2006;295(17):2018-2026. doi:10.1001/jama.295.17.2018 - DOI - PubMed
    1. Ferrucci L, Levine ME, Kuo P-L, Simonsick EM. Time and the metrics of aging. Circ Res. 2018;123(7):740-744. doi:10.1161/CIRCRESAHA.118.312816 - DOI - PMC - PubMed
    1. Lin FR, Thorpe R, Gordon-Salant S, Ferrucci L. Hearing loss prevalence and risk factors among older adults in the United States. J Gerontol A Biol Sci Med Sci. 2011;66(5):582-590. doi:10.1093/gerona/glr002 - DOI - PMC - PubMed
    1. Deal JA, Betz J, Yaffe K, et al. ; Health ABC Study Group . Hearing impairment and incident dementia and cognitive decline in older adults: the Health ABC Study. J Gerontol A Biol Sci Med Sci. 2017;72(5):703-709. - PMC - PubMed

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