R.J. Kamil, J. Betz, B. Brott Powers, S. Pratt, S. Kritchevsky, H.N. Ayonayon, T.B. Harris, E.Helzner, J.A. Deal, K. Martin, M. Peterson, S. Satterfield, E.M. Simonsick, F.R. Lin, for the Health ABC study
Journal of Aging and Health. 2016;28(4):644-60
Whether hearing impairment (HI), which is highly prevalent but undertreated in older adults, contributes to frailty risk, remains poorly studied.
This study aimed at determining whether HI in older adults is associated with the development of frailty and falls.
Data from the Health Aging and Body Composition (Health ABC study) prospective, observational study of 2000 community-dwelling older adults living in America (aged 70 to 79 years) enrolled in 1997-1998, were analyzed.
Hearing was defined by the pure-tone-average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better hearing ear. Frailty was defined as a gait speed of <0.60 m/s and/or inability to rise from a chair without using arms. Falls were assessed annually by self-report. Older adults with moderate-or-greater HI had a 63% increased risk of developing frailty (adjusted hazard ratio [HR] = 1.63, 95% confidence interval [CI] = [1.26, 2.12]) compared with normal-hearing individuals. Moderate-or-greater HI was significantly associated with a greater annual percent increase in odds of falling over time (9.7%, 95% CI = [7.0, 12.4] compared with normal hearing, 4.4%, 95% CI = [2.6, 6.2]).
Comment: This study demonstrated that moderate or greater HI is associated with increased risk of developing frailty over time, independent of age, demographic characteristics, and cardiovascular risk factors. Furthermore, it showed also an association between HI and the increased annual risk of falling. Future research is needed to determine the underlying mechanistic pathways of these associations and whether hearing loss treatments could influence these pathways.