老年人自我报告视力和听力功能障碍及其交互作用与衰弱的相关性研究

doi:10.3969/j.issn.1003-9198.2024.04.005

摘要/Abstract

摘要： 目的探讨基于老年人群自我报告的视力障碍和听力障碍及其交互作用与衰弱的关联。方法 2022年10月至2023年3月采用便利抽样方法选取遵义市6所医疗机构共5925例老年人进行调查。收集病人一般临床资料,采用衰弱筛查量表评估衰弱情况,感官功能自评表评价其视听功能。采用多因素Logistic回归分析探究视力和听力障碍与老年人衰弱的关联强度和交互作用。结果控制混杂因素后,Logistic回归分析结果显示,视力障碍(OR=2.814,95%CI:2.422~3.270)、听力障碍(OR=1.899,95%CI:1.603~2.249)是老年人发生衰弱的影响因素。交互作用结果显示,视力障碍与听力障碍对老年人衰弱的发生具有相加交互作用(OR=5.709,95%CI:4.507～7.231),相对超额危险度(RERI)=2.515(95%CI:1.241～3.790),归因比(AP)=0.441(95%CI:0.298～0.583),交互作用指数(S)=2.147(95%CI:1.532～3.008)。结论视力障碍、听力障碍是老年人发生衰弱的影响因素,且二者对老年人衰弱的发生具有相加交互作用,提示应重视老年人视听功能的筛查和管理,尽早采取针对性的干预,可有助于预防或延缓老年人衰弱进程,促进健康老龄化。

关键词: 衰弱, 老年人, 视力障碍, 听力障碍, 交互作用

Abstract: Objective To explore the association of self-reported visual and hearing impairment and their interaction with frailty in the elderly. Methods From October 2022 to March 2023, a total of 5925 elderly patients from 6 medical institutions in Zunyi City were selected by convenience sampling method for investigation. The general information was collected, and the frailty screening scale was used to evaluate frailty, and the sensory function self-rating scale was used to evaluate audio-visual function in all subjects. Multivariate Logistic regression analysis was used to evaluate the association of vision and hearing impairment and their interaction with frailty in the elderly. Results After controlling the confounding factors, Logistic regression analysis showed that visual impairment (OR=2.814, 95%CI: 2.422-3.270) and hearing impairment (OR=1.899, 95%CI: 1.603-2.249) were the influencing factors of frailty in the elderly. The visual impairment and hearing impairment had additive interaction on the occurrence of frailty in the elderly (OR=5.709, 95%CI: 4.507-7.231), with relative excess risk due to interaction (RERI) =2.515(95%CI: 1.241-3.790), attributable proportion (AP)=0.441 (95%CI: 0.298-0.583), the synergy index (S) =2.147(95%CI: 1.532-3.008). Conclusions Visual impairment and hearing impairment are the influencing factors of frailty in the elderly, and they have a combined interaction on the occurrence of frailty in the elderly, which suggests that attention should be paid to the screening and management of audiovisual function in the elderly, and taking targeted intervention as early as possible can prevent or delay the frailty process in the elderly and promote healthy aging.

Key words: frailty, aged, visual impairment, hearing impairment, interactions

中图分类号:

R 592

李霜, 袁晓丽, 江智霞, 杨晓玲, 赵小玲, 梁鹤婷, 王朝平. 老年人自我报告视力和听力功能障碍及其交互作用与衰弱的相关性研究[J]. 实用老年医学, 2024, 38(4): 343-347.

LI Shuang, YUAN Xiaoli, JIANG Zhixia, YANG Xiaoling, ZHAO Xiaoling, LIANG Heting, WANG Chaoping. Association of self-reported visual and hearing impairment and their interaction with frailty in the elderly[J]. Practical Geriatrics, 2024, 38(4): 343-347.

参考文献

[1] CLEGG A, YOUNG J, ILIFFE S, et al. Frailty in elderly people[J]. Lancet, 2013, 381(9868): 752-762.
[2] KOJIMA G. Frailty as a predictor of disabilities among community -dwelling older people: a systematic review and meta-analysis[J]. Disabil Rehabil, 2017, 39(19): 1897-1907.
[3] HOU T, LIU M, ZHANG J. Bidirectional association between visual impairment and frailty among community-dwelling older adults: a longitudinal study[J]. BMC Geriatr, 2022, 22(1): 1-9.
[4] NING H, ZHANG H, XIE Z, et al. Relationship of hearing impairment, social participation and depressive symptoms to the incidence of frailty in a community cohort[J]. J Am Geriatr Soc, 2023, 71(4): 1167-1176.
[5] 吴珍珍, 张瑞, 常艳, 等. 衰弱表型和衰弱筛查量表在老年住院患者中的应用比较[J]. 中华护理杂志, 2021, 56(5):673-679.
[6] VAN KAN G A, ROLLAND Y, BERGMAN H, et al. The I.A.N.A. Task Force on frailty assessment of older people in clinical practice[J]. JNHA,2008, 12(1): 29-37.
[7] STANG A. Kenneth J. Rothman: Epidemiology. An introduction [J]. Eur J Epidemiol, 2012, 27(10): 827-829.
[8] ANDERSSON T, ALFREDSSON L, KÄLLBERG H, et al. Calculating measures of biological interaction[J]. Eur J Epidemiol, 2005, 20(7): 575-579.
[9] 李晓飞, 陈芳芳, 陈旭. 老年住院病人衰弱的影响因素[J]. 中国老年学杂志, 2019, 39(4):970-974.
[10]余静雅, 高静, 柏丁兮, 等. 成都市社区老年人衰弱现状与影响因素[J]. 中国老年学杂志, 2021, 41(9):1972-1977.
[11]曾鸣, 李璇, 丁静云, 等. 老年冠心病病人衰弱相关因素分析[J]. 实用老年医学, 2021, 35(8):825-828.
[12]YE B, CHEN H, HUANG L, et al. Changes in frailty among community-dwelling Chinese older adults and its predictors: evidence from a two-year longitudinal study[J]. BMC Geriatr, 2020, 20(1):1-10.
[13]YU X, SHI Z, WANG D, et al. Prevalence and associated factors of frailty among community dwelling older adults in northwest China: a cross-sectional study[J]. BMJ open, 2022, 12(8):60-89.
[14]周白瑜, 陶永康, 石婧, 等. 北京市社区老年人衰弱状况及其相关因素分析[J]. 中华老年医学杂志, 2020, 39(2):214-219.
[15]王洪梅, 李娜, 王红, 等. 住院老年眩晕患者衰弱现状及影响因素研究[J]. 中华护理杂志, 2023, 58(2):205-210.
[16]SCHAUMBERG D A, CHRISTEN W G, BURING J E, et al. High-sensitivity C-reactive protein, other markers of inflammation, and the incidence of macular degeneration in women[J]. Arch Ophthalmol, 2007, 125(3): 300-305.
[17]KANAPURU B, ERSHLER W B. Inflammation, coagulation, and the pathway to frailty[J]. Am J Med, 2009, 122(7): 605-613.
[18]GONZALES-TURÍN J M, RODRÍGUEZ-LASO Á, CARNICERO J A, et al. Relationship between self-reported visual impairment and worsening frailty transition states in older people: a longitudinal study[J]. Aging Clin Exp Res, 2021, 33(9):2491-2498.
[19]董凡, 胡慧秀, 孙超, 等. 我国老年人自我报告听力障碍与躯体功能关系研究[J]. 中华现代护理杂志, 2022, 28(21):2831-2837.
[20]邱宏, 余德新, 谢立亚, 等. Logistic回归模型中连续变量交互作用的分析[J]. 中华流行病学杂志, 2010,31(7): 812-814.
[21]BRABYN J A, SCHNECK M E, HAEGERSTROM-PORTNOY G, et al. Dual sensory loss: overview of problems, visual assessment, and rehabilitation[J]. Trends Amplif, 2007, 11(4): 219-226.
[22]KONG H H, SHIN K, WON C W. Association of dual sensory impairment with declining physical function in community-dwelling older adults[J]. Int J Env Res, 2023, 20(4): 35-46.