2020年我国社区老年人听力损失状况调查

Prevalence of hearing loss among community-dwelling older people in China in 2020

目的调查我国社区60岁及以上老年人群听力损失状况,比较主观报告听力下降与客观听力测量之间的差异。方法调查对象来自老年期重点疾病预防和干预项目,该项目采用多阶段分层整群随机抽样的方法,于2020年在辽宁、河南和广东三省12个县区完成对10347例60岁及以上老年人的耳镜检查、纯音测听和问卷调查。客观听力损失评估采用世界卫生组织推荐标准。主观报告听力下降通过询问调查对象是否存在听力不好来获取。不同特征老年人听力损失现患率的差异检验采用χ^(2)检验和Cochran-Armitage趋势检验,影响听力损失的因素采用多因素Logistic回归分析。结果2020年我国辽宁、河南和广东三省60岁及以上老年人听力损失现患率为69.8%(95%CI:68.9%~70.7%),男高于女,随年龄增加而逐步上升。轻度听力损失现患率为47.2%,中度、重度和极重度听力损失现患率分别为18.0%、3.6%和0.9%。多因素Logistic回归分析显示,与听力损失正相关的因素有:增龄、男性、居住在农村以及从事体力劳动,而受教育程度与听力损失呈负相关。在7223例客观测量存在轻度及以上听力损失的人群中,5106例(70.7%)主观报告听力良好,并且年龄越小、文化程度越高、有配偶以及听力严重程度越轻的其误报听力良好率越高(均P<0.05)。结论我国社区老年人群听力损失较为普遍,并且自我主观评估与客观测量偏差大,应加强老年人群听力损失的筛查以及综合干预。

Objective To investigate the prevalence of hearing loss among community-dwelling older people aged 60 and over,and also to compare the discrepancies between self-reported hearing loss and hearing loss diagnosed via audiometry.Methods Subjects were from the Prevention and Intervention on Neurodegenerative Disease for the Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method,a total of 10347 residents aged 60 years and over were selected from 12 counties and districts in Liaoning,Henan and Guangdong Provinces and hearing function assessment was performed in 2020 through otoscopy,pure-tone audiometry and questionnaires.Hearing loss(HL)was defined by the World Health Organization criteria.Self-reported hearing loss was assessed by asking participants whether they had difficulty in hearing.Theχ^(2) and Cochran-Armitage trend tests were used to analyze the differences in HL between different groups.The multivariate Logistic regression model was applied to assess factors influencing HL.Results In 2020,the prevalence of HL among the elderly aged 60 and older in Liaoning,Henan and Guangdong Provinces was 69.8%(95%CI:68.9%-70.7%).The prevalence of HL in men was higher than that in women,and increased gradually with age.The prevalence of mild HL was 47.2%,and the prevalence of moderate,severe and profound HL were 18.0%,3.6%and 0.9%,respectively.Multivariate Logistic regression analysis showed that factors positively correlated with HL were aging,male sex,living in rural areas and working in manual labor.Education level was negatively correlated with HL.Of the 7223 participants who were found to have HL,5106(70.7%)self-reported having good hearing.Those of a younger age,with a higher educational achievement,having a spouse,or with mild HL were more likely to report having good hearing(all P<0.05).Conclusions Hearing loss is quite prevalent among community-dwelling older people,and there is a large discrepancy in prevalence between self-reported HL and HL diagnosed via audiometry.Screening and comprehensive intervention for hearing loss for the elderly should be strengthened.