自我报告听力状况与纯音听阈测试在老年人群中的一致性及影响因素研究

Concordance between self-reported hearing loss and pure-tone audiometry in the elderly population: influencing factors and implications

吴再朝;龚丽平;陈颖;赵非凡;管磊;陈杰;韩琨;周瑾;沈祺越;俞琼菲;余佳丽;徐思佳;张奕雯;刘洁;王安娴;汪雪玲;高云鸽;王振涛;李蕴;张玉蓉;吴皓

1:上海交通大学医学院附属第九人民医院耳鼻咽喉头颈外科

2:上海市耳鼻疾病转化医学重点实验室

3:上海交通大学医学院耳科学研究所

4:上海市浦东新区泥城社区卫生服务中心

摘要
目的 探究老年人自我报告听力损失与纯音听阈测试结果之间的一致性,并分析可能导致评估结果不一致的相关影响因素。方法 对中国老年听力与认知健康队列研究(Chinese Hearing Solution for Improvement of Cognition in Elders Cohort, CHOICE-Cohort)在2021年5月至2024年9月间招募的23 930例参与者进行研究,通过调查问卷收集其健康状况信息,并通过自我报告听力状况及纯音听阈测试评估其听力状况,分析两种结果的一致性。结果 23 930例中,12 336例(51.6%,12 336/23 930)自我报告存在听力损失。17 837例(74.5%,17 837/23 930)较好耳纯音听阈(better-ear pure tone average, BPTA)≥20 dB HL,其中,7 284例(40.8%,7 284/17 837)仍自我报告听力正常。若以BPTA≥20 dB HL为听力损失界定阈值,自我报告听力损失的灵敏度为59.2%(95%CI:58.4%~59.9%),特异度为70.7%(95%CI:69.6%~71.9%);以BPTA≥35 dB HL为阈值时,分别为80.5%(95%CI:79.5%~81.5%)和58.5%(95%CI:57.8%~59.3%)。多因素逻辑回归分析结果显示,与自我报告听力损失不准确的相关因素包括:男性、年龄超过70岁、较低的教育水平、耳鸣及认知能力下降。结论 自我报告听力状况准确性可能受性别(男性)、年龄(超过70岁)、教育水平、耳鸣以及认知功能下降等因素的影响,从而导致自我报告结果不准确。
关键词
听力损失;自我报告听力;纯音听阈测试;老年人
基金项目(Foundation):
上海市耳鼻疾病转化医学重点实验室项目(14DZ2260300);; 国家自然科学基金面上项目(82371141);; 上海市自然科学基金面上项目(23ZR1437100);; 上海申康医院发展中心临床三年行动计划(SHDC2020CR1044B);; 上海交通大学医学院附属第九人民医院生物样本库项目(YBKA202205)
作者
吴再朝;龚丽平;陈颖;赵非凡;管磊;陈杰;韩琨;周瑾;沈祺越;俞琼菲;余佳丽;徐思佳;张奕雯;刘洁;王安娴;汪雪玲;高云鸽;王振涛;李蕴;张玉蓉;吴皓
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