Health-related quality of life in older adults: Effects of hearing loss and common chronic conditions

A. Simpson, K. Simpson, J. Dubno
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引用次数: 16

Abstract

Background: Recent findings on hearing loss (HL) and healthy aging have highlighted important clinical and policy implications concerning quality of life in older adults. Our objective was to explore the impact of HL on quality of life in older Americans, independent of survival, using the 2000 Medical Expenditure Panel Survey (MEPS) and 2010 Census data. Methods: A retrospective cohort of 2,567 subjects aged 60‐90 in the MEPS who provided information on selfreported HL, health‐related quality of life and chronic conditions. The EQ‐5D visual analog scale (VAS) transformation was used to estimate marginal utility decrements for 5‐year age categories and conditions, including HL, hypertension, diabetes, angina, joint pain, asthma, emphysema, or blindness. The modeled decrements were applied to the 2010 US census population to estimate annual quality‐adjusted life years (QALYs) lost. Results: Of the respondents, 15.4% had mild HL and 1.1% had moderate/severe hearing loss. Other conditions (utility decrement) included: joint pain 53% (.0643), hypertension 47.2% (.0292), diabetes 15.6% (.0577), angina 9.8% (.0352), asthma 7.9% (.0288), emphysema 4.5% (.1186), blindness 0.8% (.0836), and average age 71.0 with decrements .0033 per year. The decrement from hearing loss ranked 4th at 174,689 in the US population. Conclusions: The substantial impact of hearing loss on healthy aging may not be obvious when quality of life decrements include survival or when diluted with younger populations. Careful consideration of clinical interventions for age‐related HL is warranted and further research is needed on the effect of HL on quality of life in otherwise healthy older adults.
老年人健康相关生活质量:听力损失和常见慢性病的影响
背景:最近关于听力损失(HL)和健康老龄化的研究结果强调了老年人生活质量的重要临床和政策意义。我们的目的是利用2000年医疗支出小组调查(MEPS)和2010年人口普查数据,探讨HL对美国老年人生活质量的影响,独立于生存。方法:对2567名年龄在60 - 90岁的MEPS受试者进行回顾性队列研究,这些受试者提供了自我报告的HL、健康相关生活质量和慢性疾病的信息。EQ - 5D视觉模拟量表(VAS)转化用于估计5岁年龄组和疾病的边际效用减少,包括HL、高血压、糖尿病、心绞痛、关节痛、哮喘、肺气肿或失明。模型的减少量应用于2010年美国人口普查人口,以估计每年质量调整生命年(QALYs)的损失。结果:受访人群中,15.4%为轻度HL, 1.1%为中重度听力损失。其他疾病(效用递减)包括:关节痛53%(0.0643),高血压47.2%(0.0292),糖尿病15.6%(0.0577),心绞痛9.8%(0.0352),哮喘7.9%(0.0288),肺气肿4.5%(0.1186),失明0.8%(0.0836),平均年龄71.0,每年递减0.0033。听力损失减少在美国人口中排名第四,为174,689人。结论:当包括生存在内的生活质量下降或与较年轻人群稀释时,听力损失对健康老龄化的实质性影响可能不明显。与年龄相关的HL的临床干预措施值得仔细考虑,需要进一步研究HL对健康老年人生活质量的影响。
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