听力干预对交流功能的影响：ACHIEVE 随机对照试验的二次分析。

IF 4.3 2区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of the American Geriatrics Society Pub Date : 2024-09-12 DOI:10.1111/jgs.19185

Victoria A Sanchez,Michelle L Arnold,Emmanuel E Garcia Morales,Nicholas S Reed,Sarah Faucette,Sheila Burgard,Haley N Calloway,Josef Coresh,Jennifer A Deal,Adele M Goman,Lisa Gravens-Mueller,Kathleen M Hayden,Alison R Huang,Christine M Mitchell,Thomas H Mosley,James S Pankow,James R Pike,Jennifer A Schrack,Laura Sherry,Jacqueline M Weycker,Frank R Lin,Theresa H Chisolm,

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引用次数: 0

摘要

背景老龄化与认知健康评估（ACHIEVE）研究旨在确定最佳听力干预对社区老年人认知能力下降的影响。在此，我们对 ACHIEVE 研究进行了二次分析，以调查听力干预对自我报告的交流功能的影响。方法ACHIEVE 研究是一项平行组、无掩蔽、随机对照试验，研究对象为 70-84 岁、患有轻度至中度听力损失且未接受治疗、无严重认知障碍的成年人。参与者被随机分配（1:1）到听力干预（听力咨询和提供助听器）或健康教育对照干预（由健康教育专家提供有关慢性疾病预防主题的个人课程）中，每半年进行一次跟踪，为期 3 年。听力障碍清单-老年人筛查版（HHIE-S，范围为 0-40，分数越高表示听力障碍越严重）对自我报告的交流功能进行了测量。通过意向治疗模型分析了听力干预与对照组相比对 HHIE-S 的影响，并控制了已知的协变量。结果与对照组相比，听力干预 6 个月后 HHIE-S 有所改善，并在 3 年的随访中持续改善。我们估计干预组和对照组的 HHIE-S 分数从基线到 6 个月的变化差异为 -8.9 (95% CI: -10.4, -7.5) 分，到第一年为 -9.3 (95% CI: -10.8, -7.9)分，到第二年为 -8.4 (95% CI: -9.8, -6.9)分，到第三年为 -9.5 (95% CI: -11.0, -8.0)分。结论与对照干预相比，听力干预能在 6 个月内改善自我报告的交流功能，且效果可持续 3 年。这些研究结果表明，针对听力损失老年人的临床建议应鼓励进行听力干预，这将有益于沟通功能，并可能对其他方面的健康产生积极的下游影响。

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Effect of hearing intervention on communicative function: A secondary analysis of the ACHIEVE randomized controlled trial.

BACKGROUND The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study was designed to determine the effects of a best-practice hearing intervention on cognitive decline among community-dwelling older adults. Here, we conducted a secondary analysis of the ACHIEVE Study to investigate the effect of hearing intervention on self-reported communicative function. METHODS The ACHIEVE Study is a parallel-group, unmasked, randomized controlled trial of adults aged 70-84 years with untreated mild-to-moderate hearing loss and without substantial cognitive impairment. Participants were randomly assigned (1:1) to a hearing intervention (audiological counseling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed semiannually for 3 years. Self-reported communicative function was measured with the Hearing Handicap Inventory-Elderly Screening version (HHIE-S, range 0-40, higher scores indicate greater impairment). Effect of hearing intervention versus control on HHIE-S was analyzed through an intention-to-treat model controlling for known covariates. RESULTS HHIE-S improved after 6-months with hearing intervention compared to control, and continued to be better through 3-year follow-up. We estimated a difference of -8.9 (95% CI: -10.4, -7.5) points between intervention and control groups in change in HHIE-S score from baseline to 6 months, -9.3 (95% CI: -10.8, -7.9) to Year 1, -8.4 (95% CI: -9.8, -6.9) to Year 2, and - 9.5 (95% CI: -11.0, -8.0) to Year 3. Other prespecified sensitivity analyses that varied analytical parameters did not change the observed results. CONCLUSIONS Hearing intervention improved self-reported communicative function compared to a control intervention within 6 months and with effects sustained through 3 years. These findings suggest that clinical recommendations for older adults with hearing loss should encourage hearing intervention that could benefit communicative function and potentially have positive downstream effects on other aspects of health.

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来源期刊

Journal of the American Geriatrics Society 医学-老年医学

CiteScore

10.00

自引率

6.30%

发文量

504

审稿时长

3-6 weeks

期刊介绍： Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.