听力损失老年人跌倒的研究进展

doi:10.12114/j.issn.1007-9572.2022.0860

中国全科医学 ›› 2023, Vol. 26 ›› Issue (13): 1661-1666.DOI: 10.12114/j.issn.1007-9572.2022.0860

所属专题：跌倒最新文章合辑；老年问题最新文章合辑；老年人群健康最新文章合辑

听力损失老年人跌倒的研究进展

刘佳敏¹, 戴付敏²^,^*(), 赵亚莎¹, 韩琳¹

1．475004　河南省开封市，河南大学护理与健康学院
2．450003　河南省郑州市，河南省人民医院

收稿日期:2022-12-12 修回日期:2023-02-10 出版日期:2023-05-05 发布日期:2023-02-23
通讯作者: 戴付敏
作者贡献：刘佳敏负责文章的构思与设计、文献/资料收集和整理、论文撰写；戴付敏负责文章的质量控制及审校；赵亚莎、韩琳负责文章的可行性分析。
基金资助:
河南省医学科技攻关计划省部共建项目（SB201901069）——综合防治模式下社区居家多病共存老年人医康养一体化服务实证研究

Advances in Falls in the Elderly with Hearing Loss

LIU Jiamin¹, DAI Fumin²^,^*(), ZHAO Yasha¹, HAN Lin¹

1. School of Nursing and Health, Henan University, Kaifeng 475004, China
2. Henan Provincial People's Hospital, Zhengzhou 450003, China

Received:2022-12-12 Revised:2023-02-10 Published:2023-05-05 Online:2023-02-23
Contact: DAI Fumin

摘要/Abstract

摘要： 全球老龄化程度不断加深的背景下，老年人听力损失的发病率越来越高。听力损失会限制老年人监测和感知空间方位的听觉线索能力，导致方向混乱，增加老年人跌倒的风险。本研究介绍了听力损失老年人跌倒的流行病学特征，阐述了其发生机制，包括神经病理学机制、感官剥夺机制、物理学机制，并通过梳理相关文献，总结了影响因素，包括年龄、性别、听力损失程度、听力损失性质、步态表现、助听设备的使用等，最后，提出听力损失老年人跌倒的防治对策。本研究发现，听力损失老年人跌倒发生情况占比增高，听力损失程度、年龄增长、老年女性激素水平改变、平衡能力下降、负性情绪等是听力损失老年人发生跌倒的危险因素，建议从助听设备使用和听觉康复训练、药物治疗、平衡能力评估和身体锻炼、心理干预4个方面对听力损失老年人跌倒进行防治，从而降低患者跌倒的发生率，保障其生活质量和生命安全。

关键词: 老年人, 听力障碍, 听力损失, 跌倒, 老年人保健服务, 综述

Abstract:

The incidence of hearing loss among the elderly is increasing along with the acceleration of global aging. Hearing loss can limit the ability of the elderly to monitor and perceive auditory cues for spatial orientation, resulting in confusion of orientation and increasing the risk of falls. Based on the review of the latest relevant studies, we introduced the epidemiological characteristics of falls in the elderly with hearing loss, described the pathogenesis (including neuropathological mechanism, sensory deprivation mechanism and physical mechanism), summarized the influencing factors (including age, gender, degree of hearing loss, nature of hearing loss, gait performance, and the use of hearing aids), and put forward strategies for the prevention and treatment of falls. We found that the incidence of falls is increasing in the elderly with hearing loss, and its risk grows with the aggravation of hearing loss, age, aging-related hormonal changes (especially in elderly women), the decline in balancing ability and negative emotions. To reduce the incidence of falls to ensure quality of life and safety in elderly people with hearing loss, it is suggested to prevent or treat falls in this group by the use of hearing aids and auditory rehabilitation training, drug therapy, balance assessment and physical exercise, and psychological intervention.

Key words: Aged, Hearing disorders, Hearing loss, Fall, Health services for the aged, Review

刘佳敏,戴付敏,赵亚莎,等. 听力损失老年人跌倒的研究进展[J]. 中国全科医学, 2023, 26(13): 1661-1666. DOI: 10.12114/j.issn.1007-9572.2022.0860.
LIU Jiamin,DAI Fumin,ZHAO Yasha, et al. Advances in Falls in the Elderly with Hearing Loss[J]. Chinese General Practice, 2023, 26(13): 1661-1666. DOI: 10.12114/j.issn.1007-9572.2022.0860.

参考文献 76

[1]	WOOLLACOTT M, SHUMWAY-COOK A. Attention and the control of posture and gait：a review of an emerging area of research[J].Gait & Posture，2002，16(1):1-14.
[2]	World Health Organization. WHO：deafness and hearing loss[EB/OL].[2022-10-12].
[3]	VILJANEN A, KAPRIO J, PYYKKÖ I, et al. Hearing acuity as a predictor of walking difficulties in older women[J]. Journal of the American Geriatrics Society，2009，57(12):2282-2286.
[4]	李姗姗. 医疗保险缓解中老年家庭医疗负担的效果分析[J]. 就业与保障，2020，32(24):183-184.
[5]	World Health Organization. WHO：Falls[EB/OL]. [2022-10-12].
[6]	MERCHANT R A, CHEN M Z, WONG B L L, et al. Relationship between fear of falling，fear-related activity restriction，frailty，and sarcopenia[J]. Journal of the American Geriatrics Society，2020，68(11):2602-2608. DOI：10.1111/jgs.16719.
[7]	WANG J, LIU D, TIAN E, et al. Is hearing impairment causally associated with falls? Evidence from a two-sample mendelian randomization study[J]. Frontiers in Neurology，2022，13:876165. DOI：10.3389/fneur.2022.876165.
[8]	JOSEPH A, KUMAR D, BAGAVANDAS M. A review of epidemiology of fall among elderly in India[J]. Indian Journal of Community Medicine，2019，44(2):166-168.
[9]	AGMON M, LAVIE L, DOUMAS M. The association between hearing loss，postural control，and mobility in older adults：a systematic review[J]. Journal of the American Academy of Audiology，2017，28(6):575-588. DOI：10.3766/jaaa.16044.
[10]	JIAM N T, LI C, AGRAWAL Y. Hearing loss and falls：a systematic review and meta-analysis[J]. Laryngoscope，2016，126(11):2587-2596. DOI：10.1002/lary.25927.
[11]	GALET C, ZHOU Y, EYCK P T, et al. Fall injuries，associated deaths，and 30-day readmission for subsequent falls are increasing in the elderly US population：a query of the WHO mortality database and National Readmission Database from 2010 to 2014[J]. Clinical Epidemiology，2018，10:1627-1637.
[12]	SAKURAI R, SUZUKI H, OGAWA S, et al. Hearing loss and increased gait variability among older adults[J]. Gait & Posture，2021，87:54-58. DOI：10.1016/j.gaitpost.2021.04.007.
[13]	FARZADFAR F, FINUCANE M M, DANAEI G, et al. National，regional，and global trends in serum total cholesterol since 1980：systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants[J]. Lancet，2011，377(9765):578-586.
[14]	ZHOU Y, HU Y, LUO J, et al. Association between sensory loss and falls among middle-aged and older Chinese population：cross-sectional and longitudinal analyses[J]. Frontiers in Medicine，2021，8:810159. DOI：10.3389/fmed.2021.810159.
[15]	WANG Q, ZHANG S, WANG Y, et al. Dual sensory impairment as a predictor of loneliness and isolation in older adults：national cohort study[J]. JMIR Public Health and Surveillance，2022，8(11):e39314. DOI：10.2196/39314.
[16]	GOLUB J S, BRICKMAN A M, CIARLEGLIO A J, et al.Association of subclinical hearing loss with cognitive performance[J]. JAMA Otolaryngol Head Neck Surg，2020，146(1):57-67.
[17]	HEINE C, BROWNING C J, GONG C H. Sensory loss in China：prevalence，use of aids，and impacts on social participation[J]. Frontiers in Public Health，2019，7:5.
[18]	GRIFFITHS T D, LAD M, KUMAR S, et al. How can hearing loss cause dementia[J]. Neuron，2020，108(3):401-412. DOI：10.1016/j.neuron.2020.08.003.
[19]	WU L M, VASILIJIC S, SUN Y, et al. Losartan prevents tumor-induced hearing loss and augments radiation efficacy in NF2 schwannoma rodent models[J]. Science Translational Medicine，2021，13(602):eabd4816.
[20]	SINGH N K, JHA R H, GARGESHWARI A, et al. Altered auditory and vestibular functioning in individuals with low bone mineral density：a systematic review[J]. European Archives of Oto-rhino-laryngology，2018，275(1):1-10.
[21]	ECKERT M A, VADEN K I, DUBNO J R. Age-related hearing loss associations with changes in Brain morphology[J]. Trends in Hearing，2019，23:2331216519857267.
[22]	CAMPOS J, RAMKHALAWANSINGH R, PICHORA-FULLER M K. Hearing，self-motion perception，mobility，and aging[J]. Hearing Research，2018，369:42-55.
[23]	WUNDERLICH A, VOGEL O, ŠÖMEN M M, et al. Dual-task performance in hearing-impaired older adults-study protocol for a cross-sectional mobile brain/body imaging study[J]. Frontiers in Aging Neuroscience，2021，13:773287.
[24]	PEELLE J E. Listening effort：how the cognitive consequences of acoustic challenge are reflected in brain and behavior[J]. Ear and Hearing，2018，39(2):204-214.
[25]	CARR S, PICHORA-FULLER M K, LI K Z H, et al. Effects of age on listening and postural control during realistic multi-tasking conditions[J]. Human Movement Science，2020，73:102664. DOI：10.1016/j.humov.2020.102664.
[26]	MOHAMMADI M, ENAYATI Z, SHAABANI M, et al. Stationary auditory white noise improves postural control in healthy adults：a novel study on head-shaking[J]. J Vestib Res，2022，32(2):99-112. DOI：10.3233/VES-201616.
[27]	ROSS J M, BALASUBRAMANIAM R. Auditory white noise reduces postural fluctuations even in the absence of vision[J]. Experimental Brain Research，2015，233(8):2357-2363.
[28]	BANG S H, JEON J M, LEE J G, et al. Association between hearing loss and postural instability in older Korean adults[J].JAMA Otolaryngol Head Neck Surg，2020，146(6):530-534.
[29]	李莎，冯洁，任杰. 老年人选择性注意运动干预及评估方法[J].中国老年学杂志，2021，41(16):3610-3615. DOI：10.3969/j.issn.1005-9202.2021.16.061.
[30]	HEITZ E R, GIANATTASIO K Z, PRATHER C, et al. Self-reported hearing loss and nonfatal fall-related injury in a nationally representative sample[J]. Journal of the American Geriatrics Society，2019，67(7):1410-1416. DOI：10.1111/jgs.15849.
[31]	WILLIAMSON T T, ZHU X, PINEROS J, et al. Understanding hormone and hormone therapies' impact on the auditory system[J].Journal of Neuroscience Research，2020，98(9):1721-1730.
[32]	SMITH-RYAN A E, CABRE H E, MOORE S R. Active women across the lifespan: nutritional ingredients to support health and wellness[J]. Sports Medicine，2022，52(s1):101-117.
[33]	王昌军，尹宏.肌肉组织和脂肪组织对绝经后女性骨密度及骨强度的影响及作用机制[J].中国骨质疏松杂志，2019，25(10):1502-1508. DOI：10.3969/j.issn.1006-7108.2019.10.029.
[34]	SHUKLA A, HARPER M, PEDERSEN E, et al. Hearing loss，loneliness，and social isolation：a systematic review[J].Otolaryngolhead Neck Surg，2020，162(5):622-633.
[35]	POWELL D S, MORALES E E G, PLETNIKOVA S, et al. Self-report hearing and injury or falls in older adults from the national health and information survey[J]. Seminars in Hearing，2021，42(1):66-74. DOI：10.1055/s-0041-1726016.
[36]	LIN F R, FERRUCCI L. Hearing loss and falls among older adults in the United States[J]. Archives of Internal Medicine，2012，172(4):369-371. DOI：10.1001/archinternmed.2011.728.
[37]	KIM S Y, LEE J K, SIM S, et al. Hearing impairment increases the risk of distal radius，hip，and spine fractures：a longitudinal follow-up study using a national sample cohort[J]. PLoS One，2018，13(2):e0192820. DOI：10.1371/journal.pone.0192820.
[38]	LUBETZKY A V. Balance，falls，and hearing loss：is it time for a paradigm shift[J]. JAMA Otolaryngol Head Neck Surg，2020，146(6):535-536. DOI：10.1001/jamaoto.2020.0415.
[39]	FENG L, WU D, LIN J, et al. Associations between age-related hearing loss，cognitive decline，and depression in Chinese centenarians and oldest-old adults[J]. Therapeutic Advances in Chronic Disease，2022，13:20406223221084833.
[40]	SAXBY C, KOUMPA F, MOHAMED S, et al. The use of magnetic resonance imaging in the investigation of patients with unilateral non-pulsatile tinnitus without asymmetrical hearing loss[J]. Journal of Laryngology and Otology，2021，135(8):680-683. DOI：10.1017/S002221512100150X.
[41]	夏清清，焦青山，李佳楠，等.不对称性听力损失人工耳蜗植入2例及文献复习[J].中华耳科学杂志，2021，19(2):403-405. DOI：10.3969/j.issn.1672-2922.2021.02.043.
[42]	陈雅丽，王鑫，刘晓旭，等.职业性噪声暴露对汽车制造业工人不对称性听力损失的影响[J].中华劳动卫生职业病杂志，2019，37(4):260-264.
[43]	BEHTANI L, FUENTE A, IANISZEWSKI A, et al. Right-ear advantage for unaided and aided speech perception in noise in older adults[J]. Journal of International Advanced Otology，2021，17(2):115-120. DOI：10.5152/JIAO.2021.8343.
[44]	GIRARD S A, LEROUX T, VERREAULT R, et al. Falls risk and hospitalization among retired workers with occupational noise-induced hearing loss[J]. Canadian Journal on Aging，2014，33(1):84-91. DOI：10.1017/S0714980813000664.
[45]	SAKURAI R, KAWAI H, YANAI S, et al. Gait and age-related hearing loss interactions on global cognition and falls[J].Laryngoscope，2022，132(4):857-863.
[46]	SZETO B, ZANOTTO D, LOPEZ E M, et al. Hearing loss is associated with increased variability in double support period in the elderly[J]. Sensors，2021，21(1):278.
[47]	RUMALLA K, KARIM A M, HULLAR T E. The effect of hearing aids on postural stability[J]. Laryngoscope，2015，125(3):720-723. DOI：10.1002/lary.24974.
[48]	VITKOVIC J, LE C, LEE S L, et al. The contribution of hearing and hearing loss to balance control[J]. Audiology & Neuro-otology，2016，21(4):195-202. DOI：10.1159/000445100.
[49]	ROCHA L V, MARTINELLI M C. Cognition and benefit obtained with hearing aids：a study in elderly people[J]. Codas，2020，32(2):e20180259. DOI：10.1590/2317-1782/20192018259.
[50]	LACERDA C F, SILVA L O E, DE TAVARES CANTO R S, et al. Effects of hearing aids in the balance，quality of life and fear to fall in elderly people with sensorineural hearing loss[J]. International Archives of Otorhinolaryngology，2012，16(2):156-162.
[51]	PARIETTI-WINKLER C, LION A, MONTAUT-VERIENT B, et al.Effects of unilateral cochlear implantation on balance control and sensory organization in adult patients with profound hearing loss[J].BioMed Research International，2015，2015:621845.
[52]	KACZMARCZYK K, BLAZKIEWICZ M, WISZOMIRSKA I, et al.Assessing gait stability before and after cochlear implantation[J].BioMed Research International，2019，2019:2474273.
[53]	BERGE J E, NORDAHL S H G, AARSTAD H J, et al. Hearing as an independent predictor of postural balance in 1 075 patients evaluated for dizziness[J]. Otolaryngolhead Neck Surg，2019，161(3):478-484. DOI：10.1177/0194599819844961.
[54]	ABE-FUJISAWA I, MAEDA Y, TAKAO S, et al. Subjective evaluation of balance by the dizziness handicap inventory does not predict fall risk in older adults visiting otolaryngology clinics[J].Annals of Otology，Rhinology，and Laryngology，2021，130(9):990-995. DOI：10.1177/0003489420987972.
[55]	BARBOSA M R, MEDEIROS D D S, ROSSI-BARBOSA L A R, et al. Self-perception of the hearing-impaired elderly before and after hearing-aid fittings[J]. Geriatrics & Gerontology International，2015，15(8):977-982. DOI：10.1111/ggi.12376.
[56]	ERNST A, BASTA D, MITTMANN P, et al. Can hearing amplification improve presbyvestibulopathy and/or the risk-to-fall[J]. European Archives of Oto-rhino-laryngology，2021，278(8):2689-2694. DOI：10.1007/s00405-020-06414-9.
[57]	WELLS T S, NICKELS L D, RUSH S R, et al. Characteristics and health outcomes associated with hearing loss and hearing aid use among older adults[J]. Journal of Aging and Health，2020，32(7/8):724-734. DOI：10.1177/0898264319848866.
[58]	吴璨，饶丽华，李专，等.老年性聋的病因与治疗研究进展[J].湖北科技学院学报（医学版），2022，36(6):548-552.
[59]	STROPAHL M, BESSER J, LAUNER S. Auditory training supports auditory rehabilitation：a state-of-the-art review[J]. Ear and Hearing，2020，41(4):697-704.
[60]	SÁNCHEZ-RODRÍGUEZ C, CUADRADO E, RIESTRA-AYORA J, et al. Polyphenols protect against age-associated apoptosis in female rat cochleae[J]. Biogerontology，2018，19(2):159-169.
[61]	王桃娇，丁海峰，马晶，等. 老年性耳聋听力损失程度调查及中医辨证分型与治疗[J]. 中国老年学杂志，2011，31(15):2840-2842. DOI：10.3969/j.issn.1005-9202.2011.15.015.
[62]	丁文吉，刘洋，李琳，等. 体内激素水平对老年性耳聋的影响[J].中国实验诊断学，2022，26(10):1556-1558.
[63]	HEDERSTIERNA C, HULTCRANTZ M, COLLINS A, et al. Hearing in women at menopause. Prevalence of hearing loss，audiometric configuration and relation to hormone replacement therapy[J]. Acta Oto-laryngologica，2007，127(2):149-155.
[64]	詹钦文. 骨硬化蛋白抑制剂：Romosozumab治疗绝经后妇女骨质疏松症效果与安全性的Meta分析[D]. 重庆：重庆医科大学，2019.
[65]	胡巧玲，尹莲花. 运动对改善老年人平衡能力影响的研究进展[J]. 按摩与康复医学，2021，12(22):10-12,16.
[66]	李燕，黄丽华. 老年人平衡能力评估及干预的研究进展[J].中华护理杂志，2019，54(4):603-608.
[67]	KRISTENSEN M T, NIELSEN A Ø, TOPP U M, et al. Number of test trials needed for performance stability and interrater reliability of the one leg stand test in patients with a major non-traumatic lower limb amputation[J]. Gait & Posture，2014，39(1):424-429. DOI：10.1016/j.gaitpost.2013.08.017.
[68]	DOWNS S. The Berg Balance Scale[J]. Journal of Physiotherapy，2015，61(1):46. DOI：10.1016/j.jphys.2014.10.002.
[69]	LA PORTA F, FRANCESCHINI M, CASELLI S, et al. Unified Balance Scale：an activity-based，bed to community，and aetiology-independent measure of balance calibrated with Rasch analysis[J]. Journal of Rehabilitation Medicine，2011，43(5):435-444. DOI：10.2340/16501977-0797.
[70]	徐忠梅，于卫华，吴梦余，等. 老年2型糖尿病患者双重任务行走步态特征及其与害怕跌倒的相关性研究[J]. 中华护理杂志，2018，53(1):22-26.
[71]	王小娟，赵金芳，徐强绪. 大型机动车驾驶员听力状况调查[J].中国工业医学杂志，2019，32(1):60-61.
[72]	贾金丽，潘爱红，魏道琳，等.步态平衡操联合抗阻训练对跌倒高风险老年人平衡能力、运动能力和跌倒效能的影响[J].实用预防医学，2022，29(10):1229-1232.
[73]	SHERRINGTON C, FAIRHALL N, KWOK W, et al. Evidence on physical activity and falls prevention for people aged 65+ years：systematic review to inform the WHO guidelines on physical activity and sedentary behaviour[J]. International Journal of Behavioral Nutrition and Physical Activity，2020，17(1):144.
[74]	卜行宽.试论耳和听力保健在基层医疗卫生服务体系中的整合[J].听力学及言语疾病杂志，2021，29(3):241-242.
[75]	沈学毅. 老年听力障碍患者的心理护理及效果评价[J].内蒙古中医药，2013，32(17):167-168.
[76]	SUN J, KANG J, WANG P, et al. Self-relaxation training can improve sleep quality and cognitive functions in the older：a one-year randomised controlled trial[J]. Journal of Clinical Nursing，2013，22(9/10):1270-1280. DOI：10.1111/jocn.12096.

听力损失老年人跌倒的研究进展

Advances in Falls in the Elderly with Hearing Loss

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