Falls Related Injuries and Hearing Loss: Understanding the role of hearing healthcare intervention

跌倒相关伤害和听力损失：了解听力保健干预的作用

• 批准号: 10372946
• 负责人: Kristal Mills Riska
• 金额: $ 19.94万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10372946
• 关键词: Accident and Emergency department; Address; Adult; Affect; Area; Auditory; Awareness; Chronic Disease; Clinical Research; Cochlear Implants; Cochlear implant procedure; Cognitive; Computerized Medical Record; Coupled; Data; Data Set; Databases; Diagnosis; Dose; Early identification; Elderly; Environmental Risk Factor; Gait; Goals; Healthcare; Healthcare Systems; Hearing; Hearing Aids; Impaired cognition; Individual; Intervention; Link; Mediating; Medical; Medicare; Morbidity - disease rate; National Institute on Deafness and Other Communication Disorders; Outcome; Patient Self-Report; Patients; Pilot Projects; Polypharmacy; Prevention; Prevention strategy; Prospective cohort; Psychosocial Factor; Public Health; Questionnaires; Recording of previous events; Reporting; Research; Residual state; Risk; Risk Factors; Role; Sampling; Sensorineural Hearing Loss; Severities; Subgroup; Vision; Work; cost; design; disability; equilibration disorder; fall injury; fall risk; falls; hearing impairment; hearing loss treatment; improved; innovation; middle age; modifiable risk; mortality; patient population; prospective; public health relevance

ABSTRACT Falls and falls-related injuries result in substantial morbidity, mortality, and disability among older adults. Recently, sensorineural hearing loss and hearing handicap have been identified as independent risk factors for falls. There is an established dose-effect, in which increasing hearing loss severity and/or greater perceived handicap from hearing loss increases the odds of falling. It is unclear if falls can be mitigated by treatment of hearing loss with hearing aids or a cochlear implant. The long-term goal is to identify and understand the mechanisms that mediate the association between falls and hearing loss in an effort to develop interventions that will modify falls risk in this patient population. The current objective is to determine if amplification modifies the odds of falls-related injury in older adults. To address the current objective, the following specific aims will be pursued: 1) Determine if amplification modifies the odds of suffering a falls-related injury in older adults with hearing loss. A historical prospective cohort design will be employed that merges existing local audiometric and hearing aid databases with local electronic medical record data and Medicare data to identify individuals seeking medical treatment for falls in. Given the potential for residual hearing difficulties in patients with moderate or greater hearing loss who are amplified with a hearing aid only, a sub-analysis, will be performed to determine if type of amplification (i.e., hearing aid versus cochlear implant) modifies the odds of a fall-related injury in this subgroup We hypothesize that those with moderate or greater hearing loss receive greater auditory benefit from cochlear implantation and therefore, have lower odds of falling. 2) To conduct an exploratory study of older adults with hearing loss to identify if differences in patient-reported hearing outcomes (e.g., listening effort, spatial awareness, hearing handicap), patient-reported amplification outcomes, cognitive and psychosocial factors are associated with falls risk. Validated questionnaires will be used to examine differences in these domains between fallers and non-fallers stratified by amplification status (user versus non- user) and type (hearing aid versus cochlear implant). The current proposal is innovative as the work will determine if hearing intervention influences the risk of falls-injury in older adults and seeks to address the dose-dependent associations between hearing loss severity and falls. Moreover, it will identify candidate mechanisms that will further clarify the link between falls and hearing loss. These contributions will be significant as they will determine if hearing loss may be an appropriate target for intervention to reduce the societal and healthcare burden of falls and falls-related injury.

抽象的 与跌倒相关的损伤导致老年人的大量发病，死亡率和残疾。 最近，感官听力损失和听力障碍已被确定为独立的风险因素 瀑布。有一个已建立的剂量效应，其中增加听力损失的严重程度和/或更大的感知 听力损失的障碍增加了跌倒的几率。目前尚不清楚是否可以通过处理 助听器或人工耳蜗的听力损失。长期目标是识别和理解 介导跌倒与听力损失之间的关联的机制以制定干预措施 这将改变该患者人群的跌倒风险。当前的目标是确定放大是否修改 老年人与跌倒有关的损伤几率。为了解决当前目标，以下具体目标将 被追捕：1）确定放大是否修改 听力损失。将采用历史前瞻性队列设计，以合并现有的本地听力测量值 以及具有本地电子病历数据和医疗保险数据的助听器数据库，以识别个人 寻求跌倒的医疗。鉴于患者有残留的听力困难 仅通过助听器放大的中度或更大的听力损失将进行亚分析，将进行 确定放大类型（即助听器与人工耳蜗植入物）是否会改变与跌倒有关的几率 在此亚组中，我们假设那些听力损失或更大的听力损失的人会受到更大 听觉受益于人工耳蜗，因此掉落的几率较低。 2）进行 对听力损失的老年人的探索性研究，以确定患者报告的听力结果的差异是否存在 （例如，听力工作，空间意识，听力障碍），患者报告的放大结果，认知 和社会心理因素与跌倒风险有关。经过验证的问卷将用于检查 通过扩增状态分层的堕落者和非竞争者之间这些域的差异（用户与非 - 用户）和类型（助听器与人工耳蜗植入物）。当前的提议是创新的，因为这项工作将 确定听力干预是否影响老年人跌倒的风险，并试图解决 听力损失严重程度与跌倒之间的剂量依赖性关联。而且，它将确定候选人 将进一步阐明跌倒与听力损失之间的联系的机制。这些贡献将是 意义重大，因为他们将确定听力损失是否可能是减少干预的适当目标 与跌倒和跌倒有关的社会和医疗保健负担。

项目成果

Association Between Hearing Handicap and Life-Space Mobility in a Patient Population.

患者群体中听力障碍与生活空间流动性之间的关联。

• DOI: 10.1044/2023_aja-22-00052
• 发表时间: 2023
• 期刊: American journal of audiology
• 影响因子: 1.8
• 作者: Oliva,Allison;West,JessicaS;Smith,SherriL;Huang,RyanJ;Riska,KristalM
• 通讯作者: Riska,KristalM

Evaluating the Association Between Hearing Loss and Falls in Adults With Vestibular Dysfunction or Nonvestibular Dizziness.

• DOI: 10.1097/aud.0000000000001156
• 发表时间: 2022
• 期刊: EAR AND HEARING
• 影响因子: 3.7
• 作者: Huang, Ryan J.;Pieper, Carl F.;Whitson, Heather E.;Garrison, Douglas B.;Pavon, Juliessa M.;Riska, Kristal M.
• 通讯作者: Riska, Kristal M.

Response to Powell et al., "Do Hearing Aids Prevent Falls? Commentary on Study From the National Health and Nutrition Examination Survey".

对 Powell 等人的回应，“助听器可以预防跌倒吗？国家健康和营养检查调查研究评论”。

• DOI: 10.1044/2021_aja-21-00144
• 发表时间: 2021
• 期刊: American journal of audiology
• 影响因子: 1.8
• 作者: Riska,KristalM;Peskoe,SarahB;Gordee,Alex;Kuchibhatla,Maragatha;Smith,SherriL
• 通讯作者: Smith,SherriL

Impact of Hearing Aid Use on Falls and Falls-Related Injury: Results From the Health and Retirement Study.

• DOI: 10.1097/aud.0000000000001111
• 发表时间: 2022
• 期刊: EAR AND HEARING
• 影响因子: 3.7
• 作者: Riska, Kristal M.;Peskoe, Sarah B.;Kuchibhatla, Maragatha;Gordee, Alexander;Pavon, Juliessa M.;Kim, Se Eun;West, Jessica S.;Smith, Sherri L.
• 通讯作者: Smith, Sherri L.

A Systematic Review on the Association Between Vestibular Dysfunction and Balance Performance in Children With Hearing Loss.

• DOI: 10.1097/aud.0000000000001131
• 发表时间: 2022
• 期刊: Ear and hearing
• 影响因子: 3.7
• 作者: Singh A;Heet H;Guggenheim DS;Lim M;Garg B;Bao M;Smith SL;Garrison D;Raynor EM;Lee JW;Wrigley J;Riska KM
• 通讯作者: Riska KM