中国中老年人听力损失与抑郁症状的关联研究

Association between hearing loss and depressive symptoms among the middle-aged and elderly people in China

摘要:

目的 探索中国中老年人听力损失与抑郁症状的纵向关联，为中老年人抑郁的预防提供依据。方法 采用中国健康与养老追踪调查（China Health and Retirement Longitudinal Study，CHARLS）2011至2020年中参加2次及以上的受访者数据。听力损失通过自我报告进行评估，抑郁症状通过简版流调用抑郁自评量表（CESD-10）量表进行测量。采用K-M曲线和log-rank检验比较不同分组间发生抑郁症状的风险。采用Cox比例风险回归模型探索听力损失与抑郁症状的纵向关联。结果 研究共纳入12 952例研究对象。基线时1 416（10.9%）例研究对象自报听力损失。在中位随访时间为5.42年的随访中，5 498例研究对象出现抑郁症状。在未调整模型中，基线时的听力损失组发生抑郁症状的风险是无听力损失组的1.34倍（P<0.05），逐步调整社会人口学因素、行为生活方式因素及健康相关因素后，基线时的听力损失仍是抑郁症状的危险因素（HR=1.21，95%CI=1.10~1.34）。结论 听力损失会增加抑郁症状的发生风险，对听力损失进行干预可有效降低抑郁症状的发生。

Abstract:

Objective To investigate the longitudinal association between hearing loss and depressive symptoms among the middle-aged and elderly people in China.Methods Related data were collected from the subjects who participated in at least two waves of China Health and Retirement Longitudinal Study in 2011-2020. Hearing loss was assessed based on self-reported data，while depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. The Kaplan-Meier curves and the log-rank test were used to compare the risk of depressive symptoms between groups. The Cox proportional hazards model was used to investigate the longitudinal association between hearing loss and depressive symptoms.Results A total of 12 952 subjects were enrolled in this study. At baseline，1 416 subjects（10.9%） reported hearing loss. During the median follow-up time of 5.42 years，5 498 subjects were found to have depressive symptoms. In the unadjusted model，the risk of depressive symptoms in the group with hearing loss at baseline was 1.34 times that in the group without hearing loss（P<0.05），and after adjustment for demographic variables，behavior and life styles，and health-related factors，hearing loss at baseline was still a risk factor for depressive symptoms（hazard ratio=1.21，95%CI=1.10-1.34）.Conclusion Hearing loss may increase the risk of depressive symptoms，and intervention for hearing loss can effectively reduce depression symptoms.