[A study on the major chronic diseases and hearing impairment among middle-aged and older adults in China].

Objective

To explore the association between major chronic diseases and their cumulative number and the risk of hearing impairment in middle-aged and older adults in China.

Methods

Based on data from the China Health and Retirement Longitudinal Study from 2011 to 2020, middle-aged and older adults without hearing impairment in 2011 were included as the baseline population. Follow-up for hearing impairment outcomes was conducted in 2013, 2015, 2018, and 2020. A multivariate Cox proportional hazards regression model was used to analyze the association between major chronic diseases, their cumulative number, and the risk of hearing impairment, with HRs and 95%CIs calculated. Subgroup analyses were performed by age (<65 years and ≥65 years) and sex.

Results

Among the 8 144 middle-aged and older adults included in the study, with a mean follow-up of 7.78 person-years, 1 094 new cases of hearing impairment were identified, yielding an incidence density of 17.68 per 1 000 person-years. The multivariate Cox proportional hazards regression model analysis revealed that, for individual major chronic diseases, diabetes (HR=1.27, 95%CI: 1.01-1.60), heart disease (HR=1.66, 95%CI: 1.40-1.96), arthritis (HR=1.20, 95%CI: 1.06-1.37), and chronic kidney disease (HR=1.29, 95%CI: 1.02-1.62) were statistically significantly associated with hearing impairment risk. In contrast, hypertension, chronic lung disease, and stroke showed no statistically significant association with hearing impairment. Compared with middle-aged and older adults without any major chronic diseases, the HRs (95%CIs) for individuals with a cumulative number of 1, 2, and ≥3 major chronic diseases were 1.24 (1.07-1.43), 1.51 (1.27-1.79), and 1.86 (1.50-2.31), respectively, indicating a significant trend of increasing risk of hearing impairment with a greater number of chronic diseases (P<0.001). Subgroup analyses indicated that having 1, 2, and ≥3 major chronic diseases increased the risk of hearing impairment in both middle-aged adults (<65 years) and older adults (≥65 years). However, the trend was more pronounced in the <65 years age group compared to the ≥65 years group. Additionally, males were more susceptible to the effects in the early stages, whereas females exhibited a cumulative increase in risk.

Conclusions

Major chronic diseases and their cumulative number are risk factors for hearing impairment. In the prevention and control of hearing impairment, focused attention should be given to middle-aged and older adults with major chronic diseases. Furthermore, in clinical practice, emphasis should be placed on gender-specific considerations, which will be of significant importance for the early prevention and intervention of hearing impairment.