Analysis of Hearing Loss and Physical Activity Among US Adults Aged 60-69 Years

Pei-Lun Kuo,Frank R Lin,Junrui Di,Luigi Ferrucci

doi:10.1001/jamanetworkopen.2021.5484

Abstract

Hearing loss may be a modifiable factor associated with decreased physical activity in older adults. To examine the association of hearing loss with objectively measured physical activity, including moderate-to-vigorous physical activity, light-intensity physical activity, sedentary behavior, and pattern of physical activity (physical activity fragmentation). This population-based cross-sectional study used National Health and Nutrition Examination Survey (NHANES) data collected in the 2003 to 2004 cycle and analyzed in 2017 to 2020. Participants aged 60 to 69 years with complete audiometry, physical activity, and comorbidity data were included in the analysis. Data analysis was performed from January 2017 to December 2020. Hearing defined by the pure tone average (PTA; range, 0.5-4 kHz) in the better ear, with normal PTA defined as less than 25 dB hearing loss, mild hearing loss defined as PTA 25 to less than 40 dB hearing loss, and moderate or greater hearing loss defined as a PTA greater than or equal to 40 dB hearing loss. The primary outcomes were comprehensive metrics of objectively measured physical activity, including time spent in moderate-to-vigorous physical activity, light-intensity physical activity, and sedentary behavior, and physical activity fragmentation. Linear regression was used to model the association between hearing loss and physical activity. Of the 291 participants (mean [SD] age, 64.53 [2.96] years), 139 (47.8%) were male, 48 (16.5%) had mild hearing loss, and 22 (7.6%) had moderate or greater hearing loss. After adjusting for age, sex, education, race/ethnicity, and comorbidities, hearing loss (vs normal hearing) was significantly associated with less time spent in moderate-to-vigorous physical activity by 5.53 minutes per day (95% CI, -10.15 to -0.90 minutes per day), less time spent in light-intensity physical activity by 28.55 minutes per day (95% CI, -53.07 to -4.02 minutes per day), more time spent in sedentary behaviors by 34.07 minutes per day (95% CI, 8.32 to 59.82 minutes per day), and more fragmented physical activity pattern by 0.38 SD higher in active-to-sedentary transition probability (95% CI, to 0.10 to 0.65). The magnitude of the association of hearing loss (vs normal hearing) with physical activity metrics was equivalent to 7.28 years (95% CI, 3.19 to 11.37 years) of accelerated age for moderate-to-vigorous physical activity, 5.84 years (95% CI, 1.45 to 10.23 years) of accelerated age for light-intensity physical activity, and 10.53 years (95% CI, 2.89 to 18.16 years) of accelerated age for degree of physical activity fragmentation. These findings suggest that hearing loss is associated with a worse physical activity profile. Whether interventions to address hearing loss in adults could improve physical activity profiles will require further study.

Highlights

Physical activity is important to human beings of all ages.[1]
After adjusting for age, sex, education, race/ethnicity, and comorbidities, hearing loss was significantly associated with less time spent in moderate-to-vigorous physical activity by 5.53 minutes per day, less time spent in light-intensity physical activity by 28.55 minutes per day, more time spent in sedentary behaviors by 34.07 minutes per day, and more fragmented physical activity pattern by 0.38 SD higher in active-to-sedentary transition probability
The magnitude of the association of hearing loss with physical activity metrics was equivalent to 7.28 years of accelerated age for moderate-to-vigorous physical activity, 5.84 years of accelerated age for light-intensity physical activity, and 10.53 years of accelerated age for degree of physical activity fragmentation

Summary

Introduction

Physical activity is important to human beings of all ages.[1] For middle-aged to older adults, physical activity is associated with better quality of life, better physical and cognitive functions, lower risk for cardiovascular diseases, and lower mortality risk.[2,3,4,5,6] there is evidence supporting the health benefits of physical activity, the prevalence of physical inactivity is greater than 15% in the US.[7] it is of vital importance to investigate factors that may contribute to low physical activity. Hearing impairment may contribute to a lower level of physical activity, either directly, by inability to monitor the environment while being active, or indirectly, by social isolation and increased cognitive load.[8] A previous study[8] found that hearing impairment, which is prevalent in nearly two-thirds of adults older than 70 years, is associated with a lower level of physical activity among older adults. Further elucidating the association of hearing impairment with physical activity may offer insights into whether hearing loss is potentially a modifiable factor associated with physical inactivity among older adults

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Conclusion