Abstract
BackgroundFried physical frailty, with mobility frailty and non-motor frailty phenotypes, is a heterogeneous syndrome. The coexistence of the two phenotypes and cognitive impairment is referred to as cognitive frailty (CF). It remains unknown whether frailty phenotype has a different association with hearing loss (HL) and tinnitus.MethodsOf the 5,328 community-dwelling older adults, 429 participants aged ≥58 years were enrolled in the study. The participants were divided into robust, mobility, and non-mobility frailty, mobility and non-mobility CF (subdivided into reversible and potentially reversible CF, RCF, and PRCF), and cognitive decline [subdivided into mild cognitive impairment (MCI) and pre-MCI] groups. The severity and presentations of HL and/or tinnitus were used as dependent variables in the multivariate logistic or nominal regression analyses with forward elimination adjusted for frailty phenotype stratifications and other covariates.ResultsPatients with physical frailty (mobility frailty) or who are robust were found to have lower probability of developing severe HL and tinnitus, and presented HL and/or tinnitus than those with only cognitive decline, or CF. Patients with RCF and non-mobility RCF had higher probability with less HL and tinnitus, and the presentation of HL and/or tinnitus than those with PRCF and mobility RCF. Other confounders, age, cognitive and social function, cardiovascular disease, depression, and body mass index, independently mediated the severity of HL and tinnitus, and presented HL and/or tinnitus.ConclusionFrailty phenotypes have divergent association with HL and tinnitus. Further research is required to understand the differential mechanisms and the personalized intervention of HL and tinnitus.Clinical Trial RegistrationClinicalTrials.gov identifier, NCT2017K020.
Highlights
Frailty is a heterogeneous clinical syndrome with a decline in the functioning of multiple physiological systems, including physical, cognitive, social, or psychosocial frailty phenotypes
After the adjustment for confounders, the robust and mobility frailty phenotypes were associated with significantly higher odds of normal hearing [odds ratio (OR), 5.99 and 6.82, respectively] than that of moderate and severe hearing loss (HL) when compared with the cognitive decline phenotype
After dividing cognitive frailty (CF) into reversible cognitive frailty (RCF) and potential reversible cognitive frailty (PRCF), and cognitive decline being divided into pre-mild cognitive impairment (MCI) and MCI, the mobility RCF (OR, 3.28; p = 0.076), nonmobility RCF (OR, 27.43), and pre-MCI (OR, 4.06) phenotypes were associated with higher odds of normal hearing, and the non-mobility RCF group with higher odds of mild HL (OR, 8.33, p = 0.065) than of the moderate and severe HL when compared with the MCI phenotype
Summary
Frailty is a heterogeneous clinical syndrome with a decline in the functioning of multiple physiological systems, including physical, cognitive, social, or psychosocial frailty phenotypes It could result in adverse outcomes, such as dependency, falls, disability, and death (Andrew et al, 2008; Ruan et al, 2015; Bunt et al, 2017; Hoogendijk et al, 2019). Physical frailty could be divided into mobility and non-mobility frailty phenotypes (Liu et al, 2017) Motor dysfunctions, such as slowness and/or weakness, are the important components of physical frailty and CF (Fried et al, 2001; Kelaiditi et al, 2013; Ruan et al, 2015). It remains unknown whether frailty phenotype has a different association with hearing loss (HL) and tinnitus
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