The Study Of The Relationship Between Frailty And Hearing Loss

Objective: Previous observational studies have shown that frailty index(FI)is associated with hearing loss(HL),but the results are inconsistent.We aimed to explore the epidemiological characteristics of HL and asthenia in China,whether frailty is associated with HL,and whether there is genetic evidence indicating a potential causal association between frailty and HL.Methods: In August to October 2022,we conducted a cross-sectional survey on the epidemiological characteristics of frailty and HL among community residents aged 60 years and older in a county in Henan province to investigate the prevalence and correlation of frailty and HL in the area.We also used cross-sectional data from7515 participants(aged 40-69 years)from the National Health and Nutrition Examination Survey in the United States,who had complete data on frailty and hearing measurements.HL was defined as self-reported HL,speech-frequency HL(0.5,1,2,and 4 k Hz),and high-frequency HL(3,4,and 8 k Hz),and frailty was scored from 0 to 1 using a 49-item cumulative deficit index and categorized into four levels("non-frail","pre-frail","frail",and "severely frail").Multivariable logistic regression was used to assess the association between HL and frailty.We also conducted a Mendelian randomization(MR)study to explore the causal relationship between frailty and HL,using genetic variants associated with frailty from a largescale genome-wide association study(GWAS)meta-analysis and summary-level data for HL from a large UK Biobank GWAS.The inverse-variance weighted method was used to estimate causal effects,and sensitivity analyses were conducted to further validate the robustness of the results.Results: Among the participants aged 60 years and older who took part in the co mmunity survey,the prevalence of hearing loss(HL)was 18.1%,and the prevalence o f frailty was 3%.Multiple logistic regression analysis showed that frailty was associat ed with an increased risk of hearing loss in the area(OR=18.94,95%CI: 2.86-42.40,P<0.001),and this association persisted after stratifying by age and gender,especially i n females and individuals aged 60 to 70 years.Among the 7,515 participants from the NHANES study,3,910(52.0%)were male,and the mean age(SD)was 54.01(8.57)y ears.The study indicated that frailty was associated with an increased risk of HL,incl uding self-reported HL(OR=2.813;95%CI: 2.386-3.317;p<0.001),speech-frequency HL(OR=1.975;95%CI: 1.679-2.323;p<0.001),and high-frequency HL(OR=1.748;95%CI: 1.459-2.094;p<0.001),compared to non-frail individuals.After adjusting for confounding factors,frailty remained a significant risk factor for HL,including self-re ported HL(OR=2.780;95%CI: 2.192-3.525;p<0.001),speech-frequency HL(OR=1.549;95%CI: 1.212-1.979;p<0.001),and high-frequency HL(OR=1.355;95%CI: 1.058-1.736;p=0.017).Bidirectional MR analysis revealed a causal relationship between frailty and HL,with both frailty(OR=1.051;95%CI: 1.020-1.083;p=0.001)and HL(OR=1.051;95%CI: 1.020-1.083;p=0.001)showing a causal effect on each other.Conclusions: This observational study found that interindividual variability in fr ailty was associated with the risk of HL.Genetic evidence suggests a potential bidirec tional causal association between frailty and HL.In future work,the underlying mech anism of a causal association between frailty and HL needs to be further investigated.