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. 2022 Mar 1;5(3):e222983.
doi: 10.1001/jamanetworkopen.2022.2983.

Association of Hearing Impairment and 24-Hour Total Movement Activity in a Representative Sample of US Adults

Pablo Martinez-Amezcua  1 , Erin E Dooley  2 , Nicholas S Reed  3   4 , Danielle Powell  4   5 , Bjoern Hornikel  2 , Justin S Golub  6 , Kelley Pettee Gabriel  2 , Priya Palta  1   7
Affiliations

Association of Hearing Impairment and 24-Hour Total Movement Activity in a Representative Sample of US Adults

Pablo Martinez-Amezcua et al. JAMA Netw Open. .

Abstract

Importance: Lower physical activity (PA) levels have been proposed as a mechanism to explain the association between hearing loss and various adverse outcomes of aging. But whether hearing loss is associated with lower PA is poorly understood.

Objective: To evaluate whether hearing loss is associated with lower levels of PA.

Design, setting, and participants: This cross-sectional analysis was conducted in a representative sample of US adults (aged 30-69 years) who participated in the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES). Data analysis was conducted from July to September 2021.

Exposures: Hearing was assessed, in dB, by pure-tone audiometry and summarized as the better hearing ear's pure-tone average (BPTA) of 4 speech frequencies (500, 1000, 2000, and 4000 kHz); a higher BTPA indicates worse hearing. Hearing was also categorized into normal (BPTA ≤25 dB), mild hearing impairment (>25 to 40 dB), and moderate or greater hearing impairment (>40 dB).

Main outcomes and measures: Total 24-hour movement activity was measured using wrist accelerometers worn at all times for 7 consecutive days and summarized in monitor-independent movement summary units (MIMS) units (higher MIMS units indicate more movement). The association between BPTA and MIMS units was evaluated using a multivariable-adjusted (demographic characteristics and chronic conditions) piecewise spline regression (knot at 15 dB). Mean differences in MIMS units across hearing categories compared with normal hearing were estimated.

Results: The study included 2490 participants (mean [SE] age, 48.9 [0.3] years; 900 [weighted percentage, 69.3%] White individuals, 1248 [weighted percentage, 50.8%] female participants). Before the knot at 15 dB, we found that each 10-dB higher BPTA was associated with 860.4 (95% CI, 444.8-1276.1) higher MIMS units. Conversely, after the knot, each 10-dB higher BPTA was associated with 458.6 (95% CI, 27.7-889.4) lower MIMS units. The difference in MIMS units across hearing categories was not statistically significant.

Conclusions and relevance: In this cross-sectional study, in the range of hearing sensitivity of BPTA of 15 dB or greater, worse hearing was associated with lower MIMS units. Lower PA may be a mechanism contributing to the association between hearing impairment and adverse health.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Reed reported receiving personal fees from Shoebox Inc and Neosensory outside the submitted work. Dr Golub reported receiving travel fees from Advanced Bionics and Oticon Medical; receiving consulting fees from Oticon Medical, Auditory Insight, Optinose, Decibal Therapeutics; receiving an honorarium from Abbott; serving on the advisory board of Alcon; and that his department receives grants for an education course that he coruns outside the submitted work. Dr Pettee Gabriel reported receiving grants from the National Institutes of Health outside the submitted work. Dr Palta reported grants from National Institutes of Health during the conduct of the study. No other disclosures were reported.

Figures

Figure.
Figure.. Association Between Better Ear’s Pure-Tone Average and Daily Monitor Independent Movement Summary (MIMS) Units
Adjusted for covariates in model 2, ie, age, sex, race and ethnicity, education, marital status, employment status, body mass index, diabetes, hypertension, smoking status, stroke, heart attack, and heart failure. β coefficients were estimated with multivariable adjusted linear regression. Higher MIMS units indicates more movement. HL indicates hearing level.
See this image and copyright information in PMC

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