Changes in Frailty and Incident Hearing Loss in Middle‐Aged and Older Adults From Two Prospective Cohorts
Qin Li, Haohong Lai, Juntao Wu, Haidi YangABSTRACT
Aim
While cross‐sectional studies established an association between frailty and elevated hearing loss prevalence, the longitudinal relationship of them remains unexplored. Critically, no prior investigation has accounted for dynamic changes in frailty status during follow‐up. This study therefore explored longitudinal associations between changes in frailty status and incident hearing loss across multiple cohorts.
Methods
We analyzed longitudinal data from the Survey of Health, Aging and Retirement in Europe (SHARE) and the Health and Retirement Study (HRS). Frailty status was assessed using the Rockwood frailty index and categorized as robust, pre‐frail, or frail, with changes in status evaluated by comparing baseline and two‐year follow‐up assessments. Cox proportional hazard models were used to calculate the hazard ratio (HR).
Results
The analytical cohorts included 13 429 HRS participants and 28 475 SHARE participants. Compared to those who remained robust, participants progressing from robust to pre‐frail or frail status exhibited significantly higher risks of incident hearing loss (HRS: HR = 1.27, 95% CI 1.04–1.56; SHARE: HR = 1.22, 95% CI 1.06–1.40). Conversely, frail participants who improved to a less frail state showed lower risks of incident hearing loss (HRS: HR = 0.84, 95% CI 0.71–0.99; SHARE: HR = 0.72, 95% CI 0.58–0.90) relative to those who remained frail. Among pre‐frail participants, improvement to robust status was associated with a lower risk in SHARE (HR = 0.71, 95% CI 0.55–0.90), with a similar but non‐significant association in HRS (HR = 0.79, 95% CI 0.62–1.01), whereas progression to frailty was associated with a higher risk of incident hearing loss (HRS: HR = 1.15, 95% CI 1.00–1.33; SHARE: HR = 1.21, 95% CI 1.03–1.43).
Conclusion
Frailty progression was associated with an increased risk of incident hearing loss, whereas improvement to a less frail state was associated with a lower risk, highlighting the potential importance of frailty changes in hearing health.