Korean J Sports Med.  2024 Mar;42(1):31-37. 10.5763/kjsm.2024.42.1.31.

Joint Association of Hard of Hearing and Handgrip Strength with Falls in the Older Adults: A Cross-sectional Analysis of Data from the Korean Longitudinal Study of Aging

• Ma X
• Lee S
• Kim YS

• KMID: 2553554
• DOI: http://doi.org/10.5763/kjsm.2024.42.1.31

Abstract

Purpose
This study aimed to confirm the joint association of hard of hearing and handgrip strength with falls among Koreans aged 65 years and above.
Methods
This cross-sectional study was based on the 2020 Korean Longitudinal Study of Aging data and included 4,372 participants who completed a falls-related questionnaire. Grip strength was measured, and hearing status was self-reported. Multivariate logistic regression assessed associations between hearing status, handgrip strength, and falls. Analyses were adjusted for variables such as age, sex, body mass index, education level, and medical history.
Results
The study found a significant association between being hard of hearing and increased odds of falls (odds ratio [OR], 2.73; 95% confidence interval [CI], 1.56–4.78). Additionally, individuals with low handgrip strength had higher odds of falls (OR, 1.70; 95% CI, 0.88–3.31) than those with normal handgrip strength. Among individuals who were hard of hearing, the group with normal handgrip strength showed 28% lower odds of falls (OR, 0.72; 95% CI, 0.18–2.87), although this result did not reach statistical significance.
Conclusion
These findings highlight the high fall odds associated with being hard of hearing and suggest that handgrip strength may have a potential protective effect in individuals aged 65 years and older. Our study contributes to an increased understanding of risk factors for falls in older adults and emphasizes the need to address sensory impairment and muscle strength in prevention efforts. Future studies must validate and extend these findings to improve quality of life and reduce fall-related injuries in older adults.

Keyword

Aged; Accidental falls; Hand strength; Hearing loss

Figure

• 

  Fig. 1 Flowchart of the selection of the study subjects. KLoSA, Korean Longitudinal Study of Ageing.

• 

  Fig. 2 Joint associations of handgrip strength and hard of hearing with falls. Adjusted for age, sex, body mass index, education level, marital status, smoking and alcohol consumption status, physical activity, and medical history. OR: odds ratio, CI: confidence interval, HGS: handgrip strength, HoH: hard of hearing.

Reference

1. Statistics Korea. 2022. 2022 Aging Statistics [Internet]. Statistics Korea;Available from: https://eiec.kdi.re.kr/policy/materialView.do?num=230699. cited 2023 Apr 10.

2. Veronese N, Koyanagi A, Cereda E, et al. 2022; Sarcopenia reduces quality of life in the long-term: longitudinal analyses from the English longitudinal study of ageing. Eur Geriatr Med. 13:633–9. DOI: 10.1007/s41999-022-00627-3. PMID: 35212911. PMCID: PMC9151534.

3. Landi F, Liperoti R, Russo A, et al. 2012; Sarcopenia as a risk factor for falls in elderly individuals: results from the ilSIRENTE study. Clin Nutr. 31:652–8. DOI: 10.1016/j.clnu.2012.02.007. PMID: 22414775.

4. Ministry of Health and Welfare. 2020. Survey on the elderly' conditions. Experiences of falls among the elderly [Internet]. Ministry of Health and Welfare;Available from: https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117071_050&conn_path=I2. cited 2023 Apr 10.

5. Spoelstra SL, Given BA, Given CW. 2012; Fall prevention in hospitals: an integrative review. Clin Nurs Res. 21:92–112. DOI: 10.1177/1054773811418106. PMID: 21862700.

6. Zuniga MG, Dinkes RE, Davalos-Bichara M, et al. 2012; Association between hearing loss and saccular dysfunction in older individuals. Otol Neurotol. 33:1586–92. DOI: 10.1097/MAO.0b013e31826bedbc. PMID: 23064383. PMCID: PMC3498596.

7. Gurgel RK, Ward PD, Schwartz S, Norton MC, Foster NL, Tschanz JT. 2014; Relationship of hearing loss and dementia: a prospective, population-based study. Otol Neurotol. 35:775–81. DOI: 10.1097/MAO.0000000000000313. PMID: 24662628. PMCID: PMC4024067.

8. Karpa MJ, Gopinath B, Beath K, et al. 2010; Associations between hearing impairment and mortality risk in older persons: the Blue Mountains Hearing Study. Ann Epidemiol. 20:452–9. DOI: 10.1016/j.annepidem.2010.03.011. PMID: 20470972.

9. Lee S, Hong GS. 2020; The predictive relationship between factors related to fear of falling and mortality among community-dwelling older adults in Korea: analysis of the Korean longitudinal study of aging from 2006 to 2014. Aging Ment Health. 24:1999–2005. DOI: 10.1080/13607863.2019.1663490. PMID: 31512495.

10. Mick P, Kawachi I, Lin FR. 2014; The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg. 150:378–84. DOI: 10.1177/0194599813518021. PMID: 24384545.

11. Roberts HC, Denison HJ, Martin HJ, et al. 2011; A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 40:423–9. DOI: 10.1093/ageing/afr051. PMID: 21624928.

12. Lee J, Suh Y, Park J, Kim GU, Lee S. 2022; Combined effects of handgrip strength and sensory impairment on the prevalence of cognitive impairment among older adults in Korea. Sci Rep. 12:6713. DOI: 10.1038/s41598-022-10635-9. PMID: 35468923. PMCID: PMC9039062.

13. Kamil RJ, Betz J, Powers BB, et al. 2016; Association of hearing impairment with incident frailty and falls in older adults. J Aging Health. 28:644–60. DOI: 10.1177/0898264315608730. PMID: 26438083. PMCID: PMC5644033.

14. Kim K, Ho JH. 2020; Handgrip strength and mortality in elderly Koreans: evidence from the Korea longitudinal study of ageing. Asia Pac J Public Health. 32:302–9. DOI: 10.1177/1010539520937100. PMID: 32608248.

15. Cheung CL, Tan KC, Bow CH, Soong CS, Loong CH, Kung AW. 2012; Low handgrip strength is a predictor of osteoporotic fractures: cross-sectional and prospective evidence from the Hong Kong Osteoporosis Study. Age (Dordr). 34:1239–48. DOI: 10.1007/s11357-011-9297-2. PMID: 21853264. PMCID: PMC3448988.

16. Kim KH, Park JA, Lee SH, Lee TH. 2021. 2020 the Korean Longitudinal Study of Aging (KLoSA) preliminary analysis report [Internet]. Korea Employment Information Service;Available from: https://www.keis.or.kr/user/extra/main/3873/publication/publicationList/jsp/LayOutPage.do?categoryIdx=131&pubIdx=8537&spage=5&onlyList=N. cited 2023 Oct 23.

17. Chen LK, Woo J, Assantachai P, et al. 2020; Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 21:300–7. DOI: 10.1016/j.jamda.2019.12.012. PMID: 32033882.

18. Division of Policy for Persons with Disabilities, Ministry of Health and Welfare. 2021. Disability Registration Status (2021) [Internet]. Ministry of Health and Welfare;Available from: https://www.mohw.go.kr/board.es?mid=a10412000000&bid=0020. cited 2023 Apr 10.

19. Heitz ER, Gianattasio KZ, Prather C, Talegawkar SA, Power MC. 2019; Self-reported hearing loss and nonfatal fall-related injury in a nationally representative sample. J Am Geriatr Soc. 67:1410–6. DOI: 10.1111/jgs.15849. PMID: 30848835.

20. Stam M, Kostense PJ, Lemke U, et al. 2014; Comorbidity in adults with hearing difficulties: which chronic medical conditions are related to hearing impairment? Int J Audiol. 53:392–401. DOI: 10.3109/14992027.2013.879340. PMID: 24588528.

21. Cöster ME, Karlsson M, Ohlsson C, et al. 2020; Physical function tests predict incident falls: a prospective study of 2969 men in the Swedish Osteoporotic Fractures in Men study. Scand J Public Health. 48:436–41. DOI: 10.1177/1403494818801628.

22. Noh JH, Lim EJ. 2018; Factors influencing fear of falling among women in the early phase of old age by assessing level of hand grip strength. J Korean Acad Soc Home Health Care Nurs. 25:96–104.

23. Jiam NT, Li C, Agrawal Y. 2016; Hearing loss and falls: a systematic review and meta-analysis. Laryngoscope. 126:2587–96. DOI: 10.1002/lary.25927. PMID: 27010669.

24. Bae EJ, Park NJ, Sohn HS, Kim YH. 2019; Handgrip strength and all-cause mortality in middle-aged and older Koreans. Int J Environ Res Public Health. 16:740. DOI: 10.3390/ijerph16050740. PMID: 30823660. PMCID: PMC6427792.

25. Kim GR, Sun J, Han M, Park S, Nam CM. 2019; Impact of hand-grip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing. BMJ Open. 9:e027019. DOI: 10.1136/bmjopen-2018-027019. PMID: 31072857. PMCID: PMC6527975.

26. Lee SW, Lee KJ, Song CH. 2011; Effects of visual feedback-based balance training on balance in elderly fallers. J Muscle Joint Health. 18:16–27. DOI: 10.5953/JMJH.2011.18.1.016.