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Table 1 Summary of included studies

From: Association between hearing loss and frailty: a systematic review and meta-analysis

Study Name Study design Participants Hearing Assessment Frailty Assessment Measure of risk used in meta-analysis with 95 % CI Quality Rating
Method Criteria Method Criteria
Buttery et al., 2015 [34] Cross-sectional 1843 (1184a) community-dwelling people aged between 65 to 79 in Germany. Self-reported
Multiple questions
Questions such as “Do you have problem on the telephone?“ “Do you have problem in groups of more than 4 people?“ Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Relative risk ratio: 5.38 (2.17, 13.35) Good
Cakmur, 2015 [29] Cross-sectional 168 community-dwelling people aged above 65 in Turkey Audiology Assessment
Whisper test
A researcher stood 20–40 cm behind the individual, who had 1 ear closed, and the subject was asked to repeat something said by the researcher. Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Not included in meta-analysis Good
Castellana et al., 2021 [36] Cross-sectional 1929 (1156a) community-dwelling people aged above 65 in Italy Audiology Assessment
Audiometry
WHO standard:
A PTA average at 0.5, 1, 2, and 4 kHz was calculated for the better hearing ear (disabling HI > 40 dB)
Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 1.48 (1.10, 2.01) Good
Cheung et al., 2020 [27] Cross-sectional and Cohort 306 (165a) people aged above 60 in Hong Kong Subjective
Validated tool (assessed by examiner)
Hearing item of the interRAI Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Cross-sectional Odds ratio: 2.83 (1.00, 8.01)
Cohort component not include in meta-analysis
Good
Closs et al., 2016 [38] Cross-sectional 521 (255a) community-dwelling people aged above 60 in Brazil Audiology Assessment
Whisper test
Whispered 33 cm behind the participant’s field of vision. Hearing impairment was defined as unable to answer the simple question. Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 3.09 (1.73, 5.52) Good
Doba et al., 2012 [35] Cohort 407 community-dwelling people aged above70 in Japan. Self-reported
Multi-choice question
Hearing classified as none, slight, or obvious according to questionnaires. CSHA Clinical Frailty Scale Scored according to the scale.
non-frail group scores from 1 to 3; frail group scores from 4 to 7.
Odds ratio: 2.186 (1.197, 3.995) Good
Gu et al., 2019 [22] Cross-sectional 4323 (2188a) community-dwelling people aged above 60 in China Subjective
Validated tool Assessed by examiner
Hearing: “clear-ly hearing” and “not clearly hearing or inaudible”, judged by examiners using voice test. Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 1.30 (0.59, 2.87) Good
Herr et al., 2018 [33] Cross-sectional 1228 (867a) people aged 100 and above in Japan, France, Switzerland, Denmark, and Sweden Self-reported
Simple question
Major difficulties in hearing when talking to a single person in a
quiet room or hearing a telephone conversation
Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 7.16 (3.24, 15.8) Good
Kamil et al., 2014 [31] Cross-sectional 2109 community-dwelling people aged 70 and above in the USA Self-reported
Simple question
Participants rated hearing as good, a little trouble or a lot of trouble.
Defined as good to a little trouble hearing versus a lot of trouble hearing.
Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 1.68 (1.00, 2.82) Good
Kamil et al., 2016 [13] Cohort 2000 (1239a) community-dwelling people aged between 70 to 79 in the USA Audiology Assessment
Audiometry
WHO standard:
A PTA average at 0.5, 1, 2, and 4 kHz was calculated for the better hearing ear (normal hearing ≤ 25 dB, mild HI = 26–40 dB, moderate-or-greater HI > 40 dB)
Physical frailty A gait speed of less than 0.60 m/s;
Inability to rise from a chair without using one’s arms.
Positive for 1 test was considered frail, positive for both was considered severely frail.
Hazard ratio: 1.63 (1.26, 2.12) Good
Liljas et al., 2017 [28] Cross-sectional and Cohort Community-dwelling people aged 60 and above in the UK.
2836 (1658a) participants in cross-sectional study;
1396 participants in cohort study.
Self-reported
Validated question
Participants rated hearing as excellent, very good, good, fair, or poor.
Defined as excellent to good hearing versus fair or poor hearing.
Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: Cross-sectional: 1.52 (1.25, 1.86)
Cohort: 1.32 (0.96, 1.81)
Good
Lorenzo-López et al., 2019 [30] Cohort 749 community-dwelling people aged 65 and above in Spain. Audiology Assessment
Whispered-voice test
Whispered 0.6 m behind the participant’s field of vision. Hearing impairment was defined as unable to repeat back at least 3 out of a possible total of 6 letters/ numbers correctly. Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Not include in meta-analysis Good
Mohd Hamidin et al., 2018 [23] Cross-sectional 279 community-dwelling people aged 60 years and above in Malaysia Self-reported
questionnaire
Self-reported poor hearing Fried criteria A participant 2 or less components was defined as nonfrail, and 3 and more components as frail. Odds ratio: 2.20 (0.91, 5.37) Good
Naharci et al., 2019 [32] Cross-sectional 484 community-dwelling people aged 60 and above in the USA. Self-reported
Single question
Participants rated hearing as excellent, very good, good, fair, or poor.
Defined as excellent to good hearing versus fair or poor hearing.
Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 3.064 (1.422, 6.604) Fair
Ng et at., 2014 [37] Cross-sectional 1685 community-dwelling people aged 55 and above in Singapore. Audiology Assessment
Self-report and Standard whisper test
Standard whisper test Fried criteria A participant without any of the 5 components was defined as nonfrail, 1 to 2 components as prefrail and 3 and more components as frail. Odds ratio: 2.34 (1.21, 4.52) Good
Sable-Morita et al., 2018 [39] Cross-sectional 283 outpatients with diabetes mellitus aged 65 and above in Japan. Audiology Assessment
Finger friction test
The examiner stood 30 cm behind the subject and made the noise 5 cm from each ear twice. Hearing impairment was defined as unable to hear the sound in both ears. KCL score This checklist consists of 7 domains: exercise/fall, instrumental activities of daily living, cognition, mood, malnutrition, oral function, and social activities of daily living. Frailty was defined as a total KCL score ≥ 8. Odds ratio: 2.02 (1.085, 3.76) Fair
  1. Note: 95 % CI 95 % confidence interval; KCL Kihon Checklist; PTA pure-tone audiometry; CSHA Canadian Study for Health and Aging
  2. aNumber of participants included in the systematic review. Different from total number reported by the study because only the most severely impaired category was used when several categories were reported