Otolaryngic sensory loss as a measure of frailty among older US adults

Abstract Background Frailty is a syndrome characterized by reduced physiologic reserve and increased vulnerability to poor health outcomes. Disruption of sensorineural function appears to serve as a novel biomarker of frailty. Using population‐level data, we sought to characterize the association between otolaryngic sensory dysfunction and frailty. Methods A cross‐sectional analysis of the 2011‐2012 US National Health and Nutrition Examination Survey was performed on adults ≥40 years of age (n = 2138). Participants were grouped by subjective gustatory dysfunction (sGD), olfactory dysfunction (sOD), hearing loss (sHL), and measured hearing loss (mHL) with pure tone averages (PTAs). Frailty was operationalized using a continuous 36‐item frailty index (FI) scored from 0 to 1, stratified in 4 categories (“non‐frail,” “vulnerable,” “frail,” or “most frail”). Results All sensory loss groups had significantly higher FI scores than those without sensory loss (sGD = 0.15; sOD = 0.14; sHL = 0.15; low‐frequency mHL = 0.16; high‐frequency mHL = 0.14 vs control = 0.11; p < 0.007 for all). “Vulnerable” individuals had increased odds of sOD (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.05‐2.00), whereas “frail” individuals had increased odds of sOD (aOR, 1.85; 95% CI, 1.26‐2.71) and low‐frequency mHL (aOR, 4.01; 95% CI, 1.27‐12.63). The “most frail” individuals had increased odds of sHL (aOR, 11.72; 95% CI, 2.88‐47.66) and high‐frequency mHL (aOR 5.10; 95% CI, 1.72‐15.12). PTAs were linearly associated with FI (low: β = 10.15; 95% CI, 1.78‐18.51; high: β = 19.85; 95% CI, 5.19‐34.53). Conclusion Otolaryngic sensory loss is associated with increased frailty. Independent association of frailty with measures of olfaction and hearing suggests that olfactory and hearing assessments may help identify at‐risk individuals with modifiable risk factors.