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Arjmandi MK, Neils-Strunjas J, Nemati S, Fridriksson J, Newman-Norlund S, Newman-Norlund R, Bonilha L. Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-18. [PMID: 38995870 DOI: 10.1044/2024_jslhr-23-00810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
PURPOSE Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. METHOD We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. RESULTS Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. CONCLUSIONS Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26237060.
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Affiliation(s)
- Meisam K Arjmandi
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
- Institute for Mind and Brain, University of South Carolina, Columbia
| | - Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
- Institute for Mind and Brain, University of South Carolina, Columbia
| | - Sarah Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Roger Newman-Norlund
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
- Institute for Mind and Brain, University of South Carolina, Columbia
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Wang Y, Zhong M, Li Y, Liu Y, Tong B, Qiu J, Chen S. Association Between Hearing Loss, Asymmetric Hearing, and Postural Instability. Ear Hear 2024; 45:827-836. [PMID: 38351499 DOI: 10.1097/aud.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Recent studies have suggested that older adults with hearing loss (HL) are at a greater risk of postural instability than those with normal hearing. However, little is known regarding this association in middle-aged individuals. The relationships between HL laterality, asymmetric hearing, and posture control are similarly unclear. The purpose of this study was to investigate the effects of hearing status on postural control and to explore the dose-response relationship between the hearing threshold and postural instability risk in middle-aged adults. DESIGN This cross-sectional study included 1308 participants aged 40 to 69 years with complete audiometric and standing balance function data from the 2001-2004 National Health and Nutrition Examination Survey. Speech-frequency HL was defined as a pure-tone average at 0.5, 1, 2, and 4 kHz of >25 dB in the better-hearing ear; high-frequency HL was defined as a pure-tone average at 3, 4, and 6 kHz of >25 dB. Asymmetric hearing was defined as a difference in the pure-tone average >15 dB between ears. Postural instability was defined as participants ending the modified Romberg test in condition 4. RESULTS After adjustment for sociodemographic variables, lifestyle, and comorbidities, speech-frequency HL, except for unilateral HL, was associated with increased postural instability (mild HL: odds ratio [OR], 2.33; 95% confidence interval [CI], 1.25-4.35; moderate-to-severe HL: OR, 3.59; 95% CI, 1.61-8.03). Compared with individuals with normal bilateral hearing, participants with bilateral HL also showed a higher risk of postural instability (OR, 2.88; 95% CI, 1.61-5.14). The OR for postural instability among participants with asymmetric hearing compared with those with symmetric hearing was 2.75 (95% CI, 1.37-5.52). Furthermore, each 10 dB increase in the speech-frequency hearing threshold was associated with a 44% higher risk of postural instability. CONCLUSIONS Hearing loss is associated with poorer postural control. Individuals with asymmetric hearing have a higher postural instability risk compared with those with symmetric hearing. Further studies are needed to confirm these findings and the causality. Moreover, future studies are warranted to assess whether hearing aids are beneficial for the restoration of impaired balance functions.
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Affiliation(s)
- Yang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Mei Zhong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yifan Li
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yehai Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Busheng Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Jianxin Qiu
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
- Department of Otorhinolaryngology-Head and Neck Surgery, Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, P.R. China
| | - Shanwen Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
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Otaka E, Osawa A, Kato K, Obayashi Y, Uehara S, Kamiya M, Mizuno K, Hashide S, Kondo I. Positive Emotional Responses to Socially Assistive Robots in People With Dementia: Pilot Study. JMIR Aging 2024; 7:e52443. [PMID: 38623717 PMCID: PMC11034362 DOI: 10.2196/52443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/17/2024] Open
Abstract
Background Interventions and care that can evoke positive emotions and reduce apathy or agitation are important for people with dementia. In recent years, socially assistive robots used for better dementia care have been found to be feasible. However, the immediate responses of people with dementia when they are given multiple sensory modalities from socially assistive robots have not yet been sufficiently elucidated. Objective This study aimed to quantitatively examine the immediate emotional responses of people with dementia to stimuli presented by socially assistive robots using facial expression analysis in order to determine whether they elicited positive emotions. Methods This pilot study adopted a single-arm interventional design. Socially assistive robots were presented to nursing home residents in a three-step procedure: (1) the robot was placed in front of participants (visual stimulus), (2) the robot was manipulated to produce sound (visual and auditory stimuli), and (3) participants held the robot in their hands (visual, auditory, and tactile stimuli). Expression intensity values for "happy," "sad," "angry," "surprised," "scared," and "disgusted" were calculated continuously using facial expression analysis with FaceReader. Additionally, self-reported feelings were assessed using a 5-point Likert scale. In addition to the comparison between the subjective and objective emotional assessments, expression intensity values were compared across the aforementioned 3 stimuli patterns within each session. Finally, the expression intensity value for "happy" was compared between the different types of robots. Results A total of 29 participants (mean age 88.7, SD 6.2 years; n=27 female; Japanese version of Mini-Mental State Examination mean score 18.2, SD 5.1) were recruited. The expression intensity value for "happy" was the largest in both the subjective and objective assessments and increased significantly when all sensory modalities (visual, auditory, and tactile) were presented (median expression intensity 0.21, IQR 0.09-0.35) compared to the other 2 patterns (visual alone: median expression intensity 0.10, IQR 0.03-0.22; P<.001; visual and auditory: median expression intensity 0.10, IQR 0.04-0.23; P<.001). The comparison of different types of robots revealed a significant increase when all stimuli were presented by doll-type and animal-type robots, but not humanoid-type robots. Conclusions By quantifying the emotional responses of people with dementia, this study highlighted that socially assistive robots may be more effective in eliciting positive emotions when multiple sensory stimuli, including tactile stimuli, are involved. More studies, including randomized controlled trials, are required to further explore the effectiveness of using socially assistive robots in dementia care.
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Affiliation(s)
- Eri Otaka
- Laboratory of Practical Technology in Community, Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan
| | - Aiko Osawa
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Laboratory of Cognitive Rehabilitation and Robotics, Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan
| | - Kenji Kato
- Laboratory of Clinical Evaluation with Robotics, Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan
| | - Yota Obayashi
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Shintaro Uehara
- Faculty of Rehabilitation, Fujita Health University School of Health Sciences, Toyoake, Aichi, Japan
| | - Masaki Kamiya
- Department of Rehabilitation Medicine, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Katsuhiro Mizuno
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Department of Rehabilitation Medicine, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Shusei Hashide
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Izumi Kondo
- Assistive Robot Center, National Center for Geriatrics and Gerontology Research Institute, Obu, Aichi, Japan
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Nyirjesy SC, Lewis JH, Hallak D, Conroy S, Moberly AC, Tamati TN. Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users. Otolaryngol Head Neck Surg 2024; 170:1147-1157. [PMID: 38104319 DOI: 10.1002/ohn.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/24/2023] [Accepted: 11/24/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy-to-implement task of LE that could be useful for clinical decision making. STUDY DESIGN Prospective cohort study. SETTING Tertiary neurotology center. METHODS The Sentence Final Word Identification and Recall Task, an established measure of LE, was modified to include challenging listening conditions (multitalker babble, gender, and emotional variation; test), in addition to single-talker sentences (control). Participants listened to lists of sentences in each condition and recalled the last word of each sentence. LE was quantified by percentage of words correctly recalled and was compared across conditions, across CI groups, and within subjects (best aided vs monaural). RESULTS A total of 24 adults between the ages of 37 and 82 years enrolled, including 4 unilateral CI users (CI), 10 bilateral CI users (CICI), and 10 bimodal CI users (CIHA). Task condition impacted LE (P < .001), but hearing configuration and listener group did not (P = .90). Working memory capacity and contralateral hearing contributed to individual performance. CONCLUSION This study adds to the growing body of literature on LE in challenging listening conditions for CI users and demonstrates feasibility of a simple behavioral task that could be implemented clinically to assess LE. This study also highlights the potential benefits of bimodal hearing and individual hearing and cognitive factors in understanding individual differences in performance, which will be evaluated through further research.
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Affiliation(s)
- Sarah C Nyirjesy
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Jessica H Lewis
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
- Department of Speech and Hearing Science, The Ohio State University, Columbus, Ohio, USA
| | - Diana Hallak
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Sara Conroy
- Department of Biomedical Informatics, Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
| | - Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Terrin N Tamati
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Soons LM, Deckers K, Tange H, van Boxtel MPJ, Köhler S. Cognitive change in prevalent and incident hearing loss: The Maastricht Aging Study. Alzheimers Dement 2024; 20:2102-2112. [PMID: 38236753 PMCID: PMC10984489 DOI: 10.1002/alz.13606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/31/2023] [Accepted: 11/13/2023] [Indexed: 03/16/2024]
Abstract
INTRODUCTION Hearing loss (HL) has been associated with cognitive decline and dementia. We examined the temporal association between prevalent and incident HL and cognitive change. METHODS A total of 1823 participants (24-82 years) from the Maastricht Aging Study (MAAS) were assessed at baseline, 6 and 12 years, including pure-tone audiometry. Linear-mixed models were used to test the association between HL and cognition, adjusted for demographics and other dementia risk factors. RESULTS Participants with prevalent and incident HL showed a faster decline in verbal memory, information processing speed, and executive function than participants without HL. Decline was steady from baseline to 6 and 12 years for prevalent HL, but time-delayed from 6 to 12 years for incident HL. Having a hearing aid did not change associations. DISCUSSION Findings support the notion that HL is a risk factor for cognitive decline independent of other dementia risk factors. Onset of HL preceded onset of cognitive decline. HIGHLIGHTS We examined cognitive change in prevalent and incident hearing loss. Prevalent and incident hearing loss were associated with faster cognitive decline. For prevalent hearing loss, decline was steady from baseline to 6 and 12 years. Onset of hearing loss preceded the onset of cognitive decline. Having a hearing aid did not change the observed associations.
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Affiliation(s)
- Lion M. Soons
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtThe Netherlands
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtThe Netherlands
| | - Huibert Tange
- Care and Public Health Research Institute (CAPHRI)Department of Family MedicineFaculty of HealthMedicine and Life SciencesMaastricht UniversityMaastrichtThe Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologySchool for Mental Health and Neuroscience (MHeNs)Maastricht UniversityMaastrichtThe Netherlands
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Huang AR, Lin FR. Hearing loss and dementia in older adults: A narrative review. J Chin Med Assoc 2024; 87:252-258. [PMID: 38112446 DOI: 10.1097/jcma.0000000000001042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
The prevalence of hearing loss is high among older adults; globally, 65% of adults over 60 years have hearing loss. Over the past decade, evidence from epidemiologic studies has linked hearing loss to nearly two times greater risk of dementia. The hypothesized mechanistic pathways through which hearing loss could contribute to increased dementia risk include the effects of hearing on greater cognitive load, changes in brain structure and function, and decreased social engagement. These mechanistic pathways may be modified by management of hearing loss using existing intervention (eg, hearing aids). Hearing treatment may be an effective intervention for slowing cognitive decline in some older adults. In this review, we update existing reviews of the current epidemiologic research on the association between hearing loss and dementia risk and discuss hypothesized mechanisms of this association. We also discuss management of hearing loss as a potential intervention for slowing cognitive decline and reducing dementia risk.
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Affiliation(s)
- Alison R Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public health, Baltimore, Maryland, USA
| | - Frank R Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Department of Epidemiology, Johns Hopkins Bloomberg School of Public health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Zaninotto P, Maharani A, Di Gessa G. Vision and Hearing Difficulties and Life Expectancy Without ADL/IADL Limitations: Evidence From the English Longitudinal Study of Ageing and the Health and Retirement Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad136. [PMID: 37234038 PMCID: PMC10799758 DOI: 10.1093/gerona/glad136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Hearing and vision difficulties are some of the most common deficits experienced by older adults. Having either visual or hearing difficulties increases the risk of comorbidity, disability, and poor quality of life. So far, however, few studies have examined the association between vision and hearing difficulties on life expectancy without activities of daily living (ADL) or instrumental ADL (IADL) limitations (LEWL). METHODS Data came from the English Longitudinal Study of Ageing and the Health and Retirement Study in the United States from 2002 to 2013. The outcome was defined as reporting 2+ limitations with ADL/IADL. Life expectancy was estimated by discrete-time multistate life table models for hearing and vision difficulties separately as well as for combined vision and hearing difficulties by sex and age. RESULTS Thirteen percent of men in England and the United States had ADL/IADL limitations, whereas, for women, it was 16% and 19% in England and the United States. At all ages, either vision or hearing difficulty was associated with shorter LEWL compared to no difficulties. Dual sensory difficulty (vision and hearing) reduced LEWL by up to 12 years in both countries. At the ages of 50 and 60 in England, hearing difficulty was associated with fewer years lived without ADL/IADL limitations than vision difficulty. In contrast, in the United States, vision difficulty led to fewer years lived without ADL/IADL limitations than hearing difficulty. CONCLUSIONS The implementation of strategies to reduce the prevalence and incidence of vision and hearing difficulties has the potential to increase the number of years spent without ADL/IADL limitations.
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Affiliation(s)
- Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Asri Maharani
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Giorgio Di Gessa
- Department of Epidemiology and Public Health, University College London, London, UK
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Hunter CR, Abrahamyan H. Sensitivity, reliability and convergent validity of sequential dual-task measures of listening effort. Int J Audiol 2024; 63:30-39. [PMID: 36427054 DOI: 10.1080/14992027.2022.2145513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/04/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the current study was to assess the sensitivity, reliability and convergent validity of objective measures of listening effort collected in a sequential dual-task. DESIGN On each trial, participants viewed a set of digits and listened to a spoken sentence presented at one of a range of signal-to-noise ratios (SNR) and then typed the sentence-final word and recalled the digits. Listening effort measures included word response time, digit recall accuracy and digit response time. In Experiment 1, SNR on each trial was randomised. In Experiment 2, SNR varied in a blocked design, and in each block self-reported listening effort was also collected. STUDY SAMPLES Separate groups of 40 young adults participated in each experiment. RESULTS Effects of SNR were observed for all measures. Linear effects of SNR were generally observed even with word recognition accuracy factored out of the models. Among the objective measures, reliability was excellent, and repeated-measures correlations, though not between-subjects correlations, were nearly all significant. CONCLUSION The objective measures assessed appear to be sensitive and reliable indices of listening effort that are non-redundant with speech intelligibility and have strong within-participants convergent validity. Results support use of these measures in future studies of listening effort.
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Affiliation(s)
- Cynthia R Hunter
- Speech Perception, Cognition, and Hearing Laboratory, Department of Speech-Language-Hearing: Sciences and Disorders, University of Kansas, Lawrence, KS, USA
| | - Hayk Abrahamyan
- Language Perception Laboratory, Department of Psychology, State University of New York at Buffalo, Buffalo, NY, USA
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Wu F, Zhou C. Hearing Impairment and Cognitive Function: Mediating Role of Social Isolation and Depression. Am J Alzheimers Dis Other Demen 2024; 39:15333175241227318. [PMID: 38198589 PMCID: PMC10785707 DOI: 10.1177/15333175241227318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
ObjectivesTo examine the relationship between hearing impairment and cognitive function and the mediating role of social isolation and depression. Methods: Data came from the 2018 China Health and Retirement Longitudinal Study wave. A self-reported item, a composite index, the 10-item Center for Epidemiological Studies Depression Scale, and the Mini-Mental State Exam were used to measure hearing impairment, social isolation, depression, and cognitive function, respectively. Mediation analysis was performed. Results: 6799 participants were included. For participants reporting mild hearing impairment and severe hearing impairment, there were significant direct and indirect effects on cognitive function. Social isolation mediated 2.75% and 6.33% of the relationship between mild hearing impairment, severe hearing impairment, and cognitive function, respectively. The direct effect of hearing impairment outweighed the mediation effect of social isolation on cognitive function. Conclusions: Decreased cognitive function linked to hearing impairment might benefit from addressing hearing impairment and social isolation in older adults.
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Affiliation(s)
- Fan Wu
- College of Medicine and Health Science, Wuhan Polytechnic University, Wuhan, China
| | - Chenxi Zhou
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wei G, Tian X, Yang H, Luo Y, Liu G, Sun S, Wang X, Wen H. Adjunct Methods for Alzheimer's Disease Detection: A Review of Auditory Evoked Potentials. J Alzheimers Dis 2024; 97:1503-1517. [PMID: 38277292 DOI: 10.3233/jad-230822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
The auditory afferent pathway as a clinical marker of Alzheimer's disease (AD) has sparked interest in investigating the relationship between age-related hearing loss (ARHL) and AD. Given the earlier onset of ARHL compared to cognitive impairment caused by AD, there is a growing emphasis on early diagnosis and intervention to postpone or prevent the progression from ARHL to AD. In this context, auditory evoked potentials (AEPs) have emerged as a widely used objective auditory electrophysiological technique for both the clinical diagnosis and animal experimentation in ARHL due to their non-invasive and repeatable nature. This review focuses on the application of AEPs in AD detection and the auditory nerve system corresponding to different latencies of AEPs. Our objective was to establish AEPs as a systematic and non-invasive adjunct method for enhancing the diagnostic accuracy of AD. The success of AEPs in the early detection and prediction of AD in research settings underscores the need for further clinical application and study.
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Affiliation(s)
- Guoliang Wei
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Xuelong Tian
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Hong Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Yinpei Luo
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Guisong Liu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Shuqing Sun
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Xing Wang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Huizhong Wen
- Department of Neurobiology, School of Basic Medicine, Chongqing Key Laboratory of Neurobiology, Army Medical University, Chongqing, China
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Reed NS, Gravens‐Mueller L, Huang AR, Goman AM, Mitchell CM, Arnold ML, Bolton S, Burgard S, Chisolm TH, Couper D, Deal JA, Evans J, Faucette S, Glynn NW, Gmelin T, Hayden KM, Miller E, Minotti M, Mosley T, Naylor S, Pankow JS, Pike JR, Sanchez VA, Schrack JA, Coresh J, Lin FR. Recruitment and baseline data of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study: A randomized trial of a hearing loss intervention for reducing cognitive decline. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12453. [PMID: 38356470 PMCID: PMC10865776 DOI: 10.1002/trc2.12453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/29/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Hearing loss is highly prevalent among older adults and independently associated with cognitive decline. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a multicenter randomized control trial (partially nested within the infrastructure of an observational cohort study, the Atherosclerosis Risk in Communities [ARIC] study) to determine the efficacy of best-practice hearing treatment to reduce cognitive decline over 3 years. The goal of this paper is to describe the recruitment process and baseline results. METHODS Multiple strategies were used to recruit community-dwelling 70-84-year-old participants with adult-onset hearing loss who were free of substantial cognitive impairment from the parent ARIC study and de novo from the surrounding communities into the trial. Participants completed telephone screening, an in-person hearing, vision, and cognitive screening, and a comprehensive hearing assessment to determine eligibility. RESULTS Over a 24-month period, 3004 telephone screenings resulted in 2344 in-person hearing, vision, and cognition screenings and 1294 comprehensive hearing screenings. Among 1102 eligible, 977 were randomized into the trial (median age = 76.4 years; 53.5% female; 87.8% White; 53.3% held a Bachelor's degree or higher). Participants recruited through the ARIC study were recruited much earlier and were less likely to report hearing loss interfered with their quality of life relative to participants recruited de novo from the community. Minor differences in baseline hearing or health characteristics were found by recruitment route (i.e., ARIC study or de novo) and by study site. DISCUSSION The ACHIEVE study successfully completed enrollment over 2 years that met originally projected rates of recruitment. Substantial operational and scientific efficiencies during study startup were achieved through embedding this trial within the infrastructure of a longstanding and well-established observational study. Highlights The ACHIEVE study tests the effect of hearing intervention on cognitive decline.The study is partially nested within an existing cohort study.Over 2 years, 977 participants recruited and enrolled.Eligibility assessed by telephone and in-person for hearing, vision, and cognitive screening.The ACHIEVE study findings will have significant public health implications.
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Affiliation(s)
- Nicholas S. Reed
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Lisa Gravens‐Mueller
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Alison R. Huang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Adele M. Goman
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- School of Health and Social CareEdinburgh Napier UniversityEdinburghUK
| | - Christine M. Mitchell
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Michelle L. Arnold
- College of Science and MathematicsUniversity of South Florida Sarasota ‐ ManateeSarasotaFloridaUSA
| | - Spencer Bolton
- George W. Comstock Center for Public Health Research and PreventionJohns Hopkins Bloomberg School of Public HealthHagerstownMarylandUSA
| | - Sheila Burgard
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Theresa H. Chisolm
- Department of Communication Sciences and DisordersUniversity of South FloridaTampaFloridaUSA
| | - David Couper
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Jennifer A. Deal
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Joshua Evans
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Sarah Faucette
- The MIND CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Nancy W. Glynn
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPennsylvaniaUSA
| | - Theresa Gmelin
- Department of EpidemiologyUniversity of Pittsburgh School of Public HealthPittsburghPennsylvaniaUSA
| | - Kathleen M. Hayden
- Department of Social Sciences and Health PolicyWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Elizabeth Miller
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Melissa Minotti
- George W. Comstock Center for Public Health Research and PreventionJohns Hopkins Bloomberg School of Public HealthHagerstownMarylandUSA
| | - Thomas Mosley
- The MIND CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Stacee Naylor
- The MIND CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - James S. Pankow
- Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - James Russell Pike
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Victoria A. Sanchez
- Department of Otolaryngology‐Head and Neck SurgeryUniversity of South FloridaTampaFloridaUSA
| | - Jennifer A. Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Josef Coresh
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Frank R. Lin
- Cochlear Center for Hearing and Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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12
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Myrstad C, Engdahl BL, Costafreda SG, Krokstad S, Lin F, Livingston G, Strand BH, Øhre B, Selbæk G. Hearing impairment and risk of dementia in The HUNT Study (HUNT4 70+): a Norwegian cohort study. EClinicalMedicine 2023; 66:102319. [PMID: 38192588 PMCID: PMC10772264 DOI: 10.1016/j.eclinm.2023.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 01/10/2024] Open
Abstract
Background Hearing impairment is strongly associated with future dementia. No studies have reported objectively measured hearing impairment in a cohort with a long period of follow-up (>20 years), and few have reported follow-up over 10 years. Hence, there is a need for high quality studies with sufficient follow-up time and data to account for reverse causality and confounding. We aimed to address this knowledge gap. Methods This cohort study used individual participant data from The Trøndelag Health Study (HUNT) in Norway. All current residents aged at least 20 years in the former Norwegian Nord-Trøndelag County were invited to participate in four decennial surveys: HUNT1 (1984-1986), HUNT2 (1995-1997), HUNT3 (2006-2008), and HUNT4 (2017-2019) with individuals aged at least 70 years included in a substudy, known as HUNT4 70+. Here, we report the findings of this substudy. HUNT4 70+ comprised 7135 participants who were assessed for dementia using the Diagnostic and Statistical Manual of Mental Disorders 5 criteria and who had audiometry between 1996 and 1998. The primary objective was to investigate, with gold standard audiometric testing and dementia diagnostic assessment, whether hearing impairment was an independent risk factor for all-cause dementia. The secondary objective was to investigate if a risk also applied to Alzheimer dementia and non-Alzheimer dementia. We analysed the association using Poisson regression and adjusted for confounders. This study is registered with ClinicalTrials.gov (NCT04284384). Findings At baseline, 1058 (15%) individuals had acquired hearing impairment with a hearing threshold of at least 25 decibel (dB) and, at follow-up, 1089 (15%) had dementia. In the total group, people with hearing impairment had a relative risk (RR) 1.04 (95% confidence interval (CI) 1.00-1.09) per 10 dB increase in hearing thresholds. For individuals younger than 85 years at follow-up the RR was 1.12 (95% CI 1.05-1.21). Associations between hearing impairment and Alzheimer dementia and non-Alzheimer dementia were similar. There was no association for individuals aged at least 85 years. Interpretation We found a moderate association between objectively measured hearing impairment and dementia in the younger age group (<85 years). The findings of no association in the older age group (≥85 years) might be due to the competing risk of death. The present study adds to the literature showing that acquired hearing impairment is a risk for dementias over a period which is too long for reverse causation, and with thorough consideration of confounders. Further research is needed to investigate associations between the different aetiologies of hearing loss and dementia subtypes, and risk differences for sexes. Funding The Norwegian National Centre for Ageing and Health with a grant from Health South-East.
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Affiliation(s)
- Christian Myrstad
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Medicine, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bo Lars Engdahl
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Sergi Gonzales Costafreda
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Steinar Krokstad
- Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Frank Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Bjørn Heine Strand
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Beate Øhre
- The Norwegian National Unit for Sensory Loss and Mental Health, Oslo University Hospital, Norway
| | - Geir Selbæk
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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13
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Colby SE, McMurray B. Efficiency of spoken word recognition slows across the adult lifespan. Cognition 2023; 240:105588. [PMID: 37586157 PMCID: PMC10530619 DOI: 10.1016/j.cognition.2023.105588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/26/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023]
Abstract
Spoken word recognition is a critical hub during language processing, linking hearing and perception to meaning and syntax. Words must be recognized quickly and efficiently as speech unfolds to be successfully integrated into conversation. This makes word recognition a computationally challenging process even for young, normal hearing adults. Older adults often experience declines in hearing and cognition, which could be linked by age-related declines in the cognitive processes specific to word recognition. However, it is unclear whether changes in word recognition across the lifespan can be accounted for by hearing or domain-general cognition. Participants (N = 107) responded to spoken words in a Visual World Paradigm task while their eyes were tracked to assess the real-time dynamics of word recognition. We examined several indices of word recognition from early adolescence through older adulthood (ages 11-78). The timing and proportion of eye fixations to target and competitor images reveals that spoken word recognition became more efficient through age 25 and began to slow in middle age, accompanied by declines in the ability to resolve competition (e.g., suppressing sandwich to recognize sandal). There was a unique effect of age even after accounting for differences in inhibitory control, processing speed, and hearing thresholds. This suggests a limited age range where listeners are peak performers.
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Affiliation(s)
- Sarah E Colby
- Department of Psychological and Brain Sciences, University of Iowa, Psychological and Brain Sciences Building, Iowa City, IA, 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
| | - Bob McMurray
- Department of Psychological and Brain Sciences, University of Iowa, Psychological and Brain Sciences Building, Iowa City, IA, 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA; Department of Communication Sciences and Disorders, University of Iowa, Wendell Johnson Speech and Hearing Center, Iowa City, IA, 52242, USA; Department of Linguistics, University of Iowa, Phillips Hall, Iowa City, IA 52242, USA
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14
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Shin J, Noh S, Park J, Sung JE. Syntactic complexity differentially affects auditory sentence comprehension performance for individuals with age-related hearing loss. Front Psychol 2023; 14:1264994. [PMID: 37965654 PMCID: PMC10641445 DOI: 10.3389/fpsyg.2023.1264994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Objectives This study examined whether older adults with hearing loss (HL) experience greater difficulties in auditory sentence comprehension compared to those with typical-hearing (TH) when the linguistic burdens of syntactic complexity were systematically manipulated by varying either the sentence type (active vs. passive) or sentence length (3- vs. 4-phrases). Methods A total of 22 individuals with HL and 24 controls participated in the study, completing sentence comprehension test (SCT), standardized memory assessments, and pure-tone audiometry tests. Generalized linear mixed effects models were employed to compare the effects of sentence type and length on SCT accuracy, while Pearson correlation coefficients were conducted to explore the relationships between SCT accuracy and other factors. Additionally, stepwise regression analyses were employed to identify memory-related predictors of sentence comprehension ability. Results Older adults with HL exhibited poorer performance on passive sentences than on active sentences compared to controls, while the sentence length was controlled. Greater difficulties on passive sentences were linked to working memory capacity, emerging as the most significant predictor for the comprehension of passive sentences among participants with HL. Conclusion Our findings contribute to the understanding of the linguistic-cognitive deficits linked to age-related hearing loss by demonstrating its detrimental impact on the processing of passive sentences. Cognitively healthy adults with hearing difficulties may face challenges in comprehending syntactically more complex sentences that require higher computational demands, particularly in working memory allocation.
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Affiliation(s)
| | | | | | - Jee Eun Sung
- Department of Communication Disorders, Ewha Womans University, Seoul, Republic of Korea
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15
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Burnett LK, Richmond LL. Just write it down: Similarity in the benefit from cognitive offloading in young and older adults. Mem Cognit 2023; 51:1580-1592. [PMID: 36995572 DOI: 10.3758/s13421-023-01413-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 03/31/2023]
Abstract
Past research conducted primarily in young adults has demonstrated the utility of cognitive offloading for benefitting performance of memory-based tasks, particularly at high memory loads. At the same time, older adults show declines in a variety of memory abilities, including subtle changes in short-term memory, suggesting that cognitive offloading could also benefit performance of memory-based tasks in this group. To this end, 94 participants (62 young adults, 32 older adults) were tested on a retrospective audiovisual short-term memory task in two blocked conditions. Offloading was permitted in the offloading choice condition but not in the internal memory condition. Performance was improved for both age groups in the offloading choice condition compared to the internal memory condition. Moreover, the choice to use the offloading strategy was similar across age groups at high memory loads, and use of the offloading strategy benefitted performance for young and older adults similarly. These data suggest that older adults can make effective use of cognitive offloading to rescue performance of memory-based activities, and invites future research on the benefits of cognitive offloading for older adults in other, more complex tasks where age-related memory impairment is expected to be more prominent.
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Affiliation(s)
- Lois K Burnett
- Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY, 11794, USA
| | - Lauren L Richmond
- Department of Psychology, Stony Brook University, Psychology B Building, Stony Brook, NY, 11794, USA.
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Ying G, Zhao G, Xu X, Su S, Xie X. Association of age-related hearing loss with cognitive impairment and dementia: an umbrella review. Front Aging Neurosci 2023; 15:1241224. [PMID: 37790283 PMCID: PMC10543744 DOI: 10.3389/fnagi.2023.1241224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Background Hearing loss, cognitive impairment and dementia have become common problems for older adults. Currently, systematic reviews and meta-analyses of the association between age-related hearing loss (ARHL) with cognitive impairment and dementia may have inconsistent results. To explore and validate the association between ARHL with cognitive impairment and dementia through summarizing and evaluating existing evidence. Methods From inception to February 01, 2023, PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched. AMSTAR 2 was used to evaluate methodological quality and GRADE system was used to evaluate evidence quality. We summarized the basic characteristics of the included studies and extracted effect data for ARHL with cognitive impairment and dementia. Forest plots were used to describe the relative risk associated with ARHL and cognitive impairment, and the relative risk associated with ARHL and dementia, respectively. Results A total of 11 systematic reviews and meta-analyses met the inclusion criteria. Overall, the methodological quality of the included SRs/MAs was moderate and the quality of the evidence was low. The combined results found that the pooled risk ratio of ARHL and cognitive impairment was 1.30 (random-effects; 95% CI 1.16 to 1.45), and the pooled risk ratio of ARHL and dementia was 1.59 (random-effects; 95% CI 1.34 to 1.90). Conclusion Based on the evidence reported in this umbrella review, age-related hearing loss is significantly associated with cognitive impairment and dementia. Hearing loss may be a high risk factor for cognitive impairment and dementia in older adults.
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Affiliation(s)
- Guo Ying
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guangran Zhao
- Department of Acupuncture and Moxibustion, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xianpeng Xu
- Department of Otolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Su Su
- Department of Acupuncture and Moxibustion, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, China
| | - Xin Xie
- Department of Rehabilitation, Heilongjiang Provincial Hospital, Harbin, China
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Hackett RA, Vo TT, Vansteelandt S, Davies-Kershaw H. The role of loneliness on hearing ability and dementia: A novel mediation approach. J Am Geriatr Soc 2023; 71:2834-2844. [PMID: 37224416 DOI: 10.1111/jgs.18396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/07/2023] [Accepted: 03/25/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND To determine the potential mediating role of loneliness in the relationship between hearing ability and dementia. METHODS Design: Longitudinal observational study. SETTING English Longitudinal Study of Ageing (ELSA). PARTICIPANTS Individuals aged 50 and older (N = 4232). MEASUREMENTS Self-reported hearing ability and loneliness were assessed from Wave 2 (2004-2005) to Wave 7 (2014-2015) of ELSA. Dementia cases were ascertained via self- or carer-report or dementia medication at these waves. The medeff command in Stata version 17 was used to do cross-section mediation analysis between hearing ability, loneliness, and dementia (Waves 3-7). Path-specific effects proportional (cause-specific) hazard models were then used to investigate longitudinal mediation (Waves 2-7). RESULTS In cross-sectional analyses in Wave 7 alone, loneliness only mediated 5.4% of the total effects of limited hearing on dementia (indirect effects = increased risk of 0.06%; 95% CI: 0.002%-0.15%) under limited hearing and 0.04% (95% CI: 0.001%-0.11%) under normal hearing). In longitudinal analyses, there was no statistical evidence of a mediating role for loneliness in explaining the relationship between hearing ability and time-to-dementia (indirect effect estimate hazard ratio = 1.01 (95% CI: 0.99-1.05). CONCLUSION In this community-dwelling sample of English adults, there is a lack of evidence that loneliness mediates the relationship between hearing ability and dementia in both cross-sectional and longitudinal analyses. However, as the number of dementia cases in this cohort was low, replication in other cohorts with larger sample sizes is required to confirm the absence of a mediated effect via loneliness.
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Affiliation(s)
- Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tat Thang Vo
- Department of Statistics and Data Science, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stijn Vansteelandt
- Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - Hilary Davies-Kershaw
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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McHaney JR, Hancock KE, Polley DB, Parthasarathy A. Sensory representations and pupil-indexed listening effort provide complementary contributions to multi-talker speech intelligibility. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.13.553131. [PMID: 37645975 PMCID: PMC10462058 DOI: 10.1101/2023.08.13.553131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Optimal speech perception in noise requires successful separation of the target speech stream from multiple competing background speech streams. The ability to segregate these competing speech streams depends on the fidelity of bottom-up neural representations of sensory information in the auditory system and top-down influences of effortful listening. Here, we use objective neurophysiological measures of bottom-up temporal processing using envelope-following responses (EFRs) to amplitude modulated tones and investigate their interactions with pupil-indexed listening effort, as it relates to performance on the Quick speech in noise (QuickSIN) test in young adult listeners with clinically normal hearing thresholds. We developed an approach using ear-canal electrodes and adjusting electrode montages for modulation rate ranges, which extended the rage of reliable EFR measurements as high as 1024Hz. Pupillary responses revealed changes in listening effort at the two most difficult signal-to-noise ratios (SNR), but behavioral deficits at the hardest SNR only. Neither pupil-indexed listening effort nor the slope of the EFR decay function independently related to QuickSIN performance. However, a linear model using the combination of EFRs and pupil metrics significantly explained variance in QuickSIN performance. These results suggest a synergistic interaction between bottom-up sensory coding and top-down measures of listening effort as it relates to speech perception in noise. These findings can inform the development of next-generation tests for hearing deficits in listeners with normal-hearing thresholds that incorporates a multi-dimensional approach to understanding speech intelligibility deficits.
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Affiliation(s)
- Jacie R. McHaney
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | - Kenneth E. Hancock
- Deparment of Otolaryngology – Head and Neck Surgery, Harvard Medical School, Boston, MA
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA
| | - Daniel B. Polley
- Deparment of Otolaryngology – Head and Neck Surgery, Harvard Medical School, Boston, MA
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston MA
| | - Aravindakshan Parthasarathy
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh PA
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Gao M, Feng T, Zhao F, Shen J, Zheng Y, Liang J, Yang H. Cognitive reserve disorder in age-related hearing loss: cognitive cortical compensatory to auditory perceptual processing. Cereb Cortex 2023; 33:9616-9626. [PMID: 37381582 DOI: 10.1093/cercor/bhad230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023] Open
Abstract
The aim of this study is to ascertain the mechanisms of cognitive reserve disorder in age-related hearing loss (ARHL), to study the correlation between ARHL and cognitive decline via EEG, and to reverse the adverse remodeling of auditory-cognitive connectivity with hearing aids (HAs). In this study, 32 participants were enrolled, including 12 with ARHLs, 9 with HAs, and 11 healthy controls (HCs), to undergo EEG, Pure Tone Average (PTA), Montreal Cognitive Assessment (MoCA), and other general cognitive tests. There were the lowest MoCA in the ARHL group (P = 0.001), especially in language and abstraction. In the ARHL group, power spectral density of the gamma in right middle temporal gyrus was significantly higher than HC and HA groups, while functional connectivity between superior frontal gyrus and cingulate gyrus was weaker than HC group (P = 0.036) and HA group (P = 0.021). In the HA group, superior temporal gyrus and cuneus had higher connectivity than in the HC group (P = 0.036). In the ARHL group, DeltaTM_DTA (P = 0.042) and CTB (P = 0.011) were more frequent than in the HC group, while there was less DeltaTM_CTA (P = 0.029). PTA was found to be associated with MoCA (r = -0.580) and language (r = -0.572), DeltaTM_CTB had a likewise correlation with MoCA (r = 0.483) and language (r = 0.493), while DeltaTM_DTA was related to abstraction (r = -0.458). Cognitive cortexes compensate for worse auditory perceptual processing in ARHL, which relates to cognitive decline. The impaired functional connectivity between auditory and cognitive cortexes can be remodeled by HAs. DeltaTM may serve as a biomarker for early cognitive decline and decreased auditory speech perception in ARHL.
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Affiliation(s)
- Minqian Gao
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Department of Hearing and Speech-Language Science, Guangzhou Xinhua College, 19 of Hua Mei Road, Guangzhou 510520, China
| | - Tianci Feng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, School of Sport and Health Sciences, Cardiff Metropolitan University, Llandaff Campus, 200 Western Avenue, Cardiff CF5 2YB, United Kingdom
| | - Jingxian Shen
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education, Institute for Brain Research and Rehabilitation, South China Normal University, 55 West of Zhongshan Avenue, Guangzhou 510631, China
- Department for Neuroradiology, School of Medicine, Technical University Munich, Ismaningerstr 22, Munich 81675, Germany
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Department of Hearing and Speech-Language Science, Guangzhou Xinhua College, 19 of Hua Mei Road, Guangzhou 510520, China
| | - Jiuxing Liang
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education, Institute for Brain Research and Rehabilitation, South China Normal University, 55 West of Zhongshan Avenue, Guangzhou 510631, China
- Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, Sun Yat-Sen University, 132 East of Waihuan Road, Guangzhou Higher Education Mega Center, Guangzhou 510006, China
| | - Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, 107 West of Yan Jiang Road, Guangzhou 510120, China
- Department of Hearing and Speech-Language Science, Guangzhou Xinhua College, 19 of Hua Mei Road, Guangzhou 510520, China
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Gu H, Kong W, Yin H, Diao C, Zheng Y, Meng Z. Association of age-related hearing loss with psychomotor speed and cognitive function among older adults: a cross-sectional cohort study. Chin Med J (Engl) 2023; 136:1888-1890. [PMID: 37341659 PMCID: PMC10406033 DOI: 10.1097/cm9.0000000000002224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Indexed: 06/22/2023] Open
Affiliation(s)
- Hailing Gu
- Department of Otolaryngology, Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Weili Kong
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Huilin Yin
- Department of Otolaryngology, Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Cong Diao
- Department of Otolaryngology, Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yun Zheng
- Department of Otolaryngology, Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhaoli Meng
- Department of Otolaryngology, Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
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Aschenbrenner AJ, Crawford JL, Peelle JE, Fagan AM, Benzinger TLS, Morris JC, Hassenstab J, Braver TS. Increased cognitive effort costs in healthy aging and preclinical Alzheimer's disease. Psychol Aging 2023; 38:428-442. [PMID: 37067479 PMCID: PMC10440282 DOI: 10.1037/pag0000742] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Life-long engagement in cognitively demanding activities may mitigate against declines in cognitive ability observed in healthy or pathological aging. However, the "mental costs" associated with completing cognitive tasks also increase with age and may be partly attributed to increases in preclinical levels of Alzheimer's disease (AD) pathology, specifically amyloid. We test whether cognitive effort costs increase in a domain-general manner among older adults, and further, whether such age-related increases in cognitive effort costs are associated with working memory (WM) capacity or amyloid burden, a signature pathology of AD. In two experiments, we administered a behavioral measure of cognitive effort costs (cognitive effort discounting) to a sample of older adults recruited from online sources (Experiment 1) or from ongoing longitudinal studies of aging and dementia (Experiment 2). Experiment 1 compared age-related differences in cognitive effort costs across two domains, WM and speech comprehension. Experiment 2 compared cognitive effort costs between a group of participants who were rated positive for amyloid relative to those with no evidence of amyloid. Results showed age-related increases in cognitive effort costs were evident in both domains. Cost estimates were highly correlated between the WM and speech comprehension tasks but did not correlate with WM capacity. In addition, older adults who were amyloid positive had higher cognitive effort costs than those who were amyloid negative. Cognitive effort costs may index a domain-general trait that consistently increases in aging. Differences in cognitive effort costs associated with amyloid burden suggest a potential neurobiological mechanism for age-related differences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Jennifer L Crawford
- Department of Psychological and Brain Sciences, Washington University in St. Louis
| | | | - Anne M Fagan
- Department of Neurology, Washington University in St. Louis
| | | | - John C Morris
- Department of Neurology, Washington University in St. Louis
| | | | - Todd S Braver
- Department of Psychological and Brain Sciences, Washington University in St. Louis
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22
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Bonmassar C, Pavani F, Spinella D, Frau GN, van Zoest W. Does age-related hearing loss deteriorate attentional resources? NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:601-619. [PMID: 35531868 DOI: 10.1080/13825585.2022.2067319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Recent work suggests that age-related hearing loss (HL) is a possible risk factor for cognitive decline in older adults. Resulting poor speech recognition negatively impacts cognitive, social and emotional functioning and may relate to dementia. However, little is known about the consequences of hearing loss on other non-linguistic domains of cognition. The aim of this study was to investigate the role of HL on covert orienting of attention, selective attention and executive control. We compared older adults with and without mild to moderate hearing loss (26-60 dB) performing (1) a spatial cueing task with uninformative central cues (social vs. nonsocial cues), (2) a flanker task and (3) a neuropsychological assessment of attention. The results showed that overall response times and flanker interference effects were comparable across groups. However, in spatial cueing of attention using social and nonsocial cues, hearing impaired individuals were characterized by reduced validity effects, though no additional group differences were found between social and nonsocial cues. Hearing impaired individuals also demonstrated diminished performance on the Montreal Cognitive Assessment (MoCA) and on tasks requiring divided attention and flexibility. This work indicates that while response speed and response inhibition appear to be preserved following mild-to-moderate acquired hearing loss, orienting of attention, divided attention and the ability to flexibly allocate attentional resources are more deteriorated in older adults with HL. This work suggests that hearing loss might exacerbate the detrimental influences of aging on visual attention.
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Affiliation(s)
- Claudia Bonmassar
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
| | - Francesco Pavani
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
- Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
- Centre de Recherche en Neurosciences Lyon (CRNL), Lyon, France
| | | | | | - Wieske van Zoest
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento, Italy
- School of Psychology, University of Birmingham, Birmingham, UK
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23
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Neagu MB, Kressner AA, Relaño-Iborra H, Bækgaard P, Dau T, Wendt D. Investigating the Reliability of Pupillometry as a Measure of
Individualized Listening Effort. Trends Hear 2023; 27:23312165231153288. [PMCID: PMC9947699 DOI: 10.1177/23312165231153288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
Recordings of the pupillary response have been used in numerous studies to assess
listening effort during a speech-in-noise task. Most studies focused on averaged
responses across listeners, whereas less is known about pupil dilation as an
indicator of the individuals’ listening effort. The present study investigated
the reliability of several pupil features as potential indicators of individual
listening effort and the impact of different normalization procedures on the
reliability. The pupil diameters of 31 normal-hearing listeners were recorded
during multiple visits while performing a speech-in-noise task. The
signal-to-noise ratios (SNRs) of the stimuli ranged from
−12 dB to
+4 dB. All listeners
were measured twice at separate visits, and 11 were re-tested at a third visit.
To examine the reliability of the pupil responses across visits, the intraclass
correlation coefficient was applied to the peak and mean pupil dilation and to
the temporal features of the pupil response, extracted using growth curve
analysis. The reliability of the pupillary response was assessed in relation to
SNR and different normalization procedures over multiple visits. The most
reliable pupil features were the traditional mean and peak pupil dilation. The
highest reliability results were obtained when the data were baseline-corrected
and normalized to the individual pupil response range across all visits.
Moreover, the present study results showed only a minor impact of the SNR and
the number of visits on the reliability of the pupil response. Overall, the
results may provide an important basis for developing a standardized test for
pupillometry in the clinic.
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Affiliation(s)
- Mihaela-Beatrice Neagu
- Department of Health Technology, DTU Hearing Systems, Denmark,Mihaela-Beatrice Neagu, Department of
Health Technology, DTU Hearing Systems, Denmark.
| | - Abigail A. Kressner
- Department of Health Technology, DTU Hearing Systems, Denmark,Copenhagen Hearing and Balance Centre, Rigshospitalet, Copenhagen
University Hospital, Denmark
| | - Helia Relaño-Iborra
- Department of Health Technology, DTU Hearing Systems, Denmark,Department of Applied Mathematics and Computer Science, DTU Cognitive systems, Denmark
| | - Per Bækgaard
- Department of Applied Mathematics and Computer Science, DTU Cognitive systems, Denmark
| | - Torsten Dau
- Department of Health Technology, DTU Hearing Systems, Denmark,Copenhagen Hearing and Balance Centre, Rigshospitalet, Copenhagen
University Hospital, Denmark
| | - Dorothea Wendt
- Department of Health Technology, DTU Hearing Systems, Denmark,Eriksholm Research Centre, Denmark
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24
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Li R, Miao X, Han B, Li J. Cortical thickness of the left parahippocampal cortex links central hearing and cognitive performance in aging. Ann N Y Acad Sci 2023; 1522:117-125. [PMID: 36799333 DOI: 10.1111/nyas.14971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Hearing impairment is considered a leading modifiable risk factor of cognitive decline and dementia. While most evidence has been established on clinical assessment of peripheral hearing loss, understanding of how central hearing in real-world conditions is associated with cognitive aging is limited. This study analyzed the data of 473 unrelated healthy adults aged 36-100 years old from the Lifespan Human Connectome Project in Aging. Central hearing was evaluated using the Words-in-Noise decibel threshold. Cognitive functions were evaluated by the performance on cognitive tests, and cortical thickness was estimated from magnetic resonance imaging (MRI) data. Here, we show that a higher hearing threshold was associated with a lower performance on immediate and delayed episodic memory retrieval, switching aspect of executive function, working memory, reading decoding, and vocabulary comprehension. Cortical thickness in the left parahippocampal cortex (lPHC) was negatively associated with the hearing threshold and acted as a significant partial mediator in the association of central hearing with immediate recall, switching, reading decoding, and vocabulary comprehension. These findings suggest that cortical thickness in the lPHC, an early target of dementia, partially links central hearing and performance in multiple cognitive domains in aging.
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Affiliation(s)
- Rui Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoyan Miao
- Department of Psychology and Special Education Research, National Institute of Education Sciences, Beijing, China
| | - Buxin Han
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Juan Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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25
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Teplitxky A, Gautier J, Lievre M, Duval G, Annweiler C, Boucher S. Association between age-related hearing loss and gait disorders in older fallers. Aging Clin Exp Res 2023; 35:785-791. [PMID: 36786968 DOI: 10.1007/s40520-023-02350-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/12/2023] [Indexed: 02/15/2023]
Abstract
INTRODUCTION Falls are associated with hearing loss, which might be explained by the onset of gait disorders. The objective of this study was to examine the association between Age-Related Hearing Loss (ARHL) and gait disorders assessed with GAITrite® walkway in a population of fallers aged 75 and over while accounting for the vestibular function. METHODS We examined data from 53 older patients (mean 84.2 ± 5.1 years; 64% women) included after a GAITrite® walkway assessment together with hearing and vestibular tests. People with high-frequency hearing loss, higher than 10% of the age and sex-matched population with the worst hearing, composed untimely ARHL group (n = 30), whereas all others had expected ARHL (n = 23). Presbyvestibulopathy was assessed accordingly to Barany Society criteria. RESULTS After adjustment for age, sex, body mass index, Mini-Mental State Examination score and presbyvestibulopathy, we found an increase in stride length mean in the untimely ARHL group (p = 0.046), but no between-group differences in stride length variability, cadence or velocity. Untimely ARHL was not associated with presbyvestibulopathy. CONCLUSIONS Untimely ARHL in older fallers was not associated with gait disorders in the studied population.
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Affiliation(s)
- Antoine Teplitxky
- Department of ENT and Head and Neck Surgery, CHU of Angers, 49933, Angers, Cedex 9, France
| | - Jennifer Gautier
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France
| | - Marion Lievre
- Department of General Medicine, University Hospital of Angers, 49933, Angers, Cedex 9, France
| | - Guillaume Duval
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.,UNIV ANGERS, UPRES EA 4638, University of Angers, Angers, France
| | - Cédric Annweiler
- Department of Geriatric Medicine and Memory Clinic, Research Center on Autonomy and Longevity, University Hospital, Angers, France.,UNIV ANGERS, UPRES EA 4638, University of Angers, Angers, France.,UNIV ANGERS, School of MedicineHealth Faculty, University of Angers, Angers, France.,Gérontopôle Autonomie Longévité des Pays de la Loire, Nantes, France.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, The University of Western Ontario, London, ON, Canada
| | - Sophie Boucher
- Department of ENT and Head and Neck Surgery, CHU of Angers, 49933, Angers, Cedex 9, France. .,Mitolab Team, UNIV Angers, Mitovasc Institute, CNRS UMR6015, INSERM U1083, Angers, France.
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26
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Yeo BSY, Song HJJMD, Toh EMS, Ng LS, Ho CSH, Ho R, Merchant RA, Tan BKJ, Loh WS. Association of Hearing Aids and Cochlear Implants With Cognitive Decline and Dementia: A Systematic Review and Meta-analysis. JAMA Neurol 2023; 80:134-141. [PMID: 36469314 PMCID: PMC9856596 DOI: 10.1001/jamaneurol.2022.4427] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/23/2022] [Indexed: 12/12/2022]
Abstract
Importance Hearing loss is associated with cognitive decline. However, it is unclear if hearing restorative devices may have a beneficial effect on cognition. Objective To evaluate the associations of hearing aids and cochlear implants with cognitive decline and dementia. Data Sources PubMed, Embase, and Cochrane databases for studies published from inception to July 23, 2021. Study Selection Randomized clinical trials or observational studies published as full-length articles in peer-reviewed journals relating to the effect of hearing interventions on cognitive function, cognitive decline, cognitive impairment, and dementia in patients with hearing loss. Data Extraction and Synthesis The review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) reporting guidelines. Two authors independently searched the PubMed, Embase, and Cochrane databases for studies relating to the effect of hearing interventions on cognitive decline and dementia in patients with hearing loss. Main Outcomes and Measures Maximally adjusted hazard ratios (HRs) were used for dichotomous outcomes and ratio of means for continuous outcomes. Sources of heterogeneity were investigated using sensitivity and subgroup analyses, and publication bias was assessed using visual inspection, the Egger test, and trim and fill. Results A total of 3243 studies were screened; 31 studies (25 observational studies, 6 trials) with 137 484 participants were included, of which 19 (15 observational studies, 4 trials) were included in quantitative analyses. Meta-analysis of 8 studies, which had 126 903 participants, had a follow-up duration ranging from 2 to 25 years, and studied long-term associations between hearing aid use and cognitive decline, showed significantly lower hazards of any cognitive decline among hearing aid users compared with participants with uncorrected hearing loss (HR, 0.81; 95% CI, 0.76-0.87; I2 = 0%). Additionally, meta-analysis of 11 studies with 568 participants studying the association between hearing restoration and short-term cognitive test score changes revealed a 3% improvement in short-term cognitive test scores after the use of hearing aids (ratio of means, 1.03; 95% CI, 1.02-1.04, I2 = 0%). Conclusions and Relevance In this meta-analysis, the usage of hearing restorative devices by participants with hearing loss was associated with a 19% decrease in hazards of long-term cognitive decline. Furthermore, usage of these devices was significantly associated with a 3% improvement in cognitive test scores that assessed general cognition in the short term. A cognitive benefit of hearing restorative devices should be further investigated in randomized trials.
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Affiliation(s)
- Brian Sheng Yep Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Emma Min Shuen Toh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li Shia Ng
- Department of Otorhinolaryngology–Head and Neck Surgery, National University Hospital, Singapore
| | - Cyrus Su Hui Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore
| | - Reshma Aziz Merchant
- Geriatric Medicine, Department of Medicine, National University Hospital, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | | | - Woei Shyang Loh
- Department of Otorhinolaryngology–Head and Neck Surgery, National University Hospital, Singapore
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27
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Bsharat-Maalouf D, Degani T, Karawani H. The Involvement of Listening Effort in Explaining Bilingual Listening Under Adverse Listening Conditions. Trends Hear 2023; 27:23312165231205107. [PMID: 37941413 PMCID: PMC10637154 DOI: 10.1177/23312165231205107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 11/10/2023] Open
Abstract
The current review examines listening effort to uncover how it is implicated in bilingual performance under adverse listening conditions. Various measures of listening effort, including physiological, behavioral, and subjective measures, have been employed to examine listening effort in bilingual children and adults. Adverse listening conditions, stemming from environmental factors, as well as factors related to the speaker or listener, have been examined. The existing literature, although relatively limited to date, points to increased listening effort among bilinguals in their nondominant second language (L2) compared to their dominant first language (L1) and relative to monolinguals. Interestingly, increased effort is often observed even when speech intelligibility remains unaffected. These findings emphasize the importance of considering listening effort alongside speech intelligibility. Building upon the insights gained from the current review, we propose that various factors may modulate the observed effects. These include the particular measure selected to examine listening effort, the characteristics of the adverse condition, as well as factors related to the particular linguistic background of the bilingual speaker. Critically, further research is needed to better understand the impact of these factors on listening effort. The review outlines avenues for future research that would promote a comprehensive understanding of listening effort in bilingual individuals.
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Affiliation(s)
- Dana Bsharat-Maalouf
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Tamar Degani
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Hanin Karawani
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
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28
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O’Leary RM, Neukam J, Hansen TA, Kinney AJ, Capach N, Svirsky MA, Wingfield A. Strategic Pauses Relieve Listeners from the Effort of Listening to Fast Speech: Data Limited and Resource Limited Processes in Narrative Recall by Adult Users of Cochlear Implants. Trends Hear 2023; 27:23312165231203514. [PMID: 37941344 PMCID: PMC10637151 DOI: 10.1177/23312165231203514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 08/11/2023] [Accepted: 09/08/2023] [Indexed: 11/10/2023] Open
Abstract
Speech that has been artificially accelerated through time compression produces a notable deficit in recall of the speech content. This is especially so for adults with cochlear implants (CI). At the perceptual level, this deficit may be due to the sharply degraded CI signal, combined with the reduced richness of compressed speech. At the cognitive level, the rapidity of time-compressed speech can deprive the listener of the ordinarily available processing time present when speech is delivered at a normal speech rate. Two experiments are reported. Experiment 1 was conducted with 27 normal-hearing young adults as a proof-of-concept demonstration that restoring lost processing time by inserting silent pauses at linguistically salient points within a time-compressed narrative ("time-restoration") returns recall accuracy to a level approximating that for a normal speech rate. Noise vocoder conditions with 10 and 6 channels reduced the effectiveness of time-restoration. Pupil dilation indicated that additional effort was expended by participants while attempting to process the time-compressed narratives, with the effortful demand on resources reduced with time restoration. In Experiment 2, 15 adult CI users tested with the same (unvocoded) materials showed a similar pattern of behavioral and pupillary responses, but with the notable exception that meaningful recovery of recall accuracy with time-restoration was limited to a subgroup of CI users identified by better working memory spans, and better word and sentence recognition scores. Results are discussed in terms of sensory-cognitive interactions in data-limited and resource-limited processes among adult users of cochlear implants.
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Affiliation(s)
- Ryan M. O’Leary
- Department of Psychology, Brandeis University, Waltham, Massachusetts, USA
| | - Jonathan Neukam
- Department of Otolaryngology, NYU Langone Medical Center, New York, New York, USA
| | - Thomas A. Hansen
- Department of Psychology, Brandeis University, Waltham, Massachusetts, USA
| | | | - Nicole Capach
- Department of Otolaryngology, NYU Langone Medical Center, New York, New York, USA
| | - Mario A. Svirsky
- Department of Otolaryngology, NYU Langone Medical Center, New York, New York, USA
| | - Arthur Wingfield
- Department of Psychology, Brandeis University, Waltham, Massachusetts, USA
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29
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Schmid C, Wimmer W, Kompis M. BPACE: A Bayesian, Patient-Centered Procedure for Matrix Speech Tests in Noise. Trends Hear 2023; 27:23312165231191382. [PMID: 37501653 PMCID: PMC10388612 DOI: 10.1177/23312165231191382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Matrix sentence tests in noise can be challenging to the listener and time-consuming. A trade-off should be found between testing time, listener's comfort and the precision of the results. Here, a novel test procedure based on an updated maximum likelihood method was developed and implemented in a German matrix sentence test. It determines the parameters of the psychometric function (threshold, slope, and lapse-rate) without constantly challenging the listener at the intelligibility threshold. A so-called "credible interval" was used as a mid-run estimate of reliability and can be used as a termination criterion for the test. The procedure was evaluated and compared to a STAIRCASE procedure in a study with 20 cochlear implant patients and 20 normal hearing participants. The proposed procedure offers comparable accuracy and reliability to the reference method, but with a lower listening effort, as rated by the listeners (- 1.8 points on a 10-point scale). Test duration can be reduced by 1.3 min on average when a credible interval of 2 dB is used as the termination criterion instead of testing 30 sentences. Particularly, normal hearing listeners and well performing, cochlear implant users can benefit from shorter test duration. Although the novel procedure was developed for a German test, it can easily be applied to tests in any other language.
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Affiliation(s)
- Christoph Schmid
- Department of Otorhinolaryngology, Head and Neck Surgery, Bern University Hospital, Inselspital, Bern, Switzerland
| | - Wilhelm Wimmer
- Department of Otorhinolaryngology, Head and Neck Surgery, Bern University Hospital, Inselspital, Bern, Switzerland
- Department of Otorhinolaryngology, TUM School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Martin Kompis
- Department of Otorhinolaryngology, Head and Neck Surgery, Bern University Hospital, Inselspital, Bern, Switzerland
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30
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Evaluation of the Benefits of Bilateral Fitting in Bone-Anchored Hearing System Users: Spatial Resolution and Memory for Speech. Ear Hear 2022; 44:530-543. [PMID: 36378104 PMCID: PMC10097484 DOI: 10.1097/aud.0000000000001297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the benefits of bilateral implantation for bone-anchored hearing system (BAHS) users in terms of spatial resolution abilities and auditory memory for speech. DESIGN This is a prospective, single-center, comparative, single-blinded study where the listeners served as their own control. Twenty-four experienced bone-anchored users with a bilateral conductive or mixed hearing loss participated in the study. After fitting the listeners unilaterally and bilaterally with BAHS sound processor(s) (Ponto 3 SuperPower), spatial resolution was estimated by measuring the minimum audible angle (MAA) to achieve an 80% correct response via a two-alternative-forced choice task (right-left discrimination of noise bursts) in two conditions: both sound processors active (bilateral condition) and only one sound processor active (unilateral condition). In addition, a memory recall test, the Sentence-final Word Identification and Recall (SWIR) test was performed with five lists of seven sentences for each of the two conditions (unilateral and bilateral). Self-reported performance in everyday life with the listener's own sound processors was also evaluated via a questionnaire (the abbreviated version of the Speech, Spatial and Qualities of Hearing scale). RESULTS The MAA to discriminate noise bursts improved significantly from 75.04° in the unilateral condition to 3.61° in the bilateral condition ( p < 0.0001). The average improvement in performance was 54.28°. The SWIR test results showed that the listeners could recall, on average, 55.03% of the last words in a list of seven sentences in the unilateral condition and 57.23% in the bilateral condition. While the main effect of condition was not significant, there was a significant interaction between condition and repetition (list), revealing a significantly higher recall performance in the bilateral condition than in the unilateral condition for the second repetition/list out of five (10.2% difference; p = 0.022). Self-reported performance with bilateral BAHS obtained via the Speech, Spatial and Qualities of Hearing scale questionnaire was, on average, 4.4 for speech, 3.7 for spatial, and 5.1 for qualities of hearing. There was no correlation between self-reported performance in everyday life and bilateral performance in the MAA test, while significant correlations were obtained between self-reported performance and recall performance in the SWIR test. CONCLUSIONS These results showed a large benefit in spatial resolution for users with symmetric BC thresholds when being fitted with two BAHS, although their self-reported performance with bilateral BAHS in everyday life was rather low. In addition, there was no overall benefit of bilateral fitting on memory for speech, despite observing a benefit in one out of five repetitions of the SWIR test. Performance in the SWIR test was correlated with the users' self-reported performance in everyday life, such that users with higher recall ability reported to achieve better performance in real life. These findings highlight the advantages of bilateral fitting on spatial resolution, although bilaterally fitted BAHS users continue to experience some difficulties in their daily lives, especially when locating sounds, judging distance and movement. More research is needed to support a higher penetration of bilateral BAHS treatment for bilateral conductive and mixed hearing losses.
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31
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Yang Z, Ni J, Teng Y, Su M, Wei M, Li T, Fan D, Lu T, Xie H, Zhang W, Shi J, Tian J. Effect of hearing aids on cognitive functions in middle-aged and older adults with hearing loss: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14:1017882. [PMID: 36452439 PMCID: PMC9704725 DOI: 10.3389/fnagi.2022.1017882] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE The study aimed to examine the effects of hearing aids on cognitive function in middle-aged and older adults with hearing loss. DATA SOURCES AND STUDY SELECTION PubMed, Cochrane Library, and Embase were searched for studies published before 30 March 2022. Randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) were included in the search. Restriction was set on neither types, severity, or the time of onset of hearing impairment nor cognitive or psychiatric statuses. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data and assessed the study quality of RCTs. Cognitive function outcomes were descriptively summarized and converted to standardized mean difference (SMD) in the meta-analysis. Meta-analysis was conducted in RCTs. Sub-group analyses were conducted by cognitive statuses, psychiatric disorders, and cognitive domains. RESULTS A total of 15 studies met the inclusion criteria, including five RCTs (n = 339) and 10 NRSIs (n = 507). Groups were classified as subjects without dementia or with normal global cognition, subjects with AD or dementia, and subjects with depressive symptoms. For subjects without dementia, improvements were found in global cognition, executive function, and episodic memory. For subjects with depressive symptoms, improvements were found in immediate memory, global cognition, and executive function. No improvement was found in subjects with AD or dementia. In total, four RCTs were included in the meta-analysis. For subjects without dementia (SMD = 0.11, 95% confidence interval [CI]: -0.15-0.37) and those with AD, no significant effect was found (SMD = -0.19, 95% CI: -0.65-0.28). For subjects without dementia, no significant effect was found in language (SMD = 0.14, 95% CI: -0.30-0.59) or general executive function (SMD = -0.04, 95% CI: -0.46-0.38). Further sub-group analysis found no significant effect in executive function (SMD = -0.27, 95% CI: -0.72-0.18) or processing speed (SMD = -0.02, 95% CI: -0.49-0.44). CONCLUSION Hearing aids might improve cognitive performance in domains such as executive function in subjects without dementia. The effects on subjects with depressive symptoms remained unclear. No improvement was found in subjects with AD or dementia. Long-term RCTs and well-matched comparison-group studies with large sample sizes are warranted. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022349057.
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Affiliation(s)
- Zhizhong Yang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingnian Ni
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuou Teng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mingwan Su
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mingqing Wei
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Ting Li
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Tao Lu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Hengge Xie
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Shi
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jinzhou Tian
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
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Liu C, Nagarajan N, Assi L, Jiang K, Powell DS, Pedersen E, Rosman L, Villavisanis D, Carlson MC, Swenor BK, Deal JA. Assessment of hearing and vision impairment in cohort studies collecting cognitive data in older adults. Alzheimers Dement 2022; 18:2243-2251. [PMID: 35102691 PMCID: PMC9339590 DOI: 10.1002/alz.12575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/29/2021] [Accepted: 12/10/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION There are no standard practices for considering sensory impairment in studies measuring cognitive function among older adults. Exclusion of participants with impairments may inaccurately estimate the prevalence of cognitive impairment and dementia. METHODS We surveyed prospective cohort studies measuring cognitive function in older adults, determined the proportion that excluded participants based on sensory impairment and the proportion that assessed each type of sensory impairment, and described the methods of sensory assessment. RESULTS Investigators/staff from 85 (of 192 cohorts) responded; 6 (7%) excluded participants with severe impairment; 80 (94%) measured hearing and/or vision impairment, while 5 (6%) measured neither. Thirty-two (38%) cohorts assessed hearing objectively and 45 (53%) assessed vision objectively. DISCUSSION Findings indicate variation in methods used to assess sensory impairment, with potential implications for resource allocation. To ensure equitable inclusion of study participants, consensus is needed on best practices standardized protocols for assessment and accommodations of sensory impairment.
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Affiliation(s)
- Chelsea Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Niranjani Nagarajan
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lama Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kening Jiang
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Danielle S. Powell
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Emily Pedersen
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lori Rosman
- Welch Medical Library, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Dillan Villavisanis
- Icahn School of Medicine at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle C. Carlson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bonnielin K. Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer A. Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland, USA
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Objective and Subjective Hearing Difficulties Are Associated With Lower Inhibitory Control. Ear Hear 2022; 43:1904-1916. [PMID: 35544449 DOI: 10.1097/aud.0000000000001227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Evidence suggests that hearing loss increases the risk of cognitive impairment. However, the relationship between hearing loss and cognition can vary considerably across studies, which may be partially explained by demographic and health factors that are not systematically accounted for in statistical models. DESIGN Middle-aged to older adult participants (N = 149) completed a web-based assessment that included speech-in-noise (SiN) and self-report measures of hearing, as well as auditory and visual cognitive interference (Stroop) tasks. Correlations between hearing and cognitive interference measures were performed with and without controlling for age, sex, education, depression, anxiety, and self-rated health. RESULTS The risk of having objective SiN difficulties differed between males and females. All demographic and health variables, except education, influenced the likelihood of reporting hearing difficulties. Small but significant relationships between objective and reported hearing difficulties and the measures of cognitive interference were observed when analyses were controlled for demographic and health factors. Furthermore, when stratifying analyses for males and females, different relationships between hearing and cognitive interference measures were found. Self-reported difficulty with spatial hearing and objective SiN performance were better predictors of inhibitory control in females, whereas self-reported difficulty with speech was a better predictor of inhibitory control in males. This suggests that inhibitory control is associated with different listening abilities in males and females. CONCLUSIONS The results highlight the importance of controlling for participant characteristics when assessing the relationship between hearing and cognitive interference, which may also be the case for other cognitive functions, but this requires further investigations. Furthermore, this study is the first to show that the relationship between hearing and cognitive interference can be captured using web-based tasks that are simple to implement and administer at home without any assistance, paving the way for future online screening tests assessing the effects of hearing loss on cognition.
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Krueger M, Schulte M, Brand T. Assessing and Modeling Spatial Release From Listening Effort in Listeners With Normal Hearing: Reference Ranges and Effects of Noise Direction and Age. Trends Hear 2022; 26:23312165221129407. [PMID: 36285532 PMCID: PMC9618758 DOI: 10.1177/23312165221129407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Listening to speech in noisy environments is challenging and effortful. Factors like the signal-to-noise ratio (SNR), the spatial separation between target speech and noise interferer(s), and possibly also the listener's age might influence perceived listening effort (LE). This study measured and modeled the effect of the spatial separation of target speech and interfering stationary speech-shaped noise on the perceived LE and its relation to the age of the listeners. Reference ranges for the relationship between subjectively perceived LE and SNR for different noise azimuths were established. For this purpose, 70 listeners with normal hearing and from three age groups rated the perceived LE using the Adaptive Categorical Listening Effort Scaling method (ACALES, Krueger et al., 2017a) with speech from the front and noise from 0°, 90°, 135°, or 180° azimuth. Based on these data, the spatial release from listening effort (SRLE) was calculated. The noise azimuth had a strong effect on SRLE, with the highest release for 135°. The binaural speech intelligibility model (BSIM2020, Hauth et al., 2020) predicted SRLE very well at negative SNRs, but overestimated for positive SNRs. No significant effect of age was found on the respective subjective ratings. Therefore, the reference ranges were determined independently of age. These reference ranges can be used for the classification of LE measurements. However, when the increase of the perceived LE with SNR was analyzed, a significant age difference was found between the listeners of the youngest and oldest group when considering the upper range of the LE function.
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Affiliation(s)
- Melanie Krueger
- Hörzentrum Oldenburg gGmbH, Oldenburg, Germany,Melanie Krueger, Hörzentrum Oldenburg gGmbH, Marie-Curie-Straße 2, D-26129 Oldenburg, Germany.
| | | | - Thomas Brand
- Medizinische Physik, Department für Medizinische Physik und Akustik, Fakultät VI, Carl-von-Ossietzky Universität Oldenburg, Oldenburg, Germany
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Kostic E, Kwak K, Kim D. Changes in sensory, postural stability and gait functions depending on cognitive decline, and possible markers for detection of cognitive status. BMC Med Inform Decis Mak 2022; 22:252. [PMID: 36138459 PMCID: PMC9502571 DOI: 10.1186/s12911-022-01955-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022] Open
Abstract
Background Numerous people never receive a formal dementia diagnosis. This issue can be addressed by early detection systems that utilize alternative forms of classification, such as gait, balance, and sensory function parameters. In the present study, said functions were compared between older adults with healthy cognition, older adults with low executive function, and older adults with cognitive impairment, to determine which parameters can be used to distinguish these groups. Results A group of cognitively healthy older men was found to have a significantly greater gait cadence than both the low executive function group (113.1 ± 6.8 vs. 108.0 ± 6.3 steps/min, p = 0.032) and the cognitively impaired group (113.1 ± 6.8 vs. 107.1 ± 7.4 steps/min, p = 0.009). The group with low executive function was found to have more gait stability than the impaired cognition group, represented by the single limb support phase (39.7 ± 1.2 vs. 38.6 ± 1.3%, p = 0.027). Additionally, the healthy cognition group had significantly greater overall postural stability than the impaired cognition group (0.6 ± 0.1 vs. 1.1 ± 0.1, p = 0.003), and the low executive function group had significantly greater mediolateral postural stability than the impaired cognition group (0.2 ± 0.1 vs. 0.6 ± 0.6, p = 0.012). The low executive function group had fewer mistakes on the sentence recognition test than the cognitively impaired (2.2 ± 3.6 vs. 5.9 ± 6.4, p = 0.005). There were no significant differences in visual capacity, however, the low executive function group displayed an overall greatest ability. Conclusions Older adults with low executive function showcased a lower walking pace, but their postural stability and sensory functions did not differ from those of the older adults with healthy cognition. The variables concluded as good cognitive status markers were (1) gait cadence for dividing cognitively healthy from the rest and (2) single limb support portion, mediolateral stability index, and the number of mistakes on the sentence recognition test for discerning between the low executive function and cognitive impairment groups.
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Affiliation(s)
- Emilija Kostic
- Department of Healthcare Engineering, The Graduate School, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Kiyoung Kwak
- Division of Biomedical Engineering, College of Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Dongwook Kim
- Division of Biomedical Engineering, College of Engineering, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea. .,Research Center for Healthcare & Welfare Instrument for the Elderly, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, Republic of Korea.
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Carter BL, Apoux F, Healy EW. The Influence of Noise Type and Semantic Predictability on Word Recall in Older Listeners and Listeners With Hearing Impairment. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3548-3565. [PMID: 35973100 PMCID: PMC9913215 DOI: 10.1044/2022_jslhr-22-00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/01/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE A dual-task paradigm was implemented to investigate how noise type and sentence context may interact with age and hearing loss to impact word recall during speech recognition. METHOD Three noise types with varying degrees of temporal/spectrotemporal modulation were used: speech-shaped noise, speech-modulated noise, and three-talker babble. Participant groups included younger listeners with normal hearing (NH), older listeners with near-normal hearing, and older listeners with sensorineural hearing loss. An adaptive measure was used to establish the signal-to-noise ratio approximating 70% sentence recognition for each participant in each noise type. A word-recall task was then implemented while matching speech-recognition performance across noise types and participant groups. Random-intercept linear mixed-effects models were used to determine the effects of and interactions between noise type, sentence context, and participant group on word recall. RESULTS The results suggest that noise type does not significantly impact word recall when word-recognition performance is controlled. When data from noise types were pooled and compared with quiet, and recall was assessed: older listeners with near-normal hearing performed well when either quiet backgrounds or high sentence context (or both) were present, but older listeners with hearing loss performed well only when both quiet backgrounds and high sentence context were present. Younger listeners with NH were robust to the detrimental effects of noise and low context. CONCLUSIONS The general presence of noise has the potential to decrease word recall, but type of noise does not appear to significantly impact this observation when overall task difficulty is controlled. The presence of noise as well as deficits related to age and/or hearing loss appear to limit the availability of cognitive processing resources available for working memory during conversation in difficult listening environments. The conversation environments that impact these resources appear to differ depending on age and/or hearing status.
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Affiliation(s)
- Brittney L. Carter
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Frédéric Apoux
- Department of Otolaryngology—Head & Neck Surgery, The Ohio State University, Columbus
| | - Eric W. Healy
- Department of Speech and Hearing Science, The Ohio State University, Columbus
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Tarawneh HY, Jayakody DM, Sohrabi HR, Martins RN, Mulders WH. Understanding the Relationship Between Age-Related Hearing Loss and Alzheimer’s Disease: A Narrative Review. J Alzheimers Dis Rep 2022; 6:539-556. [PMID: 36275417 PMCID: PMC9535607 DOI: 10.3233/adr-220035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/16/2022] [Indexed: 12/02/2022] Open
Abstract
Evidence suggests that hearing loss (HL), even at mild levels, increases the long-term risk of cognitive decline and incident dementia. Hearing loss is one of the modifiable risk factors for dementia, with approximately 4 million of the 50 million cases of dementia worldwide possibly attributed to untreated HL. This paper describes four possible mechanisms that have been suggested for the relationship between age-related hearing loss (ARHL) and Alzheimer’s disease (AD), which is the most common form of dementia. The first mechanism suggests mitochondrial dysfunction and altered signal pathways due to aging as a possible link between ARHL and AD. The second mechanism proposes that sensory degradation in hearing impaired people could explain the relationship between ARHL and AD. The occupation of cognitive resource (third) mechanism indicates that the association between ARHL and AD is a result of increased cognitive processing that is required to compensate for the degraded sensory input. The fourth mechanism is an expansion of the third mechanism, i.e., the function and structure interaction involves both cognitive resource occupation (neural activity) and AD pathology as the link between ARHL and AD. Exploring the specific mechanisms that provide the link between ARHL and AD has the potential to lead to innovative ideas for the diagnosis, prevention, and/or treatment of AD. This paper also provides insight into the current evidence for the use of hearing treatments as a possible treatment/prevention for AD, and if auditory assessments could provide an avenue for early detection of cognitive impairment associated with AD.
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Affiliation(s)
- Hadeel Y. Tarawneh
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
- Ear Science Institute Australia, Subiaco, WA, Australia
| | - Dona M.P. Jayakody
- Ear Science Institute Australia, Subiaco, WA, Australia
- Centre of Ear Science, Medical School, The University of Western Australia, Crawley, WA, Australia
| | - Hamid R. Sohrabi
- Centre for Healthy Ageing, College of Science, Health, Engineering and Education, Murdoch University, WA, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia
| | - Ralph N. Martins
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia
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Brewster KK, Deal JA, Lin FR, Rutherford BR. Considering hearing loss as a modifiable risk factor for dementia. Expert Rev Neurother 2022; 22:805-813. [PMID: 36150235 PMCID: PMC9647784 DOI: 10.1080/14737175.2022.2128769] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/22/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Accumulating evidence links hearing loss to impaired cognitive performance and increased risk for dementia. Hearing loss can lead to deafferentation-induced atrophy of frontotemporal brain regions and dysregulation of cognitive control networks from increased listening effort. Hearing loss is also associated with reduced social engagement, loneliness, and depression, which are independently associated with poor cognitive function. AREAS COVERED We summarize the evidence and postulated mechanisms linking hearing loss to dementia in older adults and synthesize the available literature demonstrating beneficial effects of hearing remediation on brain structure and function. EXPERT OPINION : Further research is needed to evaluate whether treatment of hearing loss may reduce risk of cognitive decline and improve neural consequences of hearing loss. Studies may investigate the pathologic mechanisms linking these late-life disorders and identify individuals vulnerable to dementia, and future clinical trials may evaluate whether hearing treatment may reduce the risk for dementia.
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Affiliation(s)
- Katharine K Brewster
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York State Psychiatric Institute, New York
| | - Jennifer A Deal
- Department of Otolaryngology, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University, Center on Aging and Health, Johns Hopkins University School of Medicine
| | - Frank R Lin
- Department of Otolaryngology, Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Johns Hopkins University School of Medicine
| | - Bret R Rutherford
- Columbia University Vagelos College of Physicians and Surgeons, Department of Psychiatry, New York State Psychiatric Institute, New York, USA
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Hearing Loss and Cognitive Function: Baseline Findings From the Brazilian Longitudinal Study of Adult Health: ELSA-Brasil. Ear Hear 2022; 43:1416-1425. [DOI: 10.1097/aud.0000000000001205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rönnberg J, Signoret C, Andin J, Holmer E. The cognitive hearing science perspective on perceiving, understanding, and remembering language: The ELU model. Front Psychol 2022; 13:967260. [PMID: 36118435 PMCID: PMC9477118 DOI: 10.3389/fpsyg.2022.967260] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The review gives an introductory description of the successive development of data patterns based on comparisons between hearing-impaired and normal hearing participants’ speech understanding skills, later prompting the formulation of the Ease of Language Understanding (ELU) model. The model builds on the interaction between an input buffer (RAMBPHO, Rapid Automatic Multimodal Binding of PHOnology) and three memory systems: working memory (WM), semantic long-term memory (SLTM), and episodic long-term memory (ELTM). RAMBPHO input may either match or mismatch multimodal SLTM representations. Given a match, lexical access is accomplished rapidly and implicitly within approximately 100–400 ms. Given a mismatch, the prediction is that WM is engaged explicitly to repair the meaning of the input – in interaction with SLTM and ELTM – taking seconds rather than milliseconds. The multimodal and multilevel nature of representations held in WM and LTM are at the center of the review, being integral parts of the prediction and postdiction components of language understanding. Finally, some hypotheses based on a selective use-disuse of memory systems mechanism are described in relation to mild cognitive impairment and dementia. Alternative speech perception and WM models are evaluated, and recent developments and generalisations, ELU model tests, and boundaries are discussed.
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Hwang PH, Nelson LD, Sharon JD, McCrea MA, Dikmen SS, Markowitz AJ, Manley GT, Temkin NR. Association Between TBI-Related Hearing Impairment and Cognition: A TRACK-TBI Study. J Head Trauma Rehabil 2022; 37:E327-E335. [PMID: 34698685 PMCID: PMC9035476 DOI: 10.1097/htr.0000000000000735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the association between hearing impairment and cognitive function after traumatic brain injury (TBI). SETTING A total of 18 level I trauma centers throughout the United States in the T ransforming R esearch a nd C linical K nowledge in TBI (TRACK-TBI) study. PARTICIPANTS From February 2014 to June 2018, a total of 2697 participants with TBI were enrolled in TRACK-TBI. Key eligibility criteria included external force trauma to the head, presentation to a participating level I trauma center, and receipt of a clinically indicated head computed tomographic (CT) scan within 24 hours of injury. A total of 1267 participants were evaluated in the study, with 216 participants with hearing impairment and 1051 participants without hearing impairment. Those with missing or unknown hearing status or cognitive assessment were excluded from analysis. DESIGN Prospective, observational cohort study. MAIN MEASURES Hearing impairment at 2 weeks post-TBI was based on self-report. Participants who indicated worse hearing in one or both ears were defined as having hearing impairment, whereas those who denied worse hearing in either ear were defined as not having hearing impairment and served as the reference group. Cognitive outcomes at 6 months post-TBI included executive functioning and processing speed, as measured by the Trail Making Test (TMT) B/A and the Wechsler Adult Intelligence Scale, Fourth Edition, Processing Speed Index subscale (WAIS-IV PSI), respectively. RESULTS TBI-related hearing impairment had a small but significantly greater TMT B/A ratio than without TBI-related hearing impairment: mean difference ( B ) = 0.25; 95% CI, 0.07 to 0.43; P = .005. No significant mean differences on WAIS-IV PSI scores were found between participants with and without TBI-related hearing impairment: B = 0.36; 95% CI, -2.07 to 2.60; P = .825. CONCLUSION We conclude that TBI-related hearing impairment at 6 months postinjury was significantly associated with worse executive functioning but not cognitive processing speed.
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Affiliation(s)
- Phillip H Hwang
- Department of Anatomy & Neurobiology, Boston University, Boston, Massachusetts (Dr Hwang); Departments of Neurosurgery and Neurology, Medical College of Wisconsin, Milwaukee (Drs Nelson and McCrea); Departments of Otolaryngology (Dr Sharon) and Neurological Surgery (Dr Manley), University of California San Francisco; Departments of Rehabilitation Medicine (Dr Dikmen), Neurological Surgery (Dr Temkin), and Biostatistics (Dr Temkin), University of Washington, Seattle; and Brain and Spinal Cord Injury Center, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California (Ms Markowitz)
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Zhao Y, Duan Y, Feng H, Nan J, Li X, Zhang H, Xiao LD. Trajectories of physical functioning and its predictors in older adults: A 12-year longitudinal study in China. Front Public Health 2022; 10:923767. [PMID: 36111197 PMCID: PMC9469466 DOI: 10.3389/fpubh.2022.923767] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Objective Maintaining and delaying a decline in physical function in older adults is critical for healthy aging. This study aimed to explore trajectories, critical points of the trajectory changes, and predictors among older people in the Chinese community. Design This study was one with a longitudinal design performed in China. Setting and participants The target population was community-dwelling older adults aged over 65 years. A total of 2,503 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included in this study. Methods Physical functioning was measured by instrumental activities of daily living (IADL). Population-based trajectory models were used to identify potential heterogeneity in longitudinal changes over 12 years and to investigate associations between baseline predictors and different trajectories for different cohort members using LASSO regression and logistic regression. Results Four trajectories of physical function were identified: slow decline (33.0%), poor function and moderate decline (8.1%), rapid decline (23.5%), and stable function (35.4%). Older age, male sex, worse self-reported health status, worse vision status, more chronic diseases, worse cognitive function, and a decreased frequency of leisure activity influenced changes in the trajectory of physical function. Having fewer teeth, stronger depressive symptoms, a lack of exercise, and reduced hearing may increase the rate of decline. Conclusion and implications Four trajectories of physical function were identified in the Chinese elderly population. Early prevention or intervention of the determinants of these trajectories can maintain or delay the rate of decline in physical function and improve healthy aging.
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Affiliation(s)
- Yinan Zhao
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yunzhu Duan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hui Feng
- Xiangya School of Nursing, Central South University, Changsha, China,Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China,*Correspondence: Hui Feng
| | - Jiahui Nan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoyang Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Hongyu Zhang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Lily Dongxia Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia,Lily Dongxia Xiao
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Vasudevamurthy S, Kumar U A. Effect of Occupational Noise Exposure on Cognition and Suprathreshold Auditory Skills in Normal-Hearing Individuals. Am J Audiol 2022; 31:1098-1115. [PMID: 35998292 DOI: 10.1044/2022_aja-22-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Adverse effects of noise exposure on hearing and cognition are well documented in the literature. Recently, it has becoming increasingly evident that noise exposure deteriorates suprathreshold auditory skills, even though the hearing sensitivity is intact. This condition is termed as cochlear synaptopathy or hidden hearing loss, which is apparent in animal models. However, equivocal findings are reported in humans. This study aimed at assessing the working memory, attention abilities, and suprathreshold hearing abilities in normal-hearing individuals with and without occupational noise exposure. We also explored the relationship between cognitive measures and suprathreshold auditory measures. DESIGN The study participants were divided into two groups. All the participants had normal-hearing thresholds. The control group consisted of 25 individuals with no occupational noise exposure, whereas the noise exposure group had 25 individuals exposed to occupational noise of 85 dBA for a minimum period of 1 year. Working memory was assessed using auditory digit span (forward and backward), operation span, and reading span. The Erikson flanker test was used to evaluate attention abilities. The suprathreshold hearing was assessed in terms of gap detection thresholds and sentence identification in noise. RESULTS The results showed that the noise exposure group performed poorly compared to the control group on all auditory and cognitive tasks except the reading span. CONCLUSION The results of the study suggest that occupational noise exposure may hamper the cognitive skills and suprathreshold hearing abilities of the individual despite having normal peripheral hearing.
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Affiliation(s)
| | - Ajith Kumar U
- Department of Audiology, All India Institute of Speech and Hearing, Mysuru
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Lucas JC, Arambula Z, Arambula AM, Yu K, Farrokhian N, D'Silva L, Staecker H, Villwock JA. Olfactory, Auditory, and Vestibular Performance: Multisensory Impairment Is Significantly Associated With Incident Cognitive Impairment. Front Neurol 2022; 13:910062. [PMID: 35899262 PMCID: PMC9309388 DOI: 10.3389/fneur.2022.910062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDysfunction in the olfactory, auditory, and vestibular systems are commonly seen in aging and are associated with dementia. The impact of sensory loss(es) on cognition is not well understood. Our aim was to assess the relationships between performance on objective multisensory testing and quantify the impact of dysfunction on cognition.MethodsPatients presenting with subjective hearing loss presenting to a tertiary care otologic/audiologic clinic were identified and underwent multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA), pure tone audiometric evaluations, and the Timed “Up and Go” test. Cognitive impairment (CI) was assessed via the Montreal Cognitive Assessment (MoCA) was also administered.Key Results180 patients were enrolled. Thirty one percentage (n = 57) screened positive for cognitive impairment. When evaluating single sensory impairments, we found that olfactory dysfunction, gait impairment, and sensorineural hearing loss were all statistically significantly (p < 0.05) associated with a higher risk of cognitive impairment (ORs 3.89, 3.49, and 2.78, respectively) for CI. Multisensory impairment was significantly associated with cognitive impairment. Subjects with dysfunction in all domains were at the highest risk for cognitive impairment (OR 15.7, p < 0.001) vs. those with impairment in 2 domains (OR 5.32, p < 0.001).ConclusionDysfunction of the olfactory, auditory, and vestibular systems is associated with a significantly increased risk of CI. The dramatically increased risk of CI with multisensory dysfunction in all three systems indicated that MSD may synergistically contribute to CI.
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Affiliation(s)
- Jacob C. Lucas
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
- *Correspondence: Jacob C. Lucas
| | - Zack Arambula
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
| | - Alexandra M. Arambula
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
| | - Katherine Yu
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
| | - Nathan Farrokhian
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
| | - Linda D'Silva
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, MO, United States
| | - Hinrich Staecker
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
| | - Jennifer A. Villwock
- Department of Otolaryngology- Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, MO, United States
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Dementia in a Hearing-impaired Population According to Hearing Aid Use: A Nationwide Population-based Study in Korea. Ear Hear 2022; 43:1661-1668. [PMID: 35671072 PMCID: PMC9592173 DOI: 10.1097/aud.0000000000001249] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hearing loss is considered a potentially modifiable risk factor for dementia. However, the effect of use of a hearing aid on the development of dementia has not been clearly established. We aimed to assess the incidence of dementia in hearing-impaired individuals according to hearing aid use in a nationwide population-based cohort study with matched controls. METHODS This was a retrospective, longitudinal, cohort study of South Korean national claims data for individuals newly registered with hearing disabilities (better ear ≥40 dBHL with worse ear ≥80 dBHL, or better ear ≥60 dBHL) between 2004 and 2008. The hearing aid cohort comprised individuals who received hearing aid subsidies from the National Health Insurance within a year from disability registration. The comparison cohort comprised individuals without a record of a hearing aid claim during the study period after 1:1 matching for audiologic and sociodemographic factors with the hearing aid cohort. The occurrence of dementia was followed up until 2018. RESULTS Each cohort comprised 8780 individuals. Overall incidence of dementia in the hearing aid and comparison cohorts were 156.0 and 184.5 per 10,000 person-years, respectively (incidence rate ratio = 0.85, 95% confidence interval 0.79-0.91). In a multivariable analysis of the whole study populations, hearing aid use (hazard ratio = 0.75, 95% confidence interval 0.70-0.81) attenuated the risk of dementia. CONCLUSIONS Dementia incidence in individuals with hearing disabilities was lower in hearing aid users than that in nonusers. Hearing rehabilitation with hearing aids should be encouraged for individuals with hearing loss.
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Audiovisual Integration for Saccade and Vergence Eye Movements Increases with Presbycusis and Loss of Selective Attention on the Stroop Test. Brain Sci 2022; 12:brainsci12050591. [PMID: 35624979 PMCID: PMC9139407 DOI: 10.3390/brainsci12050591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/23/2022] [Accepted: 04/28/2022] [Indexed: 11/17/2022] Open
Abstract
Multisensory integration is a capacity allowing us to merge information from different sensory modalities in order to improve the salience of the signal. Audiovisual integration is one of the most used kinds of multisensory integration, as vision and hearing are two senses used very frequently in humans. However, the literature regarding age-related hearing loss (presbycusis) on audiovisual integration abilities is almost nonexistent, despite the growing prevalence of presbycusis in the population. In that context, the study aims to assess the relationship between presbycusis and audiovisual integration using tests of saccade and vergence eye movements to visual vs. audiovisual targets, with a pure tone as an auditory signal. Tests were run with the REMOBI and AIDEAL technologies coupled with the pupil core eye tracker. Hearing abilities, eye movement characteristics (latency, peak velocity, average velocity, amplitude) for saccade and vergence eye movements, and the Stroop Victoria test were measured in 69 elderly and 30 young participants. The results indicated (i) a dual pattern of aging effect on audiovisual integration for convergence (a decrease in the aged group relative to the young one, but an increase with age within the elderly group) and (ii) an improvement of audiovisual integration for saccades for people with presbycusis associated with lower scores of selective attention in the Stroop test, regardless of age. These results bring new insight on an unknown topic, that of audio visuomotor integration in normal aging and in presbycusis. They highlight the potential interest of using eye movement targets in the 3D space and pure tone sound to objectively evaluate audio visuomotor integration capacities.
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Combined effects of handgrip strength and sensory impairment on the prevalence of cognitive impairment among older adults in Korea. Sci Rep 2022; 12:6713. [PMID: 35468923 PMCID: PMC9039062 DOI: 10.1038/s41598-022-10635-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Older adults commonly experience concurrent lower handgrip strength and sensory impairment. However, previous studies have analyzed the individual effects of either handgrip strength or sensory impairment on cognitive impairment. To address this gap, this study investigated the combined effects of handgrip strength and sensory impairment on cognitive impairment among older adults. In total, 2930 participants aged 65 and older were analyzed using 2014–2018 data from the Korean Longitudinal Study of Aging. Participants underwent assessments of handgrip strength (grip dynamometer), sensory impairment (self-reported responses), and cognitive impairment (Korean version of the Mini-Mental State Examination). Low handgrip strength, compared to normal handgrip strength, was associated with cognitive impairment. In participants with low handgrip strength, vision and hearing impairment were associated with cognitive impairment (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.06–1.75; OR 2.58, 95% CI 1.77–3.78, respectively) compared to those with normal handgrip strength. Participants with low handgrip strength and dual sensory impairment had the highest OR for cognitive impairment (OR 3.73, 95% CI 2.65–5.25). Due to the strong association of low handgrip strength and dual sensory impairment with cognitive impairment, people living with low handgrip strength and dual sensory impairment should be classified as a high-risk group for cognitive impairment and should be prioritized for interventions.
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Powell DS, Oh ES, Reed NS, Lin FR, Deal JA. Hearing Loss and Cognition: What We Know and Where We Need to Go. Front Aging Neurosci 2022; 13:769405. [PMID: 35295208 PMCID: PMC8920093 DOI: 10.3389/fnagi.2021.769405] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/29/2021] [Indexed: 12/29/2022] Open
Abstract
Although a causal association remains to be determined, epidemiologic evidence suggests an association between hearing loss and increased risk of dementia. If we determine the association is causal, opportunity for targeted intervention for hearing loss may play a fundamental role in dementia prevention. In this discussion, we summarize current research on the association between hearing loss and dementia and review potential casual mechanisms behind the association (e.g., sensory-deprivation hypothesis, information-degradation hypothesis, common cause). We emphasize key areas of research which might best inform our investigation of this potential casual association. These selected research priorities include examination of the causal mechanism, measurement of co-existing hearing loss and cognitive impairment and determination of any bias in testing, potential for managing hearing loss for prevention of dementia and cognitive decline, or the potential to reduce dementia-related symptoms through the management of hearing loss. Addressing these research gaps and how results are then translated for clinical use may prove paramount for dementia prevention, management, and overall health of older adults.
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Affiliation(s)
- Danielle S Powell
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Esther S Oh
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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Feldman A, Patou F, Baumann M, Stockmarr A, Waldemar G, Maier AM, Vogel A. Listen Carefully protocol: an exploratory case-control study of the association between listening effort and cognitive function. BMJ Open 2022; 12:e051109. [PMID: 35264340 PMCID: PMC8915370 DOI: 10.1136/bmjopen-2021-051109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI). METHODS AND ANALYSIS 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials. ETHICS AND DISSEMINATION Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.
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Affiliation(s)
- Alix Feldman
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - François Patou
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Research and Technology Group, Oticon Medical, Smørum, Denmark
| | - Monika Baumann
- Centre for Applied Audiology Research, Oticon, Smørum, Denmark
| | - Anders Stockmarr
- Statistics and Data Analysis, Department of Mathematics, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja M Maier
- Engineering Systems Design, Department of Technology Management and Economics, Technical University of Denmark, Kongens Lyngby, Denmark
- Department of Design, Manufacturing and Engineering Management, Faculty of Engineering, University of Strathclyde, Glasgow, UK
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Chern A, Irace AL, Sharma RK, Zhang Y, Chen Q, Golub JS. The Longitudinal Association of Subclinical Hearing Loss With Cognition in the Health, Aging and Body Composition Study. Front Aging Neurosci 2022; 13:789515. [PMID: 35300148 PMCID: PMC8923153 DOI: 10.3389/fnagi.2021.789515] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/28/2021] [Indexed: 01/08/2023] Open
Abstract
Objectives To examine the longitudinal association between subclinical hearing loss (SCHL) and neurocognitive performance. Design Longitudinal analyses were conducted among 2,110 subjects who underwent audiometric testing in a US multi-centered epidemiologic cohort study. The primary exposure was better ear hearing (pure tone average). SCHL was defined as hearing ≤ 25 dB. The primary outcome was neurocognitive performance, measured by Digit Symbol Substitution Test (DSST), Modified Mini Mental State Examination (3MS), and CLOX1. Linear mixed models were performed to assess the longitudinal association between hearing and cognitive performance, adjusting for covariates. Models were fit among all individuals and among individuals with SCHL only. Results Among 2,110 participants, mean (SD) age was 73.5 (2.9) years; 52.3% were women. Mean (SD) better ear pure tone average was 30.0 (13.1) dB. Mean follow-up was 9.1 years (range 3–16). Among all participants, worse hearing was associated with significantly steeper cognitive decline measured by the DSST [0.054-point/year steeper decrease per 10 dB worse hearing, 95% confidence interval (CI): 0.026–0.082] and 3MS (0.044-point/year steeper decrease per 10 dB worse hearing, CI: 0.026–0.062), but not CLOX1. Among those with SCHL, worse hearing was associated with significantly steeper cognitive performance decline as measured by DSST (0.121-point/year steeper decrease per 10 dB worse hearing, CI: 0.013–0.228), but not CLOX1 or 3MS. Conclusion Among those with SCHL, worse hearing was associated with steeper cognitive performance declines over time as measured by DSST. The relationship between hearing loss and cognition may begin at earlier levels of hearing loss than previously recognized.
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Affiliation(s)
- Alexander Chern
- Department of Otolaryngology—Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Department of Otolaryngology—Head and Neck Surgery, Weill Cornell Medical College and NewYork-Presbyterian Hospital, New York, NY, United States
| | - Alexandria L. Irace
- Department of Otolaryngology—Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Rahul K. Sharma
- Department of Otolaryngology—Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Yuan Zhang
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Justin S. Golub
- Department of Otolaryngology—Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- *Correspondence: Justin S. Golub,
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