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Kim Y, Yang CJ, Yoo MH, Song CI, Chung JW. Changes of Temporal Processing and Hearing in Noise after Use of a Monoaural Hearing Aid in Patients with Sensorineural Hearing Loss: A Preliminary Study. J Audiol Otol 2021; 25:146-151. [PMID: 34289535 PMCID: PMC8311061 DOI: 10.7874/jao.2021.00038] [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: 01/28/2021] [Accepted: 06/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives The relationship between hearing aid (HA) use and improvement in cognitive function is not fully known. This study aimed to determine whether HAs could recover temporal resolution or hearing in noise functions. Materials and Methods We designed a prospective study with two groups: HA users and controls. Patients older than 45 years, with a pure tone average threshold of worse than 40 dB and a speech discrimination score better than 60% in both ears were eligible. Central auditory processing tests and hearing in noise tests (HINTs) were evaluated at the beginning of the study and 1, 3, 6, and 12 months after the use of a monaural HA in the HA group compared to the control group. The changes in the evaluation parameters were statistically analyzed using the linear mixed model. Results A total of 26 participants (13 in the HA and 13 in the control group) were included in this study. The frequency (p<0.01) and duration test (p=0.02) scores showed significant improvements in the HA group after 1 year, while the HINT scores showed no significant change. Conclusions After using an HA for one year, patients performed better on temporal resolution tests. No improvement was documented with regard to hearing in noise.
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Affiliation(s)
- Yehree Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chan Joo Yang
- Department of Otolaryngology, Hanil General Hospital, Seoul, Korea
| | - Myung Hoon Yoo
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Kyungpook National University, Daegu, Korea
| | - Chan Il Song
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Woo Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Association of self-reported hearing loss severity and healthcare utilization outcomes among Medicare beneficiaries. Am J Otolaryngol 2021; 42:102943. [PMID: 33550025 DOI: 10.1016/j.amjoto.2021.102943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/25/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Understanding health utilization trends in the elderly population is pivotal for Medicare and policymakers. This study evaluates the association between hearing status and health utilization outcomes in a representative sample of elderly Medicare beneficiaries. MATERIALS AND METHODS We employed the 2017 Medicare Current Beneficiary Survey (MCBS), which includes self-reported hearing loss data and weighted health utilization information. Analyses were limited to Medicare beneficiaries aged 65 and older without hearing aids. Multivariable logistic regression was performed to assess association between self-reported hearing loss and health utilization outcomes. RESULTS Of 7160 respondents, 55.1%, 39.9% and 4.9% reported no trouble hearing, little trouble hearing, and a lot of trouble hearing, respectively. On multivariable logistic regression, both a little and a lot of trouble hearing were associated with trouble accessing care (little trouble hearing: odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.33-2.40, p < 0.001; lot of trouble hearing: OR = 2.89, 95% CI: 1.81-4.60, p < 0.001) and emergency room (ER) visits (little trouble hearing: OR = 1.24, 95% CI: 1.08-1.42, p = 0.002; lot of trouble hearing: OR = 1.44, 95% CI: 1.10-1.89, p = 0.01). A lot of trouble hearing was associated with avoiding doctor visits (OR = 1.63 95% CI: 1.21-2.21, p = 0.002). Self-reported hearing status was not associated with inpatient or skilled nursing facility (SNF) admission on adjusted analyses. CONCLUSIONS Increasing reported hearing loss severity is associated with decreased access to and avoidance of routine medical visits, and increased utilization of ER visits. These findings have important implications for Medicare, clinicians and policymakers. Further studies should evaluate if hearing aids can mitigate these outcomes.
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Assi L, Reed NS, Nieman CL, Willink A. Factors Associated With Hearing Aid Use Among Medicare Beneficiaries. Innov Aging 2021; 5:igab021. [PMID: 34316520 PMCID: PMC8306709 DOI: 10.1093/geroni/igab021] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 12/05/2022] Open
Abstract
Background and Objectives In the United States, up to two-thirds of older adults have hearing loss. Untreated hearing loss can have significant health outcomes, yet less than 20% of adults with hearing loss use hearing aids. In this study, we examined potential factors associated with hearing aid use, including detailed measures of health status, access to care, patient engagement, and technology use, in a nationally representative sample of Medicare beneficiaries. Research Design and Methods Cross-sectional study using the 2017 Medicare Current Beneficiary Survey. Participants with self-reported hearing loss were included. The primary outcome was hearing aid use. Factors potentially associated with hearing aid use included: sociodemographics, health determinants, access to care, patient activation, and technology access/use. Results Overall, 5,146 participants were included. Of them, 27% reported using hearing aids. In a multivariable logistic regression model, predisposing factors associated with greater odds of hearing aid use included older age, identifying as a man, identifying as White, having completed college, having 3 or more chronic conditions, having dementia, not having trouble seeing, not having limitations in activities of daily living, having moderate relative to low information-seeking scores, and having a personal computer at home (range of odds ratios [ORs]: 1.22–4.46). Enabling factors associated with greater odds of hearing aid use included higher income, living alone relative to living with family members other than a spouse, and having a usual source of care (range of ORs: 1.43–1.54). Discussion and Implications In addition to addressing previously identified factors associated with hearing aid use, improving access to health care, technology, and information about hearing aids may improve the uptake of hearing aids. These findings help further inform our understanding on how to address low treatment levels of hearing loss in the community by identifying new populations to target and potentially modifiable risk factors for hearing aid use.
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Affiliation(s)
- Lama Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Amber Willink
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia
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Hsu AK, Bassett SM, O'Dwyer LC, McHugh M, Heinemann AW, Jordan N, Dhar S. Cost-Effectiveness of Hearing Screening in Older Adults: A Scoping Review. Res Aging 2021; 44:186-204. [PMID: 33973495 DOI: 10.1177/01640275211008583] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Age is the most common predictor of hearing loss; however, many older adults are not screened. Hearing screening could improve healthcare access, participation, and outcomes. Establishing whether hearing screening in older adults is cost-effective could improve the availability and utilization of screening. METHODS We searched nine databases in January 2020. Studies with populations aged 50+ and provided data on the cost-effectiveness of hearing screening were included in the review. RESULTS Five studies met the inclusion criteria and all found hearing screening programs to be cost-effective compared to no hearing screening, regardless of screening method (i.e., instrument or strategy). The maximum number of repeated screenings, coupled with younger ages, was most cost-effective. DISCUSSION This review suggests that hearing screening in older adults is cost-effective, however, the evidence is limited. There is pressing need for research focused on economic impacts of hearing healthcare in older adults to inform research, policy and practice.
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Neuropsychological profile of hearing-impaired patients and the effect of hearing aid on cognitive functions: an exploratory study. Sci Rep 2021; 11:9384. [PMID: 33931670 PMCID: PMC8087665 DOI: 10.1038/s41598-021-88487-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/13/2021] [Indexed: 01/17/2023] Open
Abstract
Few studies have investigated the neuropsychological profile of Hearing Loss (HL) subjects and the effects of hearing-aid on cognitive decline. We investigated the neuropsychological profile of HL patients at baseline and compared the neuropsychological profiles of patients with and without hearing-aid at 6 month. Fifty-six HL patients and 40 healthy subjects (HC) underwent neuropsychological and behavioral examination and were compared at baseline. Changes at follow-up were compared between HL patients with (N = 25) and without (N = 31) hearing-aids. At baseline, significant differences between HL and HC were found in MOCA test, Raven's Coloured Progressive Matrices (CPM) and SF-36. Among mild-HL patients, patients with hearing-aid significantly improved on the Clock Drawing Test (CDT) as compared to patients without hearing-aid. Our findings indicate that hearing loss is associated with both a reduced efficiency of the global cognitive state and a worse quality of life as compared to HC, supporting the association between HL and cognitive impairment. Moreover, only patients with mild-HL shows some cognitive improvement after using hearing-aid, suggesting that rehabilitative strategies may be more effective to delay cognitive decline in such patients. However, we cannot exclude that hearing-aids may affect cognitive decline in more severe-HL, but a longer follow-up is needed.
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Uchida Y, Mise K, Suzuki D, Fukunaga Y, Hakuba N, Oishi N, Ogawa T, Takahashi M, Takumi Y, Fujimoto S, Maeda Y, Nishizaki K, Noda T, Komune N, Matsumoto N, Nakagawa T, Nishita Y, Otsuka R, Maegawa A, Kimizuka T, Miyata A, Gonda A, Ishikawa K, Higashino Y, Murakami S. A Multi-Institutional Study of Older Hearing Aids Beginners-A Prospective Single-Arm Observation on Executive Function and Social Interaction. J Am Med Dir Assoc 2021; 22:1168-1174. [PMID: 33811828 DOI: 10.1016/j.jamda.2021.02.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/16/2021] [Accepted: 02/21/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To obtain new insights into research questions on how executive function and social interaction would be observed to change after the introduction of hearing aids (HAs) in older people with hearing impairment. DESIGN Multi-institutional prospective single-arm observational study. SETTING AND PARTICIPANTS Outpatients with complaints of hearing difficulty who visited HA clinics between October 18, 2017, and June 30, 2019, in 7 different university hospitals in Japan. METHODS The inclusion criteria of the study named Hearing-Aid Introduction for Hearing-Impaired Seniors to Realize a Productive Aging Society-A Study Focusing on Executive Function and Social Activities Study (HA-ProA study) were age ≥60 years and no history of HA use. A series of multi-institution common evaluations including audiometric measurements, the digit symbol substitution test to assess executive functions, convoy model as an index of social relations, and hearing handicap inventory for the elderly (HHIE) were performed before (pre-HA) and after 6 months of the HA introduction (post-HA). RESULTS Out of 127 enrollments, 94 participants completed a 6-month follow-up, with a mean age of 76.9 years. The digit symbol substitution test score improved significantly from 44.7 at baseline to 46.1 at 6 months (P = .0106). In the convoy model, the social network size indicated by the number of persons in each and whole circles were not significantly different between pre- and post-HA; however, the total count for kin was significantly increased (P = .0344). In the analyses of HHIE, the items regarding the family and relatives showed significant improvement. CONCLUSIONS AND IMPLICATIONS HA use could benefit older individuals beginning to use HAs in executive function and social interaction, though the results should be interpreted cautiously given methodological limitations such as a single-arm short 6 months observation. Reduction in daily hearing impairment would have a favorable effect on relationships with the family.
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Affiliation(s)
- Yasue Uchida
- Department of Otorhinolaryngology, Aichi Medical University, Nagakute, Aichi, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Kazuyo Mise
- Department of Otolaryngology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki, Kanagawa, Japan
| | - Daiji Suzuki
- Department of Otolaryngology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki, Kanagawa, Japan
| | - Yoko Fukunaga
- Department of Otolaryngology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki, Kanagawa, Japan
| | - Nobuhiro Hakuba
- Department of Otolaryngology, Teikyo University School of Medicine, Mizonokuchi Hospital, Kawasaki, Kanagawa, Japan
| | - Naoki Oishi
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takaki Ogawa
- Department of Otorhinolaryngology, Aichi Medical University, Nagakute, Aichi, Japan; Department of Otorhinolaryngology, Middle Ear Surgical Center, Meitetsu Hospital, Nagoya, Aichi, Japan
| | - Mariko Takahashi
- Department of Otolaryngology-Head and Neck Surgery, Nagoya City University, Graduate School of Medical Sciences and Medical School; Department of Otorhinolaryngology-Head and Neck Surgery, Aichi Gakuin University School of Dentistry, Nagoya, Aichi, Japan
| | - Yutaka Takumi
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shohei Fujimoto
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yukihide Maeda
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazunori Nishizaki
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Teppei Noda
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noritaka Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nozomu Matsumoto
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Rei Otsuka
- Section of NILS-LSA, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Azusa Maegawa
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Tomomi Kimizuka
- Department of Otolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Miyata
- Department of Otorhinolaryngology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ayako Gonda
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Kazuha Ishikawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshie Higashino
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shingo Murakami
- Department of Otolaryngology-Head and Neck Surgery, Nagoya City University, Graduate School of Medical Sciences and Medical School; East Medical Center, Nagoya, Aichi, Japan
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Santabárbara J, Bueno-Notivol J, Lipnicki DM, de la Cámara C, López-Antón R, Lobo A, Gracia-García P. A Novel Score for Predicting Alzheimer's Disease Risk from Late Life Psychopathological and Health Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1802. [PMID: 33673250 PMCID: PMC7918511 DOI: 10.3390/ijerph18041802] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
With the increasing size of the aging population, dementia risk reduction has become a main public health concern. Dementia risk models or indices may help to identify individuals in the community at high risk to develop dementia. We have aimed to develop a novel dementia risk index focused on the late-life (65 years or more) population, that addresses risk factors for Alzheimer's disease (AD) easily identifiable at primary care settings. These risk factors include some shown to be associated with the risk of AD but not featured in existing indices, such as hearing loss and anxiety. Our index is also the first to account for the competing risk of death. The Zaragoza Dementia and Depression Project (ZARADEMP) Alzheimer Dementia Risk Score predicts an individual´s risk of developing AD within 5 years. The probability of late onset AD significantly increases in those with risk scores between 21 and 28 and, furthermore, is almost 4-fold higher for those with risk scores of 29 or higher. Our index may provide a practical instrument to identify subjects at high risk of AD and to design preventive strategies targeting the contributing risk factors.
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Affiliation(s)
- Javier Santabárbara
- Department of Preventive Medicine and Public Health, Universidad de Zaragoza, 50001 Zaragoza, Spain;
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
| | - Juan Bueno-Notivol
- Psychiatry Service, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Medicine, 2052 Randwick, Australia;
| | - Concepción de la Cámara
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Psychiatry Service, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Raúl López-Antón
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
| | - Patricia Gracia-García
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50001 Zaragoza, Spain; (C.d.l.C.); (R.L.-A.); (A.L.); (P.G.-G.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Psychiatry Service, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50001 Zaragoza, Spain
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Völter C, Götze L, Haubitz I, Müther J, Dazert S, Thomas JP. Impact of Cochlear Implantation on Neurocognitive Subdomains in Adult Cochlear Implant Recipients. Audiol Neurootol 2021; 26:236-245. [PMID: 33440376 DOI: 10.1159/000510855] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/12/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Age-related hearing loss affects about one-third of the population worldwide. Studies suggest that hearing loss may be linked to cognitive decline and auditory rehabilitation may improve cognitive functions. So far, the data are limited, and the underlying mechanisms are not fully understood. The study aimed to analyze the impact of cochlear implantation on cognition in a large homogeneous population of hearing-impaired adults using a comprehensive non-auditory cognitive assessment with regard to normal-hearing (NH) subjects. MATERIAL AND METHODS Seventy-one cochlear implant (CI) candidates with a postlingual, bilateral severe or profound hearing loss aged 66.3 years (standard deviation [SD] 9.2) and 105 NH subjects aged 65.96 years (SD 9.4) were enrolled. The computer-based neurocognitive tool applied included 11 subtests covering attention (M3), short- and long-term memory (recall and delayed recall), working memory (0- and 2-back, Operation Span [OSPAN] task), processing speed (Trail Making Test [TMT] A), mental flexibility (TMT B), inhibition (cFlanker and iFlanker), and verbal fluency. CI patients underwent a neurocognitive testing preoperatively as well as 12 months postoperatively. Impact of hearing status, age, gender, and education on cognitive subdomains was studied. Additionally, after controlling for education and age, cognitive performance of CI subjects (n = 41) was compared to that of NH (n = 34). RESULTS CI users achieved significantly better neurocognitive scores 12 months after cochlear implantation than before in most subtests (M3, [delayed] recall, 2-back, OSPAN, iFlanker, and verbal fluency; all p < 0.05) except for the TMT A and B. A significant correlation could be found between the postoperative improvement in speech perception and in the attentional task M3 (p = 0.01). Hearing status (p = 0.0006) had the strongest effect on attention, whereas education had a high impact on recall (p = 0.002), OSPAN (p = 0.0004), and TMT A (p = 0.005) and B (p = 0.003). Inhibition was mainly age-dependent with better results in younger subjects (p = 0.016). Verbal fluency was predicted by gender as females outperformed men (p = 0.009). Even after controlling for age and education NH subjects showed a significantly better performance than CI candidates in the recall (p = 0.03) and delayed recall (p = 0.01) tasks. Postoperatively, there was no significant difference between the 2 groups anymore. CONCLUSION Impact of cochlear implantation on neurocognitive functions differs according to the cognitive subdomains. Postoperatively, CI recipients performed as good as age- and education-matched NH subjects.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany,
| | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany
| | - Imme Haubitz
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany
| | - Janine Müther
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany
| | - Jan Peter Thomas
- Department of Otorhinolaryngology, Head and Neck Surgery, Katholisches Klinikum, Ruhr-University Bochum, Bochum, Germany
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Hearing Loss Is Associated with Increased Variability in Double Support Period in the Elderly. SENSORS 2021; 21:s21010278. [PMID: 33406602 PMCID: PMC7795333 DOI: 10.3390/s21010278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 01/09/2023]
Abstract
Hearing loss is a disabling condition that increases with age and has been linked to difficulties in walking and increased risk of falls. The purpose of this study is to investigate changes in gait parameters associated with hearing loss in a group of older adults aged 60 or greater. Custom-engineered footwear was used to collect spatiotemporal gait data in an outpatient clinical setting. Multivariable linear regression was used to determine the relationship between spatiotemporal gait parameters and high and low frequency hearing thresholds of the poorer hearing ear, the left ear, and the right ear, respectively, adjusting for age, sex, race/ethnicity, and the Dizziness Handicap Inventory–Screening version score. Worsening high and low frequency hearing thresholds were associated with increased variability in double support period. Effects persisted after adjusting for the effects of age and perceived vestibular disability and were greater for increases in hearing thresholds for the right ear compared to the left ear. These findings illustrate the importance of auditory feedback for balance and coordination and may suggest a right ear advantage for the influence of auditory feedback on gait.
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Kaur P, Chong SL, Kannapiran P, Teo WSK, Ling CNW, Weichen CW, Ruling G, Yin LS, Leng TY, Pei SY, Kang TT, Han LZ, Peizhen L, Yee LLH, George PP. Cost-utility analysis of hearing aid device for older adults in the community: a delayed start study. BMC Health Serv Res 2020; 20:1112. [PMID: 33261603 PMCID: PMC7709244 DOI: 10.1186/s12913-020-05977-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/25/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Hearing aids (HA) is the primary medical intervention aimed to reduce hearing handicap. This study assessed the cost-effectiveness of HA for older adults who were volunteered to be screened for hearing loss in a community-based mobile hearing clinic (MHC). METHODS Participants with (1) at least moderate hearing loss (≥40 dB HL) in at least one ear, (2) no prior usage of HA, (3) no ear related medical complications, and (4) had a Mini-Mental State Examination score ≥ 18 were eligible for this study. Using a delayed-start study design, participants were randomized into the immediate-start (Fitted) group where HA was fitted immediately or the delayed-start (Not Fitted) group where HA fitting was delayed for three months. Cost utility analysis was used to compare the cost-effectiveness of being fitted with HA combined with short-term, aural rehabilitation with the routine care group who were not fitted with HA. Incremental cost effectiveness ration (ICER) was computed. Health Utility Index (HUI-3) was used to measure utility gain, a component required to derive the quality adjusted life years (QALY). Total costs included direct healthcare costs, direct non-healthcare costs and indirect costs (productivity loss of participant and caregiver). Demographic data was collected during the index visit to MHC. Cost and utility data were collected three months after index visit and projected to five years. RESULTS There were 264 participants in the Fitted group and 163 participants in the Not Fitted group. No between-group differences in age, gender, ethnicity, housing type and degree of hearing loss were observed at baseline. At 3 months, HA fitting led to a mean utility increase of 0.12 and an ICER gain of S$42,790/QALY (95% CI: S$32, 793/QALY to S$62,221/QALY). At five years, the ICER was estimated to be at S$11,964/QALY (95% CI: S$8996/QALY to S$17,080/QALY) assuming 70% of the participants continued using the HA. As fewer individuals continued using their fitted HA, the ICER increased. CONCLUSIONS HA fitting can be cost-effective and could improve the quality of life of hearing-impaired older individuals within a brief period of device fitting. Long term cost-effectiveness of HA fitting is dependent on its continued usage.
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Affiliation(s)
- Palvinder Kaur
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Sheue Lih Chong
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Palvannan Kannapiran
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - W-S Kelvin Teo
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Charis Ng Wei Ling
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore
| | - Chiang Win Weichen
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Gan Ruling
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lee Sing Yin
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Tang Ying Leng
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Soo Ying Pei
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Then Tze Kang
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lim Zhen Han
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lin Peizhen
- Ear, Nose and Throat Head & Neck Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore
| | - Lynne Lim Hsueh Yee
- Ear Nose Throat & Hearing Centre, 3 Mount Elizabeth, Singapore, 228510, Singapore
| | - Pradeep Paul George
- Health Services and Outcomes Research, National Healthcare Group, 3 Fusionopolis Link #03-08 Nexus@One-north, Singapore, 138543, Singapore.
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Ge S, McConnell ES, Wu B, Pan W, Dong X, Plassman BL. Longitudinal Association Between Hearing Loss, Vision Loss, Dual Sensory Loss, and Cognitive Decline. J Am Geriatr Soc 2020; 69:644-650. [PMID: 33258497 DOI: 10.1111/jgs.16933] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/16/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND/OBJECTIVES To better understand the role of sensory loss as a potentially modifiable risk factor for cognitive decline, this study examined cognitive decline in relation to single modality hearing or vision loss and dual sensory loss. DESIGN Longitudinal secondary data analysis. SETTING The Health and Retirement Study (HRS) and its supplement: The Aging, Demographics, and Memory Study (ADAMS). PARTICIPANTS Individuals aged 73 and older (N = 295). MEASUREMENTS Hearing loss was defined by an inability to hear sounds of 25 dB at frequencies between 0.5 and 4.0 kHz in either ear. Vision loss was defined as having corrected binocular vision worse than 20/40. Dual sensory loss was defined as having both hearing and vision loss. We used one time point of hearing and vision data objectively measured in ADAMS Wave C (June 2006-May 2008) and five waves of cognitive function data measured by the HRS version of the Telephone Interview for Cognitive Status in HRS (2006-2014). Multilevel mixed models were used. RESULTS Among the participants, 271 completed a hearing assessment and 120 had hearing loss; 292 completed a vision assessment and 115 had vision loss; 52 had dual sensory loss. Older adults with hearing loss had a significantly faster rate of cognitive decline as they aged compared to those with normal hearing (β = -0.16, P < .05). No significant association was found between vision loss and the rate of cognitive decline (β = -0.06, P = .41). Older adults who had dual sensory loss likewise had a significantly faster rate of cognitive decline as they age (β = -0.23, P < .05) compared to those with no sensory loss. CONCLUSION Older adults with hearing loss and dual sensory loss have faster rates of cognitive decline than those with normal sensory function.
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Affiliation(s)
- Shaoqing Ge
- Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA
| | - Eleanor S McConnell
- Duke University School of Nursing, Durham, North Carolina, USA.,Durham Department of Veterans Affairs Healthcare System, Geriatric Research Education and Clinical Center, Durham, North Carolina, USA
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York City, New York, USA
| | - Wei Pan
- Duke University School of Nursing, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - XinQi Dong
- Rutgers Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, USA
| | - Brenda L Plassman
- Departments of Psychiatry and Neurology, Duke University School of Medicine, Durham, North Carolina, USA
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Late-onset depression is associated to age-related central auditory processing disorder in an older population in Southern Italy. GeroScience 2020; 43:1003-1014. [PMID: 33128133 PMCID: PMC8110676 DOI: 10.1007/s11357-020-00290-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/15/2020] [Indexed: 01/16/2023] Open
Abstract
The association between late-life depression (LLD) and age-related hearing loss (ARHL) was suggested by preliminary studies, but reliance on LLD subtypes may introduce significant bias. We examined the association between ARHL and LLD according to the age of onset (early-onset depression (EOD) and late-onset depression (LOD)). We investigated the association between ARHL and LLD diagnosed according to the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR in 1749 Italian community-dwelling older subjects from the population-based GreatAGE Study, Southern Italy. Peripheral ARHL was assessed as a pure tone average (PTA) threshold > 40 dB hearing level in the better ear- and age-related CAPD as a score of < 50% to the Synthetic Sentences Identification with Ipsilateral Competitive Message (SSI-ICM) test. LLD amounted at 10.29% of the sample, subdivided in LOD (6.21%) and EOD (4.08%). Age-related CAPD tended to be higher in LOD (28.91%) than in EOD (19.05%). After accounting for covariates, LOD was tendentially associated to age-related CAPD, but not to peripheral ARHL. This trend was confirmed by the linear models in which LOD was significantly associated to worsen SSI-ICM percentages (odds ratio 2.38, 95% confidence interval 1.32-4.30, p = 0.004), but not to PTA values. In a fully adjusted model of LOD, the effect of the association between CAPD and LOD was explained by social dysfunction. LLD was not associated to peripheral ARHL. Age-related CAPD was associated to LOD, a form of depression with cognitive dysfunction hallmark. The ARHL assessment may be an important opportunity to prevent depressive disorders in later life, particularly for LOD.
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Mitchell BL, Thorp JG, Evans DM, Nyholt DR, Martin NG, Lupton MK. Exploring the genetic relationship between hearing impairment and Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12108. [PMID: 33005726 PMCID: PMC7517507 DOI: 10.1002/dad2.12108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Hearing loss has been identified as the potentially largest modifiable risk factor for Alzheimer's disease (AD), estimated to account for a similar increase in AD risk as the apolipoprotein E (APOE) gene. METHODS We investigated the genetic relationship between hearing loss and AD, and sought evidence for a causal relationship. RESULTS We found a significant genetic overlap between hearing impairment and AD and a polygenic risk score for AD was able to significantly predict hearing loss in an independent cohort. Additionally, regions of the genome involved in inflammation were identified to be shared between hearing difficulty and AD. However, causality tests found no significant evidence of a causal relationship between these traits in either direction. DISCUSSION Overall, these results show that the relationship between hearing difficulty and AD may, in part, be due to shared genes and immune response pathways between the traits. However, currently available data do not support a causal relationship.
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Affiliation(s)
- Brittany L. Mitchell
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Jackson G. Thorp
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - David M. Evans
- The University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneQueenslandAustralia
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUnited Kingdom
| | - Dale R. Nyholt
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
| | - Nicholas G. Martin
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Michelle K. Lupton
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
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Cutler SJ, Ilinca C. On the Relationship between Hearing and Cognitive Limitations: Evidence from 51 Countries. J Aging Health 2020; 32:1309-1315. [PMID: 32539545 DOI: 10.1177/0898264320923909] [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: 11/16/2022]
Abstract
Objective: This study extends prior findings by looking at the relationship between hearing acuity and cognitive difficulties in 51 nations. Methods: We draw on data from the Integrated Public Use Microdata International Series available at the Institute for Social Research and Data Innovation at the University of Minnesota. For all countries where data are available, bivariate relationships between hearing and cognitive problems are examined using correlation coefficients (Rs) and multivariate relationships using linear regression techniques (betas), controlling for age, gender, marital status, and education. Results: For all 51 countries, the R between hearing problems and cognitive problems is 0.334 (p < .001); the multivariate beta is 0.316 (p < .001). Regional results are also statistically significant. Discussion: The relationship between hearing and memory appears to be universal, and practitioners must carefully assess and treat their client's hearing disabilities before they can expect them to remember any information.
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Abiola AO, Berry SD, Kim DH. Comment on: Can Hearing Aids Delay Time to Diagnosis of Dementia, Depression, or Falls in Older Adults? J Am Geriatr Soc 2020; 68:670-671. [PMID: 32078165 DOI: 10.1111/jgs.16367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Aanuoluwa O Abiola
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Sarah D Berry
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
| | - Dae Hyun Kim
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
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Mahmoudi E. Reply to Comment on: Can Hearing Aids Delay Time to Diagnosis of Dementia, Depression, or Falls in Older Adults? J Am Geriatr Soc 2020; 68:671-672. [PMID: 32078153 DOI: 10.1111/jgs.16366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Elham Mahmoudi
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Sarant J, Harris D, Busby P, Maruff P, Schembri A, Lemke U, Launer S. The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function? J Clin Med 2020; 9:jcm9010254. [PMID: 31963547 PMCID: PMC7020090 DOI: 10.3390/jcm9010254] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 01/11/2023] Open
Abstract
Hearing loss is a modifiable risk factor for dementia in older adults. Whether hearing aid use can delay the onset of cognitive decline is unknown. Participants in this study (aged 62–82 years) were assessed before and 18 months after hearing aid fitting on hearing, cognitive function, speech perception, quality of life, physical activity, loneliness, isolation, mood, and medical health. At baseline, multiple linear regression showed hearing loss and age predicted significantly poorer executive function performance, while tertiary education predicted significantly higher executive function and visual learning performance. At 18 months after hearing aid fitting, speech perception in quiet, self-reported listening disability and quality of life had significantly improved. Group mean scores across the cognitive test battery showed no significant decline, and executive function significantly improved. Reliable Change Index scores also showed either clinically significant improvement or stability in executive function for 97.3% of participants, and for females for working memory, visual attention and visual learning. Relative stability and clinically and statistically significant improvement in cognition were seen in this participant group after 18 months of hearing aid use, suggesting that treatment of hearing loss with hearing aids may delay cognitive decline. Given the small sample size, further follow up is required.
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Affiliation(s)
- Julia Sarant
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria 3010, Australia;
- Correspondence: ; Tel.: +61-39-0355-325
| | - David Harris
- Department of Economics, The University of Melbourne, Melbourne, Victoria 3010, Australia;
| | - Peter Busby
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria 3010, Australia;
| | - Paul Maruff
- CogState, Melbourne, Victoria 3000, Australia; (P.M.); (A.S.)
| | - Adrian Schembri
- CogState, Melbourne, Victoria 3000, Australia; (P.M.); (A.S.)
| | - Ulrike Lemke
- Sonova AG, Zurich, 8712 Stäfa, Switzerland; (U.L.); (S.L.)
| | - Stefan Launer
- Sonova AG, Zurich, 8712 Stäfa, Switzerland; (U.L.); (S.L.)
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Seven days in medicine: 11-17 September 2019. BMJ 2019; 366:l5585. [PMID: 31537543 DOI: 10.1136/bmj.l5585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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