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Han SY, Seo HW, Lee SH, Chung JH. Physical Inactivity and Sedentariness in Older Hearing Loss patients: Restoration With Hearing Aids. Laryngoscope 2024. [PMID: 39016167 DOI: 10.1002/lary.31638] [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: 03/18/2024] [Revised: 05/24/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVES Hearing loss causes numerous functional deficits. However, few studies have been conducted to assess the association between hearing loss and physical inactivity. This study aimed to evaluate the physical activity and sedentary behavior of hearing loss patients and their relation with the use of hearing aids. MATERIALS AND METHODS We extracted participants over 60 years of age with information on hearing status and physical activities from the eighth Korea National Health and Nutritional Examination Survey conducted from 2019 to 2020. We classified them into four groups: a normal hearing group (≤25 dB), a mild hearing loss group (>25 dB and ≤40 dB), a moderate hearing loss group (>40 dB and ≤50 dB), and a non-serviceable hearing group (>50 dB). Additionally, we extracted hearing aid users with hearing levels exceeding 50 dB. RESULTS After adjusting other factors, the non-serviceable hearing group walked less frequently than the moderate (p = 0.004) and mild hearing loss group (p < 0.001) and walked less and sat more than the normal hearing group (walking frequency: p < 0.001; walking time: p = 0.020; and sitting time: p = 0.034). Also, the hearing aid users walked more frequently (p = 0.003) and for longer (p = 0.045) than the non-serviceable hearing group. CONCLUSION Hearing loss is associated with reduced walking and a sedentary lifestyle. The use of hearing aids is associated with improved physical activity. Appropriate interventions, including hearing aids, should be provided to hearing loss patients. LEVEL OF EVIDENCE 3 (individual cross-sectional study) Laryngoscope, 2024.
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Affiliation(s)
- Sang-Yoon Han
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hee Won Seo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seung Hwan Lee
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jae Ho Chung
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
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Cai Y, Martinez-Amezcua P, Betz JF, Zhang T, Huang AR, Wanigatunga AA, Glynn NW, Burgard S, Chisolm TH, Coresh J, Couper D, Deal JA, Gmelin T, Goman AM, Gravens-Mueller L, Hayden KM, Mitchell CM, Mosley T, Pankow JS, Pike JR, Reed NS, Sanchez VA, Lin FR, Schrack JA. Hearing Impairment and Physical Activity and Physical Functioning in Older Adults: Baseline Results From the ACHIEVE Trial. J Gerontol A Biol Sci Med Sci 2024; 79:glae117. [PMID: 38695059 PMCID: PMC11170292 DOI: 10.1093/gerona/glae117] [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: 08/22/2023] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Hearing loss is associated with restricted physical activity (PA) and impaired physical functioning, yet the relationship between severity of hearing impairment (HI) and novel PA measures in older adults with untreated HI is not well understood. METHODS Analyses included 845 participants aged ≥70 years (mean = 76.6 years) with a better-hearing ear pure-tone average (PTA) ≥30 and <70 dB in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study who wore an ActiGraph accelerometer for 7 days. Physical functioning measures included grip strength and the Short Physical Performance Battery (SPPB). Linear regression models estimated the association by HI level (moderate or greater [PTA ≥ 40 dB] vs mild [PTA < 40 dB]) and continuous hearing with total daily activity counts, active minutes/day, activity fragmentation, grip strength, and gait speed. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of poor performance on the SPPB (≤6) and its subtests (≤2). Mixed-effects models estimated differences by HI level in activity by time of day. RESULTS Participants with moderate or greater HI had poorer physical functioning, particularly balance (OR = 2.17, 95% CI = 1.29-3.67), versus those with mild impairment. There was no association of HI level with activity quantities or fragmentation. For diurnal patterns of activity, participants with moderate or greater HI had fewer activity counts in the afternoon (12:00 pm -05:59 pm). CONCLUSIONS Older adults with worse hearing had shifted diurnal patterns and poorer balance performance. Exercise programs should be tailored to older adults with different levels of HI to maintain PA and physical functioning, particularly balance control.
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Affiliation(s)
- Yurun Cai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joshua F Betz
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Talan Zhang
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison R Huang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Amal A Wanigatunga
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Nancy W Glynn
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Sheila Burgard
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Theresa H Chisolm
- Department of Communication Sciences and Disorders, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - David Couper
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Theresa Gmelin
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Adele M Goman
- Departments of School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Gravens-Mueller
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Christine M Mitchell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Thomas Mosley
- Division of Geriatrics, The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - James S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - James R Pike
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Victoria A Sanchez
- Department of Otolaryngology – Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Frank R Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
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Stutz J, Eichenberger PA, Stumpf N, Knobel SEJ, Herbert NC, Hirzel I, Huber S, Oetiker C, Urry E, Lambercy O, Spengler CM. Energy expenditure estimation during activities of daily living in middle-aged and older adults using an accelerometer integrated into a hearing aid. Front Digit Health 2024; 6:1400535. [PMID: 38952746 PMCID: PMC11215182 DOI: 10.3389/fdgth.2024.1400535] [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: 03/13/2024] [Accepted: 05/23/2024] [Indexed: 07/03/2024] Open
Abstract
Background Accelerometers were traditionally worn on the hip to estimate energy expenditure (EE) during physical activity but are increasingly replaced by products worn on the wrist to enhance wear compliance, despite potential compromises in EE estimation accuracy. In the older population, where the prevalence of hearing loss is higher, a new, integrated option may arise. Thus, this study aimed to investigate the accuracy and precision of EE estimates using an accelerometer integrated into a hearing aid and compare its performance with sensors simultaneously worn on the wrist and hip. Methods Sixty middle-aged to older adults (average age 64.0 ± 8.0 years, 48% female) participated. They performed a 20-min resting energy expenditure measurement (after overnight fast) followed by a standardized breakfast and 13 different activities of daily living, 12 of them were individually selected from a set of 35 activities, ranging from sedentary and low intensity to more dynamic and physically demanding activities. Using indirect calorimetry as a reference for the metabolic equivalent of task (MET), we compared the EE estimations made using a hearing aid integrated device (Audéo) against those of a research device worn on the hip (ZurichMove) and consumer devices positioned on the wrist (Garmin and Fitbit). Class-estimated and class-known models were used to evaluate the accuracy and precision of EE estimates via Bland-Altman analyses. Results The findings reveal a mean bias and 95% limit of agreement for Audéo (class-estimated model) of -0.23 ± 3.33 METs, indicating a slight advantage over wrist-worn consumer devices (Garmin: -0.64 ± 3.53 METs and Fitbit: -0.67 ± 3.40 METs). Class-know models reveal a comparable performance between Audéo (-0.21 ± 2.51 METs) and ZurichMove (-0.13 ± 2.49 METs). Sub-analyses show substantial variability in accuracy for different activities and good accuracy when activities are averaged over a typical day's usage of 10 h (+61 ± 302 kcal). Discussion This study shows the potential of hearing aid-integrated accelerometers in accurately estimating EE across a wide range of activities in the target demographic, while also highlighting the necessity for ongoing optimization efforts considering precision limitations observed across both consumer and research devices.
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Affiliation(s)
- Jan Stutz
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Philipp A. Eichenberger
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Nina Stumpf
- Research & Development, Sonova AG, Stäfa, Switzerland
| | | | | | - Isabel Hirzel
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Sacha Huber
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Chiara Oetiker
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Olivier Lambercy
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Christina M. Spengler
- Exercise Physiology Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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4
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Huang H, Fan Y, Yan F, Hu Y, He H, Xu T, Zhu X, Zhu Y, Diao W, Xia X, Tu J, Li A, Lin B, Liu Q, Lu Z, Xi T, Wang W, Xu D, Chen Z, Wang Z, Chen X, Shan G. Diabetes and long duration leading to speech-, low/mid-, and high- frequency hearing loss: current evidence from the China National Health Survey 2023. J Endocrinol Invest 2024:10.1007/s40618-024-02406-2. [PMID: 38869778 DOI: 10.1007/s40618-024-02406-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/29/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE To examine the effect of diabetes, duration of diabetes, and blood glucose on speech-, low/mid-, and high-frequency hearing loss. METHODS In this cross-sectional study, 2821 participants aged 20-87 years in the China National Health Survey were included. Diabetes was defined as valid fasting blood glucose (FBG) of ≥ 7.0 mmol/L, a self-reported history of diabetes or the use of anti-diabetic medications. Speech-(500, 1000, 2000, and 4000 Hz), low/mid- (500, 1000 and 2000 Hz), and high-frequency (4000, 6000, and 8000 Hz) hearing loss was defined as pure tone average of responding frequencies > 20 dB HL in the better ear, respectively. RESULTS In fully adjusted models, for speech-, low/mid-, and high-frequency hearing loss, compared with no diabetes, those with diabetes (OR[95%CI]: 1.44 [1.12, 1.86], 1.23 [0.94, 1.61], and 1.75 [1.28, 2.41], respectively) and with diabetes for > 5 years duration (OR[95%CI]: 1.63 [1.09, 2.42], and 1.63 [1.12, 2.36], 2.15 [1.25, 3.70], respectively) were at higher risk. High FBG level was associated with a higher risk of speech-, low/ mid-, and high-frequency hearing loss. And there were stronger associations between HL and diabetes, longer duration and higher in "healthier population" (no hypertension, no dyslipidemia and younger age). CONCLUSION Diabetes, longer duration, and higher FBG level were independently associated with hearing loss for speech-, low/mid- and high-frequency hearing loss, particularly in higher frequency and "healthier population". Paying more attention to hearing loss in those populations could lower the burden of hearing loss.
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Affiliation(s)
- H Huang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Y Fan
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - F Yan
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Y Hu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - H He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - T Xu
- Department of Epidemiology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, China
| | - X Zhu
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Y Zhu
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - W Diao
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - X Xia
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - J Tu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - A Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - B Lin
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Q Liu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Z Lu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - T Xi
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - W Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - D Xu
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Z Chen
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - Z Wang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China
| | - X Chen
- Department of Otolaryngology-Head and Neck Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - G Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking, Union Medical College, Beijing, China.
- State Key Laboratory of Common Mechanism Research for Major Diseases, Beijing, China.
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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5
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Bhatt IS, Raygoza Garay JA, Bhagavan SG, Ingalls V, Dias R, Torkamani A. Polygenic Risk Score-Based Association Analysis Identifies Genetic Comorbidities Associated with Age-Related Hearing Difficulty in Two Independent Samples. J Assoc Res Otolaryngol 2024:10.1007/s10162-024-00947-0. [PMID: 38782831 DOI: 10.1007/s10162-024-00947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Age-related hearing loss is the most common form of permanent hearing loss that is associated with various health traits, including Alzheimer's disease, cognitive decline, and depression. The present study aims to identify genetic comorbidities of age-related hearing loss. Past genome-wide association studies identified multiple genomic loci involved in common adult-onset health traits. Polygenic risk scores (PRS) could summarize the polygenic inheritance and quantify the genetic susceptibility of complex traits independent of trait expression. The present study conducted a PRS-based association analysis of age-related hearing difficulty in the UK Biobank sample (N = 425,240), followed by a replication analysis using hearing thresholds (HTs) and distortion-product otoacoustic emissions (DPOAEs) in 242 young adults with self-reported normal hearing. We hypothesized that young adults with genetic comorbidities associated with age-related hearing difficulty would exhibit subclinical decline in HTs and DPOAEs in both ears. METHODS A total of 111,243 participants reported age-related hearing difficulty in the UK Biobank sample (> 40 years). The PRS models were derived from the polygenic risk score catalog to obtain 2627 PRS predictors across the health spectrum. HTs (0.25-16 kHz) and DPOAEs (1-16 kHz, L1/L2 = 65/55 dB SPL, F2/F1 = 1.22) were measured on 242 young adults. Saliva-derived DNA samples were subjected to low-pass whole genome sequencing, followed by genome-wide imputation and PRS calculation. The logistic regression analyses were performed to identify PRS predictors of age-related hearing difficulty in the UK Biobank cohort. The linear mixed model analyses were performed to identify PRS predictors of HTs and DPOAEs. RESULTS The PRS-based association analysis identified 977 PRS predictors across the health spectrum associated with age-related hearing difficulty. Hearing difficulty and hearing aid use PRS predictors revealed the strongest association with the age-related hearing difficulty phenotype. Youth with a higher genetic predisposition to hearing difficulty revealed a subclinical elevation in HTs and a decline in DPOAEs in both ears. PRS predictors associated with age-related hearing difficulty were enriched for mental health, lifestyle, metabolic, sleep, reproductive, digestive, respiratory, hematopoietic, and immune traits. Fifty PRS predictors belonging to various trait categories were replicated for HTs and DPOAEs in both ears. CONCLUSION The study identified genetic comorbidities associated with age-related hearing loss across the health spectrum. Youth with a high genetic predisposition to age-related hearing difficulty and other related complex traits could exhibit sub-clinical decline in HTs and DPOAEs decades before clinically meaningful age-related hearing loss is observed. We posit that effective communication of genetic risk, promoting a healthy lifestyle, and reducing exposure to environmental risk factors at younger ages could help prevent or delay the onset of age-related hearing difficulty at older ages.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA.
| | - Juan Antonio Raygoza Garay
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Valerie Ingalls
- Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA, 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL, 32608, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Science Institute, La Jolla, CA, 92037, USA
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6
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Fan W, Zhong X, Wu Q, Zhang L, Yang Z, Gu Y, Guo Q, Chen X, Yu C, Zhang K, Ding W, Qi H, Zhao J, Zhang L, Zhang S, Niu J. Association between hearing loss and physical performance in patients on maintenance hemodialysis. Kidney Res Clin Pract 2024; 43:358-368. [PMID: 38148523 PMCID: PMC11181039 DOI: 10.23876/j.krcp.22.231] [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: 10/11/2022] [Revised: 05/18/2023] [Accepted: 06/20/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND The correlation between hearing loss (HL) and physical performance in patients receiving maintenance hemodialysis (MHD) remains poorly investigated. This study explored the association between HL and physical performance in patients on MHD. METHODS This multicenter cross-sectional study was conducted between July 2020 and April 2021 in seven hemodialysis centers in Shanghai and Suzhou, China. The hearing assessment was performed using pure-tone average (PTA). Physical performance was assessed using the Timed Up and Go Test (TUGT), handgrip strength, and gait speed. RESULTS Finally, 838 adult patients (male, 516 [61.6%]; 61.2 ± 2.6 years) were enrolled. Among them, 423 (50.5%) had mild to profound HL (male, 48.6% and female, 53.4%). Patients with HL had poorer physical performance than patients without HL (p < 0.001). TUGT was positively correlated with PTA (r = 0.265, p < 0.001), while handgrip strength and gait speed were negatively correlated with PTA (r = -0.356, p < 0.001 and r = -0.342, p < 0.001, respectively). Physical performance in patients aged <60 years showed significant dose-response relationships with HL. After adjusting for confounders, the odds ratios (95% confidence intervals) for HL across the TUGT quartiles (lowest to highest) were 1.00 (reference), 1.15 (0.73-1.81), 1.69 (1.07-2.70), and 2.87 (1.69-4.88) (p for trend = 0.005). CONCLUSION Lower prevalence of HL was associated with a faster TUGT and a stronger handgrip strength in patients on MHD.
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Affiliation(s)
- Weifeng Fan
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Xiaojing Zhong
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Qing Wu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Lihong Zhang
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Zhenhao Yang
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
| | - Yong Gu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
- Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Chen Yu
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kun Zhang
- Department of Nephrology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Ding
- Department of Nephrology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hualin Qi
- Department of Nephrology, Shanghai Pudong New Area People’s Hospital, Shanghai, China
| | - Junli Zhao
- Department of Nephrology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Liming Zhang
- Department of Nephrology, Shanghai Jing'an District Zhabei Central Hospital, Shanghai, China
| | - Suhua Zhang
- Department of Nephrology, Suzhou Kowloon Hospital, Shanghai Jiaotong University School of Medicine, Jiangsu, China
| | - Jianying Niu
- Department of Nephrology, Shanghai Fifth People’s Hospital, Fudan University, Shanghai, China
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7
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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Kim AH, Keenan TA, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss Executive Summary. Otolaryngol Head Neck Surg 2024; 170:1209-1227. [PMID: 38682789 DOI: 10.1002/ohn.749] [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: 02/28/2024] [Revised: 03/17/2024] [Accepted: 03/21/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with an explanation of the support in the literature, the evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the Guideline Development Group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life. (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related quality of life at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, USA
| | | | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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8
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Han SY, Kim YH. Effects of Economic Status on Changes in Social Networks and Mental Health after Using Hearing Aids. Laryngoscope 2024; 134:2387-2394. [PMID: 37987221 DOI: 10.1002/lary.31195] [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: 08/23/2023] [Revised: 10/18/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES Hearing impairment affects social networks and mental health. Hearing aids (HA) can improve these deficits. However, their effects might be affected by various factors such as economic status (ES). This study aimed to identify how ES could moderate the effects of HA on social networks, depressive mood, and cognition. METHODS A prospective cohort for new HA users was established and classified into two groups based on their ES: a low ES group (LES group) and a medium to high ES group (MHES group). Audiological examination, Lubben social network scale-18 (LSNS-18), Short form of Geriatric Depression Score, Mini-Mental State Examination in the Korean version of the CERAD Assessment Packet, and surveys for satisfaction with HA were conducted before and at six months after wearing HA. RESULTS Post-HA application LSNS-18 scores were not improved in the LES group whereas they revealed significant improvement in the MHES group (p = 0.003). The LES group showed lower LSNS-18 score (p = 0.020) and its change (p = 0.042) than the MHES group. Additionally, patients with depressive moods in the MHES group showed better improvements than those in the LES group (p = 0.048). The effects of wearing HA on cognition and satisfaction with HA were not significantly different between the two groups. CONCLUSIONS HA did not improve social relationships and depressive moods in the LES group. Comprehensive and multidirectional support as well as hearing rehabilitation may be important for patients with LES. LEVEL OF EVIDENCE 3 (Nonrandomized controlled cohort/follow-up study) Laryngoscope, 134:2387-2394, 2024.
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Affiliation(s)
- Sang-Yoon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
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9
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Tsai Do BS, Bush ML, Weinreich HM, Schwartz SR, Anne S, Adunka OF, Bender K, Bold KM, Brenner MJ, Hashmi AZ, Keenan TA, Kim AH, Moore DJ, Nieman CL, Palmer CV, Ross EJ, Steenerson KK, Zhan KY, Reyes J, Dhepyasuwan N. Clinical Practice Guideline: Age-Related Hearing Loss. Otolaryngol Head Neck Surg 2024; 170 Suppl 2:S1-S54. [PMID: 38687845 DOI: 10.1002/ohn.750] [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: 02/28/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition. PURPOSE The purpose of this clinical practice guideline is to identify quality improvement opportunities and provide clinicians trustworthy, evidence-based recommendations regarding the identification and management of ARHL. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. The target patients for the guideline are any individuals aged 50 years and older. The target audience is all clinicians in all care settings. This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group (GDG). It is not intended to be a comprehensive, general guide regarding the management of ARHL. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experience and assessment of individual patients. ACTION STATEMENTS The GDG made strong recommendations for the following key action statements (KASs): (KAS 4) If screening suggests hearing loss, clinicians should obtain or refer to a clinician who can obtain an audiogram. (KAS 8) Clinicians should offer, or refer to a clinician who can offer, appropriately fit amplification to patients with ARHL. (KAS 9) Clinicians should refer patients for an evaluation of cochlear implantation candidacy when patients have appropriately fit amplification and persistent hearing difficulty with poor speech understanding. The GDG made recommendations for the following KASs: (KAS 1) Clinicians should screen patients aged 50 years and older for hearing loss at the time of a health care encounter. (KAS 2) If screening suggests hearing loss, clinicians should examine the ear canal and tympanic membrane with otoscopy or refer to a clinician who can examine the ears for cerumen impaction, infection, or other abnormalities. (KAS 3) If screening suggests hearing loss, clinicians should identify sociodemographic factors and patient preferences that influence access to and utilization of hearing health care. (KAS 5) Clinicians should evaluate and treat or refer to a clinician who can evaluate and treat patients with significant asymmetric hearing loss, conductive or mixed hearing loss, or poor word recognition on diagnostic testing. (KAS 6) Clinicians should educate and counsel patients with hearing loss and their family/care partner(s) about the impact of hearing loss on their communication, safety, function, cognition, and quality of life (QOL). (KAS 7) Clinicians should counsel patients with hearing loss on communication strategies and assistive listening devices. (KAS 10) For patients with hearing loss, clinicians should assess if communication goals have been met and if there has been improvement in hearing-related QOL at a subsequent health care encounter or within 1 year. The GDG offered the following KAS as an option: (KAS 11) Clinicians should assess hearing at least every 3 years in patients with known hearing loss or with reported concern for changes in hearing.
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Affiliation(s)
| | - Matthew L Bush
- University of Kentucky Medical Center, Lexington, Kentucky, USA
| | | | | | | | | | - Kaye Bender
- Mississippi Public Health Association, Jackson, Mississippi, USA
| | | | | | | | | | - Ana H Kim
- Columbia University Medical Center, New York, New York, USA
| | | | - Carrie L Nieman
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Joe Reyes
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
| | - Nui Dhepyasuwan
- American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA
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10
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Zhang J, Feng R, Cao Y, Mo H. A study on the relationship between recreational physical activity and audiovisual difficulty for older adults. Sci Rep 2024; 14:7059. [PMID: 38528013 DOI: 10.1038/s41598-024-55209-z] [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: 10/18/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024] Open
Abstract
Audiovisual difficulty are especially common in older adults. Audiovisual difficulty seriously affect the quality of life of older adults in their later years. It is a top priority to find out the related factors, and to intervene and prevent them. The purpose of this study was to explore the relationship between recreational physical activities and audiovisual difficulty in older adults. We hope that older adults can reduce the risk of hearing and visual difficulty through scientific physical activity. A total of 4,886 people were sampled from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Recreational physical activity was assessed through the Global Physical Activity Questionnaire (GPAQ); Hearing and visual difficulty were assessed using the Disability Questionnaire (DLQ). Chi-square test was used for categorical variables and rank sum test was used for measurement variables. P < 0.05 was considered statistically significant (bilateral test). After univariate analysis, binary Logistic regression analysis was performed with recreational physical activity as the independent variable, statistically significant demographic variable as the covariate, and hearing and visual difficulty as the dependent variable, respectively. (1) After excluding all confounding variables, recreational physical activity was significantly associated with hearing difficulty (P < 0.001), odds ratio (OR) 0.657 (95% CI 0.5899-0.733); (2) Recreational physical activity was significantly associated with visual difficulty (P < 0.001), OR 0.731 (95% CI 0.630-0.849). (1) Recreational physical activity is the protective factor of hearing difficulty in older adults; (2) Recreational physical activity is a protective factor for visual difficulty in older adults.
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Affiliation(s)
- Jipeng Zhang
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Rui Feng
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Yiwen Cao
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hongfei Mo
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, People's Republic of China
- College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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11
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Goodwin MV, Hogervorst E, Maidment DW. A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss. Br J Health Psychol 2024; 29:95-111. [PMID: 37658583 DOI: 10.1111/bjhp.12689] [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: 11/11/2022] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. DESIGN Individual semi-structured qualitative interviews. METHODS A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. RESULTS Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. CONCLUSIONS Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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12
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Lu Z, Yu D, Wang L, Fu P. Association between depression status and hearing loss among older adults: The role of outdoor activity engagement. J Affect Disord 2024; 345:404-409. [PMID: 37879413 DOI: 10.1016/j.jad.2023.10.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND More than half of Chinese older adults over 60 are suffering from hearing loss, which might increase the risk of depression. Outdoor activity engagement is a key factor to alleviate depression symptoms. This study is conducted to analyze the associations between hearing loss and depression, and explore the role of outdoor activity engagement on depression. METHODS This study was based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which collected the health and demographic information of elderly people in 23 provinces in China. In total, 12,333 older adults over 60 were recruited in the final analysis. Participants' risk of depressive symptoms was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). The relationship between self-reported hearing loss and depression in older adults was tested using logistic regression models. RESULTS The findings suggested a significant relationship between self-reported hearing loss and depressive symptoms (OR = 1.513, 95%CI = 1.391-1.646, P < 0.001). In addition, outdoor activity engagement have a moderation effect on self-reported hearing loss, among which entertainment and physical activities can better reduce the risk of depression. CONCLUSION Evidence from this study suggests that older adults with self-reported hearing loss can perform appropriate outdoor activities. Early recognition and intervention in hearing loss may reduce the risk of depression.
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Affiliation(s)
- Zhihong Lu
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Dongyue Yu
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Lijun Wang
- College of management, Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Peipei Fu
- Center for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, 44 Wen-hua-xi Road, Jinan, Shandong 250012, China.
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13
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Assi S, Twardzik E, Deal JA, Martin Ginis K, Palta P, Schrack JA, Reed NS, Martinez-Amezcua P. Hearing Loss and Physical Activity Among Older Adults in the United States. J Gerontol A Biol Sci Med Sci 2024; 79:glad186. [PMID: 37527509 PMCID: PMC10733191 DOI: 10.1093/gerona/glad186] [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: 04/23/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Hearing loss is associated with adverse health outcomes among older adults. Lower physical activity levels may partly explain these observations, yet the association between hearing loss, hearing aid use, and physical activity among older adults is understudied. METHODS Cross-sectional analysis of National Health and Aging Trends Study (2021) participants. The better-hearing ear pure-tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled continuously (10-dB increments) and categorically (no: ≤25 dB, mild: 26-40 dB, moderate or greater: >40 dB hearing loss). Activity measures were wrist accelerometry-derived (Actigraph) total activity counts, daily active minutes, activity fragmentation (using active-to-sedentary transition probability), and self-reported participation in vigorous activities and walking for exercise in the last month. We used multivariable regression adjusted for sociodemographic and health covariates. RESULTS Among 504 participants excluding hearing aid users (mean age = 79 years, 57% female, 9% Black), 338 (67%) had hearing loss. Worse hearing (continuously and categorically) was associated with fewer counts and active minutes, more fragmented activity, and greater odds of not reporting recent vigorous activities. Among 472 participants with hearing loss including hearing aid users, nonusers (n = 338) had more fragmented activity and greater odds of not reporting walking for exercise compared to users. CONCLUSIONS Older adults with hearing loss are less physically active. This may mediate the association between hearing loss and other adverse outcomes. Recognition of this potential association is essential for providers to better support older adults in maintaining an active lifestyle. Future research is warranted to understand the impact of hearing interventions.
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Affiliation(s)
- Sahar Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathleen Martin Ginis
- Department of Medicine, School of Health and Exercise Sciences, Center for Chronic Disease Prevention and Management, University of British Columbia, Kelowna, British Columbia, Canada
| | - Priya Palta
- Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Pablo Martinez-Amezcua
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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14
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Van Wier MF, Urry E, Lissenberg-Witte BI, Kramer SE. User characteristics associated with use of wrist-worn wearables and physical activity apps by adults with and without impaired speech-in-noise recognition: a cross-sectional analysis. Int J Audiol 2024; 63:49-56. [PMID: 36373621 DOI: 10.1080/14992027.2022.2135031] [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: 12/17/2021] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study weekly use of smartwatches, fitness watches and physical activity apps among adults with and without impaired speech-in-noise (SIN) recognition, to identify subgroups of users. DESIGN Cross-sectional study. STUDY SAMPLE Adults (aged 28-80 years) with impaired (n = 384) and normal SIN recognition (n = 341) as measured with a web-based digits-in-noise test, from the Netherlands Longitudinal Study on Hearing. Multiple logistic regression analyses were used to study differences and to build an association model. RESULTS Employed adults in both groups are more likely to use each type of fitness technology (all ORs >3.4, all p-values < 0.004). Specific to fitness watch use, adults living with others use it more (OR 2.5, 95%CI 1.1;5.8, p = 0.033) whereas those abstaining from alcohol (OR 0.3, 95%CI 0.1;0.6) or consuming >2 glasses/week (OR 0.4, 95%CI 0.2;0.81, overall p = 0.006) and hearing aid users (OR 0.5, 95%CI 0.2;0.9, p = 0.024) make less use. CONCLUSIONS Subgroups of adults more and less likely to use fitness technology exist, but do not differ between adults with and without impaired SIN recognition. More research is needed to confirm these results and to develop interventions to increase physical activity levels among adults with hearing loss.
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Affiliation(s)
- Marieke F Van Wier
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Birgit I Lissenberg-Witte
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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15
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Mamo SK, Pearlman J, Wheeler KA. Associations Between Age-Related Hearing Loss, Cognitive Impairment, and Multiple Chronic Conditions in a Group Care Setting. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:5087-5108. [PMID: 37934882 PMCID: PMC11001376 DOI: 10.1044/2023_jslhr-23-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/22/2023] [Accepted: 08/24/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE The purpose of this study was to explore the relationships between hearing loss, cognitive status, and a range of health outcomes over a period of 2 years in a sample of older adults who are enrolled in Program of All-Inclusive Care for the Elderly, which is a Medicare/Medicaid beneficiary program for individuals who are nursing home eligible but living in the community at time of enrollment. METHOD The sample (N = 144) includes a diverse (47% White/non-Hispanic, 35% Black/African American, and 16% Latin/Hispanic) group of adults ranging from 55 to 93 years old. We used medical chart data to measure respondents' cognitive and health status, including chronic conditions and hospital use. Hearing status was measured once at the beginning of the 2-year review period. We used logistic regression and negative binomial hurdle models for analyses. We used latent class analysis (LCA) to explore the extent to which respondents cluster into a set of "health profiles" characterized by their hearing, cognitive status, and health conditions. RESULTS We found that hearing loss is weakly associated with heart disease and diabetes and associated with cerebrovascular disease and falls; cognitive impairment is also associated with cerebrovascular disease and the number of falls. LCA indicates that respondents cluster into a variety of health profiles with a consistent pairing of hearing loss and depression. CONCLUSIONS The results are largely consistent with associations reported in epidemiological studies that include age-related hearing loss. Of particular interest in this study is the LCA that suggested that all of the profiles associated with a high likelihood of hearing loss included a high risk of depression. The co-occurrence of these two factors highlights the need to identify and treat hearing loss in older adults, especially as part of the treatment plan for individuals with depressive symptoms.
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Affiliation(s)
- Sara K. Mamo
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
| | - Jessica Pearlman
- Institute for Social Science Research, University of Massachusetts Amherst
| | - Kara A. Wheeler
- Department of Speech, Language, and Hearing Sciences, University of Massachusetts Amherst
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16
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Assi S, Zhang W, Carey JP, Deal JA, Huang A, Oh ES, Martinez-Amezcua P, Reed NS. The association of hearing loss with frailty among community-dwelling older adults: findings from the National Health and Aging Trends Study. BMC Geriatr 2023; 23:754. [PMID: 37978436 PMCID: PMC10656913 DOI: 10.1186/s12877-023-04465-1] [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: 06/01/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The identification of modifiable risk factors is crucial for the prevention and/or reversal of frailty, which is associated with significant morbidity and mortality. Hearing loss affects two-thirds of older adults in the United States (U.S.) and is associated with physical and cognitive decline which may increase frailty risk. We investigated the association of hearing loss and hearing aid use with frailty and pre-frailty in a nationally representative sample of older adults in the U.S. METHODS Cross-sectional analysis of the National Health and Aging Trends Study (2021 round). The better-hearing ear pure-tone average (BPTA) at speech-frequencies (0.5-4 kHz) was modeled continuously (per 10 dB) and categorically (no ≤ 25 dB, mild 26-40 dB, moderate or greater > 40 dB hearing loss). Hearing aid use was self-reported. The physical frailty phenotype (frail, pre-frail, robust) was determined based on Fried criteria: unintentional weight loss, exhaustion, low physical activity, weakness, slow walking speed. We used multinomial multivariable regression adjusted for sociodemographic and health characteristics (odds ratios [95% Confidence Intervals]). RESULTS Among 2,361 participants (mean age = 81 years, 56% female, 19% Black), 860 (36%) had mild and 864 (37%) had moderate or greater hearing loss. Worse hearing was associated with greater odds of being frail versus robust (OR = 1.20 [1.05-1.38] per 10 dB difference). Categorically, moderate or greater hearing loss was associated with greater odds of being frail (OR = 1.84 [1.01-3.08]) and pre-frail (OR = 1.46 [1.01-2.10]) versus robust. Among 1,724 participants with hearing loss, compared to hearing aid users (N = 522), nonusers had greater odds of being frail (OR = 2.54 [1.54-4.18]) and pre-frail (OR = 1.51 [1.05-2.17]) versus robust, and frail versus pre-frail (OR = 1.68 [1.04-2.72]). CONCLUSIONS In a nationally representative sample of older adults in the U.S., using gold-standard hearing measures and a validated frailty phenotype, hearing loss and lack of hearing aid use was cross-sectionally associated with frailty and pre-frailty. Future longitudinal studies are needed to establish if hearing loss is a risk factor for frailty, which may have significant clinical importance.
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Affiliation(s)
- Sahar Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Wuyang Zhang
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John P Carey
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison Huang
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Esther S Oh
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pablo Martinez-Amezcua
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, 2024 E Monument St, Baltimore, MD, 21205, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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17
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Kim HJ, Jeong S, Roh KJ, Oh YH, Suh MJ. Association Between Hearing Impairment and Incident Depression: A Nationwide Follow-up Study. Laryngoscope 2023; 133:3144-3151. [PMID: 36896880 DOI: 10.1002/lary.30654] [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: 09/29/2022] [Revised: 02/24/2023] [Accepted: 03/03/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Accumulating evidence suggests that hearing impairment is associated with the onset of depression. However, large-scale epidemiological studies are required to define this association more clearly. We aimed to investigate the risk of new-onset depression in Korean older adults with and without hearing impairment. METHODS From the National Health Insurance Service-Senior Cohort, which is a retrospective-prospective hybrid database, we analyzed data for 254,466 older adults enrolled in the Korea National Health Insurance Service-Senior Cohort who underwent at least one health screening between 2003 and 2019. A Cox proportional hazards regression model was used to evaluate the association between hearing impairment and the risk of incident depression, which was presented as adjusted hazard ratios (aHR) with 95% confidence intervals (CIs). All participants were followed up until the date of incident depression, death, or December 31, 2019. RESULTS During 3,417,682 person-years of follow-up investigation, hearing impairment was associated with a higher risk of incident depression (vs. no hearing impairment) in the final adjusted model (aHR, 1.11; 95% CI, 1.01-1.21; p = 0.033). Stratified analyses revealed a significant interaction among age, hearing impairment, and the risk of depression. Participants aged <65 years had a higher risk of depression (aHR, 1.29; 95% CI, 1.12-1.50; p < 0.001) than those aged 65 or above (aHR, 1.15; 95% CI, 1.01-1.30; p = 0.032). CONCLUSIONS Hearing impairment is independently associated with a higher risk of depression among older adults. The prevention and treatment of hearing impairment may aid in mitigating the risk of incident depression. LEVEL OF EVIDENCE Level 3 Laryngoscope, 133:3144-3151, 2023.
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Affiliation(s)
- Hye Jun Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, South Korea
| | - Kyung Jin Roh
- Department of Otorhinolaryngology, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong-si, South Korea
| | - Michelle J Suh
- Department of Otorhinolaryngology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, South Korea
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18
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Goodwin MV, Hogervorst E, Hardy R, Stephan BCM, Maidment DW. How are hearing loss and physical activity related? Analysis from the English longitudinal study of ageing. Prev Med 2023; 173:107609. [PMID: 37423474 DOI: 10.1016/j.ypmed.2023.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Although cross-sectional studies suggest that hearing loss in middle- and older-aged adults is associated with lower physical activity, longitudinal evidence is limited. This study aimed to investigate the potential bi-directional association between hearing loss and physical activity over time. Participants were from the English Longitudinal Study of Ageing (N = 11,292) who were 50-years or older at baseline assessment (1998-2000). Individuals were followed-up biannually for up to 20-years (2018-2019) and were classified as ever reporting hearing loss (n = 4946) or not reporting hearing loss (n = 6346). Data were analysed with Cox-proportional hazard ratios and multilevel logistic regression. The results showed that baseline physical activity was not associated with hearing loss over the follow-up. Time (i.e., wave of assessment) by hearing loss interactions showed that physical activity declined more rapidly over time in those with hearing loss, compared to those without (Odds Ratios = 0.94, 95% Confidence Intervals; 0.92-0.96, p < .001). These findings highlight the importance of addressing physical activity in middle- and older-aged adults with hearing loss. As physical activity is a modifiable behaviour that can reduce the risk of developing chronic health conditions, individuals with hearing loss may need additional, tailored support to be more physically active. Mitigating the decline in physical activity could be essential to support healthy ageing for adults with hearing loss.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, UK.
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | | | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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19
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Shahbazi M, Zhang X, Dinh PC, Sanchez VA, Trendowski MR, Shuey MM, Nguyen T, Feldman DR, Vaughn DJ, Fung C, Kollmannsberger C, Martin NE, Einhorn LH, Cox NJ, Frisina RD, Travis LB, Dolan ME. Comprehensive association analysis of speech recognition thresholds after cisplatin-based chemotherapy in survivors of adult-onset cancer. Cancer Med 2023; 12:2999-3012. [PMID: 36097363 PMCID: PMC9939144 DOI: 10.1002/cam4.5218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/14/2022] [Accepted: 08/17/2022] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Deficits in speech understanding constitute one of the most severe consequences of hearing loss. Here we investigate the clinical and genetic risk factors for symmetric deterioration of speech recognition thresholds (SRT) among cancer survivors treated with cisplatin. METHODS SRT was measured using spondaic words and calculating the mean of measurements for both ears with symmetric SRT values. For clinical associations, SRT-based hearing disability (SHD) was defined as SRT≥15 dB hearing loss and clinical variables were derived from the study dataset. Genotyped blood samples were used for GWAS with rank-based inverse normal transformed SRT values as the response variable. Age was used as a covariate in association analyses. RESULTS SHD was inversely associated with self-reported health (p = 0.004). Current smoking (p = 0.002), years of smoking (p = 0.02), BMI (p < 0.001), and peripheral motor neuropathy (p = 0.003) were positively associated with SHD, while physical activity was inversely associated with SHD (p = 0.005). In contrast, cumulative cisplatin dose, peripheral sensory neuropathy, hypertension, and hypercholesterolemia were not associated with SHD. Although no genetic variants had an association p value < 5 × 10-8 , 22 genetic variants were suggestively associated (p < 10-5 ) with SRT deterioration. Three of the top variants in 10 respective linkage disequilibrium regions were either positioned within the coding sequence or were eQTLs for genes involved in neuronal development (ATE1, ENAH, and ZFHX3). CONCLUSION Current results improve our understanding of risk factors for SRT deterioration in cancer survivors. Higher BMI, lower physical activity, and smoking are associated with SHD. Larger samples would allow for expansion of the current findings on the genetic architecture of SRT.
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Affiliation(s)
| | - Xindi Zhang
- Department of MedicineUniversity of ChicagoChicagoIllinoisUSA
| | - Paul C. Dinh
- Department of Medical OncologyIndiana UniversityIndianapolisIndianaUSA
| | - Victoria A. Sanchez
- Department of Otolaryngology—Head and Neck SurgeryUniversity of South FloridaTampaFloridaUSA
| | | | - Megan M. Shuey
- Department of Medicine and Vanderbilt Genetics Institute, Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Tessa Nguyen
- Center for Audiology, Speech, Language and LearningNorthwesthern UniversityChicagoIllinoisUSA
| | | | - Darren R. Feldman
- Department of Medical Oncology, Memorial Sloan‐Kettering Cancer CenterNew YorkNew YorkUSA
| | - David J. Vaughn
- Department of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Chunkit Fung
- J.P. Wilmot Cancer Institute, University of Rochester Medical CenterRochesterNew YorkUSA
| | | | - Neil E. Martin
- Department of Radiation OncologyDana‐Farber Cancer InstituteBostonMassachusettsUSA
| | | | - Nancy J. Cox
- Department of Medicine and Vanderbilt Genetics Institute, Vanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Robert D. Frisina
- Departments of Medical Engineering and Communication Sciences and Disorders, Global Center for Hearing and Speech ResearchUniversity of South FloridaTampaFloridaUSA
| | - Lois B. Travis
- Department of Medical OncologyIndiana UniversityIndianapolisIndianaUSA
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20
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Associations Between Physical Activity, Tinnitus, and Tinnitus Severity. Ear Hear 2022; 44:619-626. [PMID: 36404413 DOI: 10.1097/aud.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine the associations between physical activity and tinnitus development and physical activity and tinnitus severity in a large representative sample of US adults. DESIGN Data were obtained from 3826 eligible participants (20 to 69 years) in the National Health and Nutrition Examination Survey between 2015 and 2016. Physical activity was assessed using a Global Physical Activity Questionnaire. We used multivariable logistic regression to test the associations of physical activity (without physical activity, with physical activity) and amount of physical activity (min/week, in quartiles) with tinnitus symptoms. Adults with depressive symptoms were excluded, and the models were controlled for relevant sociodemographic, lifestyle, and health-related covariates. A restricted cubic spline was used to explore the dose-response relationship between the amount of physical activity and tinnitus. RESULTS Overall, 12.8% of the population who engaged in physical activity reported tinnitus, compared with 18.5% of the population who did not ( p = 0.005). Subgroup analysis based on the amount of physical activity showed that participants who performed physical activity (150 to 300, 310 to 540, and 550 to 4800 min/week) had lower risks of tinnitus than those with no physical activity (odds ratio = 0.72, 0.56, and 0.62, respectively), after adjusting for covariates. However, no correlation was observed between physical activity and tinnitus severity in the present study. The dose-response analysis showed a nonlinear relationship (P for nonlinearity = 0.04) between the amount of physical activity and the risk of tinnitus. CONCLUSIONS Physical activity may be associated with a reduced risk of tinnitus. Further research using a longitudinal design is required to confirm these findings and clarify the direction of causation.
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21
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Miyake H, Michikawa T, Nagahama S, Asakura K, Nishiwaki Y. Estimated Glomerular Filtration Rate and Hearing Impairment in Japan: A Longitudinal Analysis Using Large-Scale Occupational Health Check-Up Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12368. [PMID: 36231667 PMCID: PMC9566123 DOI: 10.3390/ijerph191912368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/23/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Several longitudinal studies have examined associations between renal dysfunction and hearing impairment. Here, we explored the longitudinal association between estimated glomerular filtration rate (eGFR) and hearing impairment among the working-age population in Japan. Participants were 88,425 males and 38,722 females aged 20-59 years, without hearing impairment at baseline (2013), who attended Japanese occupational annual health check-ups from 2013 to 2020 fiscal year. eGFR was categorized into four groups (eGFR upper half of ≥90, lower half of ≥90 (reference), 60-89, and <60 mL/min/1.73 m2). Low- and high-frequency hearing impairment were assessed using data from pure-tone audiometric testing. A Cox proportional hazards model was applied to estimate hazard ratio (HR) values for hearing impairment. Low eGFR did not increase the risk of low- or high-frequency hearing impairment. For males, multivariable-adjusted HR of high-frequency hearing impairment was 1.16 (95% confidence interval, 1.01-1.34) for the upper half of the ≥90 mL/min/1.73 m2; however, this positive association between high eGFR and high-frequency hearing impairment did not appear to be robust in a number of sensitivity analyses. We conclude that, among the Japanese working-age population, eGFR was not generally associated with hearing impairment in people of either sex.
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Affiliation(s)
- Hiroshi Miyake
- Department of Environmental and Occupational Health, Toho University Graduate School of Medicine, 5-21-16, Omorinishi, Otaku, Tokyo 143-8540, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16, Omorinishi, Otaku, Tokyo 143-8540, Japan
| | - Satsue Nagahama
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16, Omorinishi, Otaku, Tokyo 143-8540, Japan
- Division of Occupational Health and Promotion, All Japan Labor Welfare Foundation, 6-16-11, Hatanodai, Shinagawa, Tokyo 142-0064, Japan
| | - Keiko Asakura
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16, Omorinishi, Otaku, Tokyo 143-8540, Japan
| | - Yuji Nishiwaki
- Department of Environmental and Occupational Health, School of Medicine, Toho University, 5-21-16, Omorinishi, Otaku, Tokyo 143-8540, Japan
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22
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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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23
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Tong J, Zhang J, Xu L, Liu M, Min J, Yao M, Cheng X, Zhang Q, Sun X, Yuan J. Effect of hearing loss on cognitive function in patients with mild cognitive impairment: A prospective, randomized, and controlled study. Front Aging Neurosci 2022; 14:934921. [PMID: 35978946 PMCID: PMC9376470 DOI: 10.3389/fnagi.2022.934921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hearing loss (HL) may increase the risk of cognitive decline in the elderly. However, the randomized controlled study on the effect of HL on cognitive function in mild cognitive impairment (MCI) is very limited. Methods From 1 November 2020 to 30 March 2022, 1,987 individuals aged 55–65 years were randomly divided into the MCI with hearing impairment (MCI-HI), MCI without HI (MCI-nHI), and no MCI (nMCI) groups by stratified sampling, with 30 participants in each group. The Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the pure tone audiometry (PTA), and the auditory brainstem response (ABR) were measured at baseline and a follow-up 12 months later. The trial protocol was registered with ClinicalTrials.gov with the registration number NCT05336942. Results Among the 90 participants, the average age was 60.41 ± 6.48 years. In the MCI-HI group at baseline, the PTA score of both the ears was negatively correlated with the naming and memory score (p < 0.05), and the PTA score of both the ears was negatively correlated with the MoCA and abstraction score at the 12-month follow-up (p < 0.05). However, there were no significant differences among the PTA, the ABR, the MMSE, and the MoCA scores in the MCI-nHI and nMCI groups (p > 0.05). Regression analysis showed that the PTA score of the right ear at baseline was an important factor associated with the MoCA, visuospatial/executive, naming, and abstraction scores at the 12-month follow-up (β = −0.776 to −0.422, p < 0.05). Conclusion HL was significantly negatively associated with cognitive function only in patients with MCI with hearing impairment (HI), and the PTA of the right ear may be a predictor of cognitive decline after 1 year in patients with MCI with HI. This information may help primary healthcare clinicians to prevent MCI by screening and intervening in care for elderly patients with HL.
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Affiliation(s)
- Jie Tong
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Luli Xu
- Department of Otolaryngology, Shanghai Punan Hospital of Pudong New District, Shanghai, China
| | - Meiling Liu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Min
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Miaomiao Yao
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoyan Cheng
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Qi Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xirong Sun
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- Xirong Sun
| | - Jie Yuan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Jie Yuan
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24
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Longitudinal phenotypic aging metrics in the Baltimore Longitudinal Study of Aging. NATURE AGING 2022; 2:635-643. [PMID: 36910594 PMCID: PMC9997119 DOI: 10.1038/s43587-022-00243-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To define metrics of phenotypic aging, it is essential to identify biological and environmental factors that influence the pace of aging. Previous attempts to develop aging metrics were hampered by cross-sectional designs and/or focused on younger populations. In the Baltimore Longitudinal Study of Aging (BLSA), we collected longitudinally across the adult age range a comprehensive list of phenotypes within four domains (body composition, energetics, homeostatic mechanisms and neurodegeneration/neuroplasticity) and functional outcomes. We integrated individual deviations from population trajectories into a global longitudinal phenotypic metric of aging and demonstrate that accelerated longitudinal phenotypic aging is associated with faster physical and cognitive decline, faster accumulation of multimorbidity and shorter survival. These associations are more robust compared with the use of phenotypic and epigenetic measurements at a single time point. Estimation of these metrics required repeated measures of multiple phenotypes over time but may uniquely facilitate the identification of mechanisms driving phenotypic aging and subsequent age-related functional decline.
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25
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Wagatsuma Y, Daimaru K, Deng S, Chen JY. Hearing loss and the COVID-19 pandemic. BMC Res Notes 2022; 15:228. [PMID: 35761410 PMCID: PMC9235250 DOI: 10.1186/s13104-022-06120-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022] Open
Abstract
Objective Hearing loss is an important public health problem. Its causes vary, including infections, noise, and aging. The first wave of the COVID-19 pandemic occurred in April 2020 in Japan. During the pandemic, people were urged to stay at home and drastically changed their lifestyles. This study aimed to examine hearing loss before and during the pandemic. The prevalence during the pandemic after April 2020 was compared for the period in 2019. Study subjects were those who received health checkups in both periods. Hearing loss was defined as a hearing threshold of > 30 dB at 1 kHz and > 40 dB at 4 kHz in either ear using pure-tone audiometry. Results A total of 2367 persons presented in both 2019 and 2020. The overall rates of hearing loss were 9.5% and 13.2% before and after the pandemic, respectively. After controlling for age, sex, current smoking, regular exercise and alcohol consumption, the rate of hearing loss showed a significant increase in 2020 (p = < 0.0001). With age stratification, an increase was observed in the participants aged < 40 years (1.3% vs. 3.1%, p < 0.001) and 40–59 years (7.2% vs. 12.6%, p < 0.001). Further studies are needed to confirm the impact of the COVID-19 pandemic on hearing loss. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-022-06120-1.
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Affiliation(s)
- Yukiko Wagatsuma
- Department of Clinical Trials and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Kaori Daimaru
- Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Shiqi Deng
- Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Jou-Yin Chen
- Department of Clinical Trials and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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26
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Goodwin MV, Hogervorst E, Maidment DW. Test Your Health at Home: Comparing Online Screening Tests of Hearing, Cognition, and Cardiovascular Health. Am J Audiol 2022; 31:950-960. [PMID: 35239423 DOI: 10.1044/2021_aja-21-00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the extent to which validated online screening measures of cognitive impairment, psychosocial well-being, and cardiovascular health are associated with a validated hearing screener in a sample of adults based in the United Kingdom. METHOD Sixty-one adults (43 female; M age = 44.7 years) participated in a cross-sectional study delivered remotely. Participants completed the hearWHO smartphone application, a digits-in-noise hearing screener, and the Modified Telephone Interview for Cognitive Status (TICS-M), a screening tool for cognitive impairment. Psychosocial well-being (social isolation and loneliness) and cardiovascular health were assessed through self-report. RESULTS Separate independent analyses of variance, with age, gender, and education as covariates, demonstrated participants who failed the hearWHO screener had poorer scores on the TICS-M, engaged in less physical activity, and reported more sedentary behavior and greater social isolation. Multivariate regression analyses revealed that lower TICS-M scores, having obtained less education, identifying as female, and reporting greater sedentary behavior and social isolation were the strongest predictors of lower hearWHO scores. CONCLUSIONS The results from this study suggest that poorer hearing, as measured by the hearWHO screener, is independently associated with having worse cognitive function, more time spent being sedentary, and greater social isolation. Thus, this study demonstrates the potential of online screening measures to identify additional health conditions that confer risk to chronic disease as hearing loss manifests. This could help to inform the development of tailored treatment and support to improve an individual's readiness to seek help for and manage both their general and hearing health. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19251956.
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Affiliation(s)
- Maria V. Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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27
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Martinez-Amezcua P, Dooley EE, Reed NS, Powell D, Hornikel B, Golub JS, Pettee Gabriel K, Palta P. Association of Hearing Impairment and 24-Hour Total Movement Activity in a Representative Sample of US Adults. JAMA Netw Open 2022; 5:e222983. [PMID: 35302630 PMCID: PMC8933734 DOI: 10.1001/jamanetworkopen.2022.2983] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Lower physical activity (PA) levels have been proposed as a mechanism to explain the association between hearing loss and various adverse outcomes of aging. But whether hearing loss is associated with lower PA is poorly understood. OBJECTIVE To evaluate whether hearing loss is associated with lower levels of PA. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis was conducted in a representative sample of US adults (aged 30-69 years) who participated in the 2011-2012 cycle of the National Health and Nutrition Examination Survey (NHANES). Data analysis was conducted from July to September 2021. EXPOSURES Hearing was assessed, in dB, by pure-tone audiometry and summarized as the better hearing ear's pure-tone average (BPTA) of 4 speech frequencies (500, 1000, 2000, and 4000 kHz); a higher BTPA indicates worse hearing. Hearing was also categorized into normal (BPTA ≤25 dB), mild hearing impairment (>25 to 40 dB), and moderate or greater hearing impairment (>40 dB). MAIN OUTCOMES AND MEASURES Total 24-hour movement activity was measured using wrist accelerometers worn at all times for 7 consecutive days and summarized in monitor-independent movement summary units (MIMS) units (higher MIMS units indicate more movement). The association between BPTA and MIMS units was evaluated using a multivariable-adjusted (demographic characteristics and chronic conditions) piecewise spline regression (knot at 15 dB). Mean differences in MIMS units across hearing categories compared with normal hearing were estimated. RESULTS The study included 2490 participants (mean [SE] age, 48.9 [0.3] years; 900 [weighted percentage, 69.3%] White individuals, 1248 [weighted percentage, 50.8%] female participants). Before the knot at 15 dB, we found that each 10-dB higher BPTA was associated with 860.4 (95% CI, 444.8-1276.1) higher MIMS units. Conversely, after the knot, each 10-dB higher BPTA was associated with 458.6 (95% CI, 27.7-889.4) lower MIMS units. The difference in MIMS units across hearing categories was not statistically significant. CONCLUSIONS AND RELEVANCE In this cross-sectional study, in the range of hearing sensitivity of BPTA of 15 dB or greater, worse hearing was associated with lower MIMS units. Lower PA may be a mechanism contributing to the association between hearing impairment and adverse health.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Erin E. Dooley
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Danielle Powell
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Bjoern Hornikel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Justin S. Golub
- Department of Otolaryngology–Head & Neck Surgery, Columbia University Irving Medical Center, New York, New York
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
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Prevalence, Sociodemographic, and Health Correlates of Insufficient Physical Activity and High Sedentary Behavior Among Older Adults in Singapore. J Aging Phys Act 2022; 30:922-935. [PMID: 35203055 DOI: 10.1123/japa.2021-0324] [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: 08/10/2021] [Revised: 12/12/2021] [Accepted: 01/14/2022] [Indexed: 11/18/2022]
Abstract
We determined the prevalence and correlates of insufficient physical activity and high sedentary behavior among a nationally representative sample of 2,240 older adults (≥60 years) in Singapore. The Global Physical Activity Questionnaire, administered through face-to-face interviews, assessed physical activity and sedentary behavior. Logistic regression identified the correlates of insufficient physical activity (<600 metabolic equivalent of task minutes/week) and high sedentary behavior (>7 hr/day). The prevalence of insufficient physical activity and high sedentary behavior was 33.7% and 17.3%, respectively. Those older, females, Malays, residing in smaller housing, living with child but no spouse, with functional limitations and sensory impairments (vision/hearing) were more likely to have insufficient physical activity whereas those with tertiary education had lower odds. High sedentary behavior was more likely among those older, with secondary education, preobesity/obesity, and with functional limitations. While policies should encourage all older adults to be physically active, at-risk subgroups identified in our study merit greater attention.
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Martinez-Amezcua P, Suen JJ, Lin F, Schrack JA, Deal JA. Hearing impairment and objectively measured physical activity: A systematic review. J Am Geriatr Soc 2022; 70:301-304. [PMID: 34713440 PMCID: PMC8742764 DOI: 10.1111/jgs.17529] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/10/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA,Division of General Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Jonathan J. Suen
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA,Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Frank Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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30
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Tran Y, Tang D, Lo C, McMahon C, Mitchell P, Gopinath B. Co-occurring Hearing Loss and Cognitive Decline in Older Adults: A Dual Group-Based Trajectory Modeling Approach. Front Aging Neurosci 2021; 13:794787. [PMID: 35002682 PMCID: PMC8740280 DOI: 10.3389/fnagi.2021.794787] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/06/2021] [Indexed: 12/05/2022] Open
Abstract
Hearing loss and cognitive impairments are both highly prevalent neurological complications for older adults. While there is growing evidence to suggest that these two conditions are interrelated, little research has been conducted that directly examines the progression and developmental trajectories of these complications contemporaneously. The aim of the study is to identify the distinct trajectory profiles for hearing loss and cognitive function in an older population over a 10-year period. Through dual trajectory modeling, the interrelationship, co-occurring movements, and overlaps between these two complications were examined. We also investigated the influence of hearing aid ownership on cognitive function trajectories. We utilized longitudinal data from 1,445 participants in the Blue Mountains Hearing Study (aged 55+ years) involving repeated measures from a population-based survey with audiometric hearing assessments. Cognitive function was assessed using the Mini-Mental State Examination (MMSE). The group-based trajectory modeling (GBTM) identified three trajectory profiles for both hearing loss and cognitive function in two older age groups (55-69 years and 70+ years). The outputs from the dual trajectories models showed the conditional probability for "no hearing loss" trajectories to be around 90% more likely to have "high-normal" cognitive function, demonstrating co-occurring overlap. In contrast, for "moderate to severe hearing loss" trajectories, the conditional probability drops to 65% and 79% for the 55-69 age group and 70+ age group respectively. There was also an increasing probability for "cognitive decline" conditional on the severity of hearing loss with 6.7%, 7.5%, and 8.7% for no hearing loss, mild hearing loss, and moderate to severe hearing loss trajectory groups. While we did not find any statistically significant difference in the influence of hearing aid use in the cognitive function trajectories, there was a consistent greater representation of non-hearing aid users in the trajectories with poorer cognitive function. This study found GBTM to identify trajectories that were in agreement with our current understanding of hearing loss and cognitive impairment in older adults. This study also adds to the existing evidence-base as dual trajectories demonstrated co-occurrence in developmental changes in these two common neurological complications for the older population.
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Affiliation(s)
- Yvonne Tran
- MU Hearing, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Diana Tang
- MU Hearing, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Charles Lo
- Management Disciplinary Group, Wentworth Institute for Higher Education, Sydney, NSW, Australia
| | - Catherine McMahon
- MU Hearing, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Bamini Gopinath
- MU Hearing, Department of Linguistics, Macquarie University, Sydney, NSW, Australia
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Di J, Demanuele C, Kettermann A, Karahanoglu FI, Cappelleri JC, Potter A, Bury D, Cedarbaum JM, Byrom B. Considerations to address missing data when deriving clinical trial endpoints from digital health technologies. Contemp Clin Trials 2021; 113:106661. [PMID: 34954098 DOI: 10.1016/j.cct.2021.106661] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/23/2021] [Accepted: 12/18/2021] [Indexed: 11/25/2022]
Abstract
Digital health technologies (DHTs) enable us to measure human physiology and behavior remotely, objectively and continuously. With the accelerated adoption of DHTs in clinical trials, there is an unmet need to identify statistical approaches to address missing data to ensure that the derived endpoints are valid, accurate, and reliable. It is not obvious how commonly used statistical methods to handle missing data in clinical trials can be directly applied to the complex data collected by DHTs. Meanwhile, current approaches used to address missing data from DHTs are of limited sophistication and focus on the exclusion of data where the quantity of missing data exceeds a given threshold. High-frequency time series data collected by DHTs are often summarized to derive epoch-level data, which are then processed to compute daily summary measures. In this article, we discuss characteristics of missing data collected by DHT, review emerging statistical approaches for addressing missingness in epoch-level data including within-patient imputations across common time periods, functional data analysis, and deep learning methods, as well as imputation approaches and robust modeling appropriate for handling missing data in daily summary measures. We discuss strategies for minimizing missing data by optimizing DHT deployment and by including the patients' perspective in the study design. We believe that these approaches provide more insight into preventing missing data when deriving digital endpoints. We hope this article can serve as a starting point for further discussion among clinical trial stakeholders.
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Affiliation(s)
- Junrui Di
- Pfizer Inc., United States of America.
| | | | | | | | | | | | | | - Jesse M Cedarbaum
- Yale University School of Medicine, United States of America; Coeruleus Clinical Sciences LLC, United States of America
| | - Bill Byrom
- Signant Health, United States of America
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Hura N, Bernstein IA, Mady LJ, Agrawal Y, Lane AP, Rowan NR. Otolaryngic sensory loss as a measure of frailty among older US adults. Int Forum Allergy Rhinol 2021; 12:771-779. [PMID: 34878232 DOI: 10.1002/alr.22918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Frailty is a syndrome characterized by reduced physiologic reserve and increased vulnerability to poor health outcomes. Disruption of sensorineural function appears to serve as a novel biomarker of frailty. Using population-level data, we sought to characterize the association between otolaryngic sensory dysfunction and frailty. METHODS A cross-sectional analysis of the 2011-2012 US National Health and Nutrition Examination Survey was performed on adults ≥40 years of age (n = 2138). Participants were grouped by subjective gustatory dysfunction (sGD), olfactory dysfunction (sOD), hearing loss (sHL), and measured hearing loss (mHL) with pure tone averages (PTAs). Frailty was operationalized using a continuous 36-item frailty index (FI) scored from 0 to 1, stratified in 4 categories ("non-frail," "vulnerable," "frail," or "most frail"). RESULTS All sensory loss groups had significantly higher FI scores than those without sensory loss (sGD = 0.15; sOD = 0.14; sHL = 0.15; low-frequency mHL = 0.16; high-frequency mHL = 0.14 vs control = 0.11; p < 0.007 for all). "Vulnerable" individuals had increased odds of sOD (adjusted odds ratio [aOR], 1.45; 95% confidence interval [CI], 1.05-2.00), whereas "frail" individuals had increased odds of sOD (aOR, 1.85; 95% CI, 1.26-2.71) and low-frequency mHL (aOR, 4.01; 95% CI, 1.27-12.63). The "most frail" individuals had increased odds of sHL (aOR, 11.72; 95% CI, 2.88-47.66) and high-frequency mHL (aOR 5.10; 95% CI, 1.72-15.12). PTAs were linearly associated with FI (low: β = 10.15; 95% CI, 1.78-18.51; high: β = 19.85; 95% CI, 5.19-34.53). CONCLUSION Otolaryngic sensory loss is associated with increased frailty. Independent association of frailty with measures of olfaction and hearing suggests that olfactory and hearing assessments may help identify at-risk individuals with modifiable risk factors.
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Affiliation(s)
- Nanki Hura
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Isaac A Bernstein
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA
| | - Leila J Mady
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrew P Lane
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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33
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Martinez-Amezcua P, Powell D, Kuo PL, Reed NS, Sullivan KJ, Palta P, Szklo M, Sharrett R, Schrack JA, Lin FR, Deal JA. Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US. JAMA Netw Open 2021; 4:e2113742. [PMID: 34170305 PMCID: PMC8233700 DOI: 10.1001/jamanetworkopen.2021.13742] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
IMPORTANCE Hearing impairment, a common treatable condition, may contribute to poorer physical function with aging. OBJECTIVE To assess whether hearing impairment is associated with poorer physical function, reduced walking endurance, and faster decline in physical function. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, cross-sectional and longitudinal analyses were performed using data from the 2011 to 2019 period of the Atherosclerosis Risk in Communities study, a population-based study of community-dwelling adults at 4 sites in the US. EXPOSURES Hearing thresholds (per 10 dB) assessed with pure tone audiometry and categorized as normal hearing or mild, moderate, or severe hearing impairment. MAIN OUTCOMES AND MEASURES Physical function was assessed using the short physical performance battery (SPPB), with composite scores ranging from 0 to 12. A composite score of 6 or less and a score for each component (balance, gait speed, and chair stands) of 2 or less indicated poor performance. Walking endurance was assessed using a 2-minute fast-paced walk test. Tobit regression models adjusted for sociodemographic factors and medical history were used to calculate the mean differences in SPPB composite scores; logistic regression models, to estimate the odds ratios (ORs) of low SPPB composite and component scores; and linear mixed-effects models, to estimate the mean rate of change in SPPB composite scores over time. RESULTS Of the 2956 participants (mean [SD] age, 79 [4.6] years) who attended study visit 6 between 2016 and 2017, 1722 (58.3%) were women, and 2356 (79.7%) were White. As determined by pure tone audiometry, 973 (33%) participants had normal hearing, 1170 (40%) had mild hearing impairment, 692 (23%) had moderate hearing impairment, and 121 (4%) had severe hearing impairment. In the Tobit regression model, severe hearing impairment was associated with a lower mean SPPB score (β, -0.82; 95% CI, -0.34 to -1.30) compared with normal hearing. In fully adjusted logistic regression models, hearing impairment was associated with higher odds of low physical performance scores (severe impairment vs normal hearing: OR for composite physical performance, 2.51 [95% CI, 1.47-4.27]; OR for balance, 2.58 [95% CI, 1.62-4.12]; OR for gait speed, 2.11 [95% CI, 1.03-4.33]). Over time (2 to 3 visits; maximum, 8.9 years), participants with hearing impairment had faster declines in SPPB compared with those with normal hearing (moderate hearing impairment × time interaction, -0.34 [-0.52 to -0.16]). In adjusted models for walking endurance, participants with moderate or severe hearing impairment walked a mean distance of -2.81 m (95% CI, -5.45 to -0.17 m) and -5.31 m (95% CI, -10.20 to -0.36 m) than those with normal hearing, respectively, during the 2-minute walk test. CONCLUSIONS AND RELEVANCE In this cohort study, hearing impairment was associated with poorer performance, faster decline in physical function, and reduced walking endurance. The results of the longitudinal analysis suggest that hearing impairment may be associated with poorer physical function with aging. Whether management of hearing impairment could delay decline in physical function requires further investigation.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Danielle Powell
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Pei-Lun Kuo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Kevin J. Sullivan
- Department of Medicine, University of Mississippi, Medical Center, Jackson
| | - Priya Palta
- Department of Medicine, Division of General Medicine, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jennifer A. Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Frank R. Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Baltimore, Maryland
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Martinez-Amezcua P, Kuo PL, Reed NS, Simonsick EM, Agrawal Y, Lin FR, Deal JA, Ferrucci L, Schrack JA. Association of hearing impairment with higher level physical functioning and walking endurance: Results from the Baltimore Longitudinal Study of Aging (BLSA). J Gerontol A Biol Sci Med Sci 2021; 76:e290-e298. [PMID: 34003883 DOI: 10.1093/gerona/glab144] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although hearing impairment (HI) is linked to poorer physical functioning, the longitudinal associations between HI and higher-level functional measures are unclear. METHODS Data is from the Baltimore Longitudinal Study of Aging (2012-2019). Using pure-tone audiometry, we categorized hearing into normal, mild, and moderate or greater HI. Physical function was assessed with the expanded Short Physical Performance Battery (eSPPB) and walking endurance with time to walk 400m. Multivariable and mixed-effects linear models tested the hypotheses that participants with HI, at baseline, have poorer physical performance and walking endurance, and faster decline over time (up to six measurements). In a subset (n=526), we further adjusted for vestibular function. Among participants with HI, we evaluated the differences in eSPPB scores and walking endurance between hearing aid users and nonusers. RESULTS Of 831 participants 26% had mild, and 17% moderate or greater HI. Adjusting for demographics and medical history, moderate or greater impairment vs. normal hearing, was associated with poorer function (0.17 [95% CI: 0.09, 0.26] lower eSPPB score, and 13.3 [95% CI: 3.31, 23.4] seconds slower 400m time) and faster decline in these parameters over 6 years. Adjustment for vestibular function did not attenuate these associations. Hearing aid users walked 400m 24 seconds faster than nonusers (p=0.001). CONCLUSION Moderate or greater HI is associated with poorer initial and greater decline in higher-level physical performance. The observation that hearing aid users had better walking endurance suggests that screening for and treatment of HI may delay or slow progression of hearing-related functional decline.
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Affiliation(s)
- Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Pei-Lun Kuo
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA.,Division of Geriatric Medicine and Gerontology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 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, Baltimore, Maryland, USA.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Cochlear Center for Hearing and Public Health, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
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