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Malouf WT, Bachmann MP, Meegalla NT, Kirse DJ, Kiell EP, Gandolfi MM, Sioshansi PC, Hiatt KD, Bunch PM. Evaluation of Hearing Loss: Understanding Audiologic Testing to Refine Image Interpretation. Radiographics 2024; 44:e240018. [PMID: 39264839 DOI: 10.1148/rg.240018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
The standard of reference for diagnosing and characterizing hearing loss is audiologic testing. The results of audiologic testing inform the imaging algorithm and the differential diagnosis for the underlying cause. Pure-tone audiometry tests the ability to hear tones across different frequencies, and the results are displayed as an audiogram. Tympanometry measures tympanic membrane compliance as a function of pressure to generate a tympanogram. Acoustic reflex testing helps differentiate third window lesions from other causes of conductive hearing loss. Clinical and audiologic assessment of sensorineural hearing loss helps in differentiating cochlear from retrocochlear causes. Symmetrical sensorineural hearing loss is typical of cochlear disease. Asymmetry increases the likelihood of a retrocochlear lesion, the most common of which among adults is vestibular schwannoma. Unlike patients with sensorineural hearing loss, who commonly have normal imaging studies, patients with conductive hearing loss are expected to have abnormal temporal bone CT studies. By incorporating the results of audiologic testing into their evaluation, radiologists can perform a more informed and more intentional search for the structural cause of hearing loss. The authors describe several audiogram configurations that suggest specific underlying mechanisms of conductive hearing loss. By providing a practical and accessible summary of the basics of audiologic testing, the authors empower the radiologist to leverage relevant clinical information and audiologic test results to interpret temporal bone imaging more confidently and more accurately, particularly temporal bone CT in the setting of conductive hearing loss. ©RSNA, 2024.
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Affiliation(s)
- William T Malouf
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Meagan P Bachmann
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Nuwan T Meegalla
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Daniel J Kirse
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Eleanor P Kiell
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Michele M Gandolfi
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Pedrom C Sioshansi
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Kevin D Hiatt
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Paul M Bunch
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
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Powell DS, Wu MMJ, Nothelle S, Smith JM, Gleason K, Oh ES, Lum HD, Reed NS, Wolff JL. The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss? J Am Geriatr Soc 2024; 72:3089-3097. [PMID: 39058421 PMCID: PMC11461099 DOI: 10.1111/jgs.19111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/02/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Hearing loss is prevalent and consequential but under-diagnosed and managed. The Medicare Annual Wellness Visit (AWV) health risk assessment elicits patient-reported hearing concerns but whether such information affects documentation, diagnosis, or referral is unknown. METHODS We use 5 years of electronic medical record (EMR) data (2017-2022) for a sample of 13,776 older primary care patients. We identify the first (index) AWV indication of hearing concerns and existing and subsequent hearing loss EMR diagnoses (visit diagnoses or problem list diagnoses) and audiology referrals. For a 20% random sample of AWV notes (n = 474) we compared hearing loss EMR diagnoses to documentation of (1) hearing concerns, (2) hearing loss/aid use, and (3) referrals for hearing care. RESULTS Of 3845 (27.9%) older adults who identified hearing concerns (mean age 79.1 years, 57% female, 75% white) 24% had an existing hearing diagnosis recorded. Among 474 patients with AWV clinical notes reviewed, 90 (19%) had an existing hearing loss diagnosis. Clinicians were more likely to document hearing concerns or hearing loss/aid use for those with (vs. without) an existing EMR diagnosis (50.6% vs. 35.9%, p = 0.01; 68.9% vs. 37.5%, p < 0.001, respectively). EMR diagnoses of hearing loss were recorded for no more than 40% of those with indicated hearing concerns. Among those without prior diagnosis 38 (9.9%) received a hearing care referral within 1 month. Subgroup analysis suggest greater likelihood of documenting hearing concerns for patients age 80+ (OR:1.51, 95% confidence interval [CI]: 1.03, 2.19) and decreased likelihood of documenting known hearing loss among patients with more chronic conditions (OR: 0.49, 95% CI: 0.27, 0.9), with no differences observed by race. CONCLUSION Documentation of hearing loss in EMR and AWV clinical notes is limited among older adults with subjective hearing concerns. Systematic support and incorporation of hearing into EMR and clinical notes may increase hearing loss visibility by care teams.
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Affiliation(s)
- Danielle S. Powell
- Department of Hearing and Speech Sciences, University of Maryland, College Park, Maryland USA
| | - Mingche MJ Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephanie Nothelle
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jamie M. Smith
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Kelly Gleason
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Esther S. Oh
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hillary D. Lum
- Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer L. Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Pudrith C, Chen X, Buac M, Billingsly D, Hill E. Demographic Disparities in Drive Times to the Nearest Audiologist in the United States. Am J Audiol 2024; 33:768-781. [PMID: 38758682 DOI: 10.1044/2024_aja-23-00279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
PURPOSE Audiological services are underused, possibly because patients need to drive long distances to see a provider. In this study, we measured the association of drive times to the nearest audiologist with population density, income, ethnicity, race, and distance to the nearest audiology graduate program. METHOD Drive times for each census block group to the nearest audiologist were measured using census data, the National Provider Identifier Registry, and a geographic analyzing tool called ArcGIS for all block groups within the United States. The association between drive times and population density, income, ethnicity, race, and audiology program distance was evaluated with a population density-matched case-control study and multiple linear regression analyses. RESULTS Approximately 5.29 million Americans need to drive at least 1 hr to visit their closest audiologist. The 10% most rural-dwelling Americans drive an average of 33.8 min. The population density-matched case-control study demonstrated that percent below poverty, percent identifying as Hispanic, and travel times to the nearest audiology program were all significantly higher in census block groups with high drive times to the nearest audiologist. An average of 7.96% of individuals in census block groups with low drive times identified as Hispanic, but 18.8% identified as Hispanic in high drive time groups. The multiple linear regression showed that the effect of demographics and distance to the nearest audiology program was highest in rural areas. In both analyses, adjusting for poverty did not drastically change the effect of percent identifying as Hispanic on drive times. CONCLUSIONS Long drive times restrict access to audiological care for those who live in rural areas. This restriction disproportionately affects those in rural areas who identify as Hispanic or have low income.
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Affiliation(s)
- Charles Pudrith
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb
| | - Xuwei Chen
- Department of Earth, Atmosphere and Environment, Northern Illinois University, DeKalb
| | - Milijana Buac
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb
| | - Danica Billingsly
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb
| | - Elizabeth Hill
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb
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Mold JW, Lawler FH, Liao X, Bard DE. Associations between hearing loss, peripheral neuropathy, balance, and survival in older primary care patients. J Am Geriatr Soc 2024. [PMID: 39143038 DOI: 10.1111/jgs.19142] [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: 01/23/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Both age-associated hearing loss (AAHL) and peripheral neuropathy (PN) are common in older patients, and both are associated with impaired balance, falls, and premature mortality. The objectives of this study were to document the prevalence and severity of AAHL in older primary care patients, and to explore associations between AAHL, PN, balance, falls, and mortality. METHODS We analyzed information obtained in 1999 from 793 primary care patients recruited from practices participating in the Oklahoma Longitudinal Assessment of the Health Outcomes of Mature Adults (OKLAHOMA) Studies. Available data included demographic and health information, history of falls and hospitalizations, audiometry, balance testing, examination of the peripheral nerves, 50 foot timed gait, and dates of death up to 22 calendar years and 8106 person-years of follow-up. Proportionate hazards (PH) and structural equation modeling (SEM) were used to examine associations between AAHL, PN, balance, gait time, and mortality. RESULTS 501 of the 793 participants (63%) had AAHL. Another 156 (20%) had low frequency and 32 (4%) had unilateral deficits. Those with moderate or severe AAHL and the 255 (32%) with PN had impaired balance (p < 0.0001), increased gait time (p = 0.0001), and reduced survival time (p < 0.0001). In the PH model, both AAHL and PN were associated with earlier mortality (H.Rs. [95% C.I.]: 1.36 [1.13-1.64] and 1.32 [1.10-1.59] respectively). The combination of moderate or severe AAHL and PN, present in 24% of participants, predicted earlier mortality than predicted by either deficit alone (O.R. [95% C.I.I] 1.55 [1.25-1.92]). In the SEM models, the impacts of both moderate or severe AAHL and PN on survival were mediated, in part, through loss of balance. CONCLUSIONS Hearing loss and PN, both common in older patients, appear to be independently and additively associated with premature mortality. Those associations may be mediated in part by impaired balance. The Mechanisms are likely multiple and complex.
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Affiliation(s)
- James W Mold
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Chapel Hill, North Carolina, USA
| | - Frank H Lawler
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Chapel Hill, North Carolina, USA
| | - Xiaolan Liao
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Chapel Hill, North Carolina, USA
| | - David E Bard
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Chapel Hill, North Carolina, USA
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Nuesse T, Lemke U, Holube I. Associations of frailty, self-reported balance problems, hearing abilities, and posturography in a sample of older adults. Int J Audiol 2024:1-9. [PMID: 39121026 DOI: 10.1080/14992027.2024.2383985] [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: 07/05/2023] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 08/11/2024]
Abstract
OBJECTIVE The aim of this study was to identify risk factors for self-reported balance problems, and to analyse associations between hearing and balance. DESIGN A battery of tests was administered to assess hearing and balance performance, as well as additional health-related factors indicative of frailty and fall risk. In a retrospective analysis, logistic regression was used to identify risk factors for self-reported balance problems and linear regression was used to identify associations between hearing ability and functional balance. STUDY SAMPLE For the risk factor analysis, 199 volunteers aged 55-81 years (mean:67) were divided into two groups according to their self-reported balance problems. Only participants lacking self-reported balance problems (n = 157) were included in the second analysis. RESULTS Female gender, frailty, and fine-motor skills were statistically significant predictors of self-reported balance problems. Functional balance performance was related to hearing impairment for dynamic, but not for static, balance tasks. CONCLUSION For a holistic approach to healthcare and regardless of age, individuals with multiple comorbidities and/or phenotypic signs of frailty should be considered at risk for falls. For further research, it was shown that dynamic, rather than static, balance tasks may be needed to gain deeper insights into the relationship between hearing and balance.
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Affiliation(s)
- Theresa Nuesse
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence "Hearing4All", Oldenburg, Germany
| | - Ulrike Lemke
- Research and Development, Sonova AG, Stäfa, Switzerland
| | - Inga Holube
- Institute of Hearing Technology and Audiology, Jade University of Applied Sciences, Oldenburg, Germany
- Cluster of Excellence "Hearing4All", Oldenburg, Germany
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Usta Ozdemir H, Kitis A, Ardıc FN. Dual- and Single-Task Training in Older Adults With Age-Related Hearing Loss: A Randomized Controlled Study. J Aging Phys Act 2024; 32:496-507. [PMID: 38521052 DOI: 10.1123/japa.2023-0082] [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: 03/07/2023] [Revised: 12/28/2023] [Accepted: 01/20/2024] [Indexed: 03/25/2024]
Abstract
We aimed to investigate the effects of dual- and single-task training in older adults with age-related hearing loss. Intervention groups included single-, dual-task training, and control groups. The dual- and single-task trainings were held 2 days a week for 40 min for a total of 10 sessions for 5 weeks. We evaluated physical, cognitive, and auditory functions, quality-of-life, balance, concerns about falling, independence in activities of daily living, and dual-task performance. A total of 42 patients fully participated in this study. Statistically significant differences were observed in chair stand, chair sit-and-reach, global cognitive function, and delayed recall between the intervention groups and control group (p < .05). There was no statistically significant difference in quality-of-life, balance, falling concerns, independence in activities of daily living, and dual-task performance between all groups (p > .05). In conclusion, single- and dual-task training had a positive effect on physical and cognitive functioning in older adults with age-related hearing loss.
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Affiliation(s)
- Hande Usta Ozdemir
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Ali Kitis
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Fazıl Necdet Ardıc
- Department of Otorhinolaryngology, Medicine Faculty, Pamukkale University, Denizli, Turkey
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Ardıç FN, Tümkaya F, Atıgan A, Ardıç F. The Effect of Cochlear Implant Stimulation on Postural Control. Turk Arch Otorhinolaryngol 2024; 62:1-6. [PMID: 39257035 DOI: 10.4274/tao.2024.2023-12-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024] Open
Abstract
Objective There are contradictory reports on the effect of cochlear implantation on postural control. Associated vestibular loss, electrode insertion trauma, and electrical stimulus of a cochlear implant can influence postural control. This study focused on the electrical stimulation of the cochlea. We aimed to examine whether a cochlear implant's electrical stimulation affects postural control measured by posturography. Methods Thirty-three patients with unilateral cochlear implants were included. We used three preprogrammed main tests and their nine subtests in posturography. Postural stability [general stability index (GSI)], fall risk index (FRI), and sensory integration [modified clinical test of sensory integration of balance (m-CTSIB)] were calculated. All tests were performed under three conditions: implant off (1), implant on (2), and implant on music (3). Results The mean age was 46.29±16.09 years. GSI was above normal limits in 78% of adult cochlear implant users. We found that FRI was high in 30% of patients, and m-CTSIB was defective in 42%. There were no statistically significant differences in GSI, FRI, and m-CTSIB. Cochlear implant stimulation was found to have positively affected postural control when the subject's data were visualized individually. GSI, FRI, and m-CTSIB dropped to 39%, 24%, and 24%, respectively, when music was on. There was a significant correlation between age and fall index. But this correlation disappeared when music was playing. Conclusion Cochlear implant stimulation affected the vestibular system in almost all patients. The effect was positive in most patients.
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Affiliation(s)
- Fazıl Necdet Ardıç
- Department of Otorhinolaryngology, Pamukkale University School of Medicine, Denizli, Türkiye
| | - Funda Tümkaya
- Department of Otorhinolaryngology, Pamukkale University School of Medicine, Denizli, Türkiye
| | - Alev Atıgan
- Department of Physical Medicine and Rehabilitation, Pamukkale University School of Medicine, Denizli, Türkiye
| | - Füsun Ardıç
- Department of Physical Medicine and Rehabilitation, Pamukkale University School of Medicine, Denizli, Türkiye
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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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Koutná S, Kalitová P, Jeřábek J, Slabý K, Kučerová K, Bouček J, Čakrt O. Comparison of postural control and space perception outcomes between robotic and conventional cochlear implantation in adults. Eur Arch Otorhinolaryngol 2024; 281:3839-3843. [PMID: 38825603 DOI: 10.1007/s00405-024-08664-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/06/2024] [Indexed: 06/04/2024]
Abstract
PURPOSE The aim of the study is to capture the difference between the groups in direct relation to the type of electrode array insertion during cochlear implantation (CI). The robotic insertion is expected to be a more gently option. As recent studies have shown, there is a difference in perception of visual vertical (SVV) and postural control related to the CI. We assume that there can be differences in postural control and space perception outcomes depending on the type of the surgical method. METHODS In total, 37 (24 females, mean age ± SD was 42.9 ± 13.0) candidates for CI underwent an assessment. In 14 cases, the insertion of the electrode array was performed by a robotic system (RobOtol, Colin, France) and 23 were performed conventionally. In all of these patients, we performed the same examination before the surgery, the first day, and 3 weeks after the surgery. The protocol consists of static posturography and perception of visual vertical. RESULTS The both groups, RobOtol and conventional, responded to the procedure similarly despite the dissimilar electrode insertion. There was no difference between two groups in the dynamic of perception SVV and postural parameters. Patients in both groups were statistically significantly affected by the surgical procedure, SVV deviation appeared in the opposite direction from the implanted ear: 0.90° ± 1.25; - 1.67° ± 3.05 and - 0.19° ± 1.78 PRE and POST surgery (p < 0.001). And this deviation was spontaneously adjusted in FOLLOW-UP after 3 weeks (p < 0.01) in the both groups. We did not find a significant difference in postural parameters between the RobOtol and conventional group, even over time. CONCLUSION Although the robotic system RobOtol allows a substantial reduction in the speed of insertion of the electrode array into the inner ear, our data did not demonstrate a postoperative effect on vestibular functions (SVV and posturography), which have the same character and dynamics as in the group with standard manual insertion. REGISTRATION NUMBER The project is registered on clinicaltrials.gov (registration number: NCT05547113).
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Affiliation(s)
- Sára Koutná
- Department of Rehabilitation and Sport Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
| | - Petra Kalitová
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jaroslav Jeřábek
- Department of Neurology, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Kryštof Slabý
- Department of Rehabilitation and Sport Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Klára Kučerová
- Department of Rehabilitation and Sport Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Bouček
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ondřej Čakrt
- Department of Rehabilitation and Sport Medicine, 2nd Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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10
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Fujisawa C, Umegaki H, Sugimoto T, Nakashima H, Komiya H, Watanabe K, Nagae M, Yamada Y, Tajima T, Sakai T, Sakurai T. Objective physical function declines in the absence of subjective physical complaints among patients with amnestic mild cognitive impairments and mild alzheimer's disease. Eur Geriatr Med 2024:10.1007/s41999-024-01005-x. [PMID: 38877373 DOI: 10.1007/s41999-024-01005-x] [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: 03/29/2024] [Accepted: 06/05/2024] [Indexed: 06/16/2024]
Abstract
PURPOSE To examine the extent to which patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD) perceive their own physical decline. METHODS This study included 4450 outpatients (1008 normal cognition [NC], 1605 aMCI, and 1837 mild AD) who attended an initial visit to a memory clinic between July 2010 and June 2021. Their physical function was assessed by the Timed Up and Go test, one-leg standing test, and grip strength. For physical complaints, data were obtained on reports of fear of falling and dizziness or staggering. Logistic regression analysis was performed to compare the patients' physical function and complaints for each stage of NC, aMCI, and mild AD. RESULTS Objective physical function declined from aMCI and the mild AD stage, but subjective physical complaints decreased by 20-50% in aMCI and 40-60% in mild AD compared with the NC group. CONCLUSION As objective physical functional declined from the aMCI stage onward, subjective physical complaints decreased. This suggests a need for objective assessment of physical function in aMCI and mild AD patients even when they have no physical complaints in the clinical setting.
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Affiliation(s)
- Chisato Fujisawa
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan.
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan.
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
- Institute of Innovation for Future Society, Nagoya University, Nagoya, Japan
| | - Taiki Sugimoto
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hirotaka Nakashima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Hitoshi Komiya
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Kazuhisa Watanabe
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Masaaki Nagae
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Yosuke Yamada
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Tomihiko Tajima
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Tomomichi Sakai
- Department of Community Healthcare and Geriatrics, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya City, Aichi, 466-8550, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, National Center for Geriatrics and Gerontology, Obu, Japan
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11
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Assi S, Garcia Morales EE, Du EY, Martinez-Amezcua P, Reed NS. Association of Single and Dual Sensory Impairment with Falls among Medicare Beneficiaries. J Aging Health 2024; 36:390-399. [PMID: 37505080 DOI: 10.1177/08982643231190983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Objective: The purpose of this study was to determine if dual sensory impairment (DSI) is associated with falls and fear of falling among older adults. Methods: Using data from the 2019 Medicare Current Beneficiary Survey (MCBS), we studied the cross-sectional association of self-reported hearing/vision impairment with self-reported history/number of falls over the past year, fear of falling (scale 1-6), and a fall requiring medical help using weighted multivariable regressions adjusted for demographic and clinical covariates. Results: Among 11,089 Medicare beneficiaries (mean age = 74, 55% female, 9% Black), DSI is associated with increased prevalence (prevalence ratio = 1.45 [1.28-1.65]) and incidence (incidence ratio = 2.21 [1.79-2.75]) rate of falls, and greater odds of a higher fear of falling score (odds ratio = 1.38 [1.08-1.77]). Discussion: DSI is associated with falls among older adults. Consideration of DSI as a marker to initiate fall prevention programs and inclusion of sensory interventions in these programs may be valuable.
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Affiliation(s)
- Sahar Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emmanuel E Garcia Morales
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric Y Du
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Otolaryngology, Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Pablo Martinez-Amezcua
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, 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, Baltimore, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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12
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Branding M, Fleischmann N, Wittland M. [Hearing in the elderly: Employees' perspectives on hearing care in long-term care facilities. A qualitative study]. Pflege 2024. [PMID: 38809026 DOI: 10.1024/1012-5302/a000995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Hearing in the elderly: Employees' perspectives on hearing care in long-term care facilities. A qualitative study Abstract: Background: Hearing impairment is common among the elderly. More than half of individuals 80 years and older exhibit severe hearing loss, and few retain good hearing performance. This impairment significantly affects both community participation and nursing care. Aim: This study aimed to examine the impact of hearing impairment on everyday life of employees and residents at long-term care facilities. We further sought to identify how employees perceive hearing care in order to identify potential for improvement. Methods: This sub-project of a larger study comprised guided focus groups with employees of long-term care facilities. The sample included six focus groups of nurses and nursing care assistants from long-term care facilities (n = 42). Collected data were analyzed using qualitative content analysis. Results: Hearing impairment hinders elderly resident participation in the nursing process and complicates daily communication between residents and nursing staff. Hearing impaired residents are less able to take part in group activities and tend to withdraw from the community. Lack of an effective hearing support structure renders hearing care services inaccessible to some residents. Conclusions: Optimized service structures, targeted assistance and training opportunities for employees specific to hearing impairment can provide sustainable hearing care for the elderly.
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Affiliation(s)
- Melina Branding
- Fakultät V - Diakonie, Gesundheit und Soziales, Abteilung Pflege und Gesundheit, Hochschule Hannover, Deutschland
| | - Nina Fleischmann
- Fakultät V - Diakonie, Gesundheit und Soziales, Abteilung Pflege und Gesundheit, Hochschule Hannover, Deutschland
| | - Michael Wittland
- Fakultät V - Diakonie, Gesundheit und Soziales, Abteilung Pflege und Gesundheit, Hochschule Hannover, Deutschland
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13
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Pryce H, Smith S, Burns O'Connell G, Hussain S, Straus J, Shaw R. The lived experience of hearing loss - an individualised responsibility. Int J Audiol 2024:1-9. [PMID: 38767328 DOI: 10.1080/14992027.2024.2351037] [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: 09/22/2023] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE This study aimed to provide a conceptual model to understand what typifies the lived experience of hearing loss. DESIGN A grounded theory informed study of adults with hearing loss (n = 46) who participated in individual interviews. The data were analysed in line with the constant comparative approach of grounded theory. A substantial patient and public engagement (PPIE) strategy underpinned decisions and processes throughout. STUDY SAMPLE Adults were recruited from age bands (16-29; 30-49;50-79 and 80 upwards) to provide different lived experience. We recruited individuals from across the UK including urban, sub-urban and rural communities and included a typical constituency of each location including black and minority ethnic participants. Our PPIE groups included adults often marginalised in research including South Asian community groups, adults in residential care and those with additional disabilities. RESULTS We identified the consistent features of the lived experience with hearing loss, as the individualised responsibility that hearing loss confers. These are an individual auditory lifeworld; social comparison and social support; individual and patient-centred care and individual agency and capability. CONCLUSIONS This work provides new insights for those practising audiology and highlights the importance of building social support systems through implementation of family and peer support approaches.
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Affiliation(s)
- Helen Pryce
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Sian Smith
- Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Georgie Burns O'Connell
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Saira Hussain
- Department of Audiology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Rachel Shaw
- Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
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14
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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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15
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Joo HH, Huang EY, Schoo D, Ward B, Chen JX. Association Between Hearing Difficulty and Mobility in Adults of All Ages: National Health Interview Survey. Otolaryngol Head Neck Surg 2024; 170:1059-1065. [PMID: 38037415 DOI: 10.1002/ohn.593] [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: 07/26/2023] [Revised: 10/21/2023] [Accepted: 11/04/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To investigate the relationship between hearing difficulty and measures of mobility for US adults. STUDY DESIGN Cross-sectional study. SETTING 2021 National Health Interview Survey. METHODS The survey asked US adults about hearing difficulty and mobility measures, including difficulty walking 100 yards, difficulty climbing 12 steps, and injury from falling within the past 3 months. Multivariable logistic regressions examined the associations between hearing and mobility outcomes, controlling for visual difficulty, medical comorbidities, and various demographic characteristics (age [18-39, 40-64, 65+], race/ethnicity, sex, socioeconomic status). RESULTS The 2021 NHIS surveyed 29,467 adults, representing 253 million people in weighted responses (52% female; mean age 48.3, standard deviation = 18.6). Controlling for covariates, hearing difficulty was associated with increased odds of difficulty walking 100 yards (odds ratio, OR = 1.47, P < .001), difficulty climbing stairs (OR = 1.62, P < .001), and injury from falling in the past 3 months (OR = 1.51, P < .001). There was a significant interaction between age and hearing difficulty for injurious falls; stratifying by age revealed that younger adults (ages 18-39) with hearing difficulty were more likely to report recent harmful falls than their normal hearing peers; this increased risk was greater in magnitude than that observed comparing older adults with and without hearing difficulty. CONCLUSION The hearing difficulty is associated with worsened mobility for US adults and may be a stronger independent predictor of injury from falls for younger adults as compared to older adults. These findings can inform interventions to reduce the burden of declining mobility in adults with hearing difficulty.
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Affiliation(s)
- Henry H Joo
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Emily Y Huang
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Desi Schoo
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Bryan Ward
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Jenny X Chen
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA
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16
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Nieman CL, Thorpe RJ, Oh ES. Hearing loss and cognitive decline: Prioritizing equity in a world in which hearing health matters. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12484. [PMID: 38911874 PMCID: PMC11191749 DOI: 10.1002/trc2.12484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 06/25/2024]
Abstract
Alzheimer's disease and related dementias (ADRDs) and age-related hearing loss are the intersection of two major public health challenges. With age as the primary risk factor for both disease processes, the burden of ADRDs and age-related hearing loss is growing, and each field maintains significant barriers to broadscale identification and management that is affordable and accessible. With the disproportionate burden of ADRDs among racial and ethnic minority older adults and existing disparities within hearing care, both areas face challenges in achieving equitable access and outcomes across diverse populations. The publication of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial in July 2023 marked a significant moment in the fields of brain and hearing health. The ACHIEVE trial was the first randomized controlled trial to examine whether providing hearing intervention, specifically provision of hearing aids, compared to an education control, would reduce cognitive changes over 3 years. The participants most at risk for cognitive decline, with lower education, lower income, more likely to identify as Black, and have more cardiovascular risk factors, were the participants who benefited most from the hearing intervention and are also the least likely to be represented in research and the least likely to obtain hearing care. With growing evidence of the interconnection between cognitive and sensory health, we have an opportunity to prioritize equity, from purposeful inclusion of diverse participants in trials to influencing the emerging market of over-the-counter hearing aids to supporting expanded models of hearing care that reach those who have traditionally gone unserved. No longer can hearing go unrecognized by clinicians, researchers, and advocates for brain health. At the same time, the fields of brain and hearing health must center equity if we are going to meet the needs of diverse older adults in a world in which hearing health matters.
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Affiliation(s)
- Carrie L. Nieman
- Department of Otolaryngology‐Head & Neck SurgeryJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Cochlear Center for Hearing & Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
| | - Roland J. Thorpe
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging ResearchJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Division of Geriatric Medicine and Gerontology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Esther S. Oh
- Cochlear Center for Hearing & Public HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Johns Hopkins University School of NursingBaltimoreMarylandUSA
- Division of Geriatric Medicine and Gerontology, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMarylandUSA
- Division of Neuropathology, Department of PathologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
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17
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Jansen LA, van Wier MF, Vernimmen FPJ, Goderie T, van de Berg R, Lemke U, Lissenberg-Witte BI, Kramer SE. Ten-year association between change in speech-in-noise recognition and falls due to balance problems: a longitudinal cohort study. BMC Public Health 2024; 24:732. [PMID: 38454406 PMCID: PMC10919036 DOI: 10.1186/s12889-024-18187-5] [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: 08/05/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study examined the relationship between speech-in-noise recognition and incident/recurrent falls due to balance problems ten years later (RQ-1); 10-year change in speech-in-noise recognition and falls (RQ-2a), as well as the role of dizziness in this relationship (RQ-2b). The association between hearing aid use and falls was also examined (RQ-3). METHODS Data was collected from the Netherlands Longitudinal Study on Hearing between 2006 and December 2022. Participants completed an online survey and digits-in-noise test every five years. For this study, data was divided into two 10-year follow-up time intervals: T0 (baseline) to T2 (10-year follow-up), and T1 (5-years) to T3 (15-years). For all RQs, participants aged ≥ 40 years at baseline, without congenital hearing loss, and non-CI users were eligible (n = 592). Additionally, for RQ-3 participants with a speech reception threshold in noise (SRTn) ≥ -5.5 dB signal-to-noise ratio were included (n = 422). Analyses used survey variables on hearing, dizziness, falls due to balance problems, chronic health conditions, and psychosocial health. Logistic regressions using General Estimating Equations were conducted to assess all RQs. RESULTS Among individuals with obesity, those with poor baseline SRTn had a higher odds of incident falls ten years later (odds ratio (OR):14.7, 95% confidence interval (CI) [2.12, 103]). A 10-year worsening of SRTn was significantly associated with a higher odds of recurrent (OR: 2.20, 95% CI [1.03, 4.71]) but not incident falls. No interaction was found between dizziness and change in SRTn. Hearing aid use (no use/ < 2 years use vs. ≥ 2 years) was not significantly associated with incident nor recurrent falls. Although there was a significant interaction with sex for this association, the effect of hearing aid use on incident/recurrent falls was not statistically significant among males nor females. CONCLUSIONS A longitudinal association between the deterioration in SRTn and recurrent falls due to balance problems after 10 years was confirmed in this study. This result stresses the importance of identifying declines in hearing earlier and justifies including hearing ability assessments within fall risk prevention programs. Mixed results of hearing aid use on fall risk warrant further investigation into the temporality of this association and possible differences between men and women.
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Affiliation(s)
- Lotte A Jansen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Marieke F van Wier
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Freek P J Vernimmen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Thadé Goderie
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands
| | - Ulrike Lemke
- Research & Development, Sonova AG, Staefa, Switzerland
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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18
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Tran Y, Tang D, Lo C, Macken O, Newall J, Bierbaum M, Gopinath B. Establishing multifactorial risk factors for adult-onset hearing loss: A systematic review with topic modelling and synthesis of epidemiological evidence. Prev Med 2024; 180:107882. [PMID: 38296002 DOI: 10.1016/j.ypmed.2024.107882] [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: 12/03/2023] [Revised: 01/24/2024] [Accepted: 01/27/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND This systematic review explores the multifaceted nature of risk factors contributing to adult-onset HL. The objective was to synthesise the most recent epidemiological evidence to generate pooled proportional incidences for the identified risk factors. METHODS We conducted an extensive search of electronic databases (MEDLINE, EMBASE, and psychINFO) for studies providing epidemiological evidence of risk factors associated with hearing loss. Topic modelling using Latent Dirichlet Allocation (LDA) was first conducted to determine how many risk factor themes were available from the papers. Data were analysed by calculating the pooled proportional incidence using a meta-analysis of proportions. RESULTS From the 72 studies reviewed, six key risk factor themes emerged through LDA topic modelling. The review identified ototoxicity, primarily caused by cancer treatments and antibiotics, infectious diseases like COVID-19, occupational noise exposure, lifestyle factors, health conditions, biological responses, and age progression as significant risk factors for HL. The highest proportional incidence was found with cancer-related ototoxicity at 55.4% (95%CI: 39.0-70.7), followed closely by ototoxicity from infectious diseases at 50.0% (95%CI: 28.5-71.5). This high proportional incidence suggests the need to explore less destructive therapies and proactively monitor hearing function during treatments. CONCLUSIONS The findings of this review, combined with the synthesis of epidemiological evidence, enhance our understanding of hearing loss (HL) pathogenesis and highlight potential areas for intervention, thereby paving the way for more effective prevention and management of adult-onset hearing loss in our ageing global population.
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Affiliation(s)
- Yvonne Tran
- Macquarie University Hearing Research Centre, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
| | - Diana Tang
- Macquarie University Hearing Research Centre, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
| | - Charles Lo
- Australian College of Applied Professions, Sydney, NSW 2000, Australia.
| | - Oonagh Macken
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
| | - John Newall
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
| | - Mia Bierbaum
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
| | - Bamini Gopinath
- Macquarie University Hearing Research Centre, Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia.
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19
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Wallace LG, Hirschman KB, Huang L, Cacchione PZ, Naylor MD. Hospitalizations, Emergency Department Visits, and Home Health Use Among Older Adults With Sensory Loss. J Aging Health 2024; 36:133-142. [PMID: 37207352 PMCID: PMC11062497 DOI: 10.1177/08982643231176669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Objectives: This study examines healthcare resource use (hospitalizations, emergency department [ED] visits, and home health episodes) among adults 65 and older diagnosed with hearing, vision, or dual sensory loss (SL) seen in the primary care setting of an academic health system. Methods: Multivariable logistic regression models were used to examine the relationship between SL (identified using ICD-10 codes) and healthcare resource use for 45,000 primary care patients. Results: The sample included 5.5% (N = 2479) with hearing loss, 10.4% (N = 4697) with vision loss, and 1.0% with dual SL (N = 469). Hearing loss increased the likelihood of having an ED visit (OR = 1.22, CI: 1.07-1.39), and home health services (OR = 1.27, CI: 1.07-1.51) compared to older adults without any SL. Vision loss reduced the likelihood of having a hospitalization (OR = .81, CI: .73-.91). Discussion: Findings support research into the drivers of healthcare use among older adults with sensory loss.
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Affiliation(s)
- Laura G. Wallace
- University of Pennsylvania School of Nursing
- NewCourtland Center for Transitions and Health at the University of Pennsylvania
- Jonas Foundation Vision Scholars
- Leonard Davis Institute of Health Economics at the University of Pennsylvania
| | - Karen B. Hirschman
- University of Pennsylvania School of Nursing
- NewCourtland Center for Transitions and Health at the University of Pennsylvania
- Leonard Davis Institute of Health Economics at the University of Pennsylvania
| | - Liming Huang
- University of Pennsylvania School of Nursing
- NewCourtland Center for Transitions and Health at the University of Pennsylvania
| | - Pamela Z. Cacchione
- University of Pennsylvania School of Nursing
- NewCourtland Center for Transitions and Health at the University of Pennsylvania
- Jonas Foundation Vision Scholars
- Leonard Davis Institute of Health Economics at the University of Pennsylvania
| | - Mary D. Naylor
- University of Pennsylvania School of Nursing
- NewCourtland Center for Transitions and Health at the University of Pennsylvania
- Leonard Davis Institute of Health Economics at the University of Pennsylvania
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20
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Humes LE, Dhar S, Manchaiah V, Sharma A, Chisolm TH, Arnold ML, Sanchez VA. A Perspective on Auditory Wellness: What It Is, Why It Is Important, and How It Can Be Managed. Trends Hear 2024; 28:23312165241273342. [PMID: 39150412 PMCID: PMC11329910 DOI: 10.1177/23312165241273342] [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: 04/04/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024] Open
Abstract
During the last decade, there has been a move towards consumer-centric hearing healthcare. This is a direct result of technological advancements (e.g., merger of consumer grade hearing aids with consumer grade earphones creating a wide range of hearing devices) as well as policy changes (e.g., the U.S. Food and Drug Administration creating a new over-the-counter [OTC] hearing aid category). In addition to various direct-to-consumer (DTC) hearing devices available on the market, there are also several validated tools for the self-assessment of auditory function and the detection of ear disease, as well as tools for education about hearing loss, hearing devices, and communication strategies. Further, all can be made easily available to a wide range of people. This perspective provides a framework and identifies tools to improve and maintain optimal auditory wellness across the adult life course. A broadly available and accessible set of tools that can be made available on a digital platform to aid adults in the assessment and as needed, the improvement, of auditory wellness is discussed.
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Affiliation(s)
- Larry E. Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Sumitrajit Dhar
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Virtual Hearing Lab, Collaborative initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, Colorado, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anu Sharma
- Brain and Behavior Laboratory, Department of Speech Language and Hearing Sciences, Institute of Cognitive Science, Center for Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
| | - Theresa H. Chisolm
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Michelle L. Arnold
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Victoria A. Sanchez
- Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
- Department of Otolaryngology-Head & Neck Surgery, University of South Florida, Tampa, Florida, USA
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21
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Sutin AR, Luchetti M, Stephan Y, Canada B, Terracciano A. Purpose in Life and Risk of Falls: A Meta-Analysis of Cross-Sectional and Prospective Associations. Gerontol Geriatr Med 2024; 10:23337214241236039. [PMID: 38455641 PMCID: PMC10919135 DOI: 10.1177/23337214241236039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/15/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
Background and Aim: Purpose in life is an aspect of well-being that is associated with better health outcomes in older adulthood. We examine the association between purpose in life and likelihood of a recent fall and risk of an incident fall over time. Methods: Purpose in life and falls were reported concurrently and falls were reported again up to 16 years later in four established longitudinal studies of older adults (total N = 25,418). Results: A random-effects meta-analysis of the four samples indicated that purpose was associated with a 14% lower likelihood of having fallen recently at baseline (meta-analytic OR = 0.88, 95% CI [0.84-0.92]). Among participants who reported no falls at baseline (N = 15,632), purpose was associated with a nearly 10% lower risk of an incident fall over the up to 16-year follow-up (meta-analytic HR = 0.92, 95% CI [0.90-0.94]). These associations were independent of age, sex, race, ethnicity, and education, were not moderated by these factors, and persisted controlling for physical activity and disease burden. Conclusion and Recommendations: Purpose in life is a meaningful aspect of well-being that may be useful to identify individuals at risk for falling, particularly among individuals without traditional risk factors, and be a target of intervention to reduce fall risk.
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Affiliation(s)
| | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
| | - Yannick Stephan
- Euromov, University of Montpellier, Montpellier, Occitanie, France
| | - Brice Canada
- University of Lyon 1, Villeurbanne, Auvergne-Rhône-Alpes, France
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22
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Yang TH, Chen YF, Cheng YF, Huang JN, Wu CS, Chu YC. Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S. BioData Min 2023; 16:35. [PMID: 38098102 PMCID: PMC10722728 DOI: 10.1186/s13040-023-00351-z] [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: 11/04/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVES The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults. METHODS We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model-which had the greatest AUC of 0.83 (95% CI 0.81-0.85)-was then only used on the holdout testing data. RESULTS On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79-0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques-specifically, the LGBM classifier-with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects. CONCLUSIONS Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.
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Affiliation(s)
- Tzong-Hann Yang
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan
- General Education Center, University of Taipei, Taipei, 10671, Taiwan
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Fu Chen
- Department of Speech-Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, 112303, Taiwan
| | - Yen-Fu Cheng
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, 112, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Jue-Ni Huang
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Chuan-Song Wu
- Department of Otorhinolaryngology, Taipei City Hospital, Taipei, 100, Taiwan.
- College of Science and Engineering, Fu Jen University, Taipei, 243, Taiwan.
| | - Yuan-Chia Chu
- Information Management Office, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Big Data Center, Taipei Veterans General Hospital, Taipei, 112, Taiwan.
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, 112, Taiwan.
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23
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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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Powell DS, Garcia Morales EE, Oh E, Deal JA, Samus QM, Wolff JL, Reed NS. Dementia and Hearing Aid Use and Cessation: A National Study. Am J Audiol 2023; 32:898-907. [PMID: 37713529 PMCID: PMC11001429 DOI: 10.1044/2023_aja-23-00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/12/2023] [Accepted: 07/25/2023] [Indexed: 09/17/2023] Open
Abstract
PURPOSE The current standard for management of hearing loss in the United States involves the use of a hearing aid. Anecdotal evidence suggests that the use of a hearing aid may be less effective in the context of dementia, though national data on use and cessation are not described. METHOD This longitudinal analysis of the National Health and Aging Trends Study followed participants who self-reported hearing aid use to estimate risk of hearing aid cessation over 9 years. We examine whether hearing aid cessation differs by dementia status using generalized estimating equations logistic regression accounting for loss to follow-up. Supplemental analyses were undertaken to examine the contribution of caregiving and environmental factors on hearing aid cessation. RESULTS Of 1,310 older adults who reported hearing loss (25% 80-84 years, 51% women, 74% White), 22% with dementia and 57% baseline hearing aid use. Dementia increased likelihood of ceasing hearing aid use during the first year after adoption (OR = 2.07, 95% CI [1.33, 3.23], p interaction = .11). In later years, older adults with either a previous or recent diagnosis of dementia had a 95% higher odds of hearing aid cessation (OR = 1.95, 95% CI [1.31, 2.90]), a decrease in odds with respect to the first year after adoption, when compared to participants without dementia, after adjusting for demographic, health, and economic factors. Economic and social factors that may influence care demands (more caregivers, income-to-poverty ratio, and additional insurance) increased likelihood for cessation for those with dementia. CONCLUSIONS Older adults with (vs. without) dementia are more likely to cease hearing aid use over time, most notably during the first year after adoption. Strategies to support hearing ability, such as self-management or care partner education, may improve communication for those living with co-occurring hearing loss and dementia.
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Affiliation(s)
- Danielle S. Powell
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| | - Emmanuel E. Garcia Morales
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Esther Oh
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Quincy M. Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jennifer L. Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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25
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Ramos KA, Colosimo EA, Duarte YADO, Bof de Andrade F. Effect of polypharmacy and Fall-Risk-Increasing Drugs (FRIDs) on falls among Brazilian older adults: The SABE cohort study. Arch Gerontol Geriatr 2023; 115:105127. [PMID: 37480721 DOI: 10.1016/j.archger.2023.105127] [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: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/24/2023]
Abstract
Polypharmacy, considered as the use of multiple medications, has been one of the factors associated with a higher risk of falls among older adults. However, the association of this factor regardless of the use of Fall-Risk-Increasing Drugs (FRIDs) has not been extensively explored. OBJECTIVES This study aimed to evaluate the longitudinal association of polypharmacy with falls and verify whether this association is independent of FRID use. METHODS A longitudinal study was conducted with a representative sample of the urban population aged 60 years and over in the city of São Paulo, Brazil, from 2000 to 2006. The analysis of the association among polypharmacy, the use of FRIDs, and the occurrence of falls over the years was performed using Generalized Estimating Equation (GEE) models adjusted for covariates. RESULTS The association between polypharmacy and falls was significantly attenuated after the adjustment for covariates and FRIDs. Users of two or more FRIDs had higher odds of falls (OR = 1.51; CI [1.16; 1.96]). CONCLUSION FRID use was associated with the occurrence of falls among older adults. The number of medications must be kept to the minimum necessary, and FRIDs should be avoided in approaches to preventing falls among older adults.
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Affiliation(s)
- Karina Alves Ramos
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Brazil
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26
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Kojima K, Okada E, Ojima T, Kondo K. Association between hearing status and social participation in Japanese older adults: A cross-sectional study from the Japan gerontological evaluation study. Arch Gerontol Geriatr 2023; 115:105109. [PMID: 37399682 DOI: 10.1016/j.archger.2023.105109] [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: 03/16/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Hearing is known to decline with age. As sensitivity to speech declines, conversation becomes more difficult and social interactions are affected, resulting in increased risk of cognitive decline. This study aimed to examine the relationship between hearing status and social participation. MATERIALS AND METHODS The study included 21,117 adults aged 65 years or older who responded to a survey in 2019. The survey asked participants about their hearing status and how frequently they participated in certain social activities. RESULTS The analysis of the relationship between degree of hearing and social activity showed lower hearing status odds ratios for those who participated more frequently in social activities compared to those who participated less frequently. The odds ratios were as follows, hobby clubs (OR 0.81, 95%CI 0.78-0.84), activities such as teaching skills or passing on experiences to others (OR 0.69, 95%CI 0.65-0.75), and meeting with friends (OR 0.77, 95%CI 0.74-0.79). Compared to those who did not participate in social activities, those who participated in three or more types of groups had significantly lower hearing impairment (OR 0.75, 95% CI 0.72-0.79). CONCLUSION Hearing impairment was shown to inhibit participation in activities, including those that require communication with multiple people or smooth communication, those that involve a wide range of ages, and those that involve work and movement. Hearing impairment should be identified and addressed in its early stages to prevent its negative impact on social participation.
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Affiliation(s)
- Kaori Kojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan.
| | - Eisaku Okada
- Faculty of Social Policy & Administration, Hosei University, 4342 Aihara, Machida, Tokyo 194-0298, Japan.
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan.
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan; Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu City, Aichi 474-8511, Japan.
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27
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Carlson ML, Lohse CM, Marinelli JP, Sydlowski SA, Collaborative HH. Perceptions Surrounding Cochlear Implants Among At-Risk and Qualifying Older Adults in the United States. Otol Neurotol 2023; 44:1021-1026. [PMID: 37889933 PMCID: PMC10662571 DOI: 10.1097/mao.0000000000004041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
OBJECTIVE Limited evidence to date has examined public perceptions of cochlear implants among adult hearing aid users with moderate to profound hearing loss. The current work was conceived with the chief objective of characterizing the perceptions surrounding cochlear implants among the prospective candidate pool. STUDY DESIGN National cross-sectional survey study. SETTING United States. PATIENTS Adults between 50 and 80 years of age with self-reported moderate to moderately severe (n = 200) or moderately severe to profound (n = 200) hearing loss currently using hearing aids. RESULTS The overall survey response rate was 12%. Median age at time of survey for the 400 respondents was 66 years (interquartile range, 60-71 yr) and included 215 (54%) men. In total, 26% did not think of hearing loss as a medical condition, and another 23% were unsure. Overall, 63% of respondents had heard of cochlear implants, but only 2% indicated they were very familiar with them. Despite 52% of respondents reporting "very positive" or "somewhat positive" feelings about cochlear implants, only 9% indicated they were "very likely" to get a cochlear implant in the future, including 7% of those with estimated moderately severe to profound hearing loss at time of survey. CONCLUSIONS Even among people with presumed qualifying levels of hearing loss, there exists a widespread lack of familiarity with cochlear implantation as a viable treatment option. This limited awareness seems influenced by a generally poor appreciation for hearing loss as a chronic disease state that warrants treatment. However, among those familiar with cochlear implants, they are generally viewed favorably.
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Affiliation(s)
| | - Christine M. Lohse
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - John P. Marinelli
- Department of Otolaryngology–Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas
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28
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Yan L, Huo Y, Shi J, Dong Y, Tan H. Traditional Chinese medicine for the prevention and treatment of presbycusis. Heliyon 2023; 9:e22422. [PMID: 38076135 PMCID: PMC10703638 DOI: 10.1016/j.heliyon.2023.e22422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 10/10/2024] Open
Abstract
Background Presbycusis/Age-related hearing loss is a sensorineural hearing loss caused by age-related deterioration of the auditory system that poses a risk to the physical and mental health of older people, including social and cognitive decline. It is also associated with frailty, falls and depression. There are currently no specific medications for the treatment of presbycusis, and early detection and intervention are key to its prevention and management. Traditional Chinese medicine interventions may offer opportunities in the prevention and treatment of presbycusis, but there is no relevant review. Methods Literature searches was conducted using PubMed, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases for review articles, research articles, clinical trials, meta-analyses, and case studies in animal models and clinical trials. Results We summarized the pathological mechanisms associated with presbycusis, related to genetic factors, environment, lifestyle, and molecular mechanisms related to oxidative stress, mitochondrial dysfunction, and inflammatory pathways. It is suggested that traditional Chinese medicine interventions may offer opportunities in the prevention and treatment of presbycusis using active ingredients of herbs or formulas, acupuncture, and exercise such as Tai Chi Chuan or Ba Duan Jin. The active ingredients of herbs or formulas may exert ear protection through Nrf2-mediated antioxidant pathways, NF-kB and NLRP3-related anti-inflammatory signaling, and regulation of autophagy. Conclusions Here, we review the pathogenetic factors and pathological mechanisms involved in presbycusis, as well as traditional Chinese medicine interventions and treatments, with the aim of providing a new perspective for the prevention and treatment of hearing loss in the elderly and further improving their quality of life.
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Affiliation(s)
- Li Yan
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yan Huo
- Department of Otolaryngology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Jianrong Shi
- School of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yang Dong
- School of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hongsheng Tan
- Clinical Research Institute & School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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29
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Behtani L, Paromov D, Moïn-Darbari K, Houde MS, Bacon BA, Maheu M, Leroux T, Champoux F. Sensory Reweighting for Postural Control in Older Adults with Age-Related Hearing Loss. Brain Sci 2023; 13:1623. [PMID: 38137071 PMCID: PMC10741952 DOI: 10.3390/brainsci13121623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/24/2023] Open
Abstract
There is growing evidence linking hearing impairments and the deterioration of postural stability in older adults. To our knowledge, however, no study to date has investigated the effect of age-related hearing loss on the sensory reweighting process during postural control. In the absence of data, much is unknown about the possible mechanisms, both deleterious and compensatory, that could underly the deterioration of postural control following hearing loss in the elderly. The aim of this study was to empirically examine sensory reweighting for postural control in older adults with age-related hearing loss as compared to older adults with normal hearing. The center of pressure of all participants was recorded using a force platform and the modified clinical test of sensory interaction and balance protocol. The results suggest that individuals with age-related hearing loss displayed increased somatosensory reliance relative to normal hearing younger adults. This increased reliance on somatosensory input does not appear to be effective in mitigating the loss of postural control, probably due to the concomitant deterioration of tactile and proprioceptive sensitivity and acuity associated with aging. Beyond helping to further define the role of auditory perception in postural control, these results further the understanding of sensory-related mechanisms associated with postural instability in older adults.
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Affiliation(s)
- Lydia Behtani
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
- Centre de Recherche de L’institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W4, Canada
| | - Daniel Paromov
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
- Centre de Recherche de L’institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W4, Canada
| | - Karina Moïn-Darbari
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
| | - Marie-Soleil Houde
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
| | - Benoit Antoine Bacon
- Department of Psychology, Faculty of Art and Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Maxime Maheu
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
- Institut Universitaire Sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H2H 2N8, Canada
| | - Tony Leroux
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
| | - François Champoux
- School of Speech Language Pathology and Audiology, Faculty of Medecine, Université de Montréal, Montréal, QC H3T 1J4, Canada; (L.B.); (D.P.); (K.M.-D.); (M.-S.H.); (M.M.); (T.L.)
- Centre de Recherche de L’institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC H3W 1W4, Canada
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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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Shao L, Shi Y, Xie XY, Wang Z, Wang ZA, Zhang JE. Incidence and Risk Factors of Falls Among Older People in Nursing Homes: Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1708-1717. [PMID: 37433427 DOI: 10.1016/j.jamda.2023.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Falls are common among older people in nursing homes, and the assessment of fall risk factors is critical for the success of fall prevention interventions. This study aimed to systematically assess the incidence and risk factors of falls in older people living in nursing homes. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Older people living in nursing homes. METHODS Literature searches were conducted independently by 2 researchers in 8 databases. Qualities of included studies were assessed using the Newcastle-Ottawa Scale. The prevalence and risk factors of falls were analyzed with a random effects model. All analyses were performed by R software, x64 4.2.2. RESULTS In 18 prospective studies addressing older adults living in nursing homes, the pooled incidence of falls was 43% (95% CI 38%-49%), and the meta-regression analysis indicated that the incidence generally decreased from 1998 to 2021. The following risk factors had a strong association with all falls: fall history, impaired ADL performance, insomnia, and depression. Risk factors with low to moderate correlation were vertigo, walking aids, poor balance, use of antidepressants, use of benzodiazepines, use of antipsychotics, use of anxiolytics, polypharmacy, dementia, unsteady gait, hearing problems, and gender (being male). Having bed rails was identified as a protective environmental factor. CONCLUSIONS AND IMPLICATIONS The results from our meta-analysis suggest that the incidence of falls of older adults living in nursing homes is high, and the risk factors for falls are various. Assessments of balance and mobility, medical condition, and use of medications should be included as key elements in the fall risk assessments of older people in nursing homes. Environmental risk factors still need to be explored in future studies. Tailored fall prevention strategies should be implemented by addressing the modifiable risk factors.
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Affiliation(s)
- Lu Shao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ying Shi
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Xi-Yan Xie
- Nursing Department, Home for the Aged Guangzhou, Guangzhou, China
| | - Zhong Wang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Zhang-An Wang
- Research Center of Health Management, Guangxi Academy of Medical Sciences, Nanning, China
| | - Jun-E Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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Völter C, Götze L, Ballasch I, Harbert L, Dazert S, Thomas JP. Third-party disability in cochlear implant users. Int J Audiol 2023; 62:1059-1066. [PMID: 36411948 DOI: 10.1080/14992027.2022.2125913] [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: 06/13/2021] [Accepted: 09/13/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To date, auditory rehabilitation mainly focuses on the person with hearing impairment (PHI). This study aimed to analyse the burden of hearing loss on significant others (SOs), and to explore the impact of contextual and mediating psychosocial co-factors and auditory rehabilitation by cochlear implantation (CI). DESIGN AND STUDY SAMPLE Third-party disability (SOS-HEAR) and quality of life (Nijmegen Cochlear Implant Questionnaire) were evaluated in 41 PHI scheduled for CI surgery and their close partners pre- and 6-month post-implantation. Further, age, hearing status, educational level, depressive symptoms (GDS-15), coping strategies (Brief-COPE), resilience (RS-13), stress (PSQ) of SOs and PHI were studied. RESULTS Hearing loss imposes a burden on SOs, particularly in relation to changes in communication and socialisation. Third-party disability was higher in SOs of PHI with lower educational background (p = 0.04) and of advanced age (p = 0.008). Hearing status of SOs negatively correlated with SOS-HEAR (p = 0.04). After CI, quality of life of PHI and third-party disability of SOs improved (p < 0.001), except in relationship changes. SOs with higher pre-operative burden also experienced more third-party disability afterwards (p ≤ 0.003). CONCLUSION Audiological rehabilitation should expand to include SOs in the rehabilitation process, as the burden experienced by SOs might persist even after CI.
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Affiliation(s)
- Christiane Völter
- The Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
| | - Lisa Götze
- The Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
| | - Isabel Ballasch
- The Department for Neuropsychology, University of Cologne, Cologne, Germany
| | - Lisa Harbert
- The Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
| | - Stefan Dazert
- The Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
| | - Jan Peter Thomas
- The Department of Otorhinolaryngology, Head and Neck Surgery, St. Johannes-Hospital Dortmund, Dortmund, Germany
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Niknazar S, Bazgir N, Shafaei V, Abbaszadeh HA, Zali A, Asghar Peyvandi A. Assessment of prognostic biomarkers in sudden sensorineural hearing loss: A systematic review and meta-analysis. Clin Biochem 2023; 121-122:110684. [PMID: 37944628 DOI: 10.1016/j.clinbiochem.2023.110684] [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: 07/03/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of more than 30 dB in less than 72 h. SSNHL is a frequent complaint and an emergency in otolaryngology. Various biomarkers have been used to determine the prognosis of SSNHL. This systematic review and meta-analysis aims to evaluate the relationship between the different biomarkers and the prognosis of SSNHL. We searched English-language literature up to October 2022 in four databases, including PubMed, Google Scholar, Cochrane, and Science Direct. This search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. This study was reported in the International Prospective Register of Systematic Reviews (PROSPERO) database (ID = CRD42022369538). All studies examining the role of neutrophil to lymphocyte ratio (NLR) concluded that higher NLR is associated with a worse prognosis. The results of studies regarding the relationship between platelet to lymphocyte ratio (PLR) and tumor necrosis factor (TNF) are controversial. Other factors shown to be associated with SSNHL include Glycated hemoglobin (HbA1C), blood glucose, iron levels, serum endocan, salusin-beta, and bone turnover biomarkers. This meta-analysis showed that PLR, NLR, and neutrophils were significantly different between recovered and non-recovered patients. PLR, NLR, and neutrophil count are reliable tools to assess the prognosis of patients with SSNHL.
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Affiliation(s)
- Somayeh Niknazar
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Narges Bazgir
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahideh Shafaei
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hojjat-Allah Abbaszadeh
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Anatomical Sciences and Biology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Functional Neurosurgery Research Center, Shohada Tajrish Comprehensive Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Asghar Peyvandi
- Hearing Disorders Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Sakurai R, Miura Y, Kodama K, Fujimoto M. Effect of auditory deprivation on adaptive locomotion: Interaction with lower visual field occlusion. Behav Brain Res 2023; 455:114671. [PMID: 37716551 DOI: 10.1016/j.bbr.2023.114671] [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: 07/04/2023] [Revised: 08/23/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023]
Abstract
Auditory stimuli have been suggested to play a role in adequately controlling movement; however, their influence is not fully understood, particularly regarding dynamic behaviors, such as adaptive locomotion. This study aimed to investigate whether auditory deprivation affects adaptive locomotion. In particular, we aimed to elucidate the role of the auditory sense in obstacle avoidance by manipulating the visual field, which provides crucial sensory information for movement control. Sixteen participants approached a 15-cm obstacle located 6 m away and stepped over it under four different conditions that combined two factors: the hearing condition controlled by wearing earmuffs with and without holes, and the lower visual field condition controlled by carrying opaque white and transparent boards. Spatiotemporal variables during the approach to the obstacle were measured using an electronic walkway, whereas foot clearance over the obstacle was assessed using a motion-capture system. Participants who experienced auditory deprivation and lower visual field occlusion demonstrated greater variability in step length when approaching the obstacle compared with the other conditions. The leading and trailing foot clearances were higher under lower visual field occlusion conditions. Furthermore, when participants were under conditions of auditory deprivation, greater variability was observed in the clearance of the leading foot. These results suggest that auditory information contributes to movement stabilization during adaptive locomotion. Our findings provide evidence that auditory and visual senses complement each other during motor actions, indicating that adaptive locomotion can be influenced by the integration of multiple sensory inputs.
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Affiliation(s)
- Ryota Sakurai
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
| | - Yuka Miura
- School of Health and Sports Sciences, Mukogawa Women's University, 6-46 Ikebiraki, Nishinomiya, Hyogo 663-8558, Japan
| | - Kentaro Kodama
- University Education Center, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo 192-0397, Japan
| | - Masahiro Fujimoto
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
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Oosthuizen I, Kumar LMS, Nisha KV, Swanepoel DW, Granberg S, Karlsson E, Manchaiah V. Patient-Reported Outcome Measures for Hearing Aid Benefit and Satisfaction: Content Validity and Readability. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4117-4136. [PMID: 37708535 DOI: 10.1044/2023_jslhr-22-00535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
PURPOSE Numerous patient-reported outcome measures (PROMs) are available to measure hearing aid benefit and satisfaction. It is unclear to what extent currently available PROMs on hearing aid outcomes, often developed decades ago, meet current guidelines for good content validity and readability. This study evaluated the content validity and readability of PROMs that focus on perceived hearing aid benefit and/or satisfaction. METHOD A literature review was conducted to identify eligible instruments. Content validity evaluation included mapping extracted questionnaire items to the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. In addition, study design in content validity methodology was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments study design checklist for PROM instruments. Readability was estimated using the Simple Measure of Gobbledygook measure. RESULTS Thirteen questionnaires were identified and evaluated. Item content focused primarily on the components of environmental factors as well as activity limitations and participation restrictions with less emphasis on body functions and personal factors. The content validity methodology analysis revealed an underuse or lack of reporting of a qualitative methodology in assessing patient and professional perspectives. All the included questionnaires exceeded the recommended sixth-grade reading level. CONCLUSIONS The categories covered by hearing aid PROMs vary considerably, with no single instrument comprehensively covering all the key ICF components. Future development of hearing aid outcome measures should consider a mixed methodology approach for improved content validity and ensure an appropriate reading level.
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Affiliation(s)
- Ilze Oosthuizen
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
| | | | | | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
- Ear Science Institute Australia, Subiaco, Western Australia
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora
| | - Sarah Granberg
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Elin Karlsson
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Vinaya Manchaiah
- Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa
- Virtual Hearing Lab, Aurora, CO
- Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance Clinic, University of Colorado Hospital, Aurora
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
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Podury A, Jiam NT, Kim M, Donnenfield JI, Dhand A. Hearing and sociality: the implications of hearing loss on social life. Front Neurosci 2023; 17:1245434. [PMID: 37854291 PMCID: PMC10579609 DOI: 10.3389/fnins.2023.1245434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
Hearing is essential to the formation of social relationships and is the principal afferent of social life. Yet hearing loss, which is one of the most prevalent forms of sensory disability worldwide and is critical for social development, has received little attention from the social interventionalist perspective. The purpose of this mini-review is to describe the basic neurobiological principles of hearing and to explore the reciprocal relationships between social support, hearing loss, and its psychosocial comorbidities. We also discuss the role of social enrichment in sensorineural recovery and identify open questions within the fields of hearing physiology and social networks.
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Affiliation(s)
- Archana Podury
- Harvard Medical School, Boston, MA, United States
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
- Department of Otolaryngology-Head & Neck Surgery, University of California, San Diego, San Diego, CA, United States
| | - Nicole T. Jiam
- Harvard Medical School, Boston, MA, United States
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, United States
| | - Minsu Kim
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, United States
| | | | - Amar Dhand
- Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
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Purnami N, Palandeng RW, Nugroho PS, Falerina R, Wiyadi HMS, Arifianto D, Moon IS. Screening for hearing loss using the electronic whisper test: A prospective cross-sectional study. Int J Crit Illn Inj Sci 2023; 13:173-177. [PMID: 38292393 PMCID: PMC10824205 DOI: 10.4103/ijciis.ijciis_21_23] [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: 05/15/2023] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 02/01/2024] Open
Abstract
Background Hearing screening is a method for early identification of hearing loss. Hearing screening is widely used in hospitals as part of physical examination. However, some of them are difficult to operate outside the hospitals regarding portability and user-friendliness. Therefore, we developed a simple yet easy-to-use portable electronic whisper test (EWT) for field deployment, particularly on many subjects. The EWT validity is a hearing screening method compared to pure-tone audiometry. Methods This study was a cross-sectional comparative with a prospective approach. The subjects were outpatients at the Audiology Clinic of Dr. Soetomo Academic Medical Center, Surabaya, Indonesia, who met the inclusion and exclusion criteria. Statistical analysis made sensitivity and specificity tables using a 2 × 2 table, positive and negative predictive values. Results Samples of 50 participants (100 ears) obtained a sensitivity value of 83%, specificity of 78%, positive predictive value of 45%, and negative predictive value of 95%. Conclusions The EWT is valid for use as a hearing screening method.
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Affiliation(s)
- Nyilo Purnami
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - Rian Waraney Palandeng
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - Puguh Setyo Nugroho
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - Rosa Falerina
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - H. M. S. Wiyadi
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - Dhany Arifianto
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitas Airlangga, Dr. Soetomo General Academic Hospital Center, Indonesia
| | - In Seok Moon
- Department of Otorhinolaryngology, Yonsei University, Seoul, South Korea
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Campos L, Prochazka A, Anderson M, Kaizer A, Foster C, Hullar T. Consistent hearing aid use is associated with lower fall prevalence and risk in older adults with hearing loss. J Am Geriatr Soc 2023; 71:3163-3171. [PMID: 37314100 PMCID: PMC10592632 DOI: 10.1111/jgs.18461] [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: 08/23/2022] [Revised: 04/21/2023] [Accepted: 05/16/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Falls and their sequelae cost more than $50 billion every year. Older adults with hearing loss are at 2.4 times greater risk of falls than their normal hearing peers. Current research is inconclusive about whether hearing aids can offset this increased fall risk, and no previous studies considered if outcomes differed based on the consistency of hearing aid use. METHODS Individuals 60 years and older with bilateral hearing loss completed a survey consisting of the Fall Risk Questionnaire (FRQ) and questions about hearing loss history, hearing aid use, and other common fall risk factors. In this cross-sectional study, fall prevalence, as well as fall risk (based on FRQ score), was compared between hearing aid users and non-users. A separate group of consistent hearing-aid users (at least 4 h daily use for more than 1 year) was also compared with inconsistent/non-users. RESULTS Responses from 299 surveys were analyzed. Bivariate analysis found 50% reduced odds of experiencing a fall for hearing aid users compared with non-users (OR = 0.50 [95% CI: 0.29-0.85], p = 0.01). After adjusting for age, sex, hearing loss severity, and medication usage, those who reported any hearing aid use still had lower odds of falls (OR = 0.48 [95% CI: 0.26-0.90], p = 0.02) and lower odds of being at risk for falls (OR = 0.36 [95% CI: 0.19-0.66] p < 0.001) than non-users. Results for consistent hearing aid users demonstrate an even stronger association of lowered odds of falling (OR = 0.35 [95% CI: 0.19-0.67], p < 0.001) and lower odds of being at risk for falls (OR = 0.32 [95% CI: 0.12-0.59], p < 0.001), suggesting a potential dose-response relationship. CONCLUSIONS These findings suggest that use of hearing aids-especially consistent hearing aid use-is associated with lower odds of experiencing a fall or being classified as at risk for falls in older individuals with hearing loss.
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Affiliation(s)
- Laura Campos
- School of Medicine, University of Colorado-Anschutz Medical Campus
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
| | - Allan Prochazka
- School of Medicine, University of Colorado-Anschutz Medical Campus
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
| | - Melinda Anderson
- School of Medicine, University of Colorado-Anschutz Medical Campus
| | | | - Carol Foster
- School of Medicine, University of Colorado-Anschutz Medical Campus
| | - Timothy Hullar
- Clinical Sciences, University of Colorado-Anschutz Medical Campus
- Otolaryngology, VA Portland Health Care System
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Shen S, Sayyid Z, Andresen N, Carver C, Dunham R, Marsiglia D, Yeagle J, Della Santina CC, Bowditch S, Sun DQ. Longitudinal Auditory Benefit for Elderly Patients After Cochlear Implant for Bilateral Hearing Loss, Including Those Meeting Expanded Centers for Medicare & Medicaid Services Criteria. Otol Neurotol 2023; 44:866-872. [PMID: 37621128 PMCID: PMC10527933 DOI: 10.1097/mao.0000000000003983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To examine the effect of patient age on longitudinal speech understanding outcomes after cochlear implantation (CI) in bilateral hearing loss. STUDY DESIGN Retrospective cohort study. SETTING Tertiary academic center. PATIENTS One thousand one hundred five adult patients with bilateral hearing loss receiving a unilateral CI between 1987 and 2022InterventionsNone. MAIN OUTCOME MEASURES Postoperative speech recognition outcomes, including AzBio sentences, consonant-nucleus-consonant word, and Hearing in Noise Test in quiet were analyzed at short-term (<2 yr), medium-term (2-8 y), and long-term (>8 yr) term postoperative intervals. RESULTS Eighty-six very elderly (>80 yr), 409 elderly (65-80 yr), and 709 nonelderly (18-65 yr) patients were included. Short-term postoperative AzBio scores demonstrated similar magnitude of improvement relative to preoperative scores in the very elderly (47.6, 95% confidence interval [CI], 28.9-66.4), elderly (49.0; 95% CI, 39.2-58.8), and nonelderly (47.9; 95% CI, 35.4-60.4). Scores for those older than 80 years remained stable after 2 years after implant, but in those 80 years or younger, scores continued to improve for up to 8 years (elderly: 6.2 [95% CI, 1.5-12.4]; nonelderly: 9.9 [95% CI, 2.1-17.7]) after implantation. Similar patterns were observed for consonant-nucleus-consonant word scores. Across all age cohorts, patients with preoperative Hearing in Noise Test scores between 40 and 60% had similar scores to those with preoperative scores of less than 40%, at short-term (82.4, 78.9; 95% CI, -23.1 to 10.0), medium-term (77.2, 83.9; 95% CI, -15.4 to 8.2), or long-term (73.4, 71.2; 95% CI, -18.2 to 12.2) follow-up. CONCLUSIONS Patients older than 80 years gain significant and sustained auditory benefit after CI, including those meeting expanded Centers for Medicare & Medicaid Service criteria for implantation. Patients younger than 80 years demonstrated continued improvement over longer periods than older patients, suggesting a role of central plasticity in mediating CI outcomes as a function of age.
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Affiliation(s)
- Sarek Shen
- Johns Hopkins School of Medicine, Department of Otolaryngology-Head and Neck Surgery. Baltimore, Maryland. USA
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Seo H, Yoon J, Cho OH. Falls, fear of falling, and related factors in patients with diabetic foot disease. Appl Nurs Res 2023; 73:151715. [PMID: 37722783 DOI: 10.1016/j.apnr.2023.151715] [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: 09/12/2022] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Falls and fear of falling (FOF) are common in patients with diabetic foot disease (DFD). PURPOSE To understand the relationship between falls, FOF, and related factors in patients with DFD. METHOD We recruited 70 patients being treated for DFD at two hospitals in Korea. A structured questionnaire was used in investigating fall experience, FOF, and related factors. RESULTS Among the participants, 42.8 % fell in the past year, and FOF was reported in 57.1 %. Rates of "no caregiver," "DFD duration (>1 year)," and "burning pain" were higher in fallers than non-fallers. The rates of "older adults (≥65 years of age)," "unemployed," "not using assistive devices," "visual impairment," and "hearing impairment" were higher in patients with FOF than in those without FOF. However, the level of balance confidence was lower in patients with FOF. CONCLUSIONS The fall experience of patients with DFD was associated with the presence of their caregiver, disease-related factors, and foot pain symptoms, while FOF was related to age and fall-related factors.
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Affiliation(s)
- Hyerim Seo
- Department of Nursing, Chungnam National University Sejong Hospital, Sejong, Republic of Korea.
| | - Jeongeun Yoon
- Department of Nursing, Kunsan College of Nursing, Gunsan, Republic of Korea
| | - Ok-Hee Cho
- Department of Nursing, College of Nursing and Health, Kongju National University, Gongju, Republic of Korea.
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Lavie L, Tobia N, Slav-Zarfati N, Castel S, Banai K. Are Current Data Sufficient to Infer that Hearing Aids Contribute to Postural Control and Balance in Older Adults? A Systematic Review. Folia Phoniatr Logop 2023; 76:232-244. [PMID: 37717567 PMCID: PMC11151983 DOI: 10.1159/000534164] [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: 04/24/2023] [Accepted: 09/14/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION Balance and postural control are related to hearing and hearing loss, but whether they can be improved with hearing aid use in older adults is not clear. We systematically reviewed controlled studies in which balance and hearing were tested in experienced older hearing aid users to determine the potential effects of hearing aid use on balance. METHODS The review was pre-registered in PROSPERO and performed in accordance with PRISMA. The question, inclusion, and exclusion criteria were defined using the Population, Intervention, Control, Outcomes and Study design (PICOS) framework. Older adults with hearing loss and no experience with hearing aids, or balance tests conducted without hearing aids in hearing aid users served as controls. RESULTS A total of 803 studies were screened, eight of which met the inclusion and exclusion criteria and were included in the final review. Five of the eight studies found a significant correlation between the use of hearing aids and the outcomes of the balance tests. The quality of the studies was limited or moderate. Key Discussion: The role of hearing aids in balance and postural control is unclear because of the quality of the papers and the sparse reporting of hearing status and hearing aids quality of fitting and use.
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Affiliation(s)
- Limor Lavie
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Nawras Tobia
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Neta Slav-Zarfati
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Shefi Castel
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Karen Banai
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
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Criter RE, Augustyniak E. Screening for Falls: A Prospective Pilot Study for the Audiology Clinic. Am J Audiol 2023; 32:583-592. [PMID: 37541284 DOI: 10.1044/2023_aja-23-00021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
PURPOSE The purpose of this study was to determine if clinical measures that audiologists may already be using or are able to collect on a routine basis are useful in screening for future falls. METHOD This prospective cohort study protocol included 20 community-dwelling participants aged 60 years or older who completed case history questions, pure-tone and speech audiometry, common questionnaires, the Timed Up and Go test, and a prospective 6-month falls diary to determine which measures were correlated with the number of prospective 6-month falls. RESULTS Five participants (25%) fell in the 6 months after the research session. Significant correlations were noted between prospective falls and age, home safety modifications, engagement in fall prevention activities, and history of falls in the last 12 months. CONCLUSION Straightforward case history questions that could be part of a routine audiologic evaluation, such as fall history in the previous year, are significantly correlated with prospective number of falls in 6 months. These questions could help to identify audiology patients who may benefit from further fall risk assessment.
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Affiliation(s)
- Robin E Criter
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Erin Augustyniak
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
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Wang J, Chen XX, Liu D, Tian E, Guo ZQ, Chen JY, Kong WJ, Zhang SL. Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study. Ear Hear 2023; 44:1212-1220. [PMID: 37046369 DOI: 10.1097/aud.0000000000001364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVES The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population. DESIGN A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions. RESULTS Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001). CONCLUSIONS Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.
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Affiliation(s)
- Jun Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- School of Public Health, Wuhan University, Hubei, China
- Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Dan Liu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - E Tian
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhao-Qi Guo
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Yu Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Su-Lin Zhang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Norin J. Hearing Loss: Insights for Home Care Clinicians. Home Healthc Now 2023; 41:248-255. [PMID: 37682737 DOI: 10.1097/nhh.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
Hearing loss is a common problem caused by aging, noise exposure, ototoxic medications, and illness. Given their frequent contact with older adults, home care clinicians are uniquely positioned to recognize the adverse effects of hearing loss on physical, social, and cognitive health. This article explores the factors that contribute to hearing loss, highlighting their cumulative effects on overall hearing ability. The consequences of untreated hearing loss support the urgency of early identification, prompt intervention, and proper management of hearing disability. This article also provides an overview of available treatment options, including traditional prescription hearing aids and recently approved over-the-counter devices. By incorporating components of awareness, treatment, and effective communication strategies, healthcare clinicians can take an integrated approach to improve the overall well-being and quality of life of individuals struggling with hearing loss.
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Affiliation(s)
- Julie Norin
- Julie Norin, AuD, CCC-A, is Clinical Assistant Professor, Department of Speech-Language Pathology and Audiology, Towson University, Towson, Maryland
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Bekele Okuba T, Lystad RP, Boisvert I, McMaugh A, Moore RC, Walsan R, Mitchell RJ. Cochlear implantation impact on health service utilisation and social outcomes: a systematic review. BMC Health Serv Res 2023; 23:929. [PMID: 37649056 PMCID: PMC10468908 DOI: 10.1186/s12913-023-09900-y] [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: 06/05/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Hearing loss can have a negative impact on individuals' health and engagement with social activities. Integrated approaches that tackle barriers and social outcomes could mitigate some of these effects for cochlear implants (CI) users. This review aims to synthesise the evidence of the impact of a CI on adults' health service utilisation and social outcomes. METHODS Five databases (MEDLINE, Scopus, ERIC, CINAHL and PsychINFO) were searched from 1st January 2000 to 16 January 2023 and May 2023. Articles that reported on health service utilisation or social outcomes post-CI in adults aged ≥ 18 years were included. Health service utilisation includes hospital admissions, emergency department (ED) presentations, general practitioner (GP) visits, CI revision surgery and pharmaceutical use. Social outcomes include education, autonomy, social participation, training, disability, social housing, social welfare benefits, occupation, employment, income level, anxiety, depression, quality of life (QoL), communication and cognition. Searched articles were screened in two stages ̶̶̶ by going through the title and abstract then full text. Information extracted from the included studies was narratively synthesised. RESULTS There were 44 studies included in this review, with 20 (45.5%) cohort studies, 18 (40.9%) cross-sectional and six (13.6%) qualitative studies. Nine studies (20.5%) reported on health service utilisation and 35 (79.5%) on social outcomes. Five out of nine studies showed benefits of CI in improving adults' health service utilisation including reduced use of prescription medication, reduced number of surgical and audiological visits. Most of the studies 27 (77.1%) revealed improvements for at least one social outcome, such as work or employment 18 (85.7%), social participation 14 (93.3%), autonomy 8 (88.9%), education (all nine studies), perceived hearing disability (five out of six studies) and income (all three studies) post-CI. None of the included studies had a low risk of bias. CONCLUSIONS This review identified beneficial impacts of CI in improving adults' health service utilisation and social outcomes. Improvement in hearing enhanced social interactions and working lives. There is a need for large scale, well-designed epidemiological studies examining health and social outcomes post-CI.
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Affiliation(s)
- Tolesa Bekele Okuba
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Isabelle Boisvert
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Anne McMaugh
- Macquarie School of Education, Faculty of Arts, Macquarie University, Sydney, Australia
| | | | - Ramya Walsan
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Henshaw H, Calvert S, Heffernan E, Broome EE, Burgon C, Dening T, Fackrell K. New horizons in hearing conditions. Age Ageing 2023; 52:afad150. [PMID: 37604677 PMCID: PMC10442518 DOI: 10.1093/ageing/afad150] [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: 06/20/2023] [Indexed: 08/23/2023] Open
Abstract
Hearing conditions such as hearing loss, tinnitus and hyperacusis are highly prevalent in the population and can severely impact communication and quality of life. Hearing is affected by multiple factors, including heredity, noise exposure, age, sex, ear disorders and lifestyle factors. Globally, hearing loss affects over 80% of adults aged 80 years and older, is often experienced in combination with other long-term health conditions and is a mid-life risk factor for dementia. To form a themed collection, we searched Age and Ageing for articles on hearing conditions published from 2000 onwards. This resulted in 22 articles included within the collection. They examined a range of important topics related to hearing healthcare and research, including noise-induced hearing loss, health service quality and safety, psychological and psychosocial consequences of hearing loss and co-morbidities of hearing loss. All articles reported on hearing loss; there were no published articles with a primary focus on other hearing conditions such as tinnitus or hyperacusis, on the health of older people from the Deaf community or on users of Cochlear implants, suggesting key gaps in knowledge and targets for future research. This New Horizons article highlights novel directions in research and practice and takes a forward look at how research into hearing conditions may develop in years to come. It highlights opportunities for the growth of patient-centred research and hearing healthcare supported by the better integration of health and care services as well as cross-speciality working to include common co-morbid health conditions.
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Affiliation(s)
- Helen Henshaw
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Sian Calvert
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Eithne Heffernan
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Emma E Broome
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Clare Burgon
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Tom Dening
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Kathryn Fackrell
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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Zheng J, Cheng Y, Zhan Y, Liu C, Lu B, Hu J. Cardiocerebrovascular risk in sensorineural hearing loss: results from the National Health and Nutrition Examination Survey 2015 to 2018. Front Neurol 2023; 14:1115252. [PMID: 37470009 PMCID: PMC10353435 DOI: 10.3389/fneur.2023.1115252] [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: 12/03/2022] [Accepted: 05/11/2023] [Indexed: 07/21/2023] Open
Abstract
Objective This study aims to determine whether the risks of cardiocerebrovascular disease are relevant to sensorineural hearing loss (SNHL) based on a national database. Methods A total of 1,321 participants aged from 18 to 69 with complete data including medical history and audiometry from the NHANES database (2015-2018) were analyzed. All included participants had available hearing data and the average thresholds of the hearing data were measured and calculated as low-frequency pure-tone average (LFPTA; 500, 1,000, and 2,000 Hz) and high-frequency pure-tone average (HFPTA; 3,000, 4,000, 6,000, and 8,000 kHz). SNHL was defined as an average pure tone of more than or equal to 20 dB in at least one better ear. Multivariable models to assess the association between cardiocerebrovascular risks and SNHL were used in this study. Results The prevalence of stroke was 1.6% in individuals with SNHL and 0.4% in individuals without SNHL (p = 0.023). A higher cardiovascular risk score was observed in SNHL patients compared to participants without SNHL (1.58 vs. 0.90, p < 0.001). Stroke was associated with a 3.67-fold increase in the risk of SNHL (95% CI: 1.12-12.00, p = 0.032) in univariable logistic regression, and the association (OR = 4.22, 95%CI = 1.28-13.93, p = 0.020) remained significant after adjusting for several covariates. Multivariable logistic regression models indicated a positive correlation between cardiovascular risk and SNHL (OR = 1.66, 95% CI = 1.40-1.96, p < 0.001), but no significant relationship was shown with all covariates adjusted. However, significant associations were found between SNHL and both age and sex in both univariable and multivariable logistic regression models. Conclusion Our findings suggested that a higher cardiocerebrovascular risk burden was associated with an increased risk of SNHL, and the relationship may be influenced by age and sex. Future longitudinal studies are needed to investigate the mechanistic and pathologic vascular hypothesis of SNHL.
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Affiliation(s)
- Jianrong Zheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Clinical Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Yajing Cheng
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Ying Zhan
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Cong Liu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Bihua Lu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Jun Hu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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Morris B, Cosetti M, Kelly J, Yang J, Harel D, Medlin A, Lubetzky AV. Differing postural control patterns in individuals with bilateral and unilateral hearing loss. Am J Otolaryngol 2023; 44:103866. [PMID: 36989756 PMCID: PMC10330028 DOI: 10.1016/j.amjoto.2023.103866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES Hearing loss (HL) is associated with imbalance and increased fall risk. The mechanism underlying this relationship and differences across types of hearing loss remains unclear. Head mounted displays (HMD) can shed light on postural control mechanisms via an analysis of head sway. PURPOSE The purpose of this study was to evaluate head sway in response to sensory perturbations in individuals with bilateral (BHL) or unilateral hearing loss (UHL) and compare them to controls. MATERIALS AND METHODS We recruited 36 controls, 23 individuals with UHL and 14 with BHL. An HMD (HTC Vive) measured head sway while participants stood on the floor, hips-width apart. Stimuli included two levels of visuals and sound. Root Mean Square Velocity (RMSV) and Power Spectral Density (PSD) were used to quantify head sway. RESULTS Adjusting for age, individuals with BHL had significantly higher anterior-posterior and medio-lateral RMSV than controls and individuals with UHL. Individuals with UHL demonstrated significantly lower response to visual perturbations in RMSV AP and in all 3 frequency segments of PSD compared to controls. Individuals with UHL showed significantly lower movements at high frequencies compared to controls. Sounds or severity of HL did not impact head sway. CONCLUSIONS Individuals with BHL demonstrated increased sway with visual perturbations and should be clinically assessed for balance performance and fall risk. Individuals with UHL exhibited reduced responses to visual stimuli compared with controls, which may reflect conscious movement processing. Additional studies are needed to further understand the mechanistic relationship between hearing loss and imbalance.
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Affiliation(s)
- Brittani Morris
- Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States of America.
| | - Maura Cosetti
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
| | - Jennifer Kelly
- Department of Otolaryngology-Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America; Vestibular Rehabilitations, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States of America
| | - Junhui Yang
- Department of Mathematics and Statistics, College of Natural Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Daphna Harel
- Department of Applied Statistics, Social Science and Humanities, Steinhardt School of Culture Education and Human Development, New York University, New York, NY, United States of America
| | - Andrew Medlin
- Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States of America
| | - Anat V Lubetzky
- Department of Physical Therapy, Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, United States of America
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Tonelli M, Wiebe N, Lunney M, Donald M, Howarth T, Evans J, Klarenbach SW, Nicholas D, Boulton T, Thompson S, Schick Makaroff K, Manns B, Hemmelgarn B. Associations between hearing loss and clinical outcomes: population-based cohort study. EClinicalMedicine 2023; 61:102068. [PMID: 37434743 PMCID: PMC10331811 DOI: 10.1016/j.eclinm.2023.102068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Background Hearing loss (HL) is a leading cause of disability worldwide, but its clinical consequences and population burden have been incompletely studied. Methods We did a retrospective population-based cohort study of 4,724,646 adults residing in Alberta between April 1, 2004 and March 31, 2019, of whom 152,766 (3.2%) had HL identified using administrative health data. We used administrative data to identify comorbidity and clinical outcomes, including death, myocardial infarction, stroke/transient ischemic attack, depression, dementia, placement in long-term care (LTC), hospitalization, emergency visits, pressure ulcers, adverse drug events and falls. We used Weibull survival models (binary outcomes) and negative binomial models (rate outcomes) to compare the likelihood of outcomes in those with vs without HL. We calculated population-attributable fractions to estimate the number of binary outcomes associated with HL. Findings The age-sex-standardized prevalence of all 31 comorbidities at baseline was higher among participants with HL than those without. Over median follow-up of 14.4 y and after adjustment for potential confounders at baseline, participants with HL had higher rates of days in hospital (rate ratio 1.65, 95% CI 1.39, 1.97), falls (RR 1.72, 95% CI 1.59, 1.86), adverse drug events (RR 1.40, 95% CI 1.35, 1.45), and emergency visits (RR 1.21, 95% CI 1.14, 1.28) compared to those without, and higher adjusted hazards of death, myocardial infarction, stroke/transient ischemic attack, depression, heart failure, dementia, pressure ulcers and LTC placement. The estimated number of people with HL who required new LTC placement annually in Canada was 15,631, of which 1023 were attributable to HL. Corresponding estimates for new dementia among people with HL were 14,959 and 4350, and for stroke/TIA the estimates were 11,582 and 2242. Interpretation HL is common, is often accompanied by substantial comorbidity, and is associated with significant increases in risk for a broad range of adverse clinical outcomes, some of which are potentially preventable. This high population health burden suggests that increased and coordinated investment is needed to improve the care of people with HL. Funding Canadian Institutes of Health Research; David Freeze chair in health services research.
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Affiliation(s)
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Meg Lunney
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary, Calgary, Canada
| | | | | | | | - David Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Tiffany Boulton
- Department of Community Health Sciences, University of Calgary, Canada
| | | | | | - Braden Manns
- Department of Medicine, University of Calgary, Calgary, Canada
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Oliva A, West JS, Smith SL, Huang RJ, Riska KM. Association Between Hearing Handicap and Life-Space Mobility in a Patient Population. Am J Audiol 2023; 32:360-368. [PMID: 37059051 PMCID: PMC10468117 DOI: 10.1044/2023_aja-22-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 10/07/2022] [Accepted: 01/21/2023] [Indexed: 04/16/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the association between self-reported hearing handicap and life-space mobility utilizing the Life-Space Questionnaire (LSQ). Life-space mobility reflects how an individual moves through their daily physical and social environment, and the role of hearing loss in life-space mobility is not fully understood. We hypothesized that those with higher self-reported hearing handicap would be more likely to demonstrate restricted life-space mobility. METHOD A total of 189 older adults (M age = 75.76 years, SD = 5.81) completed a mail-in survey packet including the LSQ and Hearing Handicap Inventory for the Elderly (HHIE). Participants were categorized into one of three groups ("no/none," "mild/moderate," or "severe" hearing handicap) according to HHIE total score. LSQ responses were dichotomized to either "nonrestricted/typical" or "restricted" life-space mobility groups. Logistic regression models were performed to analyze life-space mobility differences among the groups. RESULTS Logistic regression results demonstrated no statistically significant association between hearing handicap and LSQ. CONCLUSIONS The results of this study indicate that there is no association between self-reported hearing handicap and life-space mobility as evaluated using a mail-in version of the LSQ. This counters other studies that have demonstrated that life space is associated with chronic illness, cognitive functioning, and social and health integration.
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Affiliation(s)
| | - Jessica S. West
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
| | - Sherri L. Smith
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham NC
- Durham Veterans Affairs Health Care System, NC
| | | | - Kristal M. Riska
- Department of Head & Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, NC
- Duke Center for the Study of Aging and Human Development, Durham, NC
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