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Phillips RS, Saunders GH. Occupational Stress in United Kingdom Audiologists. Am J Audiol 2024:1-12. [PMID: 38963786 DOI: 10.1044/2024_aja-24-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
PURPOSE Occupational stress is known to have detrimental effects on health care professionals worldwide. This study aimed to address a research gap by investigating sources and levels of occupational stress in U.K. audiologists. METHOD A mixed-methods cross-sectional design and convenience sampling were utilized. The study used the Audiologist Occupational Stress Questionnaire (AOSQ) and an audiological working practices questionnaire. The study included 100 registered U.K. audiologists. RESULTS The research revealed that over a third of participants reported experiencing moderate or higher levels of occupational stress. Pediatric audiologists and those with a high daily patient load reported significantly higher stress scores than other specialties and those seeing fewer patients per day. Identified sources of stress for U.K. audiologists included clinical demands and time constraints, staffing issues, leadership in the workplace, and equipment availability. Reported impacts of stress encompassed mental health issues, fatigue, social life disruptions, and physical health concerns. CONCLUSIONS The research validated the use of the AOSQ in a U.K. setting, and the findings provided insights into the sources and levels of occupational stress experienced by U.K. audiologists, supporting existing research on occupational stress in audiologists in other countries. The identification of consistent stress themes across the literature underscores the need for targeted support and interventions to ensure the well-being of audiologists and empower them in maintaining their pivotal role in health care.
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Affiliation(s)
- Ryan S Phillips
- Manchester Centre for Audiology and Deafness, Division of Psychology, Communication and Human Neuroscience, The University of Manchester, United Kingdom
- Betsi Cadwaladr University Health Board, North Wales, United Kingdom
| | - Gabrielle H Saunders
- Manchester Centre for Audiology and Deafness, Division of Psychology, Communication and Human Neuroscience, The University of Manchester, United Kingdom
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Sanchez VA, Dinh PC, Monahan PO, Althouse S, Rooker J, Sesso HD, Dolan ME, Weinzerl M, Feldman DR, Fung C, Einhorn LH, Frisina RD, Travis LB. Comprehensive Audiologic Analyses After Cisplatin-Based Chemotherapy. JAMA Oncol 2024:2819649. [PMID: 38842797 PMCID: PMC11157440 DOI: 10.1001/jamaoncol.2024.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/22/2023] [Indexed: 06/07/2024]
Abstract
Importance Cisplatin is highly ototoxic but widely used. Evidence is lacking regarding cisplatin-related hearing loss (CRHL) in adult-onset cancer survivors with comprehensive audiologic assessments (eg, Words-in-Noise [WIN] tests, full-spectrum audiometry, and additional otologic measures), as well as the progression of CRHL considering comorbidities, modifiable factors associated with risk, and cumulative cisplatin dose. Objective To assess CRHL with comprehensive audiologic assessments, including the WIN, evaluate the longitudinal progression of CRHL, and identify factors associated with risk. Design, Setting, and Participants The Platinum Study is a longitudinal study of cisplatin-treated testicular cancer survivors (TCS) enrolled from 2012 to 2018 with follow-up ongoing. Longitudinal comprehensive audiologic assessments at Indiana University and Memorial Sloan Kettering Cancer Center included 100 participants without audiometrically defined profound hearing loss (HL) at baseline and at least 3.5 years from their first audiologic assessment. Data were analyzed from December 2013 to December 2022. Exposures Factors associated with risk included cumulative cisplatin dose, hypertension, hypercholesterolemia, diabetes, tobacco use, physical inactivity, body mass index, family history of HL, cognitive dysfunction, psychosocial symptoms, and tinnitus. Main Outcomes and Measures Main outcomes were audiometrically measured HL defined as combined-ears high-frequency pure-tone average (4-12 kHz) and speech-recognition in noise performance measured with WIN. Multivariable analyses evaluated factors associated with risk for WIN scores and progression of audiometrically defined HL. Results Median (range) age of 100 participants at evaluation was 48 (25-67) years; median (range) time since chemotherapy: 14 (4-31) years. At follow-up, 78 (78%) TCS had audiometrically defined HL; those self-reporting HL had 2-fold worse hearing than TCS without self-reported HL (48 vs 24 dB HL; P < .001). A total of 54 (54%) patients with self-reported HL showed clinically significant functional impairment on WIN testing. Poorer WIN performance was associated with hypercholesterolemia (β = 0.88; 95% CI, 0.08 to 1.69; P = .03), lower-education (F1 = 5.95; P = .004), and severity of audiometrically defined HL (β̂ = 0.07; 95% CI, 0.06 to 0.09; P < .001). CRHL progression was associated with hypercholesterolemia (β̂ = -4.38; 95% CI, -7.42 to -1.34; P = .01) and increasing age (β̂ = 0.33; 95% CI, 0.15 to 0.50; P < .001). Importantly, relative to age-matched male normative data, audiometrically defined CRHL progression significantly interacted with cumulative cisplatin dose (F1 = 5.98; P = .02); patients given 300 mg/m2 or less experienced significantly less progression, whereas greater temporal progression followed doses greater than 300 mg/m2. Conclusions and Relevance Follow-up of cisplatin-treated cancer survivors should include strict hypercholesterolemia control and regular audiological assessments. Risk stratification through validated instruments should include querying hearing concerns. CRHL progression relative to age-matched norms is likely associated with cumulative cisplatin dose; investigation over longer follow-up is warranted.
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Affiliation(s)
- Victoria A. Sanchez
- Department of Otolaryngology–Head and Neck Surgery, University of South Florida, Tampa
| | - Paul C. Dinh
- Department of Medical Oncology, Indiana University, Indianapolis
| | - Patrick O. Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis
| | - Sandra Althouse
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis
| | | | - Howard D. Sesso
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - M. Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Mandy Weinzerl
- Rehabilitation Services, Indiana University Health, Indianapolis
| | - Darren R. Feldman
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chunkit Fung
- Department of Medical Oncology, J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York
| | | | - Robert D. Frisina
- Department of Medical Engineering, University of South Florida, Tampa
| | - Lois B. Travis
- Department of Medical Oncology, Indiana University, Indianapolis
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Chen HK, Hsieh YW, Hsu HY, Liu TY, Zhang YT, Lin CD, Tsai FJ. Increased risk of hearing loss associated with MT-RNR1 gene mutations: a real-world investigation among Han Taiwanese Population. BMC Med Genomics 2024; 17:155. [PMID: 38840095 PMCID: PMC11155076 DOI: 10.1186/s12920-024-01921-8] [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: 04/14/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Previous studies have implicated inherited mutations in mitochondrial DNA (mtDNA) in sensorineural hearing loss (SNHL). However, the definitive association between mitochondrial 12S rRNA (MT-RNR1) variants and hearing loss in the population has not been well established, particularly in Asia. The objective of this retrospective cohort study was to assess the association between MT-RNR1 variants and the risk of SNHL in patients in Taiwan. METHODS The cohort included 306,068 participants from Taiwan between January 2003 and December 2020. Participants were classified based on genetic variants, particularly mitochondrial mutations (rs267606618, rs267606619, rs267606617). MT-RNR1 variant cases were matched 1:10 with non-mutant patients by age, gender, and visit year, excluding those with pre-existing hearing loss. The primary endpoint was SNHL, identified using specific ICD-TM codes with a 90% positive predictive value. Medication exposure history was determined via self-report or electronic medical records in the hospital. Cox proportional hazard regression models were used to assess the association between MT-RNR1 variants and hearing loss, adjusting for various covariates. Kaplan-Meier survival curves and log-rank tests compared hearing loss incidence between groups. RESULTS The mean age of the mtDNA variants group is 32.4 years, with a standard deviation of 19.2 years. The incidence density of hearing loss for the mutation group was 36.42 per 10,000 person-years (95% Confidence Interval [CI], 27.21-47.73), which was higher than the 23.77per 10,000 person-years (95% CI, 21.32-26.42) in the wild-type group (p = 0.0036). Additionally, diabetes mellitus was associated with an increased risk of developing SNHL in individuals with MT-RNR1 variants (adjusted hazard ratio = 1.76 [95% CI, 1.00-3.09], p < 0.05). CONCLUSION This study highlights the increased risk of hearing loss in patients carrying MT-RNR1 variants, particularly those with diabetes mellitus. Future research that integrates genetic and clinical data is crucial for developing more precise interventions to monitor and treat hearing loss in this vulnerable population.
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Affiliation(s)
- Hou-Kuang Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Yow-Wen Hsieh
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Hsing-Yu Hsu
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Yuan Liu
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Ting Zhang
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
- Division of Pediatric Genetics, Children's Hospital of China Medical University, Taichung, Taiwan.
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan.
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Smith SK, Pryce H, O'Connell GB, Hussain S, Shaw R, Straus J. 'The burden is very much on yourself': A qualitative study to understand the illness and treatment burden of hearing loss across the life course. Health Expect 2024; 27:e14067. [PMID: 38715316 PMCID: PMC11076985 DOI: 10.1111/hex.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Hearing loss is a chronic health condition that rises sharply with age. The way people respond to and cope with health conditions is influenced by their capacity to perform illness and treatment-related work. The aim was to explore the cumulative burdens of living with hearing loss and the resources mobilised to ease the burdens. METHODS A qualitative design was used with semi-structured interviews (online or in-person) with participants recruited through audiology services and nonclinical services, such as lip-reading classes. Forty-six participants with hearing loss aged between 16 and 96 years were interviewed. An abductive approach, informed by May et al.'s burden of treatment theory, was used to analyse the data. RESULTS The illness burden involved participants working to make sense of their hearing loss, engaging in emotional work in response to changes in sound, social interactions and identity and coping with the daily frustrations required to communicate with others. Abandonment and uncertainty characterised the treatment burden; participants engaged in emotional work to adjust to hearing technology and deal with the uncertainty of how their hearing might progress. To ameliorate the burdens, participants drew on internal resources (psychological, health literacy, cognitive) and external resources (social support, financial, information, technology). CONCLUSIONS The workload of hearing loss appears largely devolved to the patient and is not always visible. Our work indicates the need to widen approaches in audiological care through the implementation of lifeworld-led care, family-centred care and peer support to build support for those with hearing loss. PATIENT OR PUBLIC CONTRIBUTION We developed the project in consultation with members of the public who have lived experience of hearing loss recruited through Aston University and volunteer links to audiology services. We also consulted people more likely to be affected by hearing loss adults including adults with learning disabilities, older adults in residential care and people from South Asia (Bangladeshi, Indian and Pakistani communities). These individuals commented on the study aims, interview schedule and participant recruitment practices. One of our co-authors (expert by experience) contributed to the development and interpretation of themes and preparation of the final manuscript.
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Affiliation(s)
- Sian K. Smith
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Helen Pryce
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | | | - Saira Hussain
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Rachel Shaw
- Aston Institute of Health and Neurodevelopment and School of Psychology, College of Health and Life SciencesAston UniversityBirminghamUK
| | - Jean Straus
- Department of Audiology, College of Health and Life SciencesAston UniversityBirminghamUK
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Goodwin MV, Hogervorst E, Maidment DW. Hearing difficulties and memory problems: the mediating role of physical health and psychosocial wellbeing. Int J Audiol 2024; 63:439-446. [PMID: 37073645 DOI: 10.1080/14992027.2023.2199443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To investigate whether the association between hearing difficulties and self-reported memory problems is mediated by physical health and psychosocial wellbeing. DESIGN A cross-sectional study. Path analyses were used to test potential theoretical models (psychosocial-cascade, common cause) of the association between hearing difficulties and memory problems, adjusting for age. STUDY SAMPLE A sample of 479 adults (18-87 years) completed self-reported outcome measures. RESULTS Half the participants reported clinically significant hearing difficulties and 30% self-reported memory problems. In the direct model, reporting hearing difficulties was associated with a greater likelihood of reporting memory problems (β = 0.17, p = 0.007, 95% Confidence Intervals [CI] = 0.00, 0.01). Hearing difficulties were also associated with poorer physical health, but this did not mediate the association with memory. Psychosocial factors, however, fully mediated the relationship between hearing difficulties and memory problems (β = 0.03, p = 0.019, 95% CI = 0.00, 0.01). CONCLUSIONS Adults with hearing difficulties may be more likely to self-report memory problems, irrespective of age. This study supports the psychosocial-cascade model, as the association between self-reported hearing and memory problems was explained entirely by psychosocial factors. Future studies should investigate these associations using behavioural measures, as well as explore whether interventions can reduce the risk of developing memory problems in this population.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
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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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Burns SD, West JS. Country Differences in Older Men's Hearing Difficulty Disadvantage. J Aging Health 2024:8982643241251939. [PMID: 38710107 DOI: 10.1177/08982643241251939] [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: 05/08/2024]
Abstract
Objectives: Hearing difficulty is prevalent in older adulthood and projected to increase via global aging, particularly among men. Currently, there is limited research on how this gender disparity might vary by country. Methods: Using 2018 data (n = 29,480) from the Health and Retirement Study (HRS) international family of studies, we investigate gender disparities in hearing difficulty among respondents ages 55-89 from the United States (n = 12,566), Mexico (n = 10,762), and Korea (n = 6152) with country-specific ordinal logistic regression models that progressively adjust for demographic, social, and health indicators. Results: In the United States, men's hearing difficulty disadvantage was consistently observed. In Mexico, men's hearing difficulty disadvantage was explained by the interactive effect of gender and age group but resurfaced after adjusting for comorbidities. In Korea, there was consistently no gender difference in hearing difficulty. Discussion: Our results highlight the heterogeneity in older men's hearing difficulty disadvantage among a diverse group of aging countries.
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Affiliation(s)
- Shane D Burns
- Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - Jessica S West
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
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O'Brien K, Hackenberg B, Döge J, Bohnert A, Rader T, Lackner KJ, Beutel ME, Münzel T, Wild PS, Chalabi J, Schuster AK, Schmidtmann I, Matthias C, Bahr-Hamm K. Age standardization and time-of-day performance for the Oldenburg Sentence Test (OLSA): results from the population-based Gutenberg Health Study. Eur Arch Otorhinolaryngol 2024; 281:2341-2351. [PMID: 38110748 PMCID: PMC11023958 DOI: 10.1007/s00405-023-08358-2] [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: 09/08/2022] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
PURPOSE The Oldenburg Sentence Test (OLSA) is a German matrix test designed to determine speech recognition thresholds (SRT). It is widely used for hearing-aids and cochlear implant fitting, but an age-adjusted standard is still lacking. In addition, knowing that the ability to concentrate is an important factor in OLSA performance, we hypothesized that OLSA performance would depend on the time of day it was administered. The aim of this study was to propose an age standardization for the OLSA and to determine its diurnal performance. METHODS The Gutenberg Health Study is an ongoing population-based study and designed as a single-centre observational, prospective cohort study. Participants were interviewed about common otologic symptoms and tested with pure-tone audiometry and OLSA. Two groups-subjects with and without hearing loss-were established. The OLSA was performed in two runs. The SRT was evaluated for each participant. Results were characterized by age in 5-year cohorts, gender and speech recognition threshold (SRT). A time stamp with an hourly interval was also implemented. RESULTS The mean OLSA SRT was - 6.9 ± 1.0 dB (group 1 male) and - 7.1 ± 0.8 dB (group 1 female) showing an inverse relationship with age in the whole cohort, whereas a linear increase was observed in those without hearing loss. OLSA-SRT values increased more in males than in females with increasing age. No statistical significance was found for the diurnal performance. CONCLUSIONS A study with 2900 evaluable Oldenburg Sentence Tests is a novelty and representative for the population of Mainz and its surroundings. We postulate an age- and gender-standardized scale for the evaluation of the OLSA. In fact, with an intergroup standard deviation (of about 1.5 dB) compared to the age dependence of 0.7 dB/10 years, this age normalization should be considered as clinically relevant.
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Affiliation(s)
- Karoline O'Brien
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Berit Hackenberg
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Andrea Bohnert
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Tobias Rader
- Division of Audiology, Department of Otolaryngology, University Hospital, Ludwig-Maximillian-University, Munich, Germany
| | - Karl J Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology-Cardiology I, University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RhineMine, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site RhineMine, Mainz, Germany
| | - Julian Chalabi
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | | | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Katharina Bahr-Hamm
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Goodwin MV, Hogervorst E, Maidment DW. A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss. Br J Health Psychol 2024; 29:95-111. [PMID: 37658583 DOI: 10.1111/bjhp.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. DESIGN Individual semi-structured qualitative interviews. METHODS A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. RESULTS Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. CONCLUSIONS Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Newsted D, Cooke B, Rosen E, Nguyen P, Campbell RJ, Beyea JA. Hearing aid utilization in Ontario - a population based study. Disabil Rehabil Assist Technol 2024; 19:383-389. [PMID: 35916329 DOI: 10.1080/17483107.2022.2091168] [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: 01/17/2022] [Accepted: 06/10/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Hearing loss is one of the most common sensory impairments and hearing aids are the most common unmet assistive device need among individuals with a disability. The benefits of hearing interventions are well-documented as they are known to deter the sequalae of hearing loss including social isolation, poor mental health, falls and cognitive decline. Identifying trends in hearing aid users can provide valuable information for improving access to hearing loss interventions. METHODS Data were retrieved from ICES databases that were used to generate a cohort of 372,448 individuals in Ontario, Canada, who first claimed hearing aids between April 2007 and March 2018 through the Assistive Devices Program. RESULTS The data indicated that the frequency distribution of hearing aids has steadily inclined since 2007. The mean age of hearing aid users was 70.25 ± 14.70 years and higher neighbourhood income quintile was associated with greater hearing aid use (p < 0.001). Most first claims occurred after visiting primary care physicians (70.60%) compared with otolaryngology (13.39%). An examination of clinical comorbidities revealed hypertension (63.41%), and diabetes (24.93%) to be the most common. Regression analysis demonstrated a positive associated between age and most comorbidities. Furthermore, higher neighbourhood income quintiles were associated with a reduced risk of having the examined comorbidities. CONCLUSIONS This study examines patient demographics and clinical comorbidities in a cohort of hearing aid users in Ontario. The results identify associations between demographics and comorbidities that provide information relevant for improving access to hearing interventions and clinical decision-making in primary care.Implications for RehabilitationScreening for hearing loss (using an audiogram) in elderly individuals that manage multiple comorbidities, and any patient with significant risk factors for hearing loss (e.g., noise exposure history, prior ototoxic medications, prior head injury, history of ear surgery, family history of hearing loss) will identify deficits and direct appropriate hearing interventions.Improving access to care in low-income communities should include community-based education around expectation management and communication strategies to reinforce proper use and care of hearing devices.Geographic proximity to hearing testing facilities and hearing aid dispensaries is a significant barrier to hearing rehabilitation strategies.
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Affiliation(s)
- Daniel Newsted
- Division of Otolaryngology - Head and Neck Surgery, Kingston Health Sciences Centre, Queen's University, Kingston, Canada
| | - Bonnie Cooke
- Department of Speech Language Pathology and Audiology, Hotel Dieu Hospital, Kingston, Canada
| | - Emily Rosen
- Department of Speech Language Pathology and Audiology, Hotel Dieu Hospital, Kingston, Canada
| | | | | | - Jason A Beyea
- Division of Otolaryngology - Head and Neck Surgery, Kingston Health Sciences Centre, Queen's University, Kingston, Canada
- ICES, Queen's University, Kingston, Canada
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Ahn JH, Yang JS, Jung J, Kang S, Jung SJ. Association between hearing loss and suicidal ideation: Discrepancy between pure tone audiometry and subjective hearing level. J Affect Disord 2024; 344:495-502. [PMID: 37838269 DOI: 10.1016/j.jad.2023.10.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND This study aimed to evaluate hearing loss by combining pure tone audiometry (PTA) with subjective hearing level concerning suicidal ideation. METHODS A total of 23,215 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2009 and 2013 were included. PTA was categorized according to average audiometric threshold levels: normal (≤25 dB), mild (26-40 dB), and moderate-severe (>40 dB). The subjective hearing level was categorized as "no discomfort," "mild discomfort," and "considerable discomfort" for hearing without a hearing aid. Next, we classified hearing loss into nine groups by combining PTA and subjective hearing levels. Suicidal ideation was defined as answering yes to the following question: "Have you ever seriously thought about killing yourself in the past 1 year?" We conducted chi-square tests and multiple logistic regression analyses. RESULTS Among the 23,215 participants aged ≥19 years (mean age 46.52 years), 3,214 (13%) reported having suicidal ideation. According to PTA, moderate to severe hearing loss was related to suicidal ideation (OR = 1.19, 95 % CI = 1.01-1.41). Subjective hearing loss was associated with suicidal ideation (mild: OR = 1.41, 95 % CI = 1.21-1.65; considerable: OR = 1.57, 95 % CI = 1.20-2.05). Moreover, as the subjective hearing level increased, the ORs of suicidal ideation increased in individuals with moderate to severe hearing loss (mild: OR = 1.52, 95 % CI = 1.24-1.88; considerable: OR = 1.81, 95 % CI = 1.39-2.36). LIMITATIONS The cross-sectional study limits the interpretation of causal relationships. CONCLUSIONS Subjective hearing loss was more strongly associated with suicidal ideation than hearing loss as measured by PTA.
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Affiliation(s)
- Jeong Hyun Ahn
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Ji Su Yang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Jinsei Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sunghyuk Kang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sun Jae Jung
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Center for Global Health, Massachusetts General Hospital, Boston, MA, USA; Center for population and development studies, Harvard University, Cambridge, MA, USA; Harvard Medical School, Boston, MA, USA.
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12
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Van Wier MF, Urry E, Lissenberg-Witte BI, Kramer SE. User characteristics associated with use of wrist-worn wearables and physical activity apps by adults with and without impaired speech-in-noise recognition: a cross-sectional analysis. Int J Audiol 2024; 63:49-56. [PMID: 36373621 DOI: 10.1080/14992027.2022.2135031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study weekly use of smartwatches, fitness watches and physical activity apps among adults with and without impaired speech-in-noise (SIN) recognition, to identify subgroups of users. DESIGN Cross-sectional study. STUDY SAMPLE Adults (aged 28-80 years) with impaired (n = 384) and normal SIN recognition (n = 341) as measured with a web-based digits-in-noise test, from the Netherlands Longitudinal Study on Hearing. Multiple logistic regression analyses were used to study differences and to build an association model. RESULTS Employed adults in both groups are more likely to use each type of fitness technology (all ORs >3.4, all p-values < 0.004). Specific to fitness watch use, adults living with others use it more (OR 2.5, 95%CI 1.1;5.8, p = 0.033) whereas those abstaining from alcohol (OR 0.3, 95%CI 0.1;0.6) or consuming >2 glasses/week (OR 0.4, 95%CI 0.2;0.81, overall p = 0.006) and hearing aid users (OR 0.5, 95%CI 0.2;0.9, p = 0.024) make less use. CONCLUSIONS Subgroups of adults more and less likely to use fitness technology exist, but do not differ between adults with and without impaired SIN recognition. More research is needed to confirm these results and to develop interventions to increase physical activity levels among adults with hearing loss.
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Affiliation(s)
- Marieke F Van Wier
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Birgit I Lissenberg-Witte
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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13
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Pryce H, Smith SK, Burns-O'Connell G, Knibb R, Greenwood R, Shaw R, Hussain S, Banks J, Hall A, Straus J, Noble S. Protocol for the development and validation of a patient-reported experience measure (PREM) for people with hearing loss: the PREM-HeLP. BMJ Open 2023; 13:e075229. [PMID: 38030247 PMCID: PMC10689349 DOI: 10.1136/bmjopen-2023-075229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Hearing loss is a common chronic health condition and adversely affects communication and social function resulting in loneliness, social isolation and depression. We know little about the patient experience of living with hearing loss and their views on the quality of the audiology service. In this study, we will develop and validate the first patient-reported experience measure (PREM) to understand patients' experiences of living with hearing loss and their healthcare interactions with audiology services. METHODS AND ANALYSIS We will develop the PREM in three phases: (1) development of PREM prototype (items/statements) derived from previous qualitative work and narrative review, (2) cognitive interview testing of the PREM prototype using a 'think aloud' technique to examine the acceptability and comprehensibility of the tool and refine accordingly and (3) psychometric testing of the modified PREM with 300 participants to assess the reliability and validity of the tool using Rasch analyses with sequential item reduction. Eligible participants will be young people and adults aged 16 years and over who have hearing loss. Participants will be recruited from three clinical sites located in England (Bath, Bristol) and Scotland (Tayside) and non-clinical settings (eg, lip-reading classes, residential care settings, national charity links, social media). ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022; ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales (HCRW) Approval (approval date: 14 June 2022; IRAS project ID: 308816). Findings will be shared with our patient and public involvement groups, academics, audiology communities and services and local commissioners via publications and presentations. The PREM will be made available to clinicians and researchers without charge.
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Affiliation(s)
- Helen Pryce
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Sian Karen Smith
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Georgina Burns-O'Connell
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Rebecca Knibb
- School of Psychology, Aston University, Birmingham, UK
| | - Rosemary Greenwood
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rachel Shaw
- School of Psychology, Aston University, Birmingham, UK
| | - Saira Hussain
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Jonathan Banks
- Social & Community Medicine, University of Bristol, Bristol, UK
| | - Amanda Hall
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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14
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Brice S, Timmer BHB, Barr C. Centering on People: How Hearing Care Professionals Can Adapt to Consumers' Need and Outcomes. Semin Hear 2023; 44:274-286. [PMID: 37484985 PMCID: PMC10361789 DOI: 10.1055/s-0043-1769624] [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] [Indexed: 07/25/2023] Open
Abstract
Audiology is experiencing exponential growth in technology, service, and provision options. These advancements give hearing care professionals the opportunity to revise, potentially improve, and adapt to the modern hearing care landscape to better serve the modern consumer. Consumer needs guide care planning and delivery, with the goal of achieving outcomes that are important to both the consumer and the clinician. The changes available to the hearing care industry can also enable consumers' needs to be identified and served in a more holistic and personalized manner than has previously been possible. The purpose of this article is to explain and encourage hearing care professionals to adopt a mindset of doing whatever is reasonable and clinically appropriate to meet the need and desires of the consumer by implementing choice in service, technology, and channel across whichever model of care adopted by a provider.
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Affiliation(s)
- Sophie Brice
- Australian Institute for Health Service Management, COBE, University of Tasmania, Tasmania, Australia
| | - Barbra H. B. Timmer
- School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
- Sonova AG, Staefa, Switzerland
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15
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Goodwin MV, Hogervorst E, Hardy R, Stephan BCM, Maidment DW. How are hearing loss and physical activity related? Analysis from the English longitudinal study of ageing. Prev Med 2023; 173:107609. [PMID: 37423474 DOI: 10.1016/j.ypmed.2023.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Although cross-sectional studies suggest that hearing loss in middle- and older-aged adults is associated with lower physical activity, longitudinal evidence is limited. This study aimed to investigate the potential bi-directional association between hearing loss and physical activity over time. Participants were from the English Longitudinal Study of Ageing (N = 11,292) who were 50-years or older at baseline assessment (1998-2000). Individuals were followed-up biannually for up to 20-years (2018-2019) and were classified as ever reporting hearing loss (n = 4946) or not reporting hearing loss (n = 6346). Data were analysed with Cox-proportional hazard ratios and multilevel logistic regression. The results showed that baseline physical activity was not associated with hearing loss over the follow-up. Time (i.e., wave of assessment) by hearing loss interactions showed that physical activity declined more rapidly over time in those with hearing loss, compared to those without (Odds Ratios = 0.94, 95% Confidence Intervals; 0.92-0.96, p < .001). These findings highlight the importance of addressing physical activity in middle- and older-aged adults with hearing loss. As physical activity is a modifiable behaviour that can reduce the risk of developing chronic health conditions, individuals with hearing loss may need additional, tailored support to be more physically active. Mitigating the decline in physical activity could be essential to support healthy ageing for adults with hearing loss.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, UK.
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | | | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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16
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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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17
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Pryce H, Smith SK, Burns-O'Connell G, Shaw R, Hussain S, Banks J, Hall A, Knibb R, Greenwood R, Straus J. Protocol for a qualitative study exploring the lived experience of hearing loss and patient reported experience in the UK: the HeLP study. BMJ Open 2023; 13:e069363. [PMID: 37286313 DOI: 10.1136/bmjopen-2022-069363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Worldwide, hearing loss is a significant public health issue and one of the most common chronic health conditions experienced by older adults. Hearing loss is associated with communication difficulties, social withdrawal, isolation and lower quality of life. Although hearing aid technology has improved significantly, the workload of managing hearing aids has increased. The aim of this qualitative study is to develop a novel theory of people's lived experience of hearing loss across the lifespan. METHODS Eligible participants will be young people and adults aged 16 years and above who have a hearing loss and carers/family members of people with a hearing loss. This study will use individual, in-depth face-to-face or online interviews. With participants' permission, interviews will be audio-recorded and transcribed verbatim. A grounded theory approach to concurrent data gathering and analysis will develop grouped codes and categories and link these to provide a novel theory to describe the experience of hearing loss. ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022 ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales Approval (approval date: 14 June 2022; IRAS project ID: 308816). The research will inform the development of a Patient Reported Experience Measure to improve the information and support given to patients. Findings will be disseminated through peer-reviewed articles and at academic conferences, as well as to our patient and public involvement groups, healthcare professionals, audiology services and local commissioners.
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Affiliation(s)
- Helen Pryce
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Sian Karen Smith
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | | | - Rachel Shaw
- Aston University School of Psychology, Birmingham, UK
- Aston Institute of Health & Neurodevelopment, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Saira Hussain
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
| | - Jonathan Banks
- University Hospitals Bristol and Weston NHS Foundation Trust, National Institute for Health Research, Applied Research Collaboration West, Bristol, UK
- Population Health Sciences, University of Bristol Medical School, Bristol, UK
| | - Amanda Hall
- Department of Audiology, Aston University College of Health and Life Sciences, Birmingham, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Rebecca Knibb
- Aston University School of Psychology, Birmingham, UK
| | - Rosemary Greenwood
- Psychology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Jean Straus
- Patient and Public Involvement Representative and Lead, HeLP study, London, UK
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18
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Houmøller SS, Wolff A, Tsai LT, Narayanan SK, Hougaard DD, Gaihede ML, Neher T, Godballe C, Schmidt JH. Impact of hearing aid technology level at first-fit on self-reported outcomes in patients with presbycusis: a randomized controlled trial. FRONTIERS IN AGING 2023; 4:1158272. [PMID: 37342862 PMCID: PMC10277865 DOI: 10.3389/fragi.2023.1158272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023]
Abstract
To provide clinical guidance in hearing aid prescription for older adults with presbycusis, we investigated differences in self-reported hearing abilities and hearing aid effectiveness for premium or basic hearing aid users. Secondly, as an explorative analysis, we investigated if differences in gain prescription verified with real-ear measurements explain differences in self-reported outcomes. The study was designed as a randomized controlled trial in which the patients were blinded towards the purpose of the study. In total, 190 first-time hearing aid users (>60 years of age) with symmetric bilateral presbycusis were fitted with either a premium or basic hearing aid. The randomization was stratified on age, sex, and word recognition score. Two outcome questionnaires were distributed: the International Outcome Inventory for Hearing Aids (IOI-HA) and the short form of the Speech, Spatial, and Qualities of Hearing Scale (SSQ-12). In addition, insertion gains were calculated from real-ear measurements at first-fit for all fitted hearing aids. Premium hearing aid users reported 0.7 (95%CI: 0.2; 1.1) scale points higher total SSQ-12 score per item and 0.8 (95%CI: 0.2; 1.4) scale points higher speech score per item, as well as 0.6 (95%CI: 0.2; 1.1) scale points higher qualities score compared to basic-feature hearing aid users. No significant differences in reported hearing aid effectiveness were found using the IOI-HA. Differences in the prescribed gain at 1 and 2 kHz were observed between premium and basic hearing aids within each company. Premium-feature devices yielded slightly better self-reported hearing abilities than basic-feature devices, but a statistically significant difference was only found in three out of seven outcome variables, and the effect was small. The generalizability of the study is limited to community-dwelling older adults with presbycusis. Thus, further research is needed for understanding the potential effects of hearing aid technology for other populations. Hearing care providers should continue to insist on research to support the choice of more costly premium technologies when prescribing hearing aids for older adults with presbycusis. Clinical Trial Registration: https://register.clinicaltrials.gov/, identifier NCT04539847.
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Affiliation(s)
- Sabina Storbjerg Houmøller
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Anne Wolff
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - Li-Tang Tsai
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | | | - Dan Dupont Hougaard
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Lyhne Gaihede
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Tobias Neher
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Christian Godballe
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jesper Hvass Schmidt
- Research Unit for ORL—Head and Neck Surgery and Audiology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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19
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Jones M, Kovacevic B, Ionescu CM, Wagle SR, Quintas C, Wong EYM, Mikov M, Mooranian A, Al-Salami H. The applications of Targeted Delivery for Gene Therapies in Hearing Loss. J Drug Target 2023:1-22. [PMID: 37211674 DOI: 10.1080/1061186x.2023.2216900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/07/2022] [Accepted: 04/09/2023] [Indexed: 05/23/2023]
Abstract
Gene therapies are becoming more abundantly researched for use in a multitude of potential treatments, including for hearing loss. Hearing loss is a condition which impacts an increasing number of the population each year, with significant burdens associated. As such, this review will present the concept that delivering a gene effectively to the inner ear may assist in expanding novel treatment options and improving patient outcomes. Historically, several drawbacks have been associated with the use of gene therapies, some of which may be overcome via targeted delivery. Targeted delivery has the potential to alleviate off-target effects and permit a safer delivery profile. Viral vectors have often been described as a delivery method, however, there is an emerging depiction of the potential for nanotechnology to be used. Resulting nanoparticles may also be tuned to allow for targeted delivery. Therefore, this review will focus on hearing loss, gene delivery techniques and inner ear targets, including highlighting promising research. Targeted delivery is a key concept to permitting gene delivery in a safe effective manner, however, further research is required, both in the determination of genes to use in functional hearing recovery and formulating nanoparticles for targeted delivery.
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Affiliation(s)
- Melissa Jones
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
| | - Bozica Kovacevic
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
| | - Corina Mihaela Ionescu
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
| | - Susbin Raj Wagle
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
| | - Christina Quintas
- School of human sciences, University of Western Australia, Crawley 6009, Perth, Western Australia, Australia
| | - Elaine Y M Wong
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
| | - Momir Mikov
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21101 Novi Sad, Serbia
| | - Armin Mooranian
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
- School of Pharmacy, University of Otago, Dunedin, Otago, New Zealand
| | - Hani Al-Salami
- The Biotechnology and Drug Development Research Laboratory, Curtin Medical School & Curtin Health Innovation Research Institute, Curtin University, Bentley 6102, Perth, Western Australia, Australia
- Hearing Therapeutics Department, Ear Science Institute Australia, Queen Elizabeth II Medical Centre, Nedlands 6009, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Perth, Western Australia, Australia
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20
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Eberhard JM, Matthews LJ, Vaden KI, Dubno JR, Eckert MA. Probability Distributions for Associations Between Cognitive Screening and Pure-tone Thresholds in Older Adults. Ear Hear 2023; 44:641-654. [PMID: 36607744 PMCID: PMC10101874 DOI: 10.1097/aud.0000000000001313] [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: 01/07/2023]
Abstract
OBJECTIVES Lower general cognitive function is frequently reported in older adults with elevated pure-tone thresholds. Here, we examined reason(s) for this association, including whether this relationship is dependent on the frequency range or extent of hearing loss and cognitive screening performance. DESIGN Linear regression was used to examine associations between better-ear pure-tone thresholds and Mini-Mental Status Exam (MMSE) performance in a cross-sectional sample of relatively healthy older adults (N = 508; 68% women, 60-89+ years; M age = 72). Quantile regression was also used to identify the ranges of 0.5 and 4.0 kHz thresholds and MMSE scores where these variables exhibited significant associations. RESULTS MMSE scores and pure-tone thresholds exhibited small but significant associations, particularly for better-ear 0.5 kHz thresholds. This hearing threshold and cognitive screening association was present among participants with better hearing, including the oldest older adults. There was limited evidence for mediating health condition effects on this association. An item analysis of the MMSE revealed that the MMSE and pure-tone threshold associations were largely due to the delayed recall item of the MMSE. CONCLUSIONS Together, the small effect results are consistent with the extant literature and suggest that there are multiple reasons for modest pure-tone threshold and cognitive screening performance associations.
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Affiliation(s)
- Jacqueline M. Eberhard
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Lois. J. Matthews
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth I. Vaden
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Judy R. Dubno
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Mark A. Eckert
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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21
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Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:124-132. [PMID: 36906066 DOI: 10.1016/j.otoeng.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/15/2022] [Indexed: 03/11/2023]
Abstract
At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system. Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued.
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Sanchez VA, Dinh PC, Rooker J, Monahan PO, Althouse SK, Fung C, Sesso HD, Einhorn LH, Dolan ME, Frisina RD, Travis LB. Prevalence and risk factors for ototoxicity after cisplatin-based chemotherapy. J Cancer Surviv 2023; 17:27-39. [PMID: 36637632 DOI: 10.1007/s11764-022-01313-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/07/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Ototoxicity is a prominent side effect of cisplatin-based chemotherapy. There are few reports, however, estimating its prevalence in well-defined cohorts and associated risk factors. METHODS Testicular cancer (TC) survivors given first-line cisplatin-based chemotherapy completed validated questionnaires. Descriptive statistics evaluated the prevalence of ototoxicity, defined as self-reported hearing loss and/or tinnitus. We compared patients with and without tinnitus or hearing loss using Chi-square test, two-sided Fisher's exact test, or two-sided Wilcoxon rank sum test. To evaluate ototoxicity risk factors, a backward selection logistic regression procedure was performed. RESULTS Of 145 TC survivors, 74% reported ototoxicity: 68% tinnitus; 59% hearing loss; and 52% reported both. TC survivors with tinnitus were more likely to indicate hypercholesterolemia (P = 0.008), and difficulty hearing (P < .001). Tinnitus was also significantly related to age at survey completion (OR = 1.79; P = 0.003) and cumulative cisplatin dose (OR = 5.17; P < 0.001). TC survivors with hearing loss were more likely to report diabetes (P = 0.042), hypertension (P = 0.007), hypercholesterolemia (P < 0.001), and family history of hearing loss (P = 0.044). Risk factors for hearing loss included age at survey completion (OR = 1.57; P = 0.036), hypercholesterolemia (OR = 3.45; P = 0.007), cumulative cisplatin dose (OR = 1.94; P = 0.049), and family history of hearing loss (OR = 2.87; P = 0.071). CONCLUSIONS Ototoxicity risk factors included age, cisplatin dose, cardiovascular risk factors, and family history of hearing loss. Three of four TC survivors report some type of ototoxicity; thus, follow-up of cisplatin-treated survivors should include routine assessment for ototoxicity with provision of indicated treatments. IMPLICATIONS FOR CANCER SURVIVORS Survivors should be aware of risk factors associated with ototoxicity. Referrals to audiologists before, during, and after cisplatin treatment is recommended.
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Affiliation(s)
- Victoria A Sanchez
- Department of Otolaryngology-Head & Neck Surgery, University of South Florida, 12901 Bruce B. Downs Blvd., MDC 73, Tampa, FL, 33612, USA.
| | - Paul C Dinh
- Department of Medical Oncology, Indiana University, Indianapolis, IN, USA
| | - Jennessa Rooker
- College of Nursing, University of South Florida, Tampa, FL, USA
| | - Patrick O Monahan
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Sandra K Althouse
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - Chunkit Fung
- J.P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Howard D Sesso
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Lawrence H Einhorn
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
| | - M Eileen Dolan
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Robert D Frisina
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | - Lois B Travis
- Department of Biostatistics and Health Data Science, Indiana University, Indianapolis, IN, USA
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23
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Bright T, Ramke J, Zhang JH, Kitema GF, Safi S, Mdala S, Yoshizaki M, Brennan-Jones CG, Mactaggart I, Gordon I, Swenor BK, Burton MJ, Evans JR. Prevalence and impact of combined vision and hearing (dual sensory) impairment: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001905. [PMID: 37192147 DOI: 10.1371/journal.pgph.0001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 04/14/2023] [Indexed: 05/18/2023]
Abstract
Hearing and vision impairments are common globally. They are often considered separately in research, and in planning and delivering services. However, they can occur concurrently, termed dual sensory impairment (DSI). The prevalence and impact of hearing and vision impairment have been well-examined, but there has been much less consideration of DSI. The aim of this scoping review was to determine the nature and extent of the evidence on prevalence and impact of DSI. Three databases were searched: MEDLINE, Embase and Global Health (April 2022). We included primary studies and systematic reviews reporting the prevalence or impact of DSI. No limits were placed on age, publication dates, or country. Only studies where the full text was available in English were included. Two reviewers independently screened titles, abstract, full texts. Data were charted by two reviewers independently using a pre-piloted form. The review identified 183 reports of 153 unique primary studies and 14 review articles. Most evidence came from high-income countries (86% of reports). Prevalence varied across reports, as did age groups of participants and definitions used. The prevalence of DSI increased with age. Impact was examined across three broad groups of outcomes-psychosocial, participation, and physical health. There was a strong trend towards poorer outcomes for people with DSI across all categories compared to people with one or neither impairment, including activities of daily living (worse for people with DSI in 78% of reports) and depression (68%). This scoping review highlights that DSI is a relatively common condition with substantial impact, particularly among older adults. There is a gap in evidence from low and middle-income countries. There is a pressing need for a consensus position on the definition(s) of DSI and standardisation of reporting age groups to enable reliable estimates to be ascertained and compared and responsive services developed.
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Affiliation(s)
- Tess Bright
- Indigenous Health Equity Unit, Centre for Health Equity, University of Melbourne, Melbourne, Australia
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Gatera Fiston Kitema
- Ophthalmology Department, School of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Sare Safi
- Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shaffi Mdala
- Ophthalmology Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Miho Yoshizaki
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Christopher G Brennan-Jones
- Ear Health Group, Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Faculty of Health Sciences, Curtin University, Perth, Australia
- Department of Audiology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Bonnielin K Swenor
- The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland, United States of America
- The Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Jennifer R Evans
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre for Public Health, Queens University Belfast, Belfast, United Kingdom
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Prevalence of Polypharmacy in Patients With Vestibular and Balance Complaints. Ear Hear 2022; 44:506-517. [PMID: 36377041 DOI: 10.1097/aud.0000000000001292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the prevalence of polypharmacy in patients presenting with dizziness to a tertiary neurotology clinic and analyze the association between polypharmacy and clinical characteristics. DESIGN Retrospective, cross-sectional review. Demographics, symptoms, diagnoses, medications, audiometry, dizziness handicap index (DHI) scores, and cognitive failure questionnaire (CFQ) scores were extracted from charts of patients seen as new patients from September 1, 2019, to March 31, 2020, with a primary complaint of dizziness. RESULTS A total of 382 patients were included. More than two-thirds of the patients (n = 265, 69.4%) met criteria for polypharmacy (≥5 medications), of which most (n = 249, 94.0%) were prescribed a potentially ototoxic drug. Approximately 10% of patients were taking five or more ototoxic medications (oto-polypharmacy). Polypharmacy was correlated to age and was more common for patients with diabetes, hypertension, other cardiovascular comorbidities, and depression (odds ratio [OR], 3.73-6.67; p < 0.05). Polypharmacy was twice as likely in patients with mild to moderate hearing loss (OR 2.02 [1.24-3.29] and OR 2.13 [1.06-4.27], respectively; p < 0.05) and ~1.5× more likely in patients who had moderate to severe DHI scores (OR 1.65 [1.05-2.59] and OR 1.63 [1.00-2.65], respectively; p < 0.05). Patients with polypharmacy also had higher CFQ scores compared to those without polypharmacy (CFQ 32.5 [19.0-48.0] versus CFQ 25.0 [13.0-40.0]; p = 0.002. Oto-polypharmacy was more common for patients with lightheadedness as a dizziness descriptor (OR 3.16 [1.56-6.41]; p < 0.01). However, oto-polypharmacy was only more common for patients with mild to moderate hearing loss (OR 2.69 [1.33-5.45] and OR 2.86 [1.31-6.20], respectively; p < 0.01) and severe DHI scores (2.31 [1.12-4.77], p = 0.02). CONCLUSIONS The prevalence of polypharmacy in patients with vestibular disorders is high. Some of the medications that patients are on are also potentially ototoxic at variable degrees. Polypharmacy is more common when lightheadedness is one of the dizziness descriptors and seems to be associated with worse scores on patient-reported outcome measures (DHI, CFQ). Medication reconciliation and multidisciplinary involvement could help to better address polypharmacy in this patient population. However, further investigation is needed to elucidate polypharmacy's role in symptom presentation, vestibular testing results, and therapeutic strategies.
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Afghah T, Alfakir R, Meis M, van Leeuwen L, Kramer SE, Hammady M, Youssif M, Wagener KC. The development of a Self-Rated ICF-based questionnaire (HEAR-COMMAND Tool) to evaluate Hearing, Communication, and Conversation disability: Multinational experts' and patients' perspectives. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1005525. [PMID: 36451803 PMCID: PMC9701723 DOI: 10.3389/fresc.2022.1005525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022]
Abstract
Objective An instrument that facilitates the advancement of hearing healthcare delivery from a biomedical model to a biopsychosocial one that underpins the International Classification of Functioning, Disability, and Health framework (ICF) brief and comprehensive Core Sets for Hearing Loss (CSHL) is currently unavailable. The objective is to describe the process of developing and validating a new questionnaire named the HEAR-COMMAND Tool created by transferring the ICF CSHL into a theory-supported, practically manageable concept. Design A team from Germany, the USA, the Netherlands, and Egypt collaborated on development. The following ICF domains were considered; "Body Functions" (BF), "Activities and Participation" (AP), and "Environmental Factors" (EF). The development yielded English, German, and Arabic versions. A pilot validation study with a total of 109 respondents across three countries, Germany, Egypt, and the USA was conducted to revise the item terminology according to the feedback provided by the respondents. Results The questionnaire included a total of 120 items. Ninety items were designed to collect information on the functioning and 30 items inquiring about demographic information, hearing status, and Personal Factors. Except for the "Body Structures" (BS) domain, all the categories of the brief ICF CSHL were covered (a total of 85% of the categories). Moreover, the items covered 44% of the comprehensive ICF CSHL categories including 73% of BF, 55% of AP, and 27% of EF domains. Overall, the terminology of 24 ICF-based items was revised based on the qualitative analysis of the respondents' feedback to further clarify the items that were found tod be unclear or misleading. The tool highlighted the broad connection of HL with bodily health and contextual factors. Conclusions The HEAR-COMMAND Tool was developed based on the ICF CSHL and from multinational experts' and patients' perspectives with the aim to improve the execution of audiological services, treatment, and rehabilitation for adult patients with HL. Additional validation of the tool is ongoing. The next step would be to pair the tool with BS categories since it was excluded from the tool and determine its effectiveness in guiding hearing health care practitioners to holistically classify categories influencing hearing, communication, and conversation disability.
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Affiliation(s)
- Tahereh Afghah
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany,Correspondence: Tahereh Afghah
| | - Razan Alfakir
- Department of Speech-Language and Hearing Sciences, Auburn University, Auburn, AL, United States
| | - Markus Meis
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany
| | - Lisette van Leeuwen
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Sophia E. Kramer
- Department of Otolaryngology, Head and Neck Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Mahmoud Hammady
- Department of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division, Sohag University Hospital, Sohag, Egypt
| | - Mostafa Youssif
- Department of Otolaryngology, Head and Neck Surgery, Audiovestibular Medicine Division, Sohag University Hospital, Sohag, Egypt
| | - Kirsten C. Wagener
- Hörzentrum Oldenburg gGmbH, Germany and Cluster of Excellence Hearing4all, Oldenburg, Germany
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Yévenes-Briones H, Caballero FF, Banegas JR, Rodríguez-Artalejo F, Lopez-Garcia E. Association of Lifestyle Behaviors With Hearing Loss: The UK Biobank Cohort Study. Mayo Clin Proc 2022; 97:2040-2049. [PMID: 35710463 DOI: 10.1016/j.mayocp.2022.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the combined association of five healthy lifestyle behaviors with hearing loss (HL) in the UK Biobank cohort, established between 2006 and 2010 in the United Kingdom. METHODS This longitudinal analysis included 61,958 participants aged 40 to 70 years from April 2007 to December 2016. The healthy behaviors examined were: never smoking, high level of physical activity, high diet quality, moderate alcohol intake, and optimal sleep. Hearing loss was self-reported at baseline and in any physical exam during the follow-up. RESULTS Over a median follow-up of 3.9±2.5 years, 3072 (5.0%) participants reported incident HL. After adjustment for potential confounders, including age, social factors, exposure to high-intensity noise, ototoxic medication, and comorbidity, the HRs of HL associated with having 1, 2, 3, and 4 to 5 vs 0 behaviors were: 0.85 (95% CI, 0.75 to 0.96), 0.85 (95% CI, 0.75 to 0.96), 0.82 (95% CI, 0.71 to 0.94), and 0.80 (95% CI, 0.67 to 0.97), respectively (P for trend, 0.02). We estimated that the population attributable risk percent for not adhering to any five low-risk lifestyle behaviors was 15.6%. CONCLUSION In this large study, an increasing number of healthy behaviors was associated with decreased risk of HL.
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Affiliation(s)
- Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - José Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Wändell P, Li X, Carlsson A, Sundquist J, Sundquist K. Hearing impairment among adult foreign-born and Swedish-born individuals: A national Swedish study. PLoS One 2022; 17:e0273406. [PMID: 36001613 PMCID: PMC9401125 DOI: 10.1371/journal.pone.0273406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives To analyze the risk of hearing impairment in adult first-generation immigrants, i.e., foreign-born individuals as compared to Swedish-born individuals. Study design A register-based study follow-up study. Methods A nationwide study of individuals 25 years of age and older (N = 5 464 245; 2 627 364 men and 2 836 881 women) in Sweden. Hearing impairment was defined as at least one registered diagnosis in the National Patient Register between January 1st, 1998 and December 31st, 2015. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident hearing impairment in foreign-born compared to Swedish-born individuals. Cox regression models were stratified by sex and adjusted for age, comorbidities, and socioeconomic status. Results A total of 244 171 cases (124 349 men and 119 822 women) of hearing impairment were registered. Hearing impairment risk expressed as fully adjusted HRs (99% CI) was somewhat lower among immigrant men 0.95 (0.92–97) but not among immigrant women 0.97 (0.95–1.00), with significantly higher fully adjusted HRs among men and women from Asia, and Eastern Europe, and women from Africa. Conclusions We observed a somewhat lower risk of hearing impairment among foreign-born men, but there was a higher risk among men and women from some regions.
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Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Axel Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden
- * E-mail:
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, United States of America
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, United States of America
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
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Calvino M, Sánchez-Cuadrado I, Gavilán J, Lassaletta L. The effect of risk factors on cognition in adult cochlear implant candidates with severe to profound hearing loss. Front Psychol 2022; 13:837366. [PMID: 36051206 PMCID: PMC9426630 DOI: 10.3389/fpsyg.2022.837366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/29/2022] [Indexed: 01/10/2023] Open
Abstract
Hearing loss has been identified as a major modifiable risk factors for dementia. Adult candidates for cochlear implantation (CI) represent a population at risk of hearing loss-associated cognitive decline. This study investigated the effect of demographics, habits, and medical and psychological risk factors on cognition within such a cohort. Data from 34 consecutive adults with post-lingual deafness scheduled for CI were analyzed. Pure tone audiometry (PTA4) and Speech Discrimination Score (SDS) were recorded. The Repeatable Battery for Assessment of Neuropsychological Status for Hearing impaired individuals (RBANS-H) was used to measure cognition. Demographics (sex, age, years of education), habits (smoking, alcohol intake, physical inactivity), and medical factors (hypertension, diabetes, traumatic brain injury) were evaluated. Depression was measured using the Hospital Anxiety and Depression Scale (HADS), and social inhibition with the Type D questionnaire (DS14). All participants (mean age 62 ± 15 years) suffered from severe to profound hearing loss (PTA4:129 ± 60 dB; SDS:14 ± 24%). The mean RBANS-H total score was 83 ± 16. Participants reported a mean of years of formal education of 12 ± 5 years. The prevalence of habits and medical risk factors was: physical inactivity (29%), body mass index >30 (28%), traumatic brain injury (25%), hypertension (24%), heavy alcohol consumption (13%), smoking (13%), and diabetes (0%). Regarding psychological factors, the mean scores of social inhibition and depression were 10 ± 6 and 6 ± 5, respectively. The number of years of education was significantly correlated with the RBANS-H total score (p < 0.001), and with the domains “Immediate memory” (p = 0.003), “Visuospatial/constructional” (p < 0.001), and “Attention” (p < 0.001). The mean RBANS-H total score in participants who had university studies or higher level (12/34) was 97 ± 9, with the remaining participants reporting a mean score of 75 ± 15. Men performed better in the “Visuospatial/constructional” (p = 0.008). Physical inactivity was associated with lower scores in the “Delayed memory” (p = 0.031); hypertension correlated with lower RBANS-H total scores (p = 0.025) and “Attention” (p = 0.006). Depression and social inhibition were negatively correlated with RBANS-H total score and with the “Immediate memory,” “Visuospatial/constructional,” and “Attention” (all p < 0.05). In adults with late-onset deafness scheduled to CI, educational level has a significant effect. Additionally, sex, physical inactivity, hypertension, and psychological traits of social inhibition and depression may also influence cognitive status. Long-term studies with more participants would enable us better understand the effects different risk factors on cognitive status.
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Affiliation(s)
- Miryam Calvino
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - Isabel Sánchez-Cuadrado
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, Hospital Universitario La Paz, IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
- *Correspondence: Luis Lassaletta,
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Presbiacusia y trastornos del equilibrio en personas mayores. Revision bibliográfica de aspectos etiopatogénicos, consecuencias sobre la calidad de vida y efectos positivos de su tratamiento. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Age-Related Hearing Loss: The Link between Inflammaging, Immunosenescence, and Gut Dysbiosis. Int J Mol Sci 2022; 23:ijms23137348. [PMID: 35806352 PMCID: PMC9266910 DOI: 10.3390/ijms23137348] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/30/2022] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
This article provides a theoretical overview of the association between age-related hearing loss (ARHL), immune system ageing (immunosenescence), and chronic inflammation. ARHL, or presbyacusis, is the most common sensory disability that significantly reduces the quality of life and has a high economic impact. This disorder is linked to genetic risk factors but is also influenced by a lifelong cumulative effect of environmental stressors, such as noise, otological diseases, or ototoxic drugs. Age-related hearing loss and other age-related disorders share common mechanisms which often converge on low-grade chronic inflammation known as “inflammaging”. Various stimuli can sustain inflammaging, including pathogens, cell debris, nutrients, and gut microbiota. As a result of ageing, the immune system can become defective, leading to the accumulation of unresolved inflammatory processes in the body. Gut microbiota plays a central role in inflammaging because it can release inflammatory mediators and crosstalk with other organ systems. A proinflammatory gut environment associated with ageing could result in a leaky gut and the translocation of bacterial metabolites and inflammatory mediators to distant organs via the systemic circulation. Here, we postulate that inflammaging, as a result of immunosenescence and gut dysbiosis, accelerates age-related cochlear degeneration, contributing to the development of ARHL. Age-dependent gut dysbiosis was included as a hypothetical link that should receive more attention in future studies.
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Hearing loss drug discovery and medicinal chemistry: Current status, challenges, and opportunities. PROGRESS IN MEDICINAL CHEMISTRY 2022; 61:1-91. [PMID: 35753714 DOI: 10.1016/bs.pmch.2022.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Hearing loss is a severe high unmet need condition affecting more than 1.5 billion people globally. There are no licensed medicines for the prevention, treatment or restoration of hearing. Prosthetic devices, such as hearing aids and cochlear implants, do not restore natural hearing and users struggle with speech in the presence of background noise. Hearing loss drug discovery is immature, and small molecule approaches include repurposing existing drugs, combination therapeutics, late-stage discovery optimisation of known chemotypes for identified molecular targets of interest, phenotypic tissue screening and high-throughput cell-based screening. Hearing loss drug discovery requires the integration of specialist therapeutic area biology and otology clinical expertise. Small molecule drug discovery projects in the global clinical portfolio for hearing loss are here collated and reviewed. An overview is provided of human hearing, inner ear anatomy, inner ear delivery, types of hearing loss and hearing measurement. Small molecule experimental drugs in clinical development for hearing loss are reviewed, including their underpinning biology, discovery strategy and activities, medicinal chemistry, calculated physicochemical properties, pharmacokinetics and clinical trial status. SwissADME BOILED-Egg permeability modelling is applied to the molecules reviewed, and these results are considered. Non-small molecule hearing loss assets in clinical development are briefly noted in this review. Future opportunities in hearing loss drug discovery for human genomics and targeted protein degradation are highlighted.
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Goodwin MV, Hogervorst E, Maidment DW. Test Your Health at Home: Comparing Online Screening Tests of Hearing, Cognition, and Cardiovascular Health. Am J Audiol 2022; 31:950-960. [PMID: 35239423 DOI: 10.1044/2021_aja-21-00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the extent to which validated online screening measures of cognitive impairment, psychosocial well-being, and cardiovascular health are associated with a validated hearing screener in a sample of adults based in the United Kingdom. METHOD Sixty-one adults (43 female; M age = 44.7 years) participated in a cross-sectional study delivered remotely. Participants completed the hearWHO smartphone application, a digits-in-noise hearing screener, and the Modified Telephone Interview for Cognitive Status (TICS-M), a screening tool for cognitive impairment. Psychosocial well-being (social isolation and loneliness) and cardiovascular health were assessed through self-report. RESULTS Separate independent analyses of variance, with age, gender, and education as covariates, demonstrated participants who failed the hearWHO screener had poorer scores on the TICS-M, engaged in less physical activity, and reported more sedentary behavior and greater social isolation. Multivariate regression analyses revealed that lower TICS-M scores, having obtained less education, identifying as female, and reporting greater sedentary behavior and social isolation were the strongest predictors of lower hearWHO scores. CONCLUSIONS The results from this study suggest that poorer hearing, as measured by the hearWHO screener, is independently associated with having worse cognitive function, more time spent being sedentary, and greater social isolation. Thus, this study demonstrates the potential of online screening measures to identify additional health conditions that confer risk to chronic disease as hearing loss manifests. This could help to inform the development of tailored treatment and support to improve an individual's readiness to seek help for and manage both their general and hearing health. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19251956.
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Affiliation(s)
- Maria V. Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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Reed M, Freedman M, Mark Fraser AE, Bromwich M, Santiago AT, Gallucci CE, Frank A. Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline. J Alzheimers Dis 2022; 86:413-424. [DOI: 10.3233/jad-215377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults. Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians’ awareness of hearing loss and improve access to timely hearing care. Methods: Patients referred to two academic medical clinics for memory disorders were offered hearing screening as part of clinic protocol. Patients with hearing loss were recruited to the study if they consented to a post-appointment telephone interview and chart review. Memory Clinic physicians were surveyed about the usefulness of the screening information and referral of patients with hearing loss to audiology. Results: Hearing loss was reliably detected in Memory Clinic patients with both in-office and online screening tools. Physicians reported that screening enhanced their awareness of hearing loss and increased the referral rate to audiology. Conclusion: Hearing screening in Memory Clinic patients is a useful component of clinic protocol that facilitates timely access to management and addresses an important risk factor for dementia.
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Affiliation(s)
- Marilyn Reed
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Morris Freedman
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Mt. Sinai Hospital, Toronto, ON, Canada
| | | | - Matthew Bromwich
- SHOEBOX Ltd., Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | | | | | - Andrew Frank
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
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Lazareva LA, Elizbaryan IS, Azamatova SA, Muzaeva BR, Sushcheva NA. [Triggers and predictors of development and formation of sensorineural hearing loss]. Vestn Otorinolaringol 2022; 87:34-43. [PMID: 35605270 DOI: 10.17116/otorino20228702134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The purpose of the study is to review the results of scientific researches in recent years in an expanded interdisciplinary view of the problem of etiopathogenesis of sensorineural hearing loss, as well as the role of comorbidities and triggers in the formation of persistent changes in the audio-receiving part of the auditory analyzer.
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Affiliation(s)
- L A Lazareva
- Kuban State Medical University, Krasnodar, Russia
| | | | - S A Azamatova
- Adygei Republican Center for Rehabilitation of the Adygea Republican Clinical Hospital, Republic of Adygea, Russia
| | - B R Muzaeva
- Kuban State Medical University, Krasnodar, Russia
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The bone conduction implant BONEBRIDGE increases quality of life and social life satisfaction. Eur Arch Otorhinolaryngol 2022; 279:5555-5563. [PMID: 35524069 PMCID: PMC9649473 DOI: 10.1007/s00405-022-07384-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/28/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Transcutaneous active bone conduction hearing aids represent an alternative approach to middle ear surgery and conventional hearing aids for patients with conductive or mixed hearing loss. The aim of this study was to determine quality of life, subjective hearing experience and patients' satisfaction after implantation of a bone conduction hearing aid. METHODS This monocentric and retrospective study included twelve adult patients who received a bone conduction hearing aid (Bonebridge, MedEL) consisting of an extracorporeal audio processor and a bone conduction implant (BCI) between 2013 and 2017. On average 40 months after implantation, the patients were asked to answer three questionnaires regarding quality of life (AqoL-8D), self-reported auditory disability (SSQ-12-B) and user's satisfaction (APSQ) after implantation of the Bonebridge (BB). A descriptive statistical analysis of the questionnaires followed. RESULTS 12 patients aged 26-85 years (sex: m = 7, w = 5) were recruited. The quality of life of all patients after implantation of the BB (AqoL 8D) averaged an overall utility score of 0.76 (SD ± 0.17). The mean for 'speech hearing' in the SSQ-12-B was + 2.43 (SD ± 2.03), + 1.94 (SD ± 1.48) for 'spatial hearing' and + 2.28 (SD ± 2.32) for 'qualities of hearing'. 11 out of 12 patients reported an improvement in their overall hearing. The APSQ score for the subsection 'wearing comfort' was 3.50 (SD ± 0.87), 'social life' attained a mean of 4.17 (SD ± 1.06). The 'device inconveniences' reached 4.02 (SD ± 0.71) and 'usability' of the device was measured at 4.23 (SD ± 1.06). The average wearing time of the audio processor in the cohort was 11 h per day, with 8 of 12 patients reporting the maximum length of 12 h per day. CONCLUSION BB implantation results in a gain in the perceived quality of life (AqoL 8D). The SSQ-12-B shows an improvement in subjective hearing. According to the APSQ, it can be assumed that the BB audio processor, although in an extracorporeal position, is rated as a useful instrument with positive impact on social life. The majority stated that they had subjectively benefited from BB implantation and that there were no significant physical or sensory limitations after implantation.
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Bourn SS, Goldstein MR, Morris SA, Jacob A. Cochlear implant outcomes in the very elderly. Am J Otolaryngol 2022; 43:103200. [PMID: 34600410 DOI: 10.1016/j.amjoto.2021.103200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 09/03/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE Managing hearing health in older adults has become a public health imperative, and cochlear implantation is now the standard of care for aural rehabilitation when hearing aids no longer provide sufficient benefit. The aim of our study was to compare speech performance in cochlear implant patients ≥80 years of age (Very Elderly) to a younger elderly cohort between ages 65-79 years (Less Elderly). MATERIALS AND METHODS Data were collected from 53 patients ≥80 years of age and 92 patients age 65-79 years who underwent cochlear implantation by the senior author between April 1, 2017 and May 12, 2020. The primary outcome measure compared preoperative AzBio Quiet scores to 6-month post-activation AzBio Quiet results for both cohorts. RESULTS Very Elderly patients progressed from an average AzBio Quiet score of 22% preoperatively to a score of 45% in the implanted ear at 6-months post-activation (p < 0.001) while the Less Elderly progressed from an average score of 27% preoperatively to 60% at 6-months (p < 0.001). Improvements in speech intelligibility were statistically significant within each of these cohorts (p < 0.001). Comparative statistics using independent samples t-test and evaluation of effect size using the Hedges' g statistic demonstrated a significant difference for average improvement of AzBio in quiet scores between groups with a medium effect size (p = 0.03, g = 0.35). However, when the very oldest patients (90+ years) were removed, the statistical difference between groups disappeared (p = 0.09). CONCLUSIONS When assessing CI performance, those over age 65 are typically compared to younger patients; however, this manuscript further stratifies audiometric outcomes for older CI recipients in a single-surgeon, high-volume practice. Our data indicates that for speech intelligibility, patients between age 65-79 perform similarly to CI recipients 80-90 years of age and should not be dismissed as potential cochlear implant candidates.
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Hackenberg B, Döge J, Lackner KJ, Beutel ME, Münzel T, Pfeiffer N, Nagler M, Schmidtmann I, Wild PS, Matthias C, Bahr K. Hearing Loss and Its Burden of Disease in a Large German Cohort-Hearing Loss in Germany. Laryngoscope 2021; 132:1843-1849. [PMID: 34904723 DOI: 10.1002/lary.29980] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/26/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Hearing loss is the most common sensory impairment worldwide. It restricts patients in many aspects of their daily lives and can lead to social exclusion. Understanding this burden is a mandatory requirement for the care of those affected. Therefore, the aim of this study was to estimate the burden of hearing loss in a large German cohort. STUDY DESIGN Cohort study. METHODS The Gutenberg Health Study is designed as a single-center, prospective, and observational cohort study and representative for the city of Mainz, Germany, with its district. Participants were interviewed concerning common otologic symptoms and tested by pure-tone audiometry. The primary outcome was hearing impairment stratified by age and sex. The prevalence of tinnitus was estimated for a subcohort to calculate disability-adjusted life years (DALYs). All results were weighted by the European Standard Population (ESP) 2013. RESULTS A total of 5,024 participants (mean age: 61.2 years, 2,591 men and 2,433 women) were included in the study. Hearing impairment showed the following prevalence: 28.2% (95% confidence interval [CI], 26.9%-29.4%) mild impairment, 10.1% (95% CI, 9.3%-11.0%) moderate impairment, 2.3% (95% CI, 1.9%-2.7%) moderately severe impairment, 0.2% (95% CI, 0.1%-0.4%) severe impairment, 0% (95% CI, 0.0%-0.1%) profound impairment, and 0.1% (95% CI, 0.0%-0.2%) complete impairment. Weighted for the ESP 2013 (all ages), hearing impairment across all levels (with/without tinnitus) causes a total of 2,118.97 DALYs per 100,000. CONCLUSION With 40.9% affected, the hearing loss represents a relevant burden of the German population. Understanding this will provide the basis for future guidelines on how to care for these patients. LEVEL OF EVIDENCE 2 Laryngoscope, 2021.
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Affiliation(s)
- Berit Hackenberg
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Julia Döge
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Karl J Lackner
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center Mainz, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology I, University Medical Center Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, Biometrics Department, University Medical Center Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine-Department of Cardiology, University Medical Center Mainz, Mainz, Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
| | - Katharina Bahr
- Department of Otorhinolaryngology, University Medical Center Mainz, Mainz, Germany
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Isherwood B, Gonçalves AC, Cousins R, Holme R. The global hearing therapeutic pipeline: 2021. Drug Discov Today 2021; 27:912-922. [PMID: 34775104 DOI: 10.1016/j.drudis.2021.11.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/20/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
Hearing loss is a serious condition affecting more than 1.5 billion people globally. Many affected people benefit from the use of devices, such as hearing aids, but these do not restore natural hearing, and many users still struggle to follow speech in the presence of background noise. Consequently, there is rapid growth in work to discover therapeutics to address this need. Our analysis of the therapeutic pipeline for inner ear and central processing disorders identified 23 assets in clinical trials and 56 in preclinical development, of which 25% have entered the pipeline in the past three years. The innovative potential of this pipeline is encouraging, but there are translational hurdles to be overcome. We highlight challenges for the pipeline and comment on opportunities to support and strengthen it.
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Affiliation(s)
| | | | - Rick Cousins
- University College London Ear Institute, London, UK; Cinnabar Consulting, Bedford, UK
| | - Ralph Holme
- Royal National Institute for Deaf People, Peterborough, UK.
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Kaspar A, Pifeleti S. A call to action for the inclusion of ENT/Audiology services in the public health approach to addressing non-communicable diseases in the Pacific Islands. PUBLIC HEALTH IN PRACTICE 2021; 2:100123. [PMID: 36101595 PMCID: PMC9461543 DOI: 10.1016/j.puhip.2021.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 11/16/2022] Open
Abstract
Non-Communicable Diseases (NCDs): a public health crisis in the Pacific Islands. Hearing loss is a silent disability associated with NCDs. Hearing disability secondary to NCDs may be prevented/minimised. Inclusion of ear/hearing health in NCD public heath agenda is advocated. Ear/hearing health support should positively impact NCD outcomes.
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Abstract
INTRODUCTION Older adults with late-onset hearing loss are at risk for cognitive decline. Our study addresses the question of whether cochlear implantation (CI) can counteract this potential influence. We investigated whether cognitive performance in older adults with severe and profound hearing loss improves 12 months after CI to a level comparable to controls with normal hearing, matched for age, sex, and education level. DESIGN This cohort study was performed at two tertiary referral centers. The study included 29 patients, of age between 60 and 80 years, with adult-onset, severe to profound bilateral sensorineural hearing loss and indication for CI (study group), as well as 29 volunteers with age-adjusted hearing abilities, according to the norm curves of ISO-702 9:2000-01, (control group). Before CI and 12 months after CI, participants completed a neurocognitive test battery including tests of global cognition, verbal and figural episodic memory, and executive functions (attentional control, inhibition, and cognitive flexibility). RESULTS Twelve months after CI, the performance of the study group improved significantly in global cognition, compared to the situation before CI. Differences in verbal episodic memory, figural episodic memory, and executive function were not significant. Moreover, the improvement of the study group was significantly larger only in global cognition compared to the control group. Noninferiority tests on the cognitive performances of the study group after CI revealed that comparable levels to normal hearing controls were reached only in global cognition, figural episodic memory (immediate recall), and attentional control. The improvement in global cognition was significantly associated with speech recognition 3 months after CI, but not with speech recognition 12 months after CI. CONCLUSION One year after CI, cognitive deficits in older individuals with adult-onset hearing loss, compared to normal-hearing peers, could only improve some cognitive skills.
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Harrison SC, Lawrence R, Hoare DJ, Wiggins IM, Hartley DEH. Use of Functional Near-Infrared Spectroscopy to Predict and Measure Cochlear Implant Outcomes: A Scoping Review. Brain Sci 2021; 11:brainsci11111439. [PMID: 34827438 PMCID: PMC8615917 DOI: 10.3390/brainsci11111439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Outcomes following cochlear implantation vary widely for both adults and children, and behavioral tests are currently relied upon to assess this. However, these behavioral tests rely on subjective judgements that can be unreliable, particularly for infants and young children. The addition of an objective test of outcome following cochlear implantation is therefore desirable. The aim of this scoping review was to comprehensively catalogue the evidence for the potential of functional near infrared spectroscopy (fNIRS) to be used as a tool to objectively predict and measure cochlear implant outcomes. A scoping review of the literature was conducted following the PRISMA extension for scoping review framework. Searches were conducted in the MEDLINE, EMBASE, PubMed, CINAHL, SCOPUS, and Web of Science electronic databases, with a hand search conducted in Google Scholar. Key terms relating to near infrared spectroscopy and cochlear implants were used to identify relevant publications. Eight records met the criteria for inclusion. Seven records reported on adult populations, with five records only including post-lingually deaf individuals and two including both pre- and post-lingually deaf individuals. Studies were either longitudinal or cross-sectional, and all studies compared fNIRS measurements with receptive speech outcomes. This review identified and collated key work in this field. The homogeneity of the populations studied so far identifies key gaps for future research, including the use of fNIRS in infants. By mapping the literature on this important topic, this review contributes knowledge towards the improvement of outcomes following cochlear implantation.
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Affiliation(s)
- Samantha C. Harrison
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Correspondence: ; Tel.: +44-115-823-2640
| | - Rachael Lawrence
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
| | - Derek J. Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Ian M. Wiggins
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
| | - Douglas E. H. Hartley
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK; (R.L.); (D.J.H.); (I.M.W.); (D.E.H.H.)
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham NG1 5DU, UK
- Nottingham University Hospitals National Health Service Trust, Nottingham NG5 1PB, UK
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The Association Between Hearing Loss and Surgical Complications in Older Adults. Ear Hear 2021; 43:961-971. [PMID: 34711743 DOI: 10.1097/aud.0000000000001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In this study, we sought to evaluate whether older patients with hearing loss who underwent surgery were at greater risk of postsurgical complications, increased inpatient length-of-stay (LOS), and hospital readmission. DESIGN This was a retrospective cohort study of patients receiving surgery at a tertiary medical center. Utilizing electronic health record data from two merged datasets, we identified patients 65 years and older, undergoing major surgery between January 1, 2014 and January 31, 2017, and who had audiometric evaluation before surgery. Patients were classified as having either normal hearing or hearing loss based on pure-tone average in the better ear. A Generalized Estimating Equations approach was used to fit multivariable regression models for outcome variables of interest. RESULTS Of patients ≥65 years undergoing major surgery in our time frame, a total of 742 surgical procedures were performed on 621 patients with available audiometric data. After adjusting for age, sex, race, and comorbidities, hearing loss was associated with an increase in the odds of developing postoperative complications. Every 10 dB increase in hearing loss was associated with a 14% increase in the odds of developing a postoperative complication (odds ratio = 1.14, 95% confidence interval = 1.01-1.29, p = 0.031). Hearing loss was not significantly associated with increased hospital LOS, 30-day readmission, or 90-day readmission. CONCLUSION Hearing loss was significantly associated with developing postoperative complications in older adults undergoing major surgery. Screening for hearing impairment may be a useful addition to the preoperative assessment and perioperative management of older patients undergoing surgery.
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De Groote E, Eqlimi E, Bockstael A, Botteldooren D, Santens P, De Letter M. Parkinson's disease affects the neural alpha oscillations associated with speech-in-noise processing. Eur J Neurosci 2021; 54:7355-7376. [PMID: 34617350 DOI: 10.1111/ejn.15477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Parkinson's disease (PD) has increasingly been associated with auditory dysfunction, including alterations regarding the control of auditory information processing. Although these alterations may interfere with the processing of speech in degraded listening conditions, behavioural studies have generally found preserved speech-in-noise recognition in PD. However, behavioural speech audiometry does not capture the neurophysiological mechanisms supporting speech-in-noise processing. Therefore, the aim of this study was to investigate the neural oscillatory mechanisms associated with speech-in-noise processing in PD. Twelve persons with PD and 12 age- and gender-matched healthy controls (HCs) were included in this study. Persons with PD were studied in the medication off condition. All subjects underwent an audiometric screening and performed a sentence-in-noise recognition task under simultaneous electroencephalography (EEG) recording. Behavioural speech recognition scores and self-reported ratings of effort, performance, and motivation were collected. Time-frequency analysis of EEG data revealed no significant difference between persons with PD and HCs regarding delta-theta (2-8 Hz) inter-trial phase coherence to noise and sentence onset. In contrast, significantly increased alpha (8-12 Hz) power was found in persons with PD compared with HCs during the sentence-in-noise recognition task. Behaviourally, persons with PD demonstrated significantly decreased speech recognition scores, whereas no significant differences were found regarding effort, performance, and motivation ratings. These results suggest that persons with PD allocate more cognitive resources to support speech-in-noise processing. The interpretation of this finding is discussed in the context of a top-down mediated compensation mechanism for inefficient filtering and degradation of auditory input in PD.
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Affiliation(s)
- Evelien De Groote
- Department of Rehabilitation Sciences, BrainComm Research Group, Ghent University, Ghent, Belgium
| | - Ehsan Eqlimi
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Annelies Bockstael
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Dick Botteldooren
- Department of Information Technology, WAVES Research Group, Ghent University, Ghent, Belgium
| | - Patrick Santens
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Miet De Letter
- Department of Rehabilitation Sciences, BrainComm Research Group, Ghent University, Ghent, Belgium
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Wändell P, Li X, Carlsson AC, Sundquist J, Sundquist K. Hearing impairment among children in Sweden with foreign-born parents and natives: A national Swedish study. Acta Paediatr 2021; 110:2817-2824. [PMID: 34139033 DOI: 10.1111/apa.15990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/11/2021] [Accepted: 06/16/2021] [Indexed: 01/07/2023]
Abstract
AIM We aimed to estimate the risk of hearing impairment in children and adolescents with foreign-born parents, compared to natives. METHODS A nationwide study of 1,923,590 (51.4% boys) individuals aged 0-17 years of age in Sweden. Hearing impairment was defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2015. We used Cox regression analysis to estimate relative risk (hazard ratios with 99% confidence intervals) of incident hearing impairment in children with foreign-born parents compared to Swedish-born natives. Cox regression models were stratified by sex and adjusted for age, co-morbidities and socioeconomic status. RESULTS A total of 20,514 cases (53.7% boys) with extended sensorineural hearing impairment were registered, also including noise-induced hearing impairment and that from other causes, and 6172 cases (50.0% boys) with conductive hearing impairment. The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, especially from Iraq, fully adjusted HR (99% CI) 1.30 (1.17-1.4), and lower in boys with parents from Nordic countries, South Europe, and North America. CONCLUSION The risk of extended sensorineural hearing impairment was higher in boys with parents from Asia, in particular Iraq.
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Affiliation(s)
- Per Wändell
- Department of Neurobiology, Care Sciences and Society Division of Family Medicine and Primary Care Karolinska Institutet Huddinge Sweden
| | - Xinjun Li
- Center for Primary Health Care Research Lund University Malmö Sweden
| | - Axel C. Carlsson
- Department of Neurobiology, Care Sciences and Society Division of Family Medicine and Primary Care Karolinska Institutet Huddinge Sweden
- Academic Primary Health Care Centre Stockholm Region Stockholm Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research Lund University Malmö Sweden
- Department of Family Medicine and Community Health Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Functional Pathology Center for Community‐based Healthcare Research and Education (CoHRE) School of Medicine Shimane University Matsue Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research Lund University Malmö Sweden
- Department of Family Medicine and Community Health Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Functional Pathology Center for Community‐based Healthcare Research and Education (CoHRE) School of Medicine Shimane University Matsue Japan
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Singh G, Driscoll C, Pachana NA. The impact of owning a hearing dog on quality of life, hearing handicap, and social functioning: an Australian cohort. Int J Audiol 2021; 61:761-768. [PMID: 34455890 DOI: 10.1080/14992027.2021.1969454] [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: 10/20/2022]
Abstract
OBJECTIVE To determine the impact of owning a hearing dog on self-reported hearing handicap, quality of life (QoL), and social functioning. DESIGN Group comparison study design, utilising five surveys (General Information Survey, Hearing Information Survey, Hearing Handicap Inventory for the Elderly/Adults, Medical Outcomes Survey, and Social Functioning Questionnaire). STUDY SAMPLE 23 respondents from the 2019 Australian Lions Hearing Dog waitlist (controls) and 58 respondents from all clients who had received a hearing dog through the Australian Lions Hearing Dog service (cases). RESULTS No significant difference was found in Hearing Handicap Inventory or Social Functioning Questionnaire scores between the groups, although there was a tendency for improvement with dog ownership. The owner group scored significantly lower than the waitlist group on three Medical Outcomes Survey sub-items (general health, physical functioning, and role limitations due to physical health), along with total health-related QoL. These results contrasted with the broad emotional and psychosocial benefits identified through thematic analysis of responses. CONCLUSIONS It is feasible, yet not certain, that owning a hearing dog may bring a reduction in hearing handicap, as well as emotional and social benefits to the QoL of individuals, but it also appears to be associated with poorer perception of health.
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Affiliation(s)
- Gurheen Singh
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Carlie Driscoll
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Australia
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Hearing difficulty is linked to Alzheimer's disease by common genetic vulnerability, not shared genetic architecture. NPJ Aging Mech Dis 2021; 7:17. [PMID: 34294723 PMCID: PMC8298411 DOI: 10.1038/s41514-021-00069-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
Age-related hearing loss was recently established as the largest modifiable risk factor for Alzheimer's disease (AD), however, the reasons for this link remain unclear. We investigate shared underlying genetic associations using results from recent large genome-wide association studies (GWAS) on adult hearing difficulty and AD. Genetic correlation and Mendelian randomization (MR) analysis do not support a genetic correlation between the disorders, but suggest a direct causal link from AD genetic risk to hearing difficulty, driven by APOE. Systematic MR analyses on the effect of other traits revealed shared effects of glutamine, gamma-glutamylglutamine, and citrate levels on reduced risk of both hearing difficulty and AD. In addition, pathway analysis on GWAS risk variants suggests shared function in neuronal signalling pathways as well as etiology of diabetes and cardiovascular disease. However, after multiple testing corrections, neither analysis led to statistically significant associations. Altogether, our genetic-driven analysis suggests hearing difficulty and AD are linked by a shared vulnerability in molecular pathways rather than by a shared genetic architecture.
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Willems M, van Berlaer G, Maes L, Leyssens L, Koehler B, Marks L. Outcome of 10 years of ear and hearing screening in people with intellectual disability in Europe: A multicentre study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:123-133. [PMID: 34197010 DOI: 10.1111/jar.12923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Undetected ear and hearing problems negatively impact the quality of life of people with intellectual disability. METHODS This multicentre retrospective study describes the outcome of 10 years of ear and hearing screening in athletes with intellectual disability in seven European countries. The screening was conducted by a trained team using a strictly standardised protocol. RESULTS Of 15,363 screened athletes with intellectual disability, more than half (58.7%) needed referral for ear and/or hearing problems, ranging from 51.7% (<20 years old) to 81.4% (≥60 years old). The most commonly detected conditions were excessive/impacted earwax (40.3%), middle ear problems (30.1%) and hearing loss (27.0%), with significant differences between age groups and countries. DISCUSSION This study demonstrates an increased risk of ear and hearing problems in people with intellectual disability as compared to the general population. Considering the unawareness and impact of these problems, it is highly recommended to organise systematic screening. Follow-up for diagnostic elaboration, therapeutic management and long-term guidance should be provided.
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Affiliation(s)
- Melina Willems
- Audiology Department, Artevelde University of Applied Sciences, Ghent, Belgium.,Special Olympics Healthy Hearing Program, Washington, DC, USA
| | - Gerlant van Berlaer
- Department of Emergency Medicine, University Hospital Brussels, Brussels, Belgium
| | - Leen Maes
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.,Ear Nose Throat Department, Ghent University Hospital, Ghent, Belgium
| | - Laura Leyssens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | | | - Luc Marks
- Ghent University Hospital, Oral Health in Special Needs, Ghent, Belgium
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Skarzynski PH, Ciesla K, Lorens A, Wojcik J, Skarzynski H. Cost-Utility Analysis of Bilateral Cochlear Implantation in Adults With Severe to Profound Sensorineural Hearing Loss in Poland. Otol Neurotol 2021; 42:706-712. [PMID: 33967247 DOI: 10.1097/mao.0000000000003040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to develop a Markov model and apply it for the evaluation of three different treatment scenarios for adult patients with severe to profound bilateral sensorineural hearing loss. STUDY DESIGN Prospective Observational Study. SETTINGS Hospital. PATIENTS A clinical group of 22 adult patients (59.1% men, 40.9% women) aged from 59.13 ± 8.9 years were included in the study. The study comprised two arms: patients in group 1 received the second cochlear implant one to three months after the first implant; while patients in group 2 got the second cochlear implant approximately one year after the first implant. MAIN OUTCOME MEASURES All participants were first asked to complete an AQoL-8D questionnaire. For the cost-effectiveness analyses, a Markov model analyzed as microsimulation was developed to compare the different treatment options. RESULTS The analyses show that bilateral cochlear implantation strategies are cost-effective compared to the 'no treatment' alternative when having a 10-year model time horizon. When all three model scenarios are compared, the bilateral simultaneous cochlear implantation strategy (Scenario 3) compared to the 'no treatment' option is even more cost-effective than the Scenarios 1 and 2, compared with the 'no treatment' alternative. CONCLUSIONS The model results summarize that bilateral (sequential and simultaneous) cochlear implantation that are represented in the model scenarios, are cost-effective strategies for Polish adult patients with bilateral severe to profound sensorineural hearing loss.
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Affiliation(s)
- Piotr Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing
- Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Warsaw
- Institute of Sensory Organs, Nadarzyn/Warsaw
- Center of Hearing and Speech Medincus, Kajetany, Poland
| | - Katarzyna Ciesla
- Bioimaging Research Center, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany
| | - Artur Lorens
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw
| | - Joanna Wojcik
- Bioimaging Research Center, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany
| | - Henryk Skarzynski
- World Hearing Center, Institute of Physiology and Pathology of Hearing
- Oto-Rhino-Laryngology Surgery Clinic, World Hearing Center
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49
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Wung D, Goderie T, van Wier MF, Stam M, Kramer SE. Association of beta blocker use and hearing ability in adults: a cross-sectional study. Int J Audiol 2021; 61:102-107. [PMID: 34057380 DOI: 10.1080/14992027.2021.1915508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To investigate the potential association between beta blocker use and hearing ability in adults and to discern whether this effect is dose-dependent. DESIGN Cross-sectional analyses. Multiple linear regression was performed with hearing ability as the dependent variable and beta blocker use as the independent variable. The independent variable was classified into three dose categories for secondary analysis. Adjustments were made for age, gender, educational level, and tobacco smoking status. STUDY SAMPLE 1636 adults, 75 of whom reported being on beta blockers, from the internet-based Netherlands Longitudinal Study on Hearing (NL-SH). RESULTS No significant association was found between beta blocker use and hearing ability in noise. In the adjusted regressions, beta blocker use changed the speech reception threshold in noise (SRT) by -0.04 dB signal-to-noise ratio (SNR) (95%CI [-0.67 to 0.58], p = 0.890). Medium dose beta blocker use changed SRT by -0.42 dB SNR (95%CI [-1.38 to 0.71], p = 0.433), while a high dose changed it by -0.26 dB SNR (95%CI [-1.74 to 1.4], p = 0.767). CONCLUSIONS No evidence was found for beta blocker-induced changes in hearing ability. Future studies on this topic should favour case-control and cohort study designs, while focussing on a hypertensive population to minimise confounding by indication.
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Affiliation(s)
- Deanna Wung
- Ecole des Hautes Etudes en Santé Publique, Rennes, France
| | - Thadé Goderie
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marieke F van Wier
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mariska Stam
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,National Health Care Institute, Diemen, The Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Monahan PO, Kroenke K, Stump TE. SymTrak-8 as a Brief Measure for Assessing Symptoms in Older Adults. J Gen Intern Med 2021; 36:1197-1205. [PMID: 33174184 PMCID: PMC8131465 DOI: 10.1007/s11606-020-06329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 10/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patient- and caregiver-reported 23-item SymTrak scales were validated for monitoring clinically actionable symptoms and impairments associated with multiple chronic conditions (MCCs) in older adults. Items capture physical and emotional symptoms and impairments in physical and cognitive functioning. An abbreviated SymTrak is desirable when response burden is a concern. OBJECTIVE Develop and validate the 8-item SymTrak. DESIGN AND PARTICIPANTS Secondary analysis of SymTrak validation study; 600 participants (200 patient-caregiver dyads; 200 patients without an identified caregiver). MAIN MEASURES Demographic questions, SymTrak, and Health Utility Index Mark 3 (HUI3). KEY RESULTS SymTrak-8 demonstrated good fit to a one-factor model using confirmatory factor analysis (CFA). Concurrent criterion validity was supported by high standardized linear regression coefficients (STB) between baseline SymTrak-8 total score (independent variable) and baseline HUI3 preference-based overall HRQOL utility score (dependent variable; 0 = death, 1 = perfect health), after adjusting for demographics, comorbid conditions, and medications, with strength comparable to SymTrak-23 (STB = - 0.81 and - 0.84, respectively, for SymTrak-8 and SymTrak-23, when patient-reported; and - 0.60 and - 0.62, respectively, when caregiver-reported). Coefficient alpha (0.74; 0.76) and 24-h test-retest reliability (0.83; 0.87) were high for SymTrak-8 for patients and caregivers, respectively. The convergent correlation between brief and parent SymTrak scales was high (0.94). SymTrak-8 demonstrated approximate normality and a linear relationship with SymTrak-23 and HUI3. Importantly, a 3-month change in SymTrak-8 was sensitive to detecting the criterion (3-month reliable change categories; improved, stable, declined in HUI3 overall utility), with results comparable to SymTrak-23. CONCLUSIONS SymTrak-8 total score demonstrates internal reliably, test-retest reliability, criterion validity, and sensitivity to change that are comparable to SymTrak-23. Thus, patient- or caregiver-reported SymTrak-8 is a viable option for identifying and monitoring the aggregate effect of symptoms and functional impairments in patients with multimorbidity when response burden is a concern.
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Affiliation(s)
- Patrick O Monahan
- School of Medicine, Indiana University, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202-3002, USA. .,Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
| | - Kurt Kroenke
- School of Medicine, Indiana University, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202-3002, USA.,Center for Health Information and Communication, VA HSR&D, Washington DC, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Timothy E Stump
- School of Medicine, Indiana University, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202-3002, USA
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