The prevalence and correlates of self-reported hearing impairment in the Ibadan study of ageing

Prevalence of Age-Related Sensorineural Hearing Loss and Related Factors in Elderly Patients Attending Tertiary Hospital in Tanzania

PURPOSE

Age-related sensorineural hearing loss (SNHL), is a progressive, usually bilateral hearing loss that occurs in elderly. It is correctable using rehabilitative hearing devices, which can vastly improve the older person's quality of life. This study aimed to find out the prevalence and related factors of age-related sensorineural hearing loss among elderly patients in Tanzania.

METHODS

A total of 380 elderly patients who received Otorhinolaryngology (ORL) services at Muhimbili tertiary hospital were enrolled. Participants were screened for hearing loss and interviewed by the structured questionnaire followed by otoscopic examination and Pure tone Audiometry (PTA).

RESULTS

This study included 182(47.9%) males, and 198 (52.1%) females. The prevalence of SNHL was 27.6%, males were mostly affected 57(31.3%) p = 0.574. Bilateral SNHL was found 90 (85.7%) p = 0.026, and the severity of age-related SNHL was found to increase as age increases.

CONCLUSION

Sensorineural hearing loss among the elderly was prevalent, mostly bilateral, and the severity increases with age. Confounding factors such as hypertension, diabetes mellitus (DM), cigarette smoking, and ototoxic medication may have contributed. Elderly should be screened for hearing loss especially on the individuals with other co-morbidities for early diagnosis and management in order to improve the quality of life of the elderly.

Systolic Blood Pressure and Objective Hearing Thresholds Among Japanese Middle-Aged Adults: A Facility-Based Retrospective Cohort Study

INTRODUCTION

Very few studies have compared the magnitude of the changes in the hearing thresholds at 1 and 4 kHz according to the systolic blood pressure (SBP). We investigated the effects of SBP on repeated measures of hearing threshold using pure-tone audiometry.

METHODS

This retrospective cohort study included 5,479 (for the analysis at 1 kHz) and 2,045 (for 4 kHz) individuals aged 50 to 59 years who underwent facility-based health checkups. A multivariable generalized linear mixed model was constructed for the analysis at 1 and 4 kHz.

RESULTS

The mean follow-up durations were 30,262 and 7,454 person-years, respectively. The interaction of SBP and year was significantly associated with the change in hearing threshold in both analyses at 1 kHz (with estimated slope, 0.00080; 95% confidence interval, 0.00049-0.00110) and 4 kHz (with estimated slope, 0.0042; 95% confidence interval, 0.0028-0.0057). The 10-year changes in hearing threshold with baseline SBP of 110 and 140 mm Hg were 0.4 and 0.6 dB at 1 kHz and 1.0 and 2.3 dB at 4 kHz, respectively.

CONCLUSIONS

Higher SBP was associated with an increased hearing threshold at both 1 and 4 kHz among middle-aged individuals.

Association between high systolic blood pressure and objective hearing impairment among Japanese adults: a facility-based retrospective cohort study

This retrospective longitudinal study examined the association between systolic blood pressure and hearing impairment among 13,187 Japanese individuals (men, 46.5%) aged 20-59 years. The systolic blood pressure of participants was categorized as <120, 120-129, 130-139, 140-149, 150-159, and ≥160 mmHg. Using pure-tone audiometry, hearing impairment at 1 and 4 kHz was defined as hearing thresholds in either ear >30 and >40 dB, respectively. We performed multivariable Cox proportional-hazards regression analysis to examine the association using two multiple-imputation methods (fully conditional specification and Markov chain Monte Carlo). There were 695 and 774 hearing-impairment cases at 1 and 4 kHz, respectively, during ~77,000 person-years of follow-up. Compared with the <120 mmHg group, the hazard ratios (95% confidence intervals) of hearing impairment for the 120-129, 130-139, 140-149, 150-159, and ≥160 mmHg groups after adjustment for age, sex, body mass index, high serum glucose, current smoking, and other potential confounders were 1.35 (1.12-1.63), 1.45 (1.13-1.86), 1.07 (0.73-1.58), 1.91 (1.18-3.07), and 1.81 (1.01-3.25), respectively, at 1 kHz using the first imputation method; 1.36 (1.13-1.63), 1.48 (1.17-1.86), 1.09 (0.76-1.58), 1.99 (1.29-3.06), and 1.92 (1.08-3.41), respectively, at 1 kHz using the second imputation method; 1.04 (0.86-1.24), 1.14 (0.91-1.43), 1.13 (0.83-1.54), 1.45 (0.96-2.19), and 1.35 (0.82-2.23), respectively, at 4 kHz using the first imputation method; and 1.03 (0.86-1.24), 1.17 (0.95-1.44), 1.15 (0.87-1.53), 1.54 (1.06-2.24), and 1.44 (0.88-2.35), respectively, at 4 kHz using the second imputation method. In conclusion, higher systolic blood pressure was associated with hearing impairment at 1 kHz. No clear association was observed at 4 kHz.

The pattern of comorbidity and its prevalence among drug-resistant tuberculosis patients at treatment initiation in Lagos, Nigeria

BACKGROUND

Multimorbidity is increasingly being recognized as a serious public health concern in the control of both drug-susceptible and drug-resistant tuberculosis (DR-TB). This study assessed the pattern of comorbidities and their prevalence in DR-TB patients at treatment initiation in Lagos, Nigeria.

METHODS

A cross-sectional study was conducted. The baseline laboratory records (human immunodeficiency virus [HIV] status, fasting blood sugar, audiometry, thyroid function tests, serum electrolyte, haemoglobin level and pregnancy test) of DR-TB patients initiated on treatment in Lagos, Nigeria between 1 August 2014 and 31 March 2017 were reviewed.

RESULTS

A total of 565 DR-TB patients' laboratory records were reviewed, of which 397 (70.3%) had comorbidities. The proportion with one, two, three and four comorbidities was 60.2%, 29.7%, 8.1% and 2.0%, respectively. Anaemia was the most common (48.1%) comorbid condition, while anaemia and hypokalaemia (7.3%), anaemia and hypothyroidism (6.5%) and anaemia and HIV (5%) were most common among patients with more than one comorbid condition. DR-TB patients with comorbidity were significantly older (34.8±12.3 y) than those without comorbidity (32.0±12.8 y) (p=0.038). Of the 176 females in the reproductive age group, 8 (4.5%) were pregnant at baseline.

CONCLUSIONS

The prevalence of comorbidity among DR-TB patients was high. There is a need for the national TB program to expand its DR-TB council of experts and also integrate reproductive health services into DR-TB management in Nigeria.

Prevalence of hearing loss at primary health care clinics in South Africa

BACKGROUND

Hearing loss prevalence data in South Africa is scarce, especially within primary health care settings.

OBJECTIVES

To determine; (i) the prevalence of hearing disorders in patients ≥3 years of age attending two primary health care clinics, and (ii) the nature and characteristics of hearing disorders at these primary health care clinics.

METHOD

A cross-sectional design was used at two primary health care clinics. Non-probability purposive sampling was used to screen participants at clinics for hearing loss with pure tone audiometry. A total of 1236 participants were screened (mean age 37.8 ±17.9 years). Diagnostic testing was available for confirmation of hearing loss on participants who failed the screening.

RESULTS

Hearing loss prevalence was 17.5% across both clinics. Most hearing losses were bilateral (70.0%) and were of a sensorineural nature (84.2%).

CONCLUSION

Hearing loss prevalence was comparable at both primary health care clinics. Participants 40 years and older were at significantly higher risk for hearing loss. The current study is the first attempt to establish hearing loss prevalence for primary health care clinics in South Africa.

Ear diseases and factors associated with ear infections among the elderly attending hospital in Arar city, Northern Saudi Arabia

Background

Changes in the anatomical structures and function of the ear can result in ear diseases, and may affect all age groups including the elderly as a result of aging

Objective

To identify the frequency and types of ear diseases among the elderly attending Abdullah bin Abdul-Aziz bin Musa’ed Al Saud hospital, Arar city, in the Northern Province of KSA, and factors associated with ear infections among them.

Methods

This cross-sectional hospital based study conducted from December 2016 through May 2017 included 138 elderly participants. A questionnaire was designed for collecting data about socio-demographic variables, the frequency and types of ear diseases among participants, and factors associated with ear infections among them. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-Square test.

Results

Findings showed that 49.3% of the participants were suffering from ear disease. Hearing impairment was detected in 37% of the elderly people studied. In addition, 9.4% and 2.9 % of the participants suffered from otitis media and otitis interna, respectively. None of the studied factors had a significant effect on the development and pattern of ear infection among the studied population.

Conclusion

Ear diseases were found among the participants with variable rates. More than one third of respondents suffered from hearing impairment. Ear infections were detected in lower rates. Although these problems are not life threating, they negatively impact the quality of life, and measures are needed for prevention and control.

Evaluation of serum antioxidants in age-related hearing loss

BACKGROUND

Age-related hearing loss (ARHL) has been linked to the shift in the pro-oxidant/antioxidant ratio. Our objectives were to assess serum levels of retinol and zinc among the elderly individuals and to correlate the levels with hearing threshold.

METHODS

Prospective study of apparently healthy individuals aged ≥60 years of age. Participants had complete clinical history, physical examination and pure tone average conducted. Blood samples were collected for determination of serum levels of retinol and zinc. Mann-Whitney U test was used to compare retinol and zinc values. Pearson's correlation test was used to determine the relationship between hearing threshold and serum levels of retinol and zinc.

RESULTS

Among 126 elderly participants with mean age 67 ± 2.7 years; the mean pure tone average for air conduction was 29.3 ± 1.6 dBHL while the mean bone conduction was 36.5 ± 1.8 dBHL. The median values of serum retinol and zinc levels in the elderly participants who had hearing loss in the speech frequencies were 52 and 83.3 μg/L, respectively, while among participants with normal hearing threshold, values were 50 and 89.9 μg/L, respectively (p = 0.59 and 0.99, respectively). For the high frequencies, the median value of serum retinol and zinc levels among the elderly participants with normal hearing threshold was 70.3 and 99.9 μg/L, while among those with hearing loss, it was 46.9 and 83.2 μg/L, respectively (p = 0.000 and 0.005, respectively).

CONCLUSION

Serum retinol and zinc levels were significantly lower among elderly with hearing loss involving the high frequencies. This is added evidence to extant literature on the possible role of antioxidants in the development of ARHL and suggests further study on the effect of antioxidants supplementation in the control of ARHL which is presently controversial and inconclusive.

[Aging and health in Sub-Saharan Africa: an urgent agenda for international cooperation]

The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.

Prevalence of hearing impairment and its correlates among a group of hospitalized chronically ill elderly patients in Alexandria, Egypt

BACKGROUND

Hearing impairment (HI) is one of the most common health problems among the elderly. The major risk factors for HI include aging, exposure to noise, chronic morbidities, and ototoxic drugs. Although the relation between HI and chronic morbidities among the elderly is well documented, it often receives minimal attention. The aim of this study was to determine the prevalence of HI and its correlates among a group of hospitalized chronically ill elderly patients in Alexandria, Egypt.

PARTICIPANTS AND METHODS

A descriptive cross-sectional study was carried out on 370 chronically ill elderly patients in the internal medicine wards of Alexandria Main University Hospital. A structured pre-coded interview schedule was used to collect data on sociodemographic characteristics and medical history. A questionnaire for screening for HI in the elderly was also used.

RESULTS

The majority of elderly patients (78.6%) complained of HI. HI was prevalent among all elderly patients aged 90 years and older. It was also more prevalent among women (82.2%), among single and divorced elderly patients (95.7 and 91.7%, respectively), among those who were illiterate or could only read and write (93.2%), among all skilled workers, and among housewives (82.2%). HI was also most prevalent among elderly patients who lived alone (82.6%), hypertensive elders (87.6%), and elderly patients taking analgesics (85.4%).

CONCLUSION AND RECOMMENDATIONS

Hypertension and the intake of a number of medications were significantly associated with HI. It is recommended to use screening procedures for the identification of individuals with HI and to refer them for further audiologic evaluation.

General dental practitioners and hearing impairment

OBJECTIVE

Hearing impairment (HI) remains a problem among dentists Hearing loss at speech frequencies was recently reported among dentists and dental hygienists. This study aimed to investigate prevalence and factors associated with perceived HI among dentists.

METHODS

In 2009-2010, 100 general dental practitioners (GDPs) and 115 general (medical) practitioners (GPs) (mean ages, 43.7 and 44.4 years) from Rome (Italy), who commenced practice ≥ 10 years ago, were interviewed on a series of occupation- and recreation-related HI risk factors and on HI-associated symptoms (tinnitus, sensation of fullness, hypoacusis). Prevalence of presumptive HI (≥ 1 symptom perceived during workdays and weekends) was assessed and factors associated with presumptive HI were investigated.

RESULTS

Prevalence was 30.0% (95% confidence interval, 21.0-39.0%) and 14.8% (95% confidence interval, 8.3-21.3%) among GDPs and GPs, respectively. Occupation (GDP vs. GP), family history of hypoacusis, hypertension, ear diseases and smoking were significantly associated with presumptive HI. Within GDPs alone, significant associations were found for frequent use of ultrasonic scalers, use of dental turbines aged≥1 year and prosthodontics as prevalent specialty.

CONCLUSIONS

GDPs experienced HI risk than GPs. Such a risk was not generalized to all dentists, but was specific for those who frequently used noisy equipment (aged turbines, ultrasonic scalers) during their daily practice.

CLINICAL SIGNIFICANCE

GDPs with 10 or more years of practice who routinely use potentially noisy equipment, could be at risk of HI. In order to prevent such condition, daily maintenance and periodical replacement of dental instruments is recommended.

Prevalence of insomnia and impact on quality of life among community elderly subjects with tinnitus

OBJECTIVES

We sought to determine the prevalence of insomnia and its impact on the quality of life (QoL) among community elderly subjects (at least 65 years of age) with subjective tinnitus.

METHODS

After household selection with multistage stratified area probability sampling, face-to-face interviews were used to obtain self-reports of subjective tinnitus and insomnia, and QoL was assessed with the WHOQoL-Bref instrument.

RESULTS

Among 1302 elderly subjects, there were 183 subjects (109 female and 74 male) with tinnitus. Among those with tinnitus, insomnia was encountered in 95 (51.9%) and was found to be significantly more common among those with tinnitus than among those without (378 of 1119, or 33.8%; p = 0.002). The insomnia symptoms included difficulty in maintaining sleep in 73.4% of subjects, difficulty in falling asleep in 70.0%, early morning wakefulness in 64.3%, nonrestorative sleep in 35.1%, and daytime sleepiness in 34.7%. Univariate analysis revealed difficulty with falling asleep (p = 0.01) and early morning wakefulness (p = 0.05) to be significantly associated with tinnitus among the symptoms. Student's t-test and logistic regression analysis revealed significant deterioration in the total QoL and in the physical, psychological, social, and environmental QoL domains among elderly subjects who had tinnitus with insomnia as compared with those without insomnia.

CONCLUSIONS

We believe that insomnia is significantly more common among elderly subjects with tinnitus than among those without, and that its presence further depreciates the QoL in these elderly individuals.

Quantitative analysis of the effect of the demographic factors on presbyacusis

BACKGROUND

Presbyacusis is the most common type of hearing loss, often having profound effects on the quality of life in old age. The objectives of this study were: To analyse of the effect of demographic factors on presbyacusis in Sri Lanka.To quantify the effect of non-demographic risk factors on presbyacusis.

METHOD

An observational cross-sectional study was carried out involving all the patients who presented to the National Hospital ENT clinic with hearing loss between April 2007 and April 2010. Patients whose pure-tone audiometry results were suggestive of sensorineural hearing deficit and whose tympanometry testing did not show any middle ear problems were assessed using an interviewer-administered questionnaire.

RESULTS

Among the 567 participants studied, the mean age was 63.4yrs. Fifty eight percent were females. The majority of the patients were from the Colombo district (59.3%), however, participants came from ten districts of Sri Lanka. Most of the study participants (64.2%) were married and living with their partners, but 24.7% were widowed and the rest were either unmarried or divorced. 6.1% had communication difficulties leading to disrupted social relationships and 21% felt that hearing impairment (HI) had adversely affected their psychological well-being. The onset of impaired hearing, as perceived by the patients initially and later confirmed by pure-tone audiometry and tymanometry, had occurred at an average age of 62.9yrs.

CONCLUSION

There was no significant association between presbyacusis and other demographic factors such as gender, education level and marital status. A significant proportion of the participants had been widowed and that fact, too, can reduce their quality of life.