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Badache AC, Mäki-Torkko E, Widen S, Fors S. A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020. BMC Public Health 2024; 24:2773. [PMID: 39390404 DOI: 10.1186/s12889-024-20217-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND The objective of this study is to estimate the prevalence of self-reported hearing difficulties, vision difficulties and combined vision and hearing difficulties in a Swedish adult population that varies according to migration status, sex, age, disability measured by ADL and IADL and educational attainment level. METHODS The study utilised data from the Survey of Health, Ageing and Retirement in Europe, which consisted of 2257 individuals aged 60 and above that were interviewed in Sweden in the 2019/2020, SHARE wave 8. To determine the prevalence of sensory difficulties (hearing, vision and dual-sensory difficulties) among various subgroups of the population, a multinomial logistic regression was used. The results of these analyses are presented in terms of predicted probabilities. RESULTS The study findings indicate that foreign-born older adults experience a lower prevalence of visual difficulties (6.2% [3.3-11.5] in comparison to their Swedish-born counterparts. Moreover, older adults with higher levels of education tend to report a lower prevalence of sensory difficulties overall. Furthermore, sex differences are apparent, with males reporting a higher prevalence of hearing difficulties (18.9% [15.5-22.8] vs. 12.8% [10.7-15.3]) and females reporting a higher prevalence of vision difficulties (12.7% [10.7-15.1] vs. 8.5%[6.8-10.5]). CONCLUSION The findings highlight disparities in the prevalence and type of perceived sensory difficulties experienced by older adults, by factors such as age, sex, education and migration status. It is important to consider these demographic factors in healthcare planning and interventions aimed at mitigating sensory difficulties in the older population.
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Affiliation(s)
- Andreea-Corina Badache
- School of Health Sciences, Örebro University, Fakultetsgatan 1, Örebro, 701 82, Sweden.
- Swedish Institute for Disability Research, Örebro, Sweden.
| | - Elina Mäki-Torkko
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Audiological Research Center, Faculty of Medicine, and Health, Örebro University, Örebro, Sweden
| | - Stephen Widen
- School of Health Sciences, Örebro University, Fakultetsgatan 1, Örebro, 701 82, Sweden
| | - Stefan Fors
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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2
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Koesters NB, Minhas R, Wittich W, McMenemy A, Johnson C. Visualizing Worldwide Prevalence of Age-Related Dual Sensory Loss. J Aging Health 2024:8982643241263879. [PMID: 38910320 DOI: 10.1177/08982643241263879] [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: 06/25/2024]
Abstract
Objectives: This study aims to create a first visualization of global prevalence of age-related dual sensory loss (DSL), significantly affecting older people's quality of life. Methods: Data from World Health Organization (WHO) regions, particularly African, American, and European, were analyzed. The study focused on DSL onset and prevalence, using adjusted life expectancy for regional comparison. Results: There were notable regional variations in DSL onset and prevalence. The African region showed consistent data, thanks to standardized methods from the World Federation of the Deafblind. However, global patterns varied when adjusted for life expectancy, hinting at possible DSL prevalence stabilization at older ages. Discussion: The study identifies a lack of standardization in DSL prevalence research regarding definitions, methodologies, and reporting. It calls for more uniform and thorough research methods for accurate global DSL understanding. The research highlights the complexity and challenges in determining DSL prevalence worldwide.
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Affiliation(s)
| | - Renu Minhas
- Department of Research and Training, Deafblind Ontario, Newmarket, ON, Canada
| | - Walter Wittich
- School of Optometry, University of Montreal, Montreal, QC, Canada
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Dillard LK, Matthews LJ, Dubno JR. Prevalence of self-reported hearing difficulty on the Revised Hearing Handicap Inventory and associated factors. BMC Geriatr 2024; 24:510. [PMID: 38867166 PMCID: PMC11167844 DOI: 10.1186/s12877-024-04901-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/19/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Hearing loss is common in aging adults and is an important public health concern. Self-reported measures of hearing difficulty are often used in research and clinical practice, as they capture the functional impacts of hearing loss on individuals. However, little research has evaluated the prevalence or factors associated with self-reported hearing difficulty. Therefore, the purpose of this study was to determine the prevalence of self-reported hearing difficulty, measured by the Revised Hearing Handicap Inventory (RHHI), and associated factors. METHODS This study was conducted in a community-based cohort study based in Charleston, SC. We determined the prevalence of RHHI self-reported hearing difficulty (score ≥ 6 points) and evaluated associated factors with logistic regression models. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals (95% CI). RESULTS There were 1558 participants included in this study (mean age 63.7 [SD 14.4], 56.9% female, 20.0% Minority race). The prevalence of RHHI self-reported hearing difficulty was 48.8%. In a multivariable model, older age (per + 1 year; OR 0.97 [95% CI 0.96, 0.98]), Minority (vs. White) race (OR 0.68 [95% CI 0.49, 0.94]), and speech-in-noise scores that are better than predicted (OR 0.99 [95% CI 0.98, 1.00]) were associated with lower odds of RHHI self-reported hearing difficulty. Furthermore, female (vs. male) sex (OR 1.39 [95% CI 1.03, 1.86]), higher PTA in the worse ear (per + 1 dB; OR 1.10 [95% CI 1.09, 1.12]), more comorbid conditions (vs. 0; 1 condition: OR 1.50 [95% CI 1.07, 2.11]; 2 conditions: OR 1.96 [95% CI 1.32, 2.93]; 3 + conditions: OR 3.00 [95% CI 1.60, 5.62]), noise exposure (OR 1.54 [95% CI 1.16, 2.03]), bothersome tinnitus (OR 2.16 [95% CI 1.59, 2.93]), and more depressive symptoms (OR 1.04 [95% CI 1.01, 1.07]) were associated with higher odds of RHHI self-reported hearing difficulty. CONCLUSIONS The prevalence of RHHI self-reported hearing difficulty is high, and associated factors included demographics, audiometric hearing and other hearing-related factors, and physical and mental health. The RHHI likely captures functional impacts of hearing loss that are not captured by audiometry alone. Study findings can support the correct interpretation of the RHHI in research and clinical settings.
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Affiliation(s)
- Lauren K Dillard
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA.
| | - Lois J Matthews
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA
| | - Judy R Dubno
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA
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4
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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] [Grants] [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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5
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Greenberg D, Rosenblum ND, Tonelli M. The multifaceted links between hearing loss and chronic kidney disease. Nat Rev Nephrol 2024; 20:295-312. [PMID: 38287134 DOI: 10.1038/s41581-024-00808-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Abstract
Hearing loss affects nearly 1.6 billion people and is the third-leading cause of disability worldwide. Chronic kidney disease (CKD) is also a common condition that is associated with adverse clinical outcomes and high health-care costs. From a developmental perspective, the structures responsible for hearing have a common morphogenetic origin with the kidney, and genetic abnormalities that cause familial forms of hearing loss can also lead to kidney disease. On a cellular level, normal kidney and cochlea function both depend on cilial activities at the apical surface, and kidney tubular cells and sensory epithelial cells of the inner ear use similar transport mechanisms to modify luminal fluid. The two organs also share the same collagen IV basement membrane network. Thus, strong developmental and physiological links exist between hearing and kidney function. These theoretical considerations are supported by epidemiological data demonstrating that CKD is associated with a graded and independent excess risk of sensorineural hearing loss. In addition to developmental and physiological links between kidney and cochlear function, hearing loss in patients with CKD may be driven by specific medications or treatments, including haemodialysis. The associations between these two common conditions are not commonly appreciated, yet have important implications for research and clinical practice.
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Affiliation(s)
- Dina Greenberg
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Norman D Rosenblum
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, Toronto, Ontario, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Gupta P, Chan A, Tai-Anh V, Man REK, Fenwick EK, Aravindhan A, Junxing C, Wood JM, Black AA, Ng JH, Cheng CY, Sabanayagam C, Lamoureux EL. Prevalence, associated risk factors; and patient and economic impact of multiple sensory impairment in a multi-ethnic elderly population in Singapore: the PIONEER study. BMC Public Health 2024; 24:1102. [PMID: 38649854 PMCID: PMC11034097 DOI: 10.1186/s12889-024-18635-2] [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: 07/05/2023] [Accepted: 04/17/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND To determine the prevalence, risk factors; and impact on patient health and economic outcomes across the laterality spectrum of multiple sensory impairment (MSI) in a multi-ethnic older Asian population. METHODS In this population-based study of Singaporeans aged ≥ 60 years, MSI was defined as concomitant vision (visual acuity > 0.3 logMAR), hearing (pure-tone air conduction average > 25 dB), and olfactory (score < 12 on the Sniffin' Sticks test) impairments across the spectrum of laterality (any, unilateral, combination [of unilateral and bilateral], and bilateral). RESULTS Among 2,057 participants (mean ± SD 72.2 ± 0.2 years; 53.1% female), the national census-adjusted prevalence rates of any, unilateral, combination, and bilateral MSI were 20.6%, 1.2%, 12.2%, and 7.2%, respectively. Older age, male gender, low socioeconomic status (SES), and smoking (all p < 0.05) were independently associated with higher likelihood of any MSI. Compared to those with no sensory loss, those with MSI had significantly decreased mobility (range 5.4%-9.2%), had poor functioning (OR range 3.25-3.45) and increased healthcare costs (range 4-6 folds) across the laterality spectrum. Additionally, bilateral MSI had a significant decrease in HRQoL (5.5%, p = 0.012). CONCLUSIONS MSI is a highly prevalent medical condition, with 1 in 5; and almost 1 in 10 community-dwelling older Asians having any and bilateral MSI, respectively, with a higher likelihood in men, smokers, and those with low SES. Critically, MSI has a substantial negative impact on patient health and economic outcomes across the laterality spectrum. Sensory testing is critical to detect and refer individuals with MSI for management to improve their functional independence and QoL.
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Affiliation(s)
- Preeti Gupta
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Aurora Chan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
| | - Vu Tai-Anh
- Duke-NUS Medical School, Singapore, Singapore
| | - Ryan E K Man
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Amudha Aravindhan
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | | | - Joanne M Wood
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Jia Hui Ng
- Singapore General Hospital (SGH), Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute (SERI), The Academia, 20 College Road, Level 6, Singapore, 169856, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Hreha K, Samper-Ternent R, Whitson HE, Downer LP, West JS, Downer B. The Association of Vision and Hearing Impairment on Cognitive Function and Loneliness: Evidence From the Mexican Health and Aging Study. J Aging Health 2024:8982643241247583. [PMID: 38621720 DOI: 10.1177/08982643241247583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Objectives: We investigated whether self-reported vision and hearing were associated with cognitive function and loneliness among Mexican adults aged 50 and older. Methods: Mexican Health and Aging Study data. Vision/hearing status was self-reported (excellent-very good, good, fair-poor). Cognition was measured using nine tasks. Loneliness was measured using the UCLA Loneliness Scale. Analyses controlled for demographic and health characteristics. Results: Among 12,353 participants (mean age = 67, 58% female), poor vision, but not hearing, was associated with lower global cognition (β = -0.03, p < .05). Poor vision (OR = 1.57, 95% CI = 1.30-1.91) and hearing (OR = 1.35, 95% CI = 1.14-1.61) were associated with higher odds of being lonely after adjusting for demographics and comorbidities, but not when adjusting for limitations in daily activities and depressive symptoms. Discussion: Poor vision is a potentially modifiable risk factor for lower cognition and loneliness among Mexican adults. These associations are partly due to functional characteristics of older adults with poor vision.
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Affiliation(s)
- K Hreha
- Occupational Therapy Doctorate Division, Department of Orthopaedic Surgery, School of Medicine, Duke University, Durham, NC, USA
| | - R Samper-Ternent
- Department of Management, Policy and Community Health, School of Public Health, UT Health Houston, Houston, TX, USA
| | - H E Whitson
- Division of Geriatrics, Department of Medicine, Duke University, Durham, NC, USA
| | - L P Downer
- Office of Planning and Innovation, Harris County Public Health, Houston, TX, USA
| | - J S West
- Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, NC, USA
| | - B Downer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
- Department of Population Health and Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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8
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Du X, Gu S, Wu Y, Zhao J, Liao H, Li S, Han D, Zhang M, Wang J. The association between dual sensory loss and healthcare expenditure: Mediating effect of depression. J Affect Disord 2024; 349:462-471. [PMID: 38199408 DOI: 10.1016/j.jad.2024.01.032] [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: 04/18/2023] [Revised: 12/04/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Previous studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous. OBJECTIVES The current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above. METHODS We first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE. RESULTS Depression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05). LIMITATIONS The DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias. CONCLUSION Significant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.
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Affiliation(s)
- Xinnan Du
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Shiping Gu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Yunyi Wu
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jie Zhao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Hui Liao
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Sangsang Li
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Dan Han
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Mei Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Jing Wang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China; Institute for Poverty Reduction and Development, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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Dumassais S, Pichora-Fuller MK, Guthrie D, Phillips NA, Savundranayagam M, Wittich W. Strategies used during the cognitive evaluation of older adults with dual sensory impairment: a scoping review. Age Ageing 2024; 53:afae051. [PMID: 38506649 PMCID: PMC10953621 DOI: 10.1093/ageing/afae051] [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: 07/11/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Dual sensory impairment (DSI), the combination of visual and hearing impairments, is associated with increased risk for age-related cognitive decline and dementia. Administering cognitive tests to individuals with sensory impairment is challenging because most cognitive measures require sufficient hearing and vision. Considering sensory limitations during cognitive test administration is necessary so that the effects of sensory and cognitive abilities on test performance can be differentiated and the validity of test results optimized. OBJECTIVE To review empirical strategies that researchers have employed to accommodate DSI during cognitive testing of older adults. METHODS Seven databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, Global Health and the Evidence-Based Medicine Reviews databases) were searched for relevant articles integrating the three concepts of cognitive evaluation, aging, and DSI. Given the inclusion criteria, this scoping review included a total of 67 papers. RESULTS Twenty-eight studies reported five categories of strategies for cognitive testing of older adult participants with DSI: the assistance of experts, the modification of standardized test scoring procedures, the use of communication strategies, environmental modifications, and the use of cognitive tests without visual and/or auditory items. CONCLUSIONS The most used strategy reported in the included studies was drawing on the assistance of team members from related fields during the administration and interpretation of cognitive screening measures. Alternative strategies were rarely employed. Future research is needed to explore the knowledge-to-practice gap between research and current clinical practice, and to develop standardized testing strategies.
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Affiliation(s)
- Shirley Dumassais
- School of Optometry, Université de Montreal, Montreal, Quebec, H3T 1P1, Canada
| | | | - Dawn Guthrie
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, N2L 3C5, Canada
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, N2L 3C5, Canada
| | - Natalie A Phillips
- Department of Psychology/Centre for Research in Human Development, Concordia University, Montreal, Quebec, H4B 1R6, Canada
| | | | - Walter Wittich
- School of Optometry, Université de Montreal, Montreal, Quebec, H3T 1P1, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Quebec, H3S 1M9, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l’Île-de-Montréal, Montreal, Quebec, H4B 1T3, Canada
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10
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Rojas C, San Martín M, Urzúa P, Guerra E. Word or pseudoword? The lexicality effect in naming and lexical decision tasks during advanced aging. PLoS One 2024; 19:e0299266. [PMID: 38422103 PMCID: PMC10903840 DOI: 10.1371/journal.pone.0299266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
Although there is evidence that recognizing pseudowords is more difficult than recognizing words during childhood, adulthood, and early old age (60-75 years), it is not yet clear what happens during advanced aging or the fourth age, a stage when the decline of fluid intelligence strongly affects processing speed, but a good performance of crystallized intelligence is described through an increase in vocabulary and knowledge. The objective of this study was to determine the lexicality effect in advanced aging, specifically exploring how the ability to recognize words and pseudowords (ortho-phonologically plausible for Spanish) is affected during the third and fourth-ages. The lexicality effect was measured using naming and lexical decision tasks. Response time and accuracy were compared between a fourth-age group (80+ years) and two third-age groups (60-69 and 70-79 years) through linear regression models. The results showed that, in general, the fourth-age group had longer response times and reduced accuracy when recognizing words and pseudowords. Moreover, they showed a significant lexicality effect (which increases from the third- age onwards), reflected in higher costs during pseudoword recognition, especially when the task required more cognitive effort (lexical decision task). These results were consistent with the impact of the deterioration of fluid intelligence on the speed of lexical recognition and with the better performance that crystallized intelligence can generate on accuracy, especially in the early stages of old age. Additionally, this study supports the fact that pseudoword recognition resists cognitive decline, as accentuated deterioration is visualized only after 80 years.
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Affiliation(s)
- Carlos Rojas
- Department of Health Rehabilitation Sciences, Universidad del Bío-Bío, Chillán, Chile
| | - Marilyn San Martín
- Department of Health Rehabilitation Sciences, Universidad del Bío-Bío, Chillán, Chile
| | - Paula Urzúa
- School of Phonoaudiology /Speech Therapy, Universidad de Las Americas, Concepción, Chile
| | - Ernesto Guerra
- Center for Advanced Research in Education (CIAE), Universidad de Chile, Santiago, Chile
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11
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Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Julie Anne L, Davis AC, McMahon CM, Bourne RRA. Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey. Br J Ophthalmol 2024; 108:484-492. [PMID: 36759151 PMCID: PMC10894815 DOI: 10.1136/bjo-2022-321439] [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: 07/18/2022] [Accepted: 01/11/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Data on population-based self-reported dual vision and hearing impairment are sparse in Europe. We aimed to investigate self-reported dual sensory impairment (DSI) in European population. METHODS A standardised questionnaire was used to collect medical and socio-economic data among individuals aged 15 years or more in 29 European countries. Individuals living in collective households or in institutions were excluded from the survey. RESULTS Among 296 677 individuals, the survey included 153 866 respondents aged 50 years old or more. The crude prevalence of DSI was of 7.54% (7.36-7.72). Among individuals aged 60 or more, 9.23% of men and 10.94% of women had DSI. Eastern and southern countries had a higher prevalence of DSI. Multivariable analyses showed that social isolation and poor self-rated health status were associated with DSI with ORs of 2.01 (1.77-2.29) and 2.33 (2.15-2.52), while higher income was associated with lower risk of DSI (OR of 0.83 (0.78-0.89). Considering country-level socioeconomic factors, Human Development Index explained almost 38% of the variance of age-adjusted prevalence of DSI. CONCLUSION There are important differences in terms of prevalence of DSI in Europe, depending on socioeconomic and medical factors. Prevention of DSI does represent an important challenge for maintaining quality of life in elderly population.
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Affiliation(s)
| | - Simon Marillet
- Public Health department, CHU Poitiers, Poitiers, France
| | - Tasanee Braithwaite
- School of Immunology and Microbiology and School of Life Course Sciences, Kings College, London, UK
- The Medical Eye Unit, Guy's and St Thomas' Hospital, London, UK
| | - Tunde Peto
- Centre for Public Health, Faculty of Medicine Health and Life Sciences, Queen's University Belfast, Belfast, Belfast, UK
| | - Pierre Ingrand
- Public health department, University of Poitiers, Poitiers, France
| | - Shahina Pardhan
- Vision and Eye Research Institute (VERI), School of Medicine, Anglia Ruskin University, Cambridge, Cambridgeshire, UK
| | - Alain M Bron
- Ophthalmology, University Hospital Centre Dijon Bourgogne, Dijon, Bourgogne-Franche-Comté, France
| | - Jost B Jonas
- Ophthalmology, Ruprecht Karls University Heidelberg Faculty of Medicine Mannheim, Mannheim, Baden-Württemberg, Germany
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVS, University of New South Wales, Sydney, New South Wales, Australia
| | - Little Julie Anne
- Centre for Optometry and Vision Science, School of Biomedical Sciences, Biomedical Sciences Research Institute, Ulster University, Coleraine, Belfast, UK
| | | | - Catherine M McMahon
- Hear Center, Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia
| | - Rupert R A Bourne
- Vision and Eye Research Unit, Anglia Ruskin University Faculty of Science and Technology, Chelmsford, Essex, UK
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12
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Kuang L, Hu H, Dai H, Ma H, Jia Y, Sheng Y. Interventions to improve social network in older people with sensory impairment: a systematic review. Aging Clin Exp Res 2024; 36:34. [PMID: 38345702 PMCID: PMC10861684 DOI: 10.1007/s40520-024-02695-w] [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: 08/19/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Sensory impairment significantly reduces speech discrimination and perception ability, presenting a challenge to effective communication. It can lead to social withdrawal and a reduced social network which can lead to cognitive impairment, seriously affecting the quality of life of older people. However, it is unclear which intervention components are effective to improving social network in older people with sensory impairment. OBJECTIVE The aim of this systematic review was to summarize interventions designed to improve social network in older people with sensory impairment. METHODS We searched seven databases from inception to December 1, 2023. Eligible studies included randomized clinical trials (RCT) and quasi-experimental studies of interventions for older people with sensory impairment aimed at improving social networks. Two reviewers searched databases, extracted data, and assessed the quality of the included studies independently. RESULTS Nine studies including five RCTs and four quasi-experimental studies were selected, enrolling 721 older people with sensory impairment. Methodological quality of the studies was modest. Eight studies demonstrated a positive impact of the interventions used in older people with sensory impairment. The detailed effective intervention components may include communication strategies, resources for older people and their significant others, exercise or tech-back of communication, sensory device fitting, and use and maintenance of sensory devices. CONCLUSION There are few interventions available for improving social network in older people with sensory impairment. Most interventions mainly focus on communication education and care, and sensory device fitting and education. To improve the social network in older people with sensory impairment, it is necessary to develop more effective, multidisciplinary collaborative effective interventions and conduct more high-quality original studies.
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Affiliation(s)
- Li Kuang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Hanyu Hu
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Halina Dai
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Huiying Ma
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yuling Jia
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No.33 of Badachu Road, Shijingshan District, Beijing, 100144, People's Republic of China.
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13
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Fang S, Liang Y. Latent transition analysis to explore patterns of physical functional decline among older adults in China: A national 6-year longitudinal study. Arch Gerontol Geriatr 2024; 117:105223. [PMID: 37832465 DOI: 10.1016/j.archger.2023.105223] [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: 08/18/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND AND AIMS Multiple limitations often co-occur and accumulate, leading to subsequent function decline. However, there is a scarcity of longitudinal studies examining the progression of physical function among the general population of older adults in China. This study aimed to define typical physical function status and its change, which were characterized by the coexistence and accumulation of diverse limitations targeting a Chinese sample of older adults. METHODS This study used the three recent public data waves of the Chinese Longitudinal Healthy Longevity Survey during a 6-year follow-up period. 9765 individuals who were over 65 and participated in the 2011 survey were included. Latent transition analysis was used to identify the latent physical function status and explore the transition of older adults among different latent statuses. RESULTS Seven latent statuses of physical function were identified, with visual impairment and related limitations being particularly prevalent among older adults. Upper limb mobility appeared to be a differentiated indicator of physical functional status. Physical function decline mainly started with the limitations in squatting, carrying weights and walking, then to the status with intact upper limb mobility and hearing function only, or converted directly into the latter, then to complete dysfunction. CONCLUSIONS Our findings suggest some indicative limitations and critical steps in the process of functional decline among older adults. These results may provide insight for researchers and policymakers to develop tailored preventive and rehabilitation care and provide support for physically limited elderly according to their latent status and course of functional decline.
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Affiliation(s)
- Shuai Fang
- Institute of Sociology, Shanghai Academy of Social Sciences, 622 Huaihai Middle Rd., Huangpu District, Shanghai 200020, China
| | - Yan Liang
- School of Nursing, Fudan University, 305 Fenglin Rd., Xuhui District, Shanghai 200032, China.
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14
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Downey R, Gagné N, Mohanathas N, Campos JL, Pichora-Fuller KM, Bherer L, Lussier M, Phillips NA, Wittich W, St-Onge N, Gagné JP, Li K. At-home computerized executive-function training to improve cognition and mobility in normal-hearing adults and older hearing aid users: a multi-centre, single-blinded randomized controlled trial. BMC Neurol 2023; 23:378. [PMID: 37864139 PMCID: PMC10588173 DOI: 10.1186/s12883-023-03405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/26/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Hearing loss predicts cognitive decline and falls risk. It has been argued that degraded hearing makes listening effortful, causing competition for higher-level cognitive resources needed for secondary cognitive or motor tasks. Therefore, executive function training has the potential to improve cognitive performance, in turn improving mobility, especially when older adults with hearing loss are engaged in effortful listening. Moreover, research using mobile neuroimaging and ecologically valid measures of cognition and mobility in this population is limited. The objective of this research is to examine the effect of at-home cognitive training on dual-task performance using laboratory and simulated real-world conditions in normal-hearing adults and older hearing aid users. We hypothesize that executive function training will lead to greater improvements in cognitive-motor dual-task performance compared to a wait-list control group. We also hypothesize that executive function training will lead to the largest dual-task improvements in older hearing aid users, followed by normal-hearing older adults, and then middle-aged adults. METHODS A multi-site (Concordia University and KITE-Toronto Rehabilitation Institute, University Health Network) single-blinded randomized controlled trial will be conducted whereby participants are randomized to either 12 weeks of at-home computerized executive function training or a wait-list control. Participants will consist of normal-hearing middle-aged adults (45-60 years old) and older adults (65-80 years old), as well as older hearing aid users (65-80 years old, ≥ 6 months hearing aid experience). Separate samples will undergo the same training protocol and the same pre- and post-evaluations of cognition, hearing, and mobility across sites. The primary dual-task outcome measures will involve either static balance (KITE site) or treadmill walking (Concordia site) with a secondary auditory-cognitive task. Dual-task performance will be assessed in an immersive virtual reality environment in KITE's StreetLab and brain activity will be measured using functional near infrared spectroscopy at Concordia's PERFORM Centre. DISCUSSION This research will establish the efficacy of an at-home cognitive training program on complex auditory and motor functioning under laboratory and simulated real-world conditions. This will contribute to rehabilitation strategies in order to mitigate or prevent physical and cognitive decline in older adults with hearing loss. TRIAL REGISTRATION Identifier: NCT05418998. https://clinicaltrials.gov/ct2/show/NCT05418998.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
- PERFORM Centre, Concordia University, Montréal, Québec, Canada.
| | - Nathan Gagné
- Department of Psychology, Concordia University, Montréal, Québec, Canada
| | - Niroshica Mohanathas
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jennifer L Campos
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | - Louis Bherer
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de L'Institut de Cardiologie de Montréal, Montréal, Québec, Canada
| | - Natalie A Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Walter Wittich
- École d'optométrie, Université de Montréal, Montréal, Québec, Canada
| | - Nancy St-Onge
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada
| | - Jean-Pierre Gagné
- École d'orthophonie Et d'audiologie, Université de Montréal, Montréal, Québec, Canada
| | - Karen Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
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15
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O’Connell ME, Kadlec H, Griffith LE, Wolfson C, Maimon G, Taler V, Kirkland S, Raina P. Cognitive impairment indicator for the neuropsychological test batteries in the Canadian Longitudinal Study on Aging: definition and evidence for validity. Alzheimers Res Ther 2023; 15:167. [PMID: 37798677 PMCID: PMC10552318 DOI: 10.1186/s13195-023-01317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Prevalence of overall cognitive impairment based on each participant's performance across a neuropsychological battery is challenging; consequently, we define and validate a dichotomous cognitive impairment/no cognitive indicator (CII) using a neuropsychological battery administered in a population-based study. This CII approximates the clinical practice of interpretation across a neuropsychological battery and can be applied to any neuropsychological dataset. METHODS Using data from participants aged 45-85 in the Canadian Longitudinal Study on Aging receiving a telephone-administered neuropsychological battery (Tracking, N = 21,241) or a longer in-person battery (Comprehensive, N = 30,097), impairment was determined for each neuropsychological test based on comparison with normative data. We adjusted for the joint probability of abnormally low scores on multiple neuropsychological tests using baserates of low scores demonstrated in the normative samples and created a dichotomous CII (i.e., cognitive impairment vs no cognitive impairment). Convergent and discriminant validity of the CII were assessed with logistic regression analyses. RESULTS Using the CII, the prevalence of cognitive impairment was 4.3% in the Tracking and 5.0% in the Comprehensive cohorts. The CII demonstrated strong convergent and discriminant validity. CONCLUSIONS The approach for the CII is a feasible method to identify participants who demonstrate cognitive impairment on a battery of tests. These methods can be applied in other epidemiological studies that use neuropsychological batteries.
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Affiliation(s)
- Megan E. O’Connell
- Department of Psychology and Health Studies, University of Saskatchewan, 9 Campus Drive, Arts 182, Saskatoon, SK S7N 5A5 Canada
| | - Helena Kadlec
- Institute On Aging & Lifelong Health, University of Victoria, STN CSC, PO Box 1700, Victoria, BC V8W 2Y2 Canada
| | - Lauren E. Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 175 Longwood Rd. S. Suite 309a, Hamilton, ON L8P 0A1 Canada
| | - Christina Wolfson
- Department of Epidemiology and Biostatistics and Occupational Health, School of Population and Global Health, McGill University, 2001 McGill College Avenue Suite 1200, Montreal, QC H3A 1G1 Canada
| | - Geva Maimon
- CLSA Data Curation Centre, Research Institute of the McGill University Health Centre, 2155 Guy Street, 4th Floor, Montreal, QC H3H 2R9 Canada
| | - Vanessa Taler
- School of Psychology, University of Ottawa, 136 Jean Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5 Canada
| | - Susan Kirkland
- Department of Community Health and Epidemiology, Dalhousie University, 5790 University Ave, Halifax, NS B3H 1V7 Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster Institute for Research On Aging & Labarge Centre for Mobility in Aging, McMaster University, MIP Suite 309A, 1280 Main St. W, Hamilton, ON L8S 4K1 Canada
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16
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Iskakova B, Forster LN, Mann KD, Brown M, Slack EL, Rees A, Pearce MS. Differences Between Self-Reported and Objectively Measured Hearing Loss at Age 61-63 Years: The Newcastle Thousand Families Birth Cohort. Am J Audiol 2023; 32:500-506. [PMID: 37348490 DOI: 10.1044/2023_aja-22-00111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
PURPOSE Hearing loss is most prevalent among older adults, yet underestimated by patients, clinicians, and research communities. This study aimed to assess the accuracy of self-reported hearing difficulties among a group of adults aged 61-63 years, against audiometric measures. METHOD The analysis used a sample (N = 346) of the Newcastle Thousand Families Study birth cohort. Data from audiological examinations and self-reported hearing difficulties were used to compare subjective and objective hearing. Hearing aid use was also assessed. RESULTS Over 40% of the participants had some level of hearing loss (n = 155, 44.8%), and 31% (n = 133) of these reported having hearing problems during subjective assessment. Only 18 (10%) of those with objectively measured hearing loss reported using hearing aids. CONCLUSIONS There was an inconsistency between measured and self-perceived hearing loss among adults aged 61-63 years in this cohort. The small number of hearing aid users in the cohort is a concern, in that people in this age group appear not to be getting the help they need. The data also add to the research evidence that people at this age underestimate their hearing loss.
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Affiliation(s)
- Balnur Iskakova
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Lara N Forster
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Kay D Mann
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Morven Brown
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma L Slack
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Adrian Rees
- Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mark S Pearce
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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17
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Janower A, St John P. Dual Sensory Impairment and Functional Status in a Prospective Cohort Study. Can Geriatr J 2023; 26:364-371. [PMID: 37662059 PMCID: PMC10444523 DOI: 10.5770/cgj.26.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Objective To examine the impact of visual impairment, hearing impairment, and dual sensory impairment (DSI) on functional status in older adults. Methods Secondary analysis of the Manitoba Health and Aging Study, a population-based cohort study of 1751 adults age 65+. Data were collected from 1991 to 1992 (Time 1), with follow-up five years later (Time 2). Vision and hearing were self-reported. Functional status was measured using the Older Americans Resource and Services (OARS). Logistic regression models were constructed to assess functional status at both Time 1 and Time 2. Results Dual sensory impairment (DSI) at Time 1 predicted poor functional status at both Time 1 and Time 2. The adjusted odds ratios (OR; 95% confidence interval [CI]) for poor functional status at Time 1 for those with only hearing impairment was 1.74 (1.25, 2.44) for visual impairment was 2.95 (2.19, 3.98), and for DSI was 3.58 (2.58, 4.95). At Time 2, the adjusted ORs for poor functional status for those with only hearing impairment was 1.32 (0.86, 2.03), for visual impairment was 1.63 (1.05, 2.52), and for DSI was 2.61 (1.54, 4.40). Conclusions DSI is associated with lower functional status, but the effect of visual impairment is more pronounced than hearing impairment.
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Affiliation(s)
- Amber Janower
- Section of General Internal Medicine, Max Rady College of Medicine, University of Manitoba
| | - Philip St John
- Section of Geriatric Medicine, Max Rady College of Medicine, University of Manitoba
- Centre on Aging, University of Manitoba, Winnipeg, MB, Canada
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18
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Tonelli M, Wiebe N, Lunney M, Donald M, Howarth T, Evans J, Klarenbach SW, Nicholas D, Boulton T, Thompson S, Schick Makaroff K, Manns B, Hemmelgarn B. Associations between hearing loss and clinical outcomes: population-based cohort study. EClinicalMedicine 2023; 61:102068. [PMID: 37434743 PMCID: PMC10331811 DOI: 10.1016/j.eclinm.2023.102068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Background Hearing loss (HL) is a leading cause of disability worldwide, but its clinical consequences and population burden have been incompletely studied. Methods We did a retrospective population-based cohort study of 4,724,646 adults residing in Alberta between April 1, 2004 and March 31, 2019, of whom 152,766 (3.2%) had HL identified using administrative health data. We used administrative data to identify comorbidity and clinical outcomes, including death, myocardial infarction, stroke/transient ischemic attack, depression, dementia, placement in long-term care (LTC), hospitalization, emergency visits, pressure ulcers, adverse drug events and falls. We used Weibull survival models (binary outcomes) and negative binomial models (rate outcomes) to compare the likelihood of outcomes in those with vs without HL. We calculated population-attributable fractions to estimate the number of binary outcomes associated with HL. Findings The age-sex-standardized prevalence of all 31 comorbidities at baseline was higher among participants with HL than those without. Over median follow-up of 14.4 y and after adjustment for potential confounders at baseline, participants with HL had higher rates of days in hospital (rate ratio 1.65, 95% CI 1.39, 1.97), falls (RR 1.72, 95% CI 1.59, 1.86), adverse drug events (RR 1.40, 95% CI 1.35, 1.45), and emergency visits (RR 1.21, 95% CI 1.14, 1.28) compared to those without, and higher adjusted hazards of death, myocardial infarction, stroke/transient ischemic attack, depression, heart failure, dementia, pressure ulcers and LTC placement. The estimated number of people with HL who required new LTC placement annually in Canada was 15,631, of which 1023 were attributable to HL. Corresponding estimates for new dementia among people with HL were 14,959 and 4350, and for stroke/TIA the estimates were 11,582 and 2242. Interpretation HL is common, is often accompanied by substantial comorbidity, and is associated with significant increases in risk for a broad range of adverse clinical outcomes, some of which are potentially preventable. This high population health burden suggests that increased and coordinated investment is needed to improve the care of people with HL. Funding Canadian Institutes of Health Research; David Freeze chair in health services research.
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Affiliation(s)
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Meg Lunney
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary, Calgary, Canada
| | | | | | | | - David Nicholas
- Faculty of Social Work, University of Calgary, Calgary, Canada
| | - Tiffany Boulton
- Department of Community Health Sciences, University of Calgary, Canada
| | | | | | - Braden Manns
- Department of Medicine, University of Calgary, Calgary, Canada
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19
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Abraham AG, Hong C, Deal JA, Bettcher BM, Pelak VS, Gross A, Jiang K, Swenor B, Wittich W. Are cognitive researchers ignoring their senses? The problem of sensory deficit in cognitive aging research. J Am Geriatr Soc 2023; 71:1369-1377. [PMID: 36680402 DOI: 10.1111/jgs.18229] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 01/22/2023]
Abstract
Sensory impairments are common in older adult populations and have notable impacts on aging outcomes. Relationships between sensory and cognitive functions have been clearly established, though the mechanisms underlying those relationships are not fully understood. Given the growing burden of dementia, older adults with sensory deficits are an important and growing population to study in cognitive aging research. Yet, cognitive research sometimes excludes those with uncorrected significant/severe sensory deficits and often poorly or inconsistently assesses those deficits. Observational and interventional studies that exclude participants with sensory deficits will be limited in their generalizability to the narrower subset of the older adult population without vision or hearing impairment and may be missing an opportunity to study a growing population of older adults at higher risk of cognitive impairment. Strategies exist for adapting cognitive testing instruments, and inroads could be made into collecting normative data to inform ongoing research. Bringing together psychometricians with researchers who specialize in vision and hearing impairments could launch highly innovative research on both measurement methods and cognitive disease etiology, as sensory organs provide readily accessible neuronal and vascular beds that may show pathology earlier and elucidate innovative screening opportunities for early signs of cognitive disease.
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Affiliation(s)
- Alison G Abraham
- University of Colorado, Colorado School of Public Health, Department of Epidemiology, Aurora, Colorado, USA.,Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA.,Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Chris Hong
- Johns Hopkins Zanvyl Krieger School of Arts and Sciences, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Brianne M Bettcher
- Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Victoria S Pelak
- Department of Ophthalmology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Neurology, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alden Gross
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | - Kening Jiang
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, Maryland, USA
| | | | - Walter Wittich
- École d'optométrie, Université de Montréal, Montreal, Canada
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20
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Reavis KM, Bisgaard N, Canlon B, Dubno JR, Frisina RD, Hertzano R, Humes LE, Mick P, Phillips NA, Pichora-Fuller MK, Shuster B, Singh G. Sex-Linked Biology and Gender-Related Research Is Essential to Advancing Hearing Health. Ear Hear 2023; 44:10-27. [PMID: 36384870 PMCID: PMC10234332 DOI: 10.1097/aud.0000000000001291] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
There is robust evidence that sex (biological) and gender (behavioral/social) differences influence hearing loss risk and outcomes. These differences are noted for animals and humans-in the occurrence of hearing loss, hearing loss progression, and response to interventions. Nevertheless, many studies have not reported or disaggregated data by sex or gender. This article describes the influence of sex-linked biology (specifically sex-linked hormones) and gender on hearing and hearing interventions, including the role of sex-linked biology and gender in modifying the association between risk factors and hearing loss, and the effects of hearing loss on quality of life and functioning. Most prevalence studies indicate that hearing loss begins earlier and is more common and severe among men than women. Intrinsic sex-linked biological differences in the auditory system may account, in part, for the predominance of hearing loss in males. Sex- and gender-related differences in the effects of noise exposure or cardiovascular disease on the auditory system may help explain some of these differences in the prevalence of hearing loss. Further still, differences in hearing aid use and uptake, and the effects of hearing loss on health may also vary by sex and gender. Recognizing that sex-linked biology and gender are key determinants of hearing health, the present review concludes by emphasizing the importance of a well-developed research platform that proactively measures and assesses sex- and gender-related differences in hearing, including in understudied populations. Such research focus is necessary to advance the field of hearing science and benefit all members of society.
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Affiliation(s)
- Kelly M. Reavis
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Barbara Canlon
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Judy R. Dubno
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Robert D. Frisina
- Department of Medical Engineering and Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA
| | - Ronna Hertzano
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Institute for Genome Science, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Larry E. Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, Indiana, USA
| | - Paul Mick
- Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | | | - Benjamin Shuster
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
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21
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Guthrie DM, Williams N, Jaiswal A, Mick P, O’Rourke HM, Pichora-Fuller MK, Wittich W, Sutradhar R. Prevalence of sensory impairments in home care and long-term care using interRAI data from across Canada. BMC Geriatr 2022; 22:944. [PMID: 36482317 PMCID: PMC9733010 DOI: 10.1186/s12877-022-03671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In the general population, sensory impairments increase markedly with age in adults over 60 years of age. We estimated the prevalence of hearing loss only (HL), vision loss only (VL), and a combined impairment (i.e., dual sensory loss or DSL) in Canadians receiving home care (HC) or long-term care (LTC). METHODS Annual cross-sectional analyses were conducted using data collected with one of two interRAI assessments, one used for the HC setting (n = 2,667,199), and one for LTC (n = 1,538,691). Items in the assessments were used to measure three mutually exclusive outcomes: prevalence of VL only, HL only, or DSL. Trends over time for each outcome were examined using the Cochran-Armitage trend test. A negative binomial model was used to quantify the trends over time for each outcome while adjusting for age, sex and province. RESULTS In HC, there was a significant trend in the rate for all three outcomes (p < 0.001), with a small increase (roughly 1%) each year. In HC, HL was the most prevalent sensory loss, with a rate of roughly 25% to 29%, while in LTC, DSL was the most prevalent impairment, at roughly 25% across multiple years of data. In both settings, roughly 60% of the sample was female. Males in both HC and LTC had a higher prevalence of HL compared to females, but the differences were very small (no more than 2% in any given year). The prevalence of HL differed by province after adjusting for year, age and sex. Compared to Ontario, Yukon Territory had a 26% higher rate of HL in HC (relative rate [RR] = 1.26; 95% confidence interval [CI]:1.11, 1.43), but LTC residents in Newfoundland and Labrador had a significantly lower rate of HL (RR: 0.57; CI: 0.43, 0.76).When combined, approximately 60% of LTC residents, or HC clients, had at least one sensory impairment. CONCLUSIONS Sensory impairments are highly prevalent in both HC and LTC, with small sex-related differences and some variation across Canadian provinces. The interRAI assessments provide clinicians with valuable information to inform care planning and can also be used to estimate the prevalence of these impairments in specific population sub-groups.
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Affiliation(s)
- Dawn M. Guthrie
- grid.268252.90000 0001 1958 9263Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON Canada ,grid.268252.90000 0001 1958 9263Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON Canada
| | - Nicole Williams
- grid.268252.90000 0001 1958 9263Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON Canada
| | - Atul Jaiswal
- grid.14848.310000 0001 2292 3357School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Paul Mick
- grid.25152.310000 0001 2154 235XDepartment of Surgery, University of Saskatchewan, Saskatoon, SK Canada
| | - Hannah M. O’Rourke
- grid.17089.370000 0001 2190 316XFaculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB Canada
| | | | - Walter Wittich
- grid.14848.310000 0001 2292 3357School of Optometry, Université de Montréal, Montréal, Québec Canada
| | - Rinku Sutradhar
- grid.17063.330000 0001 2157 2938Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON Canada
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22
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Rojas C, Riffo B, Guerra E. Visual word recognition among oldest old people: The effect of age and cognitive load. Front Aging Neurosci 2022; 14:1007048. [PMID: 36247989 PMCID: PMC9561928 DOI: 10.3389/fnagi.2022.1007048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/14/2022] [Indexed: 11/13/2022] Open
Abstract
During the fourth age, a marked physiological deterioration and critical points of dysfunction are observed, during which cognitive performance exhibits a marked decline in certain skills (fluid intelligence) but good performance of others (crystallized intelligence). Experimental evidence describes important constraints on word production during old age, accompanied by a relative stabilization of speech comprehension. However, cognitive changes associated with advanced aging could also affect comprehension, particularly word recognition. The present study examines how the visual recognition of words is affected during the fourth age when tasks involving different cognitive loads are applied. Through linear regression models, performance was compared between two third-age groups and a fourth-age group on reaction time (RT) and accuracy in naming, priming and lexical decision experiments. The fourth-age group showed a significant RT increase in all experiments. In contrast, accuracy was good when the task involved a low cognitive demand (Experiments 1 and 2); however, when a decisional cognitive factor was included (Experiment 3), the fourth-age group performed significantly worse than the younger third-age group. We argue that the behavior observed among fourth-age individuals is consistent with an unbalanced cognitive configuration, in which the fluid intelligence deficit significantly reduces the speed necessary to recognize words, independent of the cognitive load associated with the test. In contrast, the maintenance in crystallized intelligence improves the accuracy of the process, strengthening linguistic functionality in the advanced stages of old age.
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Affiliation(s)
- Carlos Rojas
- Department of Health Rehabilitation Sciences, University of Bío-Bío, Chillán, Chile
- *Correspondence: Carlos Rojas,
| | - Bernardo Riffo
- Department of Spanish, Universidad de Concepción, Concepción, Chile
| | - Ernesto Guerra
- Center for Advanced Research in Education, Institute of Education (IE), Universidad de Chile, Santiago, Chile
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23
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Lisan Q, Goldberg M, Lahlou G, Ozguler A, Lemonnier S, Jouven X, Zins M, Empana JP. Prevalence of Hearing Loss and Hearing Aid Use Among Adults in France in the CONSTANCES Study. JAMA Netw Open 2022; 5:e2217633. [PMID: 35713903 PMCID: PMC9206187 DOI: 10.1001/jamanetworkopen.2022.17633] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Although hearing loss is common in the population worldwide, the prevalence of hearing loss and hearing aid use is not known. OBJECTIVE To estimate the prevalence of hearing loss and hearing aid use in the adult French population. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the CONSTANCES cohort, a representative sample of the French population. Volunteers aged 18 to 75 years were recruited at 21 preventive health centers between January 1, 2012, and December 31, 2019. The present study included participants with audiometric data. MAIN OUTCOMES AND MEASURES The main outcomes were prevalence of hearing loss and disabling hearing loss overall and by sex and age group and prevalence of self-reported hearing aid use among those with disabling hearing loss. Hearing loss was defined as a pure-tone average (PTA) in the better ear of 20 dB or higher, and disabling hearing loss was defined as a PTA in the better ear of 35 dB or higher. RESULTS Of 200 870 participants in the CONSTANCES study, 186 460 had full audiometric data and were included in this study (mean [SD] age, 47.1 [13.5] years); 100 330 (53.8%) were female, and 86 130 (46.2%) were male. Of these participants, 24.8% (95% CI, 24.6%-25.0%) had hearing loss and 4.3% (95% CI, 4.2%-4.4%) had disabling hearing loss. The prevalence rates of hearing loss increased from 3.4% (95% CI, 2.8%-3.9%) at age 18 to 25 years to 73.3% (95% CI, 69.5%-77.2%) at age 71 to 75 years among men and from 4.4% (95% CI, 3.9%-5.0%) at age 18 to 25 years to 64.1% (95% CI, 59.7%-68.4%) at age 71 to 75 years among women. The prevalence of disabling hearing loss increased from 0.3% (95% CI, 0.2%-0.4%) among participants aged 18 to 25 years to 23.3% (95% CI, 20.7%-26.0%) among participants aged 71 to 75 years. Among the 8050 participants with disabling hearing loss, 36.8% (95% CI, 35.8%-37.9%) reported using hearing aids, including 56.7% (95% CI, 38.9%-74.4%) aged 18 to 25 years and 32.9% (95% CI, 26.8%-39.2%) aged 71 to 75 years. CONCLUSIONS AND RELEVANCE In this cohort study, hearing loss was prevalent in France, and the prevalence of hearing loss increased with age among both men and women. Hearing aids were underused, particularly among older individuals. These findings suggest that hearing loss prevention and screening in the French population are needed.
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Affiliation(s)
- Quentin Lisan
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Ghizlene Lahlou
- Assistance Publique–Hôpitaux de Paris Sorbonne Université, Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Département d’Oto-Rhino-Laryngologie, Unité Fonctionnelle Implants Auditifs, Paris, France
- Institut de l’Audition/Institut Pasteur, Équipe Technologies and Gene Therapy for Deafness, Paris, France
| | - Anna Ozguler
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Sylvie Lemonnier
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Xavier Jouven
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
- Department of Cardiology, European Hospital Georges Pompidou, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Marie Zins
- Université Paris Cité, Population-based Cohorts Unit, INSERM, Paris Saclay University, Université de Versailles Saint-Quentin-en-Yvelines, UMS 011, Paris, France
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM, U970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease, Paris, France
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24
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Klil-Drori S, Phillips N, Fernandez A, Solomon S, Klil-Drori AJ, Chertkow H. Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study. J Geriatr Psychiatry Neurol 2022; 35:374-381. [PMID: 33858238 DOI: 10.1177/08919887211002640] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). METHODS Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. RESULTS Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). CONCLUSIONS Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.
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Affiliation(s)
- Sivan Klil-Drori
- Rotman Research Institute, 7942Baycrest Health Sciences, University of Toronto, Ontario, Canada
| | - Natalie Phillips
- Department of Psychology, 5618Concordia University, Montreal, Quebec, Canada
| | - Alita Fernandez
- Rotman Research Institute, 7942Baycrest Health Sciences, University of Toronto, Ontario, Canada
| | - Shelley Solomon
- 5621Jewish General Hospital, Lady Davis Institute, McGill University, Montreal, Quebec, Canada
| | - Adi J Klil-Drori
- Odette Cancer Centre, 293290Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
| | - Howard Chertkow
- Rotman Research Institute, 7942Baycrest Health Sciences, University of Toronto, Ontario, Canada.,5621Jewish General Hospital, Lady Davis Institute, McGill University, Montreal, Quebec, Canada
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25
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Tonelli M, Warick R. Focusing on the Needs of People With Hearing Loss During the COVID-19 Pandemic and Beyond. JAMA 2022; 327:1129-1130. [PMID: 35238871 DOI: 10.1001/jama.2022.3026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ruth Warick
- International Federation of Hard of Hearing People, Hamburg, Germany
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26
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Al-Yawer F, Bruce H, Li KZH, Pichora-Fuller MK, Phillips NA. Sex-Related Differences in the Associations Between Montreal Cognitive Assessment Scores and Pure-Tone Measures of Hearing. Am J Audiol 2022; 31:220-227. [PMID: 35226818 DOI: 10.1044/2021_aja-21-00131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Hearing loss (HL) is associated with cognitive performance in older adults, including performance on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening test. Yet, despite well-established sex-related differences in both hearing and cognition, very few studies have tested whether there are sex-related differences in auditory-cognitive associations. METHOD In the current cross-sectional retrospective analysis, we examined sex-related differences in hearing and cognition in 193 healthy older adults (M = 69 years, 60% women). Hearing was measured using audiometry (pure-tone average [PTA] of thresholds at 500, 1000, 2000, and 4000 Hz in the worse ear). Cognition was assessed using the MoCA. Additionally, we calculated MoCA scores with hearing-dependent subtests excluded from scoring (MoCA-Modified). RESULTS Men and women did not differ in age, education, or history of depression. Women had better hearing than men. Women with normal hearing were more likely to pass the MoCA compared with their counterparts with HL. In contrast, the likelihood of passing the MoCA did not depend on hearing status in men. Linear regression analysis showed an interaction between sex and PTA in the worse ear. PTAs were significantly correlated with both MoCA and MoCA-Modified scores in women, whereas this was not observed in the men. CONCLUSIONS This study is one of the first to demonstrate significant sex-related differences in auditory-cognitive associations even when hearing-related cognitive test items are omitted. Potential mechanisms underlying these female-specific effects are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19233297.
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Affiliation(s)
- Faisal Al-Yawer
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
| | - Halina Bruce
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- PERFORM Centre, Concordia University, Montréal, Québec, Canada
| | - M. Kathleen Pichora-Fuller
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Department of Psychology, University of Toronto, Mississauga, Ontario, Canada
- Department of Gerontology and Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
- Rotman Research Institute, Toronto, Ontario, Canada
| | - Natalie A. Phillips
- Department of Psychology, Concordia University, Montréal, Québec, Canada
- Center for Research in Human Development (CRDH), Concordia University, Montréal, Québec, Canada
- Centre for Research on Brain, Language & Music (CRBLM), McGill University, Montréal, Québec, Canada
- Bloomfield Centre for Research in Aging, Lady Davis Institute for Medical Research/Jewish General Hospital/McGill University, Montréal, Québec, Canada
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27
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Gosselin P, Guan DX, Chen HY, Pichora-Fuller MK, Phillips N, Faris P, Smith EE, Ismail Z. The Relationship Between Hearing and Mild Behavioral Impairment and the Influence of Sex: A Study of Older Adults Without Dementia from the COMPASS-ND Study. J Alzheimers Dis Rep 2022; 6:57-66. [PMID: 35360276 PMCID: PMC8925139 DOI: 10.3233/adr-210045] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/19/2022] [Indexed: 12/15/2022] Open
Abstract
Background Hearing loss and mild behavioral impairment (MBI), both non-cognitive markers of dementia, can be early warning signs of incident cognitive decline. Objective We investigated the relationship between these markers and reported the influence of sex, using non-dementia participants (n = 219; 107 females) from the Canadian Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND). Methods Hearing was assessed with the 10-item Hearing Handicap for the Elderly-Screening (HHIE-S) questionnaire, a speech-in-noise test, screening audiometry, and hearing aid use. MBI symptoms were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Multivariable linear regressions examined the association between hearing and MBI symptom severity and multiple logistic regressions examined the association between hearing and MBI domains. Results HHIE-S score was significantly associated with greater global MBI symptom burden, and symptoms in the apathy and affective dysregulation domains. Objective measures of audiometric hearing loss and speech-in-noise testing as well as hearing aid use were not associated with global MBI symptom severity or the presence of MBI domain-specific symptoms. Males were older, had more audiometric and speech-in-noise hearing loss, higher rates of hearing-aid use, and showed more MBI symptoms than females, especially apathy. Conclusion The HHIE-S, a subjective self-report measure that captures emotional and social aspects of hearing disability, was associated with informant-reported global MBI symptom burden, and more specifically the domains of affective dysregulation and apathy. These domains can be potential drivers of depression and social isolation. Hearing and behavior change can be assessed with non-invasive measures, adding value to a comprehensive dementia risk assessment.
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Affiliation(s)
- Penny Gosselin
- Audiology & Children’s Allied Health Services, Alberta Health Services, Lethbridge, AB, Canada
| | | | - Hung-Yu Chen
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | | | | | - Peter Faris
- Health Services Statistical and Analytic Methods, Data and Analytics (DIMR), Foothills Medical Centre, Alberta Health Services, Calgary, AB, Canada
| | - Eric E. Smith
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Departments of Clinical Neurosciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Ron and Rene Ward Centre for Healthy Brain Aging Research, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Departments of Clinical Neurosciences and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
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28
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Minhas R, Jaiswal A, Chan S, Trevisan J, Paramasivam A, Spruyt-Rocks R. Prevalence of Individuals with Deafblindness and Age-Related Dual-Sensory Loss. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x211072541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction The authors of this paper have compiled a report on the prevalence of deafblindness and dual-sensory loss based on the review of existing estimates. The purpose is to inform readers of the importance of using consistent, well-researched definitions and survey questions in future prevalence studies. Methods Articles were extracted through ProQuest and EBSCOhost, online library databases of Cambrian College and Laurentian University. Keywords search included “deafblindness,” “dual-sensory impairment,” “dual-sensory loss,” “age-related,” “congenital,” “acquired,” and “prevalence.” Additionally, the authors conducted a search with Google for research reports and Google Scholar for other relevant peer-reviewed articles. Results This review provides a current overview of prevalence estimates of deafblindness and age-related dual-sensory loss around the world, examining 19 articles or reports published over the last 20 years (2000–2020) in 18 countries, including the European Union (consisting of 8 countries). In line with the prevalence estimates by the World Federation for the Deafblind global report 2018, the review indicates an estimated 0.2–2% prevalence of dual-sensory impairment and underscores varying ranges of prevalence among populations, studies or countries, age groups, and types of deafblindness. The review highlights that the prevalence of deafblindness or dual-sensory loss was often not comparable across studies, but it is clear that the prevalence of dual-sensory impairment increases with age. The studies varied in methods (e.g., population surveys, cross-sectional, and longitudinal studies). Implication for practitioners The review provides evidence of varying ranges of prevalence rates. Future prevalence studies may benefit from consistent definitions, standard data-collection tools to do better comparisons across countries, and identify factors that predict higher or lower prevalence rates among populations and age groups.
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Affiliation(s)
- Renu Minhas
- DeafBlind Ontario Services, Newmarket, ON, Canada
| | - Atul Jaiswal
- CIHR Health System Postdoctoral Fellow, School of Optometry, University of Montreal, Montreal, QC, Canada
| | - Serena Chan
- DeafBlind Ontario Services, Newmarket, ON, Canada
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29
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A Newly Identified Impairment in Both Vision and Hearing Increases the Risk of Deterioration in Both Communication and Cognitive Performance. Can J Aging 2021; 41:363-376. [DOI: 10.1017/s0714980821000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.
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30
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Haanes GG, Roin Á, Petersen MS. Preventive Home Visit (PHV) Screening of Hearing and Vision Among Older Adults in Tórshavn, Faroe Islands: A Feasibility Study in a Small-Scale Community. J Multidiscip Healthc 2021; 14:1691-1699. [PMID: 34234456 PMCID: PMC8257060 DOI: 10.2147/jmdh.s298374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/21/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose Hearing and vision loss are common in later life but often overlooked and undertreated. The study aims to examine hearing and vision as part of preventive home visits (PHV) among 76-year-old home-dwelling citizens in Tórshavn, the capital of Faroe Islands. Patients and Methods In this cross-sectional study, three specially trained nurses conducted the examinations and tests, for this purpose, in the community health-centre. Results A total of 74 individuals participated (56% participation rate) of whom 77% had some degree of hearing impairment, 89% had visual impairment and 22% had dual sensory loss. A significant correlation between self-reported hearing ability and clinical findings was found, whereas self-reported vision did not correlate significantly with test-results. Conclusion Results indicate that implementing clinical assessments of hearing and vision as part of preventive home visits would benefit people receiving visits, and society by helping maintain the conditions that allow them to stay in their own homes for as long as possible.
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Affiliation(s)
- Gro Gade Haanes
- Faculty of Health and Social Science, Institute for Nursing and Health Science, University of Southeast-Norway (USN), Borre, NO-3199, Norway
| | - Ása Roin
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO-100, Faroe Islands
| | - Maria Skaalum Petersen
- Centre of Health Sciences, Faculty of Health Sciences, University of the Faroe Islands, Tórshavn, FO-100, Faroe Islands.,Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, FO-100, Faroe Islands
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31
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Stanimirovic A, Francis T, Cooper Reed A, Meerai S, Sutakovic O, Merritt R, Brent M, Rac V. Impact of Intersecting Systems of Oppression on Diabetic Retinopathy Screening Among Those Who Identify as Women of Low Socioeconomic Status: Protocol for a Convergent Mixed Methods Study. JMIR Res Protoc 2021; 10:e23492. [PMID: 33666559 PMCID: PMC7980119 DOI: 10.2196/23492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/06/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background By 2025, 5 million Canadians will be diagnosed with diabetes, and women from lower socioeconomic groups will likely account for most new diagnoses. Diabetic retinopathy is a primary vision complication of diabetes and a leading cause of blindness among adults, with 26% prevalence among women. Tele-retina is a branch of telemedicine that delivers eye care remotely. Screening for diabetic retinopathy has great potential to reduce the incidence of blindness, yet there is an adverse association among screening, income, and gender. Objective We aim to explore gender disparity in the provision of tele-retina program services for diabetic retinopathy screening in a cohort of women of low socioeconomic status (SES) receiving services in South Riverdale Community Health Centre (SRCHC) between 2014 and 2019. Methods Using a convergent mixed methods design, we want to understand patients’, providers’, administrators’, and decision makers’ perceptions of the facilitators and barriers associated with the implementation and adoption of tele-retina. Multivariate logistic regression will be utilized to assess the association among client characteristics, referral source, and diabetic retinopathy screening. Guided by a grounded theory approach, systematic coding of data and thematic analysis will be utilized to identify key facilitators and barriers to the implementation and adoption of tele-retina. Results For the quantitative component, we anticipate a cohort of 2500 patients, and we expect to collect data on the overall patterns of tele-retina program use, including descriptions of program utilization rates (such as data on received and completed diabetic retinopathy screening referrals) along the landscape of patient populations receiving these services. For the qualitative component, we plan to interview up to 21 patients and 14 providers, administrators, and decision makers, and to conduct up to 14 hours of observations alongside review of relevant documents. The interview guide is being developed in collaboration with our patient partners. Through the use of mixed methods research, the inquiry will be approached from different perspectives. Mixed methods will guide us in combining the rich subjective insights on complex realities from qualitative inquiry with the standard generalizable data that will be generated through quantitative research. The study is under review by the University Health Network Research Ethics Board (19-5628). We expect to begin recruitment in winter 2021. Conclusions In Ontario, the screening rate for diabetic retinopathy among low income groups remains below 65%. Understanding the facilitators and barriers to diabetic retinopathy screening may be a prerequisite in the development of a successful screening program. This study is the first Ontario study to focus on diabetic retinopathy screening practices in women of low SES, with the aim to improve their health outcomes and revolutionize access to quality care. International Registered Report Identifier (IRRID) PRR1-10.2196/23492
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Affiliation(s)
- Aleksandra Stanimirovic
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Troy Francis
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Anna Cooper Reed
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sonia Meerai
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Gender, Feminist & Women Studies, Faculty of Graduate Studies, York University, Toronto, ON, Canada.,Lyle S Hallman Faculty of Social Work, Wilfrid Laurier University, Brantford, ON, Canada
| | - Olivera Sutakovic
- Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - Rebecca Merritt
- South Riverdale Community Health Centre, Toronto, ON, Canada
| | - Michael Brent
- Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - Valeria Rac
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
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Höbler F, McGilton KS, Wittich W, Dupuis K, Reed M, Dumassais S, Mick P, Pichora-Fuller MK. Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review. J Alzheimers Dis 2021; 84:1115-1138. [PMID: 34633326 PMCID: PMC8673512 DOI: 10.3233/jad-215087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. OBJECTIVE To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. METHODS Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O'Malley's scoping review and appraisal process was followed. RESULTS There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. CONCLUSION Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.
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Affiliation(s)
- Fiona Höbler
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Katherine S. McGilton
- KITE – Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Walter Wittich
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kate Dupuis
- Sheridan Centre for Elder Research, Sheridan College, Oakville, ON, Canada
| | - Marilyn Reed
- Audiology, Baycrest Health Sciences, Toronto, ON, Canada
| | - Shirley Dumassais
- École d’optométrie, Université de Montréal, Montréal, QC, Canada
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Rockwood K, Andrew MK, Aubertin‐Leheudre M, Belleville S, Bherer L, Bowles SK, Kehler DS, Lim A, Middleton L, Phillips N, Wallace LM. CCCDTD5: Reducing the risk of later-life dementia. Evidence informing the Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5). ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12083. [PMID: 33204818 PMCID: PMC7656906 DOI: 10.1002/trc2.12083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
The Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD-5) was a year-long process to synthesize the best available evidence on several topics. Our group undertook evaluation of risk reduction, in eight domains: nutrition; physical activity; hearing; sleep; cognitive training and stimulation; social engagement and education; frailty; and medications. Here we describe the rationale for the undertaking and summarize the background evidence-this is also tabulated in the Appendix. We further comment specifically on the relationship between age and dementia, and offer some suggestions for how reducing the risk of dementia in the seventh decade and beyond might be considered if we are to improve prospects for prevention in the near term. We draw to attention that a well-specified model of success in dementia prevention need not equate to the elimination of cognitive impairment in late life.
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Affiliation(s)
- Kenneth Rockwood
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Melissa K. Andrew
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | | | - Sylvie Belleville
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontréalQuebecCanada
- Psychology DepartmentUniversité de MontréalMontréalCanada
| | - Louis Bherer
- Département de Médecine, Faculté de médecine, Université de Montréal, Centre de recherche, Institut de cardiologie de Montréal, Centre de rechercheInstitut universitaire de gériatrie de MontréalMontréalQuébecCanada
| | - Susan K. Bowles
- Division of Geriatric MedicineDalhousie UniversityHalifaxNova ScotiaCanada
- College of PharmacyDalhousie UniversityHalifaxNova ScotiaCanada
| | - D Scott Kehler
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Andrew Lim
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences CentreUniversity of TorontoTorontoOntarioCanada
| | - Laura Middleton
- Department of KinesiologyUniversity of WaterlooWaterlooOntarioCanada
| | - Natalie Phillips
- Department of PsychologyConcordia UniversityMontréalQuébecCanada
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Gopinath B, Liew G, Burlutsky G, McMahon CM, Mitchell P. Association between vision and hearing impairment and successful aging over five years. Maturitas 2020; 143:203-208. [PMID: 33308630 DOI: 10.1016/j.maturitas.2020.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/07/2020] [Accepted: 10/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to prospectively examine the relationship between vision and hearing loss and successful aging in a cohort of older adults. STUDY DESIGN We analyzed 5-year data (1997-9 to 2002-4) from 1,085 adults aged 55+ years, who were free of cancer, coronary artery disease and stroke at baseline and who had complete data on sensory loss. MAIN OUTCOME MEASURES Visual impairment was defined as visual acuity <20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold >25 dBHL (500-4000 Hz, better ear). Successful aging was defined as the absence of: disability, depressive symptoms, cognitive impairment, respiratory symptoms and chronic diseases (cancer, coronary artery disease and stroke) at 5-year follow-up. RESULTS At 5-year follow-up, 243 (22.4%) participants had died and 248 (22.9%) had aged successfully. After multivariable adjustment, participants who had either best-corrected visual impairment or bilateral hearing impairment, versus those who did not have sensory impairment at baseline, had 37% reduced odds of successful aging after 5 years: OR 0.63 (95% CI 0.43-0.94). Concurrent vision and hearing loss at baseline was not associated with 5-year aging status. Participants with moderate and severe hearing handicap at baseline had 50% and 61% reduced odds of aging successfully after 5 years, respectively. CONCLUSION The presence of a single sensory impairment in older adults was associated with reduced odds of being disease-free and fully functional or having aged successfully, 5 years later. Objectively measured hearing loss and self-perceived hearing handicap, rather than vision loss, was more likely to negatively influence 5-year aging status.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, NSW, Australia; Department of Linguistics, Macquarie University, Sydney, NSW, Australia.
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, NSW, Australia
| | - George Burlutsky
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, NSW, Australia
| | | | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, NSW, Australia
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Montero‐Odasso M, Pieruccini‐Faria F, Ismail Z, Li K, Lim A, Phillips N, Kamkar N, Sarquis‐Adamson Y, Speechley M, Theou O, Verghese J, Wallace L, Camicioli R. CCCDTD5 recommendations on early non cognitive markers of dementia: A Canadian consensus. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2020; 6:e12068. [PMID: 33094146 PMCID: PMC7568425 DOI: 10.1002/trc2.12068] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/09/2020] [Indexed: 12/21/2022]
Abstract
Introduction Cognitive impairment is the hallmark of Alzheimer's disease (AD) and related dementias. However, motor decline has been recently described as a prodromal state that can help to detect at‐risk individuals. Similarly, sensory changes, sleep and behavior disturbances, and frailty have been associated with higher risk of developing dementia. These clinical findings, together with the recognition that AD pathology precedes the diagnosis by many years, raises the possibility that non‐cognitive changes may be early and non‐invasive markers for AD or, even more provocatively, that treating non‐cognitive aspects may help to prevent or treat AD and related dementias. Methods A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non‐cognitive markers of dementia. We examined the literature for five non‐cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro‐behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non‐cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia? Results Evidence supported that gait speed, dual‐task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia. Conclusions Non‐cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non‐cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
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Affiliation(s)
- Manuel Montero‐Odasso
- Gait and Brain LaboratoryParkwood InstituteLawson Health Research InstituteLondonOntarioCanada
- Division of Geriatric MedicineDepartment of MedicineSchulich School of Medicine and DentistryLondonOntarioCanada
- Department of Epidemiology and BiostatisticsUniversity of Western OntarioLondonOntarioCanada
| | - Frederico Pieruccini‐Faria
- Gait and Brain LaboratoryParkwood InstituteLawson Health Research InstituteLondonOntarioCanada
- Division of Geriatric MedicineDepartment of MedicineSchulich School of Medicine and DentistryLondonOntarioCanada
| | - Zahinoor Ismail
- Departments of PsychiatryClinical Neurosciencesand Community Health SciencesHotchkiss Brain Institute and O'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
| | - Karen Li
- Centre for Research in Human DevelopmentConcordia UniversityMontrealQuebecCanada
- Department of PsychologyConcordia UniversityQuebecCanada
| | - Andrew Lim
- Division of NeurologyDepartment of MedicineSunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Natalie Phillips
- Centre for Research in Human DevelopmentConcordia UniversityMontrealQuebecCanada
- Department of PsychologyConcordia UniversityQuebecCanada
| | - Nellie Kamkar
- Gait and Brain LaboratoryParkwood InstituteLawson Health Research InstituteLondonOntarioCanada
| | - Yanina Sarquis‐Adamson
- Gait and Brain LaboratoryParkwood InstituteLawson Health Research InstituteLondonOntarioCanada
| | - Mark Speechley
- Department of Epidemiology and BiostatisticsUniversity of Western OntarioLondonOntarioCanada
| | - Olga Theou
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
- Department of MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Joe Verghese
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Lindsay Wallace
- Department of MedicineDalhousie UniversityHalifaxNova ScotiaCanada
| | - Richard Camicioli
- Division of NeurologyDepartment of MedicineUniversity of AlbertaEdmontonAlbertaCanada
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Kurthen I, Meyer M, Schlesewsky M, Bornkessel-Schlesewsky I. Individual Differences in Peripheral Hearing and Cognition Reveal Sentence Processing Differences in Healthy Older Adults. Front Neurosci 2020; 14:573513. [PMID: 33177981 PMCID: PMC7596743 DOI: 10.3389/fnins.2020.573513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/02/2020] [Indexed: 11/15/2022] Open
Abstract
When viewed cross-sectionally, aging seems to negatively affect speech comprehension. However, aging is a heterogeneous process, and variability among older adults is typically large. In this study, we investigated language comprehension as a function of individual differences in older adults. Specifically, we tested whether hearing thresholds, working memory, inhibition, and individual alpha frequency would predict event-related potential amplitudes in response to classic psycholinguistic manipulations at the sentence level. Twenty-nine healthy older adults (age range 61-76 years) listened to English sentences containing reduced relative clauses and object-relative clauses while their electroencephalogram was recorded. We found that hearing thresholds and working memory predicted P600 amplitudes early during reduced relative clause processing, while individual alpha frequency predicted P600 amplitudes at a later point in time. The results suggest that participants with better hearing and larger working memory capacity simultaneously activated both the preferred and the dispreferred interpretation of reduced relative clauses, while participants with worse hearing and smaller working memory capacity only activated the preferred interpretation. They also suggest that participants with a higher individual alpha frequency had a higher likelihood of successfully reanalysing the sentence toward the reduced relative clause reading than participants with a lower individual alpha frequency. By contrast, we found no relationship between object-relative clause processing and working memory or hearing thresholds. Taken together, the results support the view that older adults employ different strategies during auditory sentence processing dependent on their hearing and cognitive abilities and that there is no single ability that uniformly predicts sentence processing outcomes.
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Affiliation(s)
- Ira Kurthen
- Developmental Psychology: Infancy and Childhood, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- Cognitive Psychology Unit, Institute of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Matthias Schlesewsky
- Cognitive and Systems Neuroscience Research Hub, University of South Australia, Adelaide, SA, Australia
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Phillips NA, Chertkow H, Pichora‐Fuller MK, Wittich W. Special Issues on Using theMontreal Cognitive Assessmentfor telemedicine Assessment DuringCOVID‐19. J Am Geriatr Soc 2020; 68:942-944. [DOI: 10.1111/jgs.16469] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Howard Chertkow
- Department of Neurology, University of Toronto Toronto Ontario Canada
| | | | - Walter Wittich
- School of Optometry, Université de Montréal Montréal Quebec Canada
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