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Hooper E, Brown LJ, Cross H, Dawes P, Leroi I, Armitage CJ. Enablers and Barriers to Hearing aid Use in People Living With Dementia. J Appl Gerontol 2024; 43:978-989. [PMID: 38235997 PMCID: PMC11168016 DOI: 10.1177/07334648231225346] [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: 07/28/2023] [Revised: 10/19/2023] [Accepted: 12/10/2023] [Indexed: 01/19/2024] Open
Abstract
Hearing loss is highly prevalent in dementia; however, people with dementia are less likely to use hearing aids consistently than people with intact cognition are. This qualitative study is the first of its kind to explore factors that influence hearing aid use from the perspective of community-living people with mild to moderate dementia and their care partners. Eleven UK-based dyads from the European SENSE-Cog Randomized Controlled Trial of a sensory intervention for people with dementia completed semi-structured interviews based on the Theoretical Domains Framework (TDF). Our findings suggest that the TDF domains environmental context and resources, behavioral regulation, reinforcement, and social influences are of greatest relevance to hearing aid use in dementia. Within these domains, we identified a range of factors that may influence the target behavior of hearing aid use. The findings suggest that adoption of multifaceted, flexible intervention approaches may support hearing aid use in dementia.
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Affiliation(s)
- Emma Hooper
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Department of Rehabilitation and Sports Science, Institute of Health, University of Cumbria, Carlisle, UK
| | - Laura J.E. Brown
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
| | - Hannah Cross
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, Faculty of Health and Behavioral Sciences, University of Queensland, Saint Lucia, QLD, Australia
| | - Iracema Leroi
- Global Brain Health Institute and School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Christopher J. Armitage
- Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, UK
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Urbanski DP, Wolf JM, Langworthy BW, Parikh RR, Jutkowitz E, Shippee TP. Reported Unmet Hearing Aid Need in Older People With Dementia: The US National Core Indicators Survey. J Am Med Dir Assoc 2024; 25:853-859. [PMID: 38643971 DOI: 10.1016/j.jamda.2024.03.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Hearing aids have important health benefits for older adults with Alzheimer disease and related dementias (ADRD); however, hearing aid adoption in this group is low. This study aimed to determine where to target hearing aid interventions for American long-term care recipients with ADRD by examining the association of ADRD and residence type with respondent-reported unmet hearing aid need. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the United States National Core Indicators-Aging and Disabilities survey (2015-2019) for long-term care recipients aged ≥65 years. METHODS We used multivariable logistic regression to model the likelihood of reporting unmet hearing aid need conditional on ADRD status and residence type (own/family house or apartment, residential care, or nursing facility/home), adjusting for sociodemographic factors and response type (self vs proxy). RESULTS Of the 25,492 respondents [median (IQR) age, 77 (71, 84) years; 7074 (27.8%) male], 5442 (21.4%) had ADRD and 3659 (14.4%) owned hearing aids. Residence types were 17,004 (66.8%) own/family house or apartment, 4966 (19.5%) residential care, and 3522 (13.8%) nursing home. Among non-hearing aid owners, ADRD [adjusted odds ratio (AOR) 0.90, 95% CI 0.80-1.0] and residence type were associated with respondent-reported unmet hearing aid need. Compared to the nursing home reference group, respondents in their own/family home (AOR 1.85, 95% CI 1.61-2.13) and residential care (AOR 1.30, 95% CI 1.10-1.53) were more likely to report unmet hearing aid need. This pattern was significantly more pronounced in people with ADRD than in those without, stemming from an interaction between ADRD and residence type. CONCLUSIONS AND IMPLICATIONS American long-term care recipients with ADRD living in their own/family home are more likely to report unmet hearing aid need than those with ADRD in institutional and congregate settings. This information can inform the design and delivery of hearing interventions for older adults with ADRD.
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Affiliation(s)
- Dana P Urbanski
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
| | - Jack M Wolf
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Benjamin W Langworthy
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Romil R Parikh
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Eric Jutkowitz
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, RI, USA; Evidence Synthesis Program Center Providence VA Medical Center, Providence, RI, USA
| | - Tetyana P Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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Dawes P, Munro KJ. Hearing Loss and Dementia: Where to From Here? Ear Hear 2024; 45:529-536. [PMID: 38379156 PMCID: PMC11008448 DOI: 10.1097/aud.0000000000001494] [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: 01/11/2024] [Accepted: 01/29/2024] [Indexed: 02/22/2024]
Abstract
Victorian era psychologists were the first to comment on associations between sensory and cognitive function. More recently, hearing loss has been shown as a marker of risk for dementia. However, it is not known whether this association represents a causal impact of hearing loss, nor whether treating hearing loss may help prevent dementia. Most studies on relationships between hearing loss and cognitive outcomes are observational, are at risk of confounding, and cannot reach conclusions about causation. A recent high quality randomized controlled trial, relatively uncommon in audiology, reported no impact of a comprehensive hearing intervention in mitigating cognitive decline in older adults. Although secondary analysis revealed potential benefits in a sub-sample of adults, this finding may be spurious. Encouraging policymakers, patients, and other health care practitioners to address hearing loss in terms of dementia prevention may be inappropriate on the grounds of both relevance at individual level and lack of clear evidence of benefit. In addition, advocating need to address hearing loss in terms of mitigating dementia risk may reduce the importance of addressing hearing loss in its own right. Linking hearing loss to dementia risk may also exacerbate the stigma of hearing loss, inadvertently discouraging people from seeking help for hearing. We suggest that treating hearing loss may have important benefits in preventing or delaying diagnosis of dementia via improving orientation and functioning in daily life, without changing the underlying pathology. Rather than linking hearing loss to dementia risk, we suggest a positive message focusing on the known benefits of addressing hearing loss in terms of improved communication, quality of life, and healthy aging.
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Affiliation(s)
- Piers Dawes
- Centre for Hearing Research, School of Health and Rehabilitation Sciences, University of Queensland, Queensland, Australia
- Manchester Centre for Audiology and Deafness, University of Manchester, UK
| | - Kevin J. Munro
- Manchester Centre for Audiology and Deafness, University of Manchester, UK
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Ruencharoen S, Lertsukprasert K, Suvanich R, Seesangnom J, Chockboondee M, Aekplakorn W, Jariengprasert C, Kiatthanabumrung S, Wisupagan T. Hearing health survey of the population in Bangkok. BMC Public Health 2024; 24:1024. [PMID: 38609927 PMCID: PMC11015571 DOI: 10.1186/s12889-024-18424-x] [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: 08/31/2023] [Accepted: 03/24/2024] [Indexed: 04/14/2024] Open
Abstract
In this cross-sectional random survey among Thai adults living in Bangkok, we aimed to identify the prevalence of hearing problems and examine their relationship with individual factors. We administered a self-report questionnaire and performed pure-tone air conduction threshold audiometry. A total of 2463 participants (1728 female individuals) aged 15-96 years were included. The hearing loss prevalence was 53.02% and increased with age. The prevalence of a moderate or greater degree of hearing impairment was 2.8%. Participants aged 65 years and over had 8.56 and 6.79 times greater hearing loss and hearing impairment than younger participants, respectively. Male participants were twice as likely to have hearing loss and hearing impairment as female individuals. Participants with higher education levels showed less likelihood of having hearing loss and hearing impairment than those with no or a primary school education. Participants who ever worked under conditions with loud noise for > 8 h per day had 1.56 times greater hearing loss than those without such exposure. An inconsistent correlation was found between hearing loss, hearing impairment and noncommunicable diseases (diabetes, hypertension, and obesity). Although most participants had mild hearing loss, appropriate care and monitoring are necessary to prevent further loss in such individuals. The questionnaire-based survey found only people with hearing problems that affect daily communication.
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Affiliation(s)
- Suwimol Ruencharoen
- Department of Communication Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Krisna Lertsukprasert
- Department of Communication Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ravin Suvanich
- Department of Communication Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jirapat Seesangnom
- Department of Communication Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Mondnath Chockboondee
- Department of Communication Disorders, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Tosapohn Wisupagan
- Department of Otolaryngology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Sayyid ZN, Wang H, Cai Y, Gross AL, Swenor BK, Deal JA, Lin FR, Wanigatunga AA, Dougherty RJ, Tian Q, Simonsick EM, Ferrucci L, Schrack JA, Resnick SM, Agrawal Y. Sensory and motor deficits as contributors to early cognitive impairment. Alzheimers Dement 2024; 20:2653-2661. [PMID: 38375574 PMCID: PMC11032563 DOI: 10.1002/alz.13715] [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: 07/17/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Age-related sensory and motor impairment are associated with risk of dementia. No study has examined the joint associations of multiple sensory and motor measures on prevalence of early cognitive impairment (ECI). METHODS Six hundred fifty participants in the Baltimore Longitudinal Study of Aging completed sensory and motor function tests. The association between sensory and motor function and ECI was examined using structural equation modeling with three latent factors corresponding to multisensory, fine motor, and gross motor function. RESULTS The multisensory, fine, and gross motor factors were all correlated (r = 0.74 to 0.81). The odds of ECI were lower for each additional unit improvement in the multisensory (32%), fine motor (30%), and gross motor factors (12%). DISCUSSION The relationship between sensory and motor impairment and emerging cognitive impairment may guide future intervention studies aimed at preventing and/or treating ECI. HIGHLIGHTS Sensorimotor function and early cognitive impairment (ECI) prevalence were assessed via structural equation modeling. The degree of fine and gross motor function is associated with indicators of ECI. The degree of multisensory impairment is also associated with indicators of ECI.
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Affiliation(s)
- Zahra N. Sayyid
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Hang Wang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Yurun Cai
- Department of Health and Community SystemsUniversity of Pittsburgh School of NursingPittsburghPennsylvaniaUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Bonnielin K. Swenor
- The Johns Hopkins School of NursingBaltimoreMarylandUSA
- The Johns Hopkins Disability Health Research Center, Johns Hopkins UniversityBaltimoreMarylandUSA
| | - Jennifer A. Deal
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Frank R. Lin
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Amal A. Wanigatunga
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Ryan J. Dougherty
- Department of NeurologyJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, BaltimoreBaltimoreMarylandUSA
| | - Eleanor M. Simonsick
- Intramural Research Program, National Institute on Aging, BaltimoreBaltimoreMarylandUSA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, BaltimoreBaltimoreMarylandUSA
| | - Jennifer A. Schrack
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Susan M. Resnick
- Intramural Research Program, National Institute on Aging, BaltimoreBaltimoreMarylandUSA
| | - Yuri Agrawal
- Department of Otolaryngology‐Head and Neck SurgeryJohns Hopkins School of MedicineBaltimoreMarylandUSA
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Hooper E, Brown LJE, Dawes P, Leroi I, Armitage CJ. What are the Correlates of Hearing Aid Use for People Living With Dementia? J Aging Health 2024:8982643241238253. [PMID: 38497649 DOI: 10.1177/08982643241238253] [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: 03/19/2024]
Abstract
OBJECTIVES To identify correlates of hearing aid use in people with dementia and age-related hearing loss. METHODS Bivariate and multivariate logistic regression analyses of predictor variables from 239 participants with dementia and hearing loss in the European SENSE-Cog Randomized Controlled Trial (Cyprus, England, France, Greece, and Ireland). RESULTS In multivariate analysis, four variables were significantly associated with hearing aid use: greater self-perceived hearing difficulties (OR 2.61 [CI 1.04-6.55]), lower hearing acuity (OR .39 [CI .2-.56]), higher cognitive ability (OR 1.19 [CI 1.08-1.31]), and country of residence. Participants in England had significantly increased odds of use compared to Cyprus (OR .36 [CI .14-.96]), France (OR .12 [CI .04-.34]) or Ireland (OR .05 [CI .01-.56]) but not Greece (OR 1.13 [CI .42-3.00]). CONCLUSIONS Adapting interventions to account for cognitive ability, country of residence, self-perceived hearing difficulties, and hearing acuity may support hearing aid use in people with dementia.
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Affiliation(s)
- Emma Hooper
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Department of Rehabilitation and Sports Science, Institute of Health, University of Cumbria, Carlisle, UK
| | - Laura J E Brown
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- Manchester Centre for Health Psychology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Iracema Leroi
- Global Brain Health Institute and School of Medicine, Trinity College, Dublin, Ireland
| | - Christopher J Armitage
- Manchester Centre for Health Psychology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, UK
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Blanchette V, Maranda-Pelletier S, Bilodeau G, Giguere A. Factors influencing the engagement of older adults with neurocognitive disorders in the design of decision aids: A qualitative descriptive study. PATIENT EDUCATION AND COUNSELING 2024; 119:108061. [PMID: 38035412 DOI: 10.1016/j.pec.2023.108061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To identify factors influencing the engagement of older adults with neurocognitive disorders (NCDs) in the design of decision aids (DAs). METHODS We conducted a qualitative descriptive study using semi-structured interviews with 23 older adults with NCDs who were accompanied by 27 caregivers. This is a secondary analysis of a published study to identify the features of DAs designed for this population and their caregivers. RESULTS Several behaviours and attitudes of caregivers and researchers hindered the older adults' engagement in the DA design process. Specific communication strategies can be employed to support their engagement and overcome the communication challenges inherent to this population, such as memory, attention, hearing, or visual impairments. Adopting the appropriate attitude, taking the time, and providing guidance to the older person can help them focus on the topic, while developing trust between participants is a facilitator to obtain their feedback. CONCLUSION Findings from this project could serve to inform the communication and co-design of DAs with older people with NCDs and their caregivers. PRACTICE IMPLICATIONS Caregivers and researchers have key roles to play in facilitating communication with older persons with NCDs so they are empowered to help in co-designing DAs.
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Affiliation(s)
- Virginie Blanchette
- VITAM - Research Centre on Sustainable Health, Quebec City, Canada; Department of Human Kinetic and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Sarah Maranda-Pelletier
- University Laval, Quebec City, Canada; School of Psychology, University Laval, Quebec City, Canada
| | | | - Anik Giguere
- VITAM - Research Centre on Sustainable Health, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, Canada.
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Tisato V, Castiglione A, Ciorba A, Aimoni C, Silva JA, Gallo I, D'Aversa E, Salvatori F, Bianchini C, Pelucchi S, Secchiero P, Zauli G, Singh AV, Gemmati D. LINE-1 global DNA methylation, iron homeostasis genes, sex and age in sudden sensorineural hearing loss (SSNHL). Hum Genomics 2023; 17:112. [PMID: 38098073 PMCID: PMC10722762 DOI: 10.1186/s40246-023-00562-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Sudden sensorineural hearing loss (SSNHL) is an abrupt loss of hearing, still idiopathic in most of cases. Several mechanisms have been proposed including genetic and epigenetic interrelationships also considering iron homeostasis genes, ferroptosis and cellular stressors such as iron excess and dysfunctional mitochondrial superoxide dismutase activity. RESULTS We investigated 206 SSNHL patients and 420 healthy controls for the following genetic variants in the iron pathway: SLC40A1 - 8CG (ferroportin; FPN1), HAMP - 582AG (hepcidin; HEPC), HFE C282Y and H63D (homeostatic iron regulator), TF P570S (transferrin) and SOD2 A16V in the mitochondrial superoxide dismutase-2 gene. Among patients, SLC40A1 - 8GG homozygotes were overrepresented (8.25% vs 2.62%; P = 0.0015) as well SOD2 16VV genotype (32.0% vs 24.3%; P = 0.037) accounting for increased SSNHL risk (OR = 3.34; 1.54-7.29 and OR = 1.47; 1.02-2.12, respectively). Moreover, LINE-1 methylation was inversely related (r2 = 0.042; P = 0.001) with hearing loss score assessed as pure tone average (PTA, dB HL), and the trend was maintained after SLC40A1 - 8CG and HAMP - 582AG genotype stratification (ΔSLC40A1 = + 8.99 dB HL and ΔHAMP = - 6.07 dB HL). In multivariate investigations, principal component analysis (PCA) yielded PC1 (PTA, age, LINE-1, HAMP, SLC40A1) and PC2 (sex, HFEC282Y, SOD2, HAMP) among the five generated PCs, and logistic regression analysis ascribed to PC1 an inverse association with moderate/severe/profound HL (OR = 0.60; 0.42-0.86; P = 0.0006) and with severe/profound HL (OR = 0.52; 0.35-0.76; P = 0.001). CONCLUSION Recognizing genetic and epigenetic biomarkers and their mutual interactions in SSNHL is of great value and can help pharmacy science to design by pharmacogenomic data classical or advanced molecules, such as epidrugs, to target new pathways for a better prognosis and treatment of SSNHL.
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Affiliation(s)
- Veronica Tisato
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
- LTTA Centre, University of Ferrara, 44121, Ferrara, Italy
- University Strategic Centre for Studies on Gender Medicine, University of Ferrara, 44121, Ferrara, Italy
| | | | - Andrea Ciorba
- Department of Neurosciences, University Hospital of Ferrara, 44121, Ferrara, Italy
| | - Claudia Aimoni
- Department of Neurosciences, University Hospital of Ferrara, 44121, Ferrara, Italy
| | - Juliana Araujo Silva
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
| | - Ines Gallo
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
| | - Elisabetta D'Aversa
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
| | - Francesca Salvatori
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
| | - Chiara Bianchini
- Department of Neurosciences, University Hospital of Ferrara, 44121, Ferrara, Italy
| | - Stefano Pelucchi
- Department of Neurosciences, University Hospital of Ferrara, 44121, Ferrara, Italy
| | - Paola Secchiero
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy
| | - Giorgio Zauli
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121, Ferrara, Italy
| | - Ajay Vikram Singh
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), 10589, Berlin, Germany
| | - Donato Gemmati
- Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
- University Strategic Centre for Studies on Gender Medicine, University of Ferrara, 44121, Ferrara, Italy.
- Centre Haemostasis and Thrombosis, University of Ferrara, 44121, Ferrara, Italy.
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Powell DS, Garcia Morales EE, Oh E, Deal JA, Samus QM, Wolff JL, Reed NS. Dementia and Hearing Aid Use and Cessation: A National Study. Am J Audiol 2023; 32:898-907. [PMID: 37713529 PMCID: PMC11001429 DOI: 10.1044/2023_aja-23-00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/12/2023] [Accepted: 07/25/2023] [Indexed: 09/17/2023] Open
Abstract
PURPOSE The current standard for management of hearing loss in the United States involves the use of a hearing aid. Anecdotal evidence suggests that the use of a hearing aid may be less effective in the context of dementia, though national data on use and cessation are not described. METHOD This longitudinal analysis of the National Health and Aging Trends Study followed participants who self-reported hearing aid use to estimate risk of hearing aid cessation over 9 years. We examine whether hearing aid cessation differs by dementia status using generalized estimating equations logistic regression accounting for loss to follow-up. Supplemental analyses were undertaken to examine the contribution of caregiving and environmental factors on hearing aid cessation. RESULTS Of 1,310 older adults who reported hearing loss (25% 80-84 years, 51% women, 74% White), 22% with dementia and 57% baseline hearing aid use. Dementia increased likelihood of ceasing hearing aid use during the first year after adoption (OR = 2.07, 95% CI [1.33, 3.23], p interaction = .11). In later years, older adults with either a previous or recent diagnosis of dementia had a 95% higher odds of hearing aid cessation (OR = 1.95, 95% CI [1.31, 2.90]), a decrease in odds with respect to the first year after adoption, when compared to participants without dementia, after adjusting for demographic, health, and economic factors. Economic and social factors that may influence care demands (more caregivers, income-to-poverty ratio, and additional insurance) increased likelihood for cessation for those with dementia. CONCLUSIONS Older adults with (vs. without) dementia are more likely to cease hearing aid use over time, most notably during the first year after adoption. Strategies to support hearing ability, such as self-management or care partner education, may improve communication for those living with co-occurring hearing loss and dementia.
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Affiliation(s)
- Danielle S. Powell
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| | - Emmanuel E. Garcia Morales
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Esther Oh
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer A. Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Quincy M. Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Jennifer L. Wolff
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Nicholas S. Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Chen Y, Guan L, Chen J, Han K, Yu Q, Zhou J, Wang X, Ma Y, Ji X, Zhao Z, Shen Q, Wang A, Wang M, Li J, Yu J, Zhang Y, Xu S, Liu J, Lu W, Ye B, Fang Y, Hu H, Shi H, Xiang M, Li X, Li Y, Wu H. Hearing intervention for decreasing risk of developing dementia in elders with mild cognitive impairment: study protocol of a multicenter randomized controlled trial for Chinese Hearing Solution for Improvement of Cognition in Elders (CHOICE). Trials 2023; 24:767. [PMID: 38017543 PMCID: PMC10685713 DOI: 10.1186/s13063-023-07813-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Age-related hearing loss (ARHL) signifies the bilateral, symmetrical, sensorineural hearing loss that commonly occurs in elderly individuals. Several studies have suggested a higher risk of dementia among patients diagnosed with ARHL. Although the precise causal association between ARHL and cognitive decline remains unclear, ARHL has been recognized as one of the most significant factors that can be modified to reduce the risk of developing dementia potentially. Mild cognitive impairment (MCI) typically serves as the initial stage in the transition from normal cognitive function to dementia. Consequently, the objective of our randomized controlled trial (RCT) is to further investigate whether the use of hearing aids can enhance cognitive function in older adults diagnosed with ARHL and MCI. METHODS AND DESIGN This study is a parallel-arm, randomized controlled trial conducted at multiple centers in Shanghai, China. We aim to enlist a total of 688 older adults (age ≥ 60) diagnosed with moderate-to-severe ARHL and MCI from our four research centers. Participants will be assigned randomly to either the hearing aid fitting group or the health education group using block randomization with varying block sizes. Audiometry, cognitive function assessments, and other relevant data will be collected at baseline, as well as at 6, 12, and 24 months post-intervention by audiologists and trained researchers. The primary outcome of our study is the rate of progression to dementia among the two groups of participants. Additionally, various evaluations will be conducted to measure hearing improvement and changes in cognitive function. Apart from the final study results, we also plan to conduct an interim analysis using data from 12-month follow-up. DISCUSSION In recent years, there has been a notable lack of randomized controlled trials (RCTs) investigating the possible causal relationship between hearing fitting and the improvement of cognitive function. Our findings may demonstrate that hearing rehabilitation can be a valuable tool in managing ARHL and preventing cognitive decline, which will contribute to the development of a comprehensive framework for the prevention and control of cognitive decline. TRIAL REGISTRATION Chinese Clinical Trial Registry chictr.org.cn ChiCTR2000036139. Registered on 21 August 2020.
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Affiliation(s)
- Ying Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Guan
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Chen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kun Han
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiongfei Yu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xue Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yunqian Ma
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiangyu Ji
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhonglu Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiyue Shen
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anxian Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengping Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jin Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiali Yu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiwen Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sijia Xu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wen Lu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Ye
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Fang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haixia Hu
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haibo Shi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingliang Xiang
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Translational Medicine On Ear and Nose Diseases (14DZ2260300), Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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11
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Zhang Y, Wang H, Wang L, Zhang J, Cao Y, Wan L, Wang C, Xin H, Ding H. Hearing aids utilization, effect factors, and its benefit in the association between hearing and cognition decline: A longitudinal follow-up in Shanghai, China. Exp Gerontol 2023; 181:112272. [PMID: 37597711 DOI: 10.1016/j.exger.2023.112272] [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: 06/01/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE To explore the rate and effect factors of hearing aids utilization in Chinese community elderly people, as well as the benefit role of hearing aids in the association of hearing loss and cognition decline. METHODS This study was designed based on a longitudinal 7-years follow-up conducted in Shanghai (China). Demographic characteristics, hearing level, hearing aids utilization and Activities of Daily Living (ADL) of participants were collected by Unified Needs Assessment Form for Elderly Care Questionnaire. Cognition function was assessed by Mini-mental State Examination (MMSE) scale. Multivariate logistic regression and linear regression were used for statistical analysis. RESULTS Hearing aids utilization rate in Chinese community elderly people is below 10 %. Participants with older age (≥80 years old), higher education (7-12 years and >12 years), who can manage money more independently were more likely to use hearing aids (P < 0.05). Whether hearing aids are used or not, hearing level is significantly associated with cognition in elderly people, but participants with hearing aids showed a slower cognitive decline speed. CONCLUSION Hearing aids utilization may slow down the cognition descent via assisting hearing in daily life, so strategies need to be concerned in order to protect hearing function in all elderly and improve the use of hearing aids in HL elderly.
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Affiliation(s)
- Yunwei Zhang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China
| | - Hua Wang
- Siping Community Health Service Center of Yangpu District, Shanghai, PR China
| | - Lihua Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, PR China
| | - Jing Zhang
- Jiangning Road Community Health Service Center of Jing'an District, Shanghai, PR China
| | - Yifan Cao
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China
| | - Lingshan Wan
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China
| | - Changying Wang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China
| | - Hongyun Xin
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China
| | - Hansheng Ding
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, PR China.
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12
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Abstract
The United States does not ensure equitable access to hearing health care for all age groups, largely because these services are costly and even unobtainable in some places. Barriers to care are discussed within a context of the social determinants of health, under-representativeness of hearing-care professionals from historically marginalized communities, older adults and age-related hearing loss, and associated health conditions. The MarkeTrak 2022 study generated a sample of 15,138 respondents with information on 43,597 individuals. Data analysis revealed that self-reported hearing difficulty appears to increase with age with a rate of 12.4% for adults 18 years of age and older. A substantial proportion of individuals with hearing difficulty assumed that their problem was age-related, followed by exposure to loud sound and noise. Individuals with hearing difficulty were nearly three to four times more likely to have tinnitus, cognitive problems, and issues with balance and falling than those with no hearing problems. Self-reported hearing difficulty was lower for historically marginalized groups (7%) than for the White population (12%). Recommendations are presented to reduce the burden of hearing difficulty and hearing aid deserts for rural and urban populations.
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Affiliation(s)
- Antony R. Joseph
- Hearing Loss Prevention Laboratory, Department of Communication Sciences and Disorders, Illinois State University, Normal, Illinois,Address for correspondence Antony R. Joseph, Au.D., Ph.D. Hearing Loss Prevention Laboratory, Department of Communication Sciences and Disorders, Illinois State UniversityCampus Box 4720, NormalIL
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13
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Chen HL, Tan CT, Wu CC, Liu TC. Effects of Diet and Lifestyle on Audio-Vestibular Dysfunction in the Elderly: A Literature Review. Nutrients 2022; 14:nu14224720. [PMID: 36432406 PMCID: PMC9698578 DOI: 10.3390/nu14224720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The world's age-related health concerns continue to rise. Audio-vestibular disorders, such as hearing loss, tinnitus, and vertigo, are common complaints in the elderly and are associated with social and public health burdens. Various preventative measures can ease their impact, including healthy food consumption, nutritional supplementation, and lifestyle modification. We aim to provide a comprehensive summary of current possible strategies for preventing the age-related audio-vestibular dysfunction. METHODS A PubMed, Embase, and Cochrane review databases search was conducted to identify the relationship between diet, lifestyle, and audio-vestibular dysfunction. "Diet", "nutritional supplement", "lifestyle", "exercise", "physical activity", "tinnitus", "vertigo" and "age-related hearing loss" were used as keywords. RESULTS Audio-vestibular dysfunction develops and progresses as a result of age-related inflammation and oxidative stress. Diets with anti-inflammatory and antioxidant effects have been proposed to alleviate this illness. A high-fat diet may induce oxidative stress and low protein intake is associated with hearing discomfort in the elderly. Increased carbohydrate and sugar intake positively correlate with the incidence of audio-vestibular dysfunction, whereas a Mediterranean-style diet can protect against the disease. Antioxidants in the form of vitamins A, C, and E; physical activity; good sleep quality; smoking cessation; moderate alcohol consumption; and avoiding noise exposure are also beneficial. CONCLUSIONS Adequate diet or nutritional interventions with lifestyle modification may protect against developing audio-vestibular dysfunction in elderly individuals.
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Affiliation(s)
- Hsin-Lin Chen
- Department of Surgical Oncology, National Taiwan University Cancer Center Hospital, Taipei 100, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Ching-Ting Tan
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Chen-Chi Wu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
- Department of Medical Research, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 302, Taiwan
- Department of Medical Genetics, National Taiwan University Hospital, Taipei 100, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 100, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: (C.-C.W.); (T.-C.L.)
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14
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Bestel J, Legris E, Rembaud F, Mom T, Galvin JJ. Speech understanding in diffuse steady noise in typically hearing and hard of hearing listeners. PLoS One 2022; 17:e0274435. [PMID: 36103551 PMCID: PMC9473430 DOI: 10.1371/journal.pone.0274435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Spatial cues can facilitate segregation of target speech from maskers. However, in clinical practice, masked speech understanding is most often evaluated using co-located speech and maskers (i.e., without spatial cues). Many hearing aid centers in France are equipped with five-loudspeaker arrays, allowing masked speech understanding to be measured with spatial cues. It is unclear how hearing status may affect utilization of spatial cues to segregate speech and noise. In this study, speech reception thresholds (SRTs) for target speech in “diffuse noise” (target speech from 1 speaker, noise from the remaining 4 speakers) in 297 adult listeners across 9 Audilab hearing centers. Participants were categorized according to pure-tone-average (PTA) thresholds: typically-hearing (TH; ≤ 20 dB HL), mild hearing loss (Mild; >20 ≤ 40 dB HL), moderate hearing loss 1 (Mod-1; >40 ≤ 55 dB HL), and moderate hearing loss 2 (Mod-2; >55 ≤ 65 dB HL). All participants were tested without aided hearing. SRTs in diffuse noise were significantly correlated with PTA thresholds, age at testing, as well as word and phoneme recognition scores in quiet. Stepwise linear regression analysis showed that SRTs in diffuse noise were significantly predicted by a combination of PTA threshold and word recognition scores in quiet. SRTs were also measured in co-located and diffuse noise in 65 additional participants. SRTs were significantly lower in diffuse noise than in co-located noise only for the TH and Mild groups; masking release with diffuse noise (relative to co-located noise) was significant only for the TH group. The results are consistent with previous studies that found that hard of hearing listeners have greater difficulty using spatial cues to segregate competing speech. The data suggest that speech understanding in diffuse noise provides additional insight into difficulties that hard of hearing individuals experience in complex listening environments.
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Affiliation(s)
| | | | | | - Thierry Mom
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - John J. Galvin
- University Hospital Center of Tours, Tours, France
- House Institute Foundation, Los Angeles, CA, United States of America
- * E-mail:
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15
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Systematic Review of Factors Associated With Hearing Aid Use in People Living in the Community With Dementia and Age-related Hearing Loss. J Am Med Dir Assoc 2022; 23:1669-1675.e16. [PMID: 35988590 DOI: 10.1016/j.jamda.2022.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate factors that influence hearing aid use according to the Theoretical Domains Framework (TDF). The TDF is a behavioral science framework that aids understanding of factors that influence behavior. DESIGN Systematic review. SETTING AND PARTICIPANTS People living in the community with dementia and age-related hearing loss who have air conduction hearing aids. METHODS Systematic literature review following PRISMA guidelines. We searched for studies in 8 databases, including Ovid MEDLINE, Scopus, and OpenGrey. We undertook an interpretive data synthesis by mapping findings onto the TDF. We assessed confidence in the findings according to the GRADE-CERQual approach. RESULTS Twelve studies (6 quantitative, 3 qualitative, and 3 mixed methods) were included in the review. The majority of these were rated low-moderate quality. We identified 27 component constructs (facilitators, barriers, or noncorrelates of hearing aid use) nested within the 14 domains of the TDF framework. Our GRADE-CERQual confidence rating was high for 5 findings. These suggest that hearing aid use for people living in the community with dementia and hearing loss is influenced by (1) degree of hearing aid handling proficiency, (2) positive experiential consequences, (3) degree of hearing aid comfort or fit, (4) person-environment interactions, and (5) social reinforcement. CONCLUSIONS AND IMPLICATIONS Hearing aid interventions should adopt a multifaceted approach that optimizes the capabilities of people with dementias to handle and use hearing aids; addresses or capitalizes on their motivation; and ensures their primary support network is supportive and encouraging of hearing aid use. The findings also emphasize the need for further high-quality research that investigates optimal hearing aid use, influencing factors, and interventions that support hearing aid use.
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16
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Kwak C, Seo YJ, Park KH, Han W. Analysis of the Knowledge, Attitudes, and Practice Model of Healthcare Professionals on Hearing Loss at Elderly Dementia Residences in Korea. Healthcare (Basel) 2022; 10:healthcare10050792. [PMID: 35627929 PMCID: PMC9140935 DOI: 10.3390/healthcare10050792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Due to a lack of knowledge about age-related hearing loss, its early identification and appropriate intervention are not being carried out in the field of dementia care. Since the untreated hearing loss of the elderly leads to a more rapid cognitive decline, the present study aimed to understand the hearing-related knowledge, attitudes, and practices of healthcare professionals in long-term care (LTC) facilities in Korea. A total of 557 workers (104 facility managers and 453 healthcare professionals) in residential LTC participated in this cross-sectional multicenter survey study. The Korean version of the knowledge, attitudes, and practice (KAP) on-line survey with a five-point scale or yes/no response was applied as the experimental tool. The results of structural equation modeling showed that knowledge significantly affected the attitudes and health-seeking practices of the facility manager, and allied healthcare professionals demonstrated similar results, which showed the significant effects of that knowledge on attitudes and health-seeking practices. This clearly indicated that sufficient knowledge is the driving force for the health-seeking practices and positive attitudes of both the facility manager and the healthcare professionals. Thus, we suggest that a further step, such as the development of comprehensive and professional guidelines regarding hearing care information for these professionals in residential LTC facilities, should be followed, and believe that this effort could lead to improving hearing-related knowledge, attitudes, and practices in order to clinically and politically care for the elderly population.
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Affiliation(s)
- Chanbeom Kwak
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon 24252, Korea;
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon 24252, Korea
| | - Young Joon Seo
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
| | - Kyoung Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Woojae Han
- Division of Speech Pathology and Audiology, College of Natural Sciences, Hallym University, Chuncheon 24252, Korea;
- Laboratory of Hearing and Technology, Research Institute of Audiology and Speech Pathology, College of Natural Sciences, Hallym University, Chuncheon 24252, Korea
- Correspondence: ; Tel.: +82-33-248-2216
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17
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Kim AS, Betz JF, Albert M, Deal JA, Faucette SP, Oh ES, Reed NS, Lin FR, Nieman CL. Accuracy of self- and proxy-rated hearing among older adults with and without cognitive impairment. J Am Geriatr Soc 2022; 70:490-500. [PMID: 34813080 PMCID: PMC8821325 DOI: 10.1111/jgs.17558] [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: 08/09/2021] [Revised: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Hearing loss is highly prevalent among older adults with cognitive impairment and may exacerbate neuropsychiatric symptoms and affect interactions with others. Although audiometry is the gold standard for measuring hearing, it is not always used in research or clinical settings focused on the care of individuals with cognitive impairment. Subjective assessments of hearing, both self- and proxy-rated, are widespread but may not adequately capture the presence of hearing loss as compared to audiometry. This study investigates the concordance between subjective and objective hearing assessments among older adults with and without cognitive impairment and evaluates factors associated with concordance. METHODS Participants were a subset of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS), a prospective cohort study representing four US communities with adjudicated cognitive diagnoses and audiometric data, totaling 3326 self-rated and 520 proxy-rated hearing assessments. Sensitivity and specificity were calculated, and multivariable logistic regression estimated the magnitude of the association between the concordance of hearing assessments and variables of interest. RESULTS Sensitivity and specificity for self-rated hearing status were 71.2% and 85.9% among cognitively normal older adults, 61.1% and 84.9% among persons with MCI, and 52.6% and 81.2% among persons with dementia, respectively. For proxy-rated hearing, sensitivity and specificity were 65.7% and 83.3% for persons with MCI and 73.3% and 60.3% for persons with dementia, respectively. Female sex was positively associated with concordance for self-rated hearing assessments. CONCLUSIONS The low sensitivity of self- and proxy-rated hearing assessments compared to audiometry suggests that hearing loss among older adults with cognitive impairment may go underreported and unaddressed in subjective assessments. Clinicians and researchers should recognize the limitations of using self- and proxy-rated hearing assessments as measures of hearing status and incorporate objective audiometric evaluation whenever possible.
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Affiliation(s)
- Alexander S Kim
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Joshua F Betz
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Sarah P Faucette
- Department of Otolaryngology - Head and Neck Surgery, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Esther S Oh
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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18
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Abstract
Hearing impairment commonly co-occurs with dementia. Audiologists, therefore, need to be prepared to address the specific needs of people living with dementia (PwD). PwD have needs in terms of dementia-friendly clinical settings, assessments, and rehabilitation strategies tailored to support individual requirements that depend on social context, personality, background, and health-related factors, as well as audiometric HL and experience with hearing assistance. Audiologists typically receive limited specialist training in assisting PwD and professional guidance for audiologists is scarce. The aim of this review was to outline best practice recommendations for the assessment and rehabilitation of hearing impairment for PwD with reference to the current evidence base. These recommendations, written by audiology, psychology, speech-language, and dementia nursing professionals, also highlight areas of research need. The review is aimed at hearing care professionals and includes practical recommendations for adapting audiological procedures and processes for the needs of PwD.
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19
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Frank A, Goldlist S, Mark Fraser AE, Bromwich M. Validation of SHOEBOX QuickTest Hearing Loss Screening Tool in Individuals With Cognitive Impairment. Front Digit Health 2021; 3:724997. [PMID: 34713195 PMCID: PMC8521917 DOI: 10.3389/fdgth.2021.724997] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The aim of this study was to validate a novel iPad-based rapid hearing loss screening tool (SHOEBOX QuickTest) in individuals with cognitive impairment. Design: Cross-sectional validation study. Setting: Bruyère Research Institute, Ottawa, Canada. Subjects and Methods: Twenty-five individuals with mild cognitive impairment (MCI) and mild dementia from the Bruyère Memory Program were included in this study. The study consisted of two components: (1) SHOEBOX QuickTest hearing screener and (2) a conventional hearing test (pure tone audiometry). Measurements: Hearing was assessed at 1,000, 2,000, and 4,000 Hz separately for each ear. The agreement between hearing ability groupings (good vs. reduced) from conventional hearing test and SHOEBOX QuickTest was determined. Specifically, accuracy, sensitivity, specificity, as well as alignment between conventional thresholds and hearing threshold ranges. Results: An overall accuracy of 84% was observed for SHOEBOX QuickTest, and a sensitivity and specificity of 100 and 66.7%, respectively. 72% ([95% CI], 60.0–84.1%) of conventional audiometry thresholds were within the pre-established 10 dB SHOEBOX QuickTest. Conclusion: SHOEBOX QuickTest is a valid hearing loss screening tool for individuals with cognitive impairment. Implementing this iPad-based screening tool in memory clinics could not only aid in the timely diagnosis of hearing loss, but also assist physicians in providing a better assessment of cognitive impairment by ruling out hearing loss as a confounding variable.
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Affiliation(s)
| | | | | | - Matthew Bromwich
- SHOEBOX Ltd, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, CHEO, Ottawa, ON, Canada.,Department of Otolaryngology- Head and Neck Surgery, University of Ottawa, Ottawa, ON, Canada
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20
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Yi JS, Pittman CA, Price CL, Nieman CL, Oh ES. Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators. J Am Med Dir Assoc 2021; 22:1396-1402.e18. [PMID: 33887231 PMCID: PMC8292189 DOI: 10.1016/j.jamda.2021.03.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES An increasing reliance on telemedicine for older adults with cognitive impairment requires a better understanding of the barriers and facilitators for this unique patient population. DESIGN The study team queried PubMed, Embase, the Cochrane Library, PsycINFO, CINAHL, Scopus, and ClinicalTrials.gov on May 1, 2020, for studies in English published from January 2010 to May 2020. SETTING AND PARTICIPANTS We conducted a systematic review of articles investigating the use of telemedicine among older adults with Alzheimer's disease and related dementia (ADRD) or mild cognitive impairment (MCI) that focused on the patient and care partner perspectives. METHODS Telemedicine encounter purpose, technological requirements, and findings regarding sensory needs were extracted. The Cochrane Collaboration's Risk of Bias Tool was applied for quality assessment. RESULTS The search yielded 3551 abstracts, from which 90 articles were reviewed and 17 were included. The purpose of telemedicine encounters included routine care, cognitive assessment, and telerehabilitation. All studies reported successful implementation of telemedicine, supported by patient and care partner satisfaction, similar results on cognitive assessment and diagnosis compared to in-person visits, and improvement in outcome measures following rehabilitation. Sixteen studies relied on staff and care partners to navigate technologies. Six studies reported participants reporting difficulty hearing the provider during the telemedicine visits. Five studies excluded participants with visual or hearing impairment because of the potential difficulty of using telemedicine technology. No studies reported technological adaptations to account for sensory impairment. CONCLUSIONS AND IMPLICATIONS Telemedicine is well received among patients and care partners, but successful delivery incorporates support staff and the care partners to navigate technologies. The exclusion of older adults with sensory impairment, especially given that it is highly prevalent, in developing telemedicine systems may further exacerbate access to care in this population. Adapting technologies for sensory needs is critical to the advancement of accessible dementia care through telemedicine.
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Affiliation(s)
- Julie S Yi
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corinne A Pittman
- Howard University College of Medicine, Washington, DC, USA; Cochlear Center for Hearing & Public Health-Johns Hopkins University School of Public Health, Baltimore, MD, USA
| | - Carrie L Price
- Albert S. Cook Library, Towson University, Towson, MD, USA
| | - Carrie L Nieman
- Cochlear Center for Hearing & Public Health-Johns Hopkins University School of Public Health, Baltimore, MD, USA; Division of Otology, Neurotology & Skull Base Surgery, Department of Otolaryngology-HNS, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Esther S Oh
- Cochlear Center for Hearing & Public Health-Johns Hopkins University School of Public Health, Baltimore, MD, USA; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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21
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Sugiura S, Uchida Y, Nishita Y, Teranishi M, Shimono M, Suzuki H, Nakashima T, Tange C, Otsuka R, Ando F, Shimokata H. Prevalence of usage of hearing aids and its association with cognitive impairment in Japanese community-dwelling elders with hearing loss. Auris Nasus Larynx 2021; 49:18-25. [PMID: 33865654 DOI: 10.1016/j.anl.2021.03.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/09/2021] [Accepted: 03/19/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Hearing loss is a risk factor for cognitive impairment, and the use of a hearing aid (HA) may prevent cognitive decline alongside hearing loss. We aimed to elucidate the prevalence of self-reported HA usage in Japanese community-dwelling elders with hearing loss, and the effect of hearing and HA on cognitive impairment. METHODS A total of 1193 participants, who had audiometric defined hearing loss and were aged 60 years or over, had their cumulative 3260 observations followed up for 10 years from a large cohort of a Japanese study. Association between hearing (pure-tone average threshold level at 500, 1000, 2000, and 4000 Hz from the better hearing ear: PTABHE) and HA usage with cognitive impairment (total score of Mini-Mental State Estimation was under 27 or diagnosed as dementia) was analyzed using generalized estimating equations. RESULTS The HA usage rate of the 1193 community-dwelling elders with hearing loss was 6% during the first involvement. The majority (59.2%) of HA users always used an HA. HA usage rate was 0.7% for the mild hearing loss group and 32.4% for the moderate or greater hearing loss group in the latest participating wave. PTABHE was significantly associated with cognitive impairment (odds ratio for every 10 dB 1.36; 95% CI 1.21-1.53, p<0.0001) after adjusting for age, sex, education, depressed mood, smoking status, alcohol intake, income, activity, obesity, histories of hypertension, dyslipidemia, ischemic heart disease, diabetes, stroke, ear disease, and occupational noise exposure. PTABHE was also significantly associated with cognitive impairment in the mild hearing loss group (odds ratio for every 10 dB 1.34; 95% CI 1.05-1.72, p = 0.020) and moderate hearing loss group (odds ratio for every 10 dB 1.82; 95% CI 1.27-2.61, p = 0.001). HA use showed a significant suppressive effect on cognitive impairment in those with moderate hearing loss who always use an HA (odds ratio 0.54; 95% CI 0.30-1.00, p = 0.049). CONCLUSION The prevalence of HA usage among Japanese community-dwelling elders with hearing loss is consistent, at around 10%. The hearing level remained a primary risk factor for cognitive impairment among elders with hearing loss after adjusting for several confounding factors. Regular HA use may have a protective effect on cognitive impairment in those with moderate hearing loss.
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Affiliation(s)
- Saiko Sugiura
- Toyota Josui Mental Clinic, 86-2 Minamidaira, Josui, Toyota, Aichi 470-0343, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan.
| | - Yasue Uchida
- Department of Otorhinolaryngology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Masaaki Teranishi
- Department of Otorhinolaryngology, Nagoya University School of Medicine, 65 Tsurumai, Syowa, Nagoya, Aichi 466-8560, Japan
| | - Mariko Shimono
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Hirokazu Suzuki
- Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Tsutomu Nakashima
- Ichinomiya Medical Treatment and Habilitation Center, 1679-2 Tomidanagaresuji, Ichinomiya, Aichi 494-0018, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Chikako Tange
- Section of NILS-LSA, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Rei Otsuka
- Section of NILS-LSA, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Fujiko Ando
- Department of Health and Medical Sciences, Aichi Shukutoku University, 2-9 Katahira, Nagakute, Aichi 480-1197, Japan; Section of NILS-LSA, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
| | - Hiroshi Shimokata
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, 57 Takenoyama, Iwasaki, Nisshin, Aichi 470-0196, Japan; Section of NILS-LSA, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi 474-8511, Japan
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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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23
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Mittal R, Bencie N, Liu G, Eshraghi N, Nisenbaum E, Blanton SH, Yan D, Mittal J, Dinh CT, Young JI, Gong F, Liu XZ. Recent advancements in understanding the role of epigenetics in the auditory system. Gene 2020; 761:144996. [PMID: 32738421 DOI: 10.1016/j.gene.2020.144996] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/21/2020] [Indexed: 11/19/2022]
Abstract
Sensorineural deafness in mammals is most commonly caused by damage to inner ear sensory epithelia, or hair cells, and can be attributed to genetic and environmental causes. After undergoing trauma, many non-mammalian organisms, including reptiles, birds, and zebrafish, are capable of regenerating damaged hair cells. Mammals, however, are not capable of regenerating damaged inner ear sensory epithelia, so that hair cell damage is permanent and can lead to hearing loss. The field of epigenetics, which is the study of various phenotypic changes caused by modification of genetic expression rather than alteration of DNA sequence, has seen numerous developments in uncovering biological mechanisms of gene expression and creating various medical treatments. However, there is a lack of information on the precise contribution of epigenetic modifications in the auditory system, specifically regarding their correlation with development of inner ear (cochlea) and consequent hearing impairment. Current studies have suggested that epigenetic modifications influence differentiation, development, and protection of auditory hair cells in cochlea, and can lead to hair cell degeneration. The objective of this article is to review the existing literature and discuss the advancements made in understanding epigenetic modifications of inner ear sensory epithelial cells. The analysis of the emerging epigenetic mechanisms related to inner ear sensory epithelial cells development, differentiation, protection, and regeneration will pave the way to develop novel therapeutic strategies for hearing loss.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nicole Bencie
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - George Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nicolas Eshraghi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eric Nisenbaum
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan H Blanton
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA; Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Denise Yan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeenu Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christine T Dinh
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan I Young
- Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Feng Gong
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Xue Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA; Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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24
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Clark JG, English KM, Montano JJ. Heightening our vigilance towards patient well-being. Int J Audiol 2020; 60:4-11. [PMID: 33143471 DOI: 10.1080/14992027.2020.1834632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Audiology patients frequently experience psychosocial difficulties created by their hearing loss or exacerbated by the loss. Clinicians are not always attuned to the unstated emotional undercurrents which may signal a need for further discussion or referral. This article aims to heighten audiologists' vigilance towards patient well-being. DESIGN A series of case vignettes with sample dialogue demonstrate the need for heightened clinical awareness of confounding consequences patients may grapple with and possible responses to these issues. CONCLUSIONS Beyond hearing loss, contributing detractors to patient well-being can be difficult to recognise for clinicians, and exploration and discussions may feel challenging to broach. A heightened vigilance within patient care calls upon audiologists to be alert for concerns or conditions beyond hearing loss that may be threatening our patients or further decreasing the quality of their lives and that of their families.
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Affiliation(s)
- John Greer Clark
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Kristina M English
- School of Speech-Language Pathology and Audiology, University of Akron, Akron, OH, USA
| | - Joseph J Montano
- Audiology and Speech-Language Pathology Department, Weill Cornell Medical College, New York, NY, USA
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25
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Recent advancements in understanding the role of epigenetics in the auditory system. Gene 2020. [DOI: 10.1016/j.gene.2020.144996
expr 848609818 + 898508594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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26
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Kim AS, Garcia Morales EE, Amjad H, Cotter VT, Lin FR, Lyketsos CG, Nowrangi MA, Mamo SK, Reed NS, Yasar S, Oh ES, Nieman CL. Association of Hearing Loss With Neuropsychiatric Symptoms in Older Adults With Cognitive Impairment. Am J Geriatr Psychiatry 2020; 29:544-553. [PMID: 33168388 PMCID: PMC8044263 DOI: 10.1016/j.jagp.2020.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 01/04/2023]
Abstract
UNLABELLED Neuropsychiatric symptoms (NPS) in persons with dementia (PWD) are common and can lead to poor outcomes, such as institutionalization and mortality, and may be exacerbated by sensory loss. Hearing loss is also highly prevalent among older adults, including PWD. OBJECTIVE This study investigated the association between hearing loss and NPS among community- dwelling patients from a tertiary memory care center. DESIGN, SETTING, AND PARTICIPANTS Participants of this cross-sectional study were patients followed at the Johns Hopkins Memory and Alzheimer's Treatment Center who underwent audiometric testing during routine clinical practice between October 2014 and January 2017. OUTCOME MEASUREMENTS Included measures were scores on the Neuropsychiatric Inventory-Questionnaire and the Cornell Scale for Depression in Dementia. RESULTS Participants (n = 101) were on average 76 years old, mostly female and white, and had a mean Mini-Mental State Examination score of 23. We observed a positive association between audiometric hearing loss and the number of NPS (b = 0.7 per 10 dB; 95% confidence interval [CI]: 0.2, 1.1; t = 2.86; p = 0.01; df = 85), NPS severity (b = 1.3 per 10 dB; 95% CI: 0.4, 2.5; t = 2.13; p = 0.04; df = 80), and depressive symptom severity (b = 1.5 per 10 dB; 95% CI: 0.4, 2.5; t = 2.83; p = 0.01; df = 89) after adjustment for demographic and clinical characteristics. Additionally, the use of hearing aids was inversely associated with the number of NPS (b = -2.09; 95% CI -3.44, -0.75; t = -3.10; p = 0.003; df = 85), NPS severity (b = -3.82; 95% CI -7.19, -0.45; t = -2.26; p = 0.03; df = 80), and depressive symptom severity (b = -2.94; 95% CI: -5.93, 0.06; t = 1.70; p = 0.05; df = 89). CONCLUSION Among patients at a memory clinic, increasing severity of hearing loss was associated with a greater number of NPS, more severe NPS, and more severe depressive symptoms, while hearing aid use was associated with fewer NPS, lower severity, and less severe depressive symptoms. Identifying and addressing hearing loss may be a promising, low-risk, non-pharmacological intervention in preventing and treating NPS.
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Affiliation(s)
- Alexander S Kim
- Johns Hopkins University School of Medicine (ASK), Baltimore, MD; Cochlear Center for Hearing and Public Health (ASK, EEGM, FRL, NSR, ESO, CLN), Baltimore, MD
| | | | - Halima Amjad
- Division of Geriatric Medicine and Gerontology (HA, SY, ESO), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valerie T Cotter
- Johns Hopkins University School of Nursing (VTC, ESO), Baltimore, MD
| | - Frank R Lin
- Cochlear Center for Hearing and Public Health (ASK, EEGM, FRL, NSR, ESO, CLN), Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery (FRL, CLN), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences (CGL, MAN, ESO), Johns Hopkins Bayview and Johns Hopkins University, Baltimore, MD
| | - Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences (CGL, MAN, ESO), Johns Hopkins Bayview and Johns Hopkins University, Baltimore, MD
| | - Sara K Mamo
- Department of Communication Disorders (SKM), University of Massachusetts Amherst, Amherst, MD
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health (ASK, EEGM, FRL, NSR, ESO, CLN), Baltimore, MD; Department of Epidemiology (NSR), Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Sevil Yasar
- Division of Geriatric Medicine and Gerontology (HA, SY, ESO), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Esther S Oh
- Cochlear Center for Hearing and Public Health (ASK, EEGM, FRL, NSR, ESO, CLN), Baltimore, MD; Division of Geriatric Medicine and Gerontology (HA, SY, ESO), Johns Hopkins University School of Medicine, Baltimore, MD; Johns Hopkins University School of Nursing (VTC, ESO), Baltimore, MD; Department of Psychiatry and Behavioral Sciences (CGL, MAN, ESO), Johns Hopkins Bayview and Johns Hopkins University, Baltimore, MD
| | - Carrie L Nieman
- Cochlear Center for Hearing and Public Health (ASK, EEGM, FRL, NSR, ESO, CLN), Baltimore, MD; Department of Otolaryngology-Head and Neck Surgery (FRL, CLN), Johns Hopkins University School of Medicine, Baltimore, MD.
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27
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Kim JS, Lee HJ, Lee S, Lee HS, Jeong YJ, Son Y, Kim JM, Lee YJ, Park MH. Conductive Hearing Loss Aggravates Memory Decline in Alzheimer Model Mice. Front Neurosci 2020; 14:843. [PMID: 32903751 PMCID: PMC7438902 DOI: 10.3389/fnins.2020.00843] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022] Open
Abstract
The study of cognitive impairment associated with hearing loss has recently garnered considerable interest. Epidemiological data have demonstrated that hearing loss is a risk factor for cognitive decline as a result of aging. However, no previous study has examined the effect of hearing loss in patients with cognitive problems such as Alzheimer’s disease. Therefore, we investigated the effect of conductive hearing loss in an Alzheimer’s mouse model. Positron emission tomography (PET) and magnetic resonance imaging (MRI) were used to evaluate changes in glucose metabolism and gray matter concentrations in the 5xFAD Alzheimer’s Disease (AD) transgenic mouse model with and without conductive hearing loss (HL). Conductive hearing loss was induced using chronic perforation of the tympanic membrane. Behavioral data from the Y-maze and passive avoidance tests revealed greater memory deficits in the AD with HL (AD-HL) group than in the AD group. Following induction of hearing loss, lower cerebral glucose metabolism in the frontal association cortex was observed in the AD-HL group than in the AD group. Although lower glucose metabolism in the hippocampus and cerebellum was found in the AD-HL group than in the AD group at 3 months, the gray matter concentrations in these regions were not significantly different between the groups. Furthermore, the gray matter concentrations in the simple lobule, cingulate/retrosplenial cortex, substantia nigra, retrosigmoid nucleus, medial geniculate nucleus, and anterior pretectal nucleus at 7 months were significantly lower in the AD-HL group than in the AD group. Taken together, these results indicate that even partial hearing loss can aggravate memory impairment in Alzheimer’s disease.
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Affiliation(s)
- Jin Su Kim
- Division of RI Application, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea.,Radiological and Medico-Oncological Sciences, University of Science and Technology, Seoul, South Korea
| | - Hae-June Lee
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Seonhwa Lee
- Division of RI Application, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea.,Department of Bio-Convergence Engineering, Korea University, Seoul, South Korea
| | - Ho Sun Lee
- Department of Otorhinolaryngology, Boramae Medical Center, Seoul Metropolitan Government-Seoul National University, Seoul, South Korea.,Department of Otorhinolaryngology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Ye Ji Jeong
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Yeonghoon Son
- Division of Radiation Biomedical Research, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea.,National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Cheongju, South Korea
| | - Jung Min Kim
- Department of Bio-Convergence Engineering, Korea University, Seoul, South Korea
| | - Yong Jin Lee
- Division of RI Application, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Min-Hyun Park
- Department of Otorhinolaryngology, Boramae Medical Center, Seoul Metropolitan Government-Seoul National University, Seoul, South Korea.,Department of Otorhinolaryngology, College of Medicine, Seoul National University, Seoul, South Korea
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28
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Barriers to help-seeking for memory problems in older adults. Eur Geriatr Med 2020; 11:1027-1033. [PMID: 32720158 PMCID: PMC7716933 DOI: 10.1007/s41999-020-00371-6] [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: 03/24/2020] [Accepted: 07/15/2020] [Indexed: 11/25/2022]
Abstract
Aim The aim of this study was to investigate potential barriers to help-seeking for memory problems as well as outreach to providers. Findings Participants who endorsed having hearing problems were the most likely to endorse barriers to help-seeking as well as speaking to a physician. Message Physicians and healthcare agencies can work to design outreach for persons who experience barriers, particularly hearing loss. Purpose Early detection of age- and disease-related cognitive problems affords patients the opportunities to receive medical treatment, engage in research, and plan for the future. Understanding help-seeking behavior has potential to aid both patients and clinicians. This study was designed to identify predictors of endorsed barriers to memory-related help-seeking as well as medical help-seeking endorsement. Methods This cross-sectional correlational study used a convenience sample of 97 older adults. The participants answered anonymous questionnaires about subjective memory, mood, and health and several items designed to investigate help-seeking for memory issues. Results Persons who endorsed multiple barriers to help-seeking were more likely to also endorse having hearing problems. In addition, participants who reported that they would not talk to a doctor or physician about memory concerns also had significantly worse subjective hearing. Conclusion Hearing loss may be a particular risk for not seeking help for memory problems. Physicians and healthcare agencies can work to design outreach for persons who experience barriers, such as hearing loss and the concomitant outcomes.
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Jiang F, Kubwimana C, Eaton J, Kuper H, Bright T. The relationship between mental health conditions and hearing loss in low‐ and middle‐income countries. Trop Med Int Health 2020; 25:646-659. [DOI: 10.1111/tmi.13393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Fan Jiang
- International Centre for Evidence in Disability London School of Hygiene & Tropical Medicine London UK
- School of Public Health Shandong University Jinan China
| | - Chris Kubwimana
- International Centre for Evidence in Disability London School of Hygiene & Tropical Medicine London UK
| | - Julian Eaton
- CBM Global and London School of Hygiene &Tropical Medicine London UK
| | - Hannah Kuper
- International Centre for Evidence in Disability London School of Hygiene & Tropical Medicine London UK
| | - Tess Bright
- International Centre for Evidence in Disability London School of Hygiene & Tropical Medicine London UK
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Gregory S, Billings J, Wilson D, Livingston G, Schilder AG, Costafreda SG. Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer's disease dementia: A qualitative study. SAGE Open Med 2020; 8:2050312120904572. [PMID: 32166027 PMCID: PMC7054731 DOI: 10.1177/2050312120904572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives: Hearing aid usage supports communication and independence; however, many do
not use their hearing aids. This study explored the experiences of hearing
aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using
thematic analysis. Ten people (six males, age range 75–86 years old) with
mild cognitive impairment or Alzheimer’s disease who had been fitted with
hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to
using hearing aids, (2) practical aspects of hearing aids, (3) benefits of
hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the
experience of using hearing aids. This population may benefit from targeted
strategies to support use of hearing aids. The findings from this study can
inform future research to optimise use of hearing aids in this
population.
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Affiliation(s)
- Sarah Gregory
- Centres for Dementia Prevention and Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Danielle Wilson
- Oxford Imaging Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
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Gyanwali B, Hilal S, Venketasubramanian N, Chen C, Loo JHY. Hearing handicap in Asian patients with dementia. Am J Otolaryngol 2020; 41:102377. [PMID: 31864727 DOI: 10.1016/j.amjoto.2019.102377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/09/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hearing loss and hearing handicap may contribute to cognitive impairment and dementia. The purpose of this study was to analyze the association between hearing loss and hearing handicap with dementia in an Asian memory clinic parents. METHODS This study includes the data obtained from patients with mild dementia who attended the National University hospital memory clinic and non-demented healthy subjects among spouses and caregivers who are non-genetically related to our patients. All participants underwent comprehensive physical, medical, neuropsychological and audiological assessments (i.e. pure tone audiometry - PTA). Disabling hearing loss was defined as a hearing loss of >40 dB in the better ear on PTA. Amsterdam Inventory for Auditory Disability and Handicap (AIADH) questionnaire was administered through the verbal interview to measure their hearing handicap score. Linear regression models were used to investigate the association between hearing loss and hearing handicap with dementia. Mean differences (β) with 95% confidence intervals (CI) were calculated. RESULTS 91 participants (65-90 years old) were recruited for this study; 39 of them were patients with dementia and 52 were non-demented healthy controls. 48.7% of the patients with dementia had disabling hearing loss, which is higher than the non-demented controls (25.0%) (p = 0.019). The significant association between hearing handicap (as measured by AIADH) and dementia was observed, which was independent of demographic factors and audiology related history and PTA average (β = -6.40; 95% CI =0.11.99, -0.81, p = 0.025). There was no independent association between hearing loss and dementia (p > 0.05). CONCLUSION A significant association between hearing handicap and dementia was found. The mechanism of this association requires further research and may involve higher order central processing disorder.
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Yang AN, Wang XL, Rui HR, Luo H, Pang M, Dou XM. Neuropsychiatric Symptoms and Risk Factors in Mild Cognitive Impairment: A Cohort Investigation of Elderly Patients. J Nutr Health Aging 2020; 24:237-241. [PMID: 32003417 DOI: 10.1007/s12603-020-1312-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) have been shown to affect the progression and development of Alzheimer's disease (AD) in the elderly. However, the published data are still controversial and limited in large cohort-based NPS study. AIM To explore the potential relationship between NPS and mild cognitive impairment (MCI) among the elderly of Chinese community. METHODS A total of 465 Chinese community-dwelling elderly (age ≥ 60 years) with mild cognitive impairment (MCI) were recruited into this investigation. At baseline, enrolled participants were assessed for Clinical Dementia Rating (CDR), mini-psychiatric examination. They were also subjected to categorical language fluency test, list learning and delayed recall. We assessed the NPS severity by Neuropsychological Inventory (NPI). The global cognitive status (GCS) of the participants at the end of the 3-year study period were measured with the CDR. RESULTS Approximately 41.6% of subjects had 1 or more NPS (total NPI score ≥ 1) at baseline. The most common NPSs were nocturnal behavior (20.8%), depression (17.3%), apathy (12.7%) and anxiety (13.2%). At the end of 3-year follow-up, 26.9% of baseline depressed patients developed AD, while 15.2% of baseline non-depressed patients developed AD (χ2 = 4.86, P=0. 04). Abnormal motor behavior was significantly correlated with cognitive deterioration as well (χ2 = 5.75, P=0. 03). Logistic regression analysis revealed that depression was considered as a risk factor for AD progression at baseline (95% CI: 1.12-5.67, OR=2.37, P=0.03). CONCLUSIONS Depression may be an independent factor representing early neurodegeneration in elder patients with MCI. Further studies are warranted to assess whether effective management of NPS promotes the cognitive functions.
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Affiliation(s)
- A-N Yang
- Xin-Man Dou, Lanzhou University Second Hospital, China, E-Mail:
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Michalowsky B, Hoffmann W, Kostev K. Association Between Hearing and Vision Impairment and Risk of Dementia: Results of a Case-Control Study Based on Secondary Data. Front Aging Neurosci 2019; 11:363. [PMID: 31920631 PMCID: PMC6933300 DOI: 10.3389/fnagi.2019.00363] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/11/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction: Hearing and vision loss are highly prevalent in elderly adults, and thus frequently occur in conjunction with cognitive impairments. Studies have shown that hearing impairment is associated with a higher risk of dementia. However, evidence concerning the association between vision loss and dementia, as well as the co-occurrence of vision and hearing loss and dementia, has been inconclusive. Objectives: To assess the association between: (i) either hearing or vision loss and the risk of dementia, as well as between; and (ii) the combination of both sensory impairments and the risk of dementia. Methods: This case-control study was based on a 5-year data set that included patients aged 65 years and older who had initially been diagnosed with dementia diseases by one of 1,203 general practitioners in Germany between January 2013 and December 2017. In total, 61,354 identified dementia cases were matched to non-dementia controls, resulting in a sample size of 122,708 individuals. Hearing loss and vision loss were identified using the ICD-10 diagnoses documented in the general practitioners' files prior to the initial dementia diagnosis. Multivariate logistic regression models were fitted to evaluate the associations between visual and/or hearing impairment and the risk of dementia and controlled for sociodemographic and clinical variables. Results: Hearing impairment was documented in 11.2% of patients with a dementia diagnosis and 9.5% of patients without such a diagnosis. Some form of vision impairment was documented in 28.4% of patients diagnosed with dementia and 28.8% of controls. Visual impairment was not significantly associated with dementia (OR = 0.97, CI = 95% 0.97-1.02, p = 0.219). However, patients with hearing impairment were at a significantly higher risk of developing dementia (OR = 1.26, CI = 95% 1.15-1.38, p < 0.001), a finding that very likely led to the observed significant association of the combination of both visual and hearing impairments and the risk of dementia (OR = 1.14, CI = 95% 1.04-1.24, p = 0.005). Discussion: This analysis adds important evidence that contributes to the limited body of knowledge about the association between hearing and/or vision loss and dementia. It further demonstrates that, of the two, only hearing impairment affects patients' cognition and thus contributes to dementia risk.
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Affiliation(s)
- Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE) Site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald (UMG), Greifswald, Germany
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Cousins RPC. Medicines discovery for auditory disorders: Challenges for industry. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3652. [PMID: 31795652 DOI: 10.1121/1.5132706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Currently, no approved medicines are available for the prevention or treatment of hearing loss. Pharmaceutical industry productivity across all therapeutic indications has historically been disappointing, with a 90% chance of failure in delivering a marketed drug after entering clinical evaluation. To address these failings, initiatives have been applied in the three cornerstones of medicine discovery: target selection, clinical candidate selection, and clinical studies. These changes aimed to enable data-informed decisions on the translation of preclinical observations into a safe, clinically effective medicine by ensuring the best biological target is selected, the most appropriate chemical entity is advanced, and that the clinical studies enroll the correct patients. The specific underlying pathologies need to be known to allow appropriate patient selection, so improved diagnostics are required, as are methodologies for measuring in the inner ear target engagement, drug delivery and pharmacokinetics. The different therapeutic strategies of protecting hearing or preventing hearing loss versus restoring hearing are reviewed along with potential treatments for tinnitus. Examples of current investigational drugs are discussed to highlight key challenges in drug discovery and the learnings being applied to improve the probability of success of launching a marketed medicine.
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Affiliation(s)
- Rick P C Cousins
- University College London Ear Institute, University College London, London, WC1X 8EE, United Kingdom
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Ray M, Dening T, Crosbie B. Dementia and hearing loss: A narrative review. Maturitas 2019; 128:64-69. [DOI: 10.1016/j.maturitas.2019.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 02/05/2023]
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McRackan TR, Hand BN, Velozo CA, Dubno JR. Cochlear Implant Quality of Life (CIQOL): Development of a Profile Instrument (CIQOL-35 Profile) and a Global Measure (CIQOL-10 Global). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3554-3563. [PMID: 31479616 PMCID: PMC6808347 DOI: 10.1044/2019_jslhr-h-19-0142] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Purpose Valid, reliable, and efficient patient-reported outcome measures are needed to quantify quality of life (QOL) outcomes after cochlear implantation to supplement information obtained from performance-based outcomes. We previously developed the Cochlear Implant Quality of Life (CIQOL) item bank to serve as the source of items for subsequent instruments. This study reports the development and psychometric properties for 2 of these new instruments, the CIQOL-35 Profile and the CIQOL-10 Global. Method Cochlear implant (CI) users referred from the CIQOL Development Consortium (n = 371), consisting of 20 CI centers across the United States, provided responses to the 81-item CIQOL item bank, which are grouped into 6 QOL domains (communication, emotional, entertainment, environment, listening effort, and social). Responses to the 81 CIQOL items were analyzed using item response theory to determine individual item difficulty, discrimination, and model fit to select the set of items for the profile instrument and global measure that would optimize their measurement characteristics. Results The 35-item CIQOL-35 Profile instrument assesses outcomes represented in the 6 domains of the CIQOL final item pool. The 10-item CIQOL-10 Global measure produces a single, overall QOL score. After ensuring the upper and lower ends of the item difficulty continuum were represented (item difficulty range: -2.48 to 2.47), the items with the highest discrimination ability for each domain were selected for the CIQOL-35 Profile instrument (discrimination range: 0.67-1.37). Items were selected for the CIQOL-10 Global measure in a similar manner. Conclusion The CIQOL-35 Profile and CIQOL-10 Global instruments provide psychometrically sound and efficient measures that can be used to assess QOL in adult CI users in both clinical and research settings. Supplemental Material https://doi.org/10.23641/asha.9745010.
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Affiliation(s)
- Theodore R. McRackan
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston
| | - Brittany N. Hand
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | | | - Craig A. Velozo
- Division of Occupational Therapy, Medical University of South Carolina, Charleston
| | - Judy R. Dubno
- Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, Charleston
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Abstract
Hearing loss is one of the most common yet unrecognized impairments experienced by adults, especially as they age. Mental health investigators and practitioners require better understanding of hearing loss, its association with psychiatric disorders, and the treatment of these disorders in the presence of hearing loss as well as the treatment of hearing loss itself. In this review, the authors briefly explore the global burden of hearing loss. Next we provide an overview of the extant literature on hearing loss associated with cognitive impairment, depression, anxiety disorders, psychoses, and quality of life with attention focused on the strength of the association, possible mechanisms explaining the association, data on treatment options specific to these disorders, and future research opportunities for these disorders. Current approaches to the treatment of hearing loss are presented, including hearing aids, rehabilitation including psychotherapies, surgical procedures (specifically cochlear implants), and induction loops connected to telecoils. Finally, cutting edge research into the pathophysiology and potential biological treatments of hearing loss is described.
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Affiliation(s)
- Dan G Blazer
- Department of Psychiatry and Behavioral Sciences,Duke University School of Medicine, Duke University Medical Center,Durham, NC 27710 Box 3003,USA
| | - Debara L Tucci
- Division of Head and Neck Surgery and Communication Sciences, Department of Surgery,Duke University School of Medicine,Durham, NC 27710 Box 3003,USA
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Bott A, Meyer C, Hickson L, Pachana NA. Can adults living with dementia complete pure-tone audiometry? A systematic review. Int J Audiol 2019; 58:185-192. [PMID: 30663914 DOI: 10.1080/14992027.2018.1550687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE It is estimated that over 60% of adults with dementia will also have a hearing impairment, resulting in a dual sensory-cognitive communication disability. Hearing interventions may lessen the impact of hearing impairment on a communication disability; yet, for audiologists to recommend appropriate hearing interventions, the individual's hearing thresholds must first be accurately established. The gold standard test for establishing hearing thresholds is pure-tone audiometry (PTA). However, the ability of adults with dementia to successfully complete PTA is uncertain. This systematic review examined studies of adults with dementia to better determine the proportion who could complete PTA. DESIGN Systematic review. STUDY SAMPLE Studies were included that assessed hearing in older adults who were reported as having mild and greater dementia. From a total of 1,237 eligible studies, only three were found to meet all inclusion criteria. RESULTS Across these three studies, the proportion of adults with dementia who could successfully complete PTA ranged from 56% to 59%. CONCLUSIONS Further research is needed in this area, particularly for adults with moderate and severe stages of dementia. Future research should also consider the feasibility of complementary, non-behavioural hearing tests. This systematic review was registered with the PROSPERO database, registration number CRD42017073041.
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Affiliation(s)
- Anthea Bott
- a The HEARing Cooperative Research Centre , Melbourne , Australia.,b School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia
| | - Carly Meyer
- a The HEARing Cooperative Research Centre , Melbourne , Australia.,b School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia
| | - Louise Hickson
- a The HEARing Cooperative Research Centre , Melbourne , Australia.,b School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia
| | - Nancy A Pachana
- c School of Psychology, The University of Queensland , Brisbane , Australia
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Mamo SK, Reed NS, Price C, Occhipinti D, Pletnikova A, Lin FR, Oh ES. Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:2589-2603. [PMID: 30304320 PMCID: PMC6428235 DOI: 10.1044/2018_jslhr-h-18-0077] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/17/2018] [Accepted: 06/06/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population. METHOD A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools. RESULTS Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems. CONCLUSION Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.
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Affiliation(s)
| | - Nicholas S. Reed
- Johns Hopkins University Center on Aging and Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | | | - Frank R. Lin
- Johns Hopkins University Center on Aging and Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Mittal R, Patel AP, Nguyen D, Pan DR, Jhaveri VM, Rudman JR, Dharmaraja A, Yan D, Feng Y, Chapagain P, Lee DJ, Blanton SH, Liu XZ. Genetic basis of hearing loss in Spanish, Hispanic and Latino populations. Gene 2018; 647:297-305. [PMID: 29331482 PMCID: PMC5806531 DOI: 10.1016/j.gene.2018.01.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 01/02/2018] [Accepted: 01/06/2018] [Indexed: 12/13/2022]
Abstract
Hearing loss (HL) is the most common neurosensory disorder affecting humans. The screening, prevention and treatment of HL require a better understanding of the underlying molecular mechanisms. Genetic predisposition is one of the most common factors that leads to HL. Most HL studies include few Spanish, Hispanic and Latino participants, leaving a critical gap in our understanding about the prevalence, impact, unmet health care needs, and genetic factors associated with hearing impairment among Spanish, Hispanic and Latino populations. The few studies which have been performed show that the gene variants commonly associated with HL in non-Spanish and non-Hispanic populations are infrequently responsible for hearing impairment in Spanish as well as Hispanic and Latino populations (hereafter referred to as Hispanic). To design effective screening tools to detect HL in Spanish and Hispanic populations, studies must be conducted to determine the gene variants that are most commonly associated with hearing impairment in this racial/ethnic group. In this review article, we summarize gene variants and loci associated with HL in Spanish and Hispanic populations. Identifying new genetic variants associated with HL in Spanish and Hispanic populations will pave the way to develop effective screening tools and therapeutic strategies for HL.
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Affiliation(s)
- Rahul Mittal
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Amit P Patel
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Desiree Nguyen
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Debbie R Pan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Vasanti M Jhaveri
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jason R Rudman
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Arjuna Dharmaraja
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Denise Yan
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yong Feng
- Department of Otolaryngology, Xiangya Hospital, Central South University, Changsha, China
| | - Prem Chapagain
- Department of Physics and Biomolecular Sciences Institute, Florida International University, Miami, FL, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan H Blanton
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA; Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Xue Zhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Otolaryngology, Xiangya Hospital, Central South University, Changsha, China; Tsinghua University School of Medicine, Beijing 10084, China; Dr. John T. Macdonald Foundation Department of Human Genetics and John P. Hussman Institute for Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Abstract
Hearing loss is among the most frequent problems experienced by older adults, yet psychiatrists and other clinicians often ignore the problem as an aggravation rather than recognizing that the problem might benefit from appropriate hearing health care. Many psychiatric disorders have been associated with hearing loss, including depression, schizophrenia and other psychoses, anxiety, and neurocognitive disorders. In this article, hearing loss among older adults is reviewed, with special attention directed toward the recognition and proper referral to a hearing health care provider. Finally, major advances in hearing health care are discussed.
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Affiliation(s)
- Dan G Blazer
- JP Gibbons Professor Emeritus of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3003, 3521 Hosp South, Durham, NC 27710, USA.
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Abstract
Presbycusis, or age-related hearing loss (ARHL), is the result of physiologic and pathologic changes associated with advancing age. ARHL presents typically with a high-frequency hearing loss, which contributes to greater trouble hearing consonants within words. Consonants convey the bulk of meaning within a word, and this loss of linguistic information results in complaints associated with ARHL. Hearing aids and cochlear implants significantly improve the lives of older adults with hearing loss, in particular, those with depression and dementia. Successful current research in gene therapy, pharmacotherapy, and stems cells holds the promise of being able to restore native cochlear function.
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Affiliation(s)
- Rohan Patel
- Drexel University College of Medicine, 2900 West Queen Lane, Philadelphia, PA 19129, USA
| | - Brian J McKinnon
- Departments of Otolaryngology-Head and Neck Surgery and Neurosurgery, 219 North Broad Street, 10th Floor, Philadelphia, PA 19107, USA.
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Differential associations between sensory loss and neuropsychiatric symptoms in adults with and without a neurocognitive disorder. Int Psychogeriatr 2018; 30:261-272. [PMID: 28724467 DOI: 10.1017/s1041610217001120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To investigate the differential associations between sensory loss and neuropsychiatric symptoms among older adults with and without diagnosed neurocognitive disorder. METHODS The sample comprised 1,393 adults (52.3% men) aged between 72 and 79 years from a community-based cohort study. There were 213 cases of mild and 64 cases of major neurocognitive disorders. The main outcome was number of informant reported symptoms on the Neuropsychiatric Inventory (NPI). Sensory loss was defined by visual acuity worse the 0.3 logMAR (6/12 or 20/40) and self-reported hearing problems. RESULTS Clinically relevant NPI symptoms were reported in 182 (13.1%) participants, but no individual symptom occurred in more than 5% of the total sample. Among participants diagnosed with a major neurocognitive disorder, those with any sensory loss had over three times (95%CI: 1.72-11.78) greater rates of NPI symptoms than those with unimpaired levels of sensory functioning. There were no differences in the number of neuropsychiatric symptoms by type of sensory loss, and no additional risk associated with a dual sensory loss compared to a single sensory loss. There was no evidence of an association between sensory loss and number of neuropsychiatric symptoms among cognitively healthy adults. CONCLUSIONS The extent to which this association is the result of underlying neuropathology, unmet need, or interpersonal factors is unclear. These findings have significant implications for dementia care settings, including hospitals and respite care, as patients with sensory loss are at increased risk of neuropsychiatric symptoms and may require additional psychosocial support. Interventions to manage sensory loss and reduce the impact of sensory limitations on neuropsychiatric symptoms are needed.
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Mukari SZMS, Ishak WS, Maamor N, Wan Hashim WF. A Preliminary Study Investigating the Association Between Hearing Acuity and a Screening Cognitive Tool. Ann Otol Rhinol Laryngol 2017; 126:697-705. [DOI: 10.1177/0003489417727547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Siti Zamratol-Mai Sarah Mukari
- Institute of Ear, Hearing and Speech, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Wan Syafira Ishak
- Institute of Ear, Hearing and Speech, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
- Audiology Program, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Nashrah Maamor
- Institute of Ear, Hearing and Speech, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
- Audiology Program, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Wan Fazlina Wan Hashim
- Audiology Program, School of Rehabilitation Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
- Hospital Canselor Tuanku Muhriz, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
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Mamo SK, Oh E, Lin FR. Enhancing Communication in Adults with Dementia and Age-Related Hearing Loss. Semin Hear 2017; 38:177-183. [PMID: 28522892 DOI: 10.1055/s-0037-1601573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
For many adults with dementia, age-related hearing loss is undiagnosed and/or untreated. Untreated hearing loss can exacerbate common dementia-related behavioral symptoms, such as depression, apathy, agitation. Despite the potential benefits to the individual and the family, pursuing and adopting hearing aids for persons with dementia presents with many challenges. As such, this group of vulnerable older adults is well suited for alternative approaches that adopt an interventional audiology framework. This article reviews alternative hearing care models that we have tested when working with older adults with cognitive impairments. We have found that some individuals show improvements in dementia-related problem behaviors and/or in measures of social engagement after brief aural rehabilitation interventions that provide non-custom amplification. We have developed simple training materials to help family and professional caregivers use communication strategies and non-custom amplification. Providing services that can be integrated into the person's broader dementia care has the potential to improve communication and quality of life for individuals and families. There are opportunities in this population to provide basic, simple strategies and make substantial improvements as long as we adopt approaches that bring the services to the people, instead of bringing the people to us in the audiology clinic.
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Affiliation(s)
- Sara K Mamo
- Communication Disorders Department, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts
| | - Esther Oh
- Department of Otolaryngology-Head/Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Frank R Lin
- Department of Otolaryngology-Head/Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of (Geriatric) Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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