Vision and hearing impairments are associated with depressive--anxiety syndrome in Italian elderly

Factors related to preoperative anxiety in older patients with sensory impairment: A cross-sectional study

AIM

To identify the factors related to preoperative anxiety in older adults with sensory impairment.

DESIGN

Descriptive quantitative research design.

METHODS

Study participants were 120 older adults admitted to a tertiary hospital in Seoul, South Korea to undergo eye or ear surgery. Data were collected from 11 February to 30 April 2023. The collected data were analysed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis using SPSS 28.0. The study was reported following the STROBE checklist.

RESULTS

Preoperative anxiety differed significantly according to gender (p = .002), average monthly household income (p < .001), subjective health status (p = .003), subjective vision loss (p = .004), one-sided or both-sided eye discomfort (p = .002), use of glasses (p = .010), subjective hearing loss (p = .022) and anxiety coping mechanisms (p < .001). The results of a multiple regression analysis on the significant variables identified that gender (β = .178, p = .036) and anxiety coping mechanisms (β = .336, p < .001) had the most significant effect on preoperative anxiety, with an explanatory power of 34.5%.

CONCLUSION

The development and practical application of tailored nursing interventions catering to specific genders and anxiety coping mechanisms would contribute to reducing preoperative anxiety and providing efficient nursing care for older adults with sensory impairment.

Longitudinal analysis of anxiety and sleep disorders in the Korean population with disabilities, from 2006 to 2017: Incidence, prevalence, and association with disability type and severity

BACKGROUND

Individuals with disabilities often face a higher risk of concurrent psychological problems, yet comprehensive assessments of the anxiety and sleep disorders in this population remain limited. This study examined longitudinal trends in the incidence and prevalence of anxiety and sleep disorders among people with disabilities and explored their associations with disability type and severity.

METHODS

Utilizing claim data from the National Health Insurance database and the National Disability Registry, which cover the entire Korean population, we estimated the age-standardized incidence and prevalence of anxiety and sleep disorders between 2006 and 2017. Logistic regression was used to analyze the associations between disability type and severity and these disorders.

RESULTS

The unadjusted incidence and prevalence of anxiety and sleep disorders were consistently higher among individuals with disabilities during the study period. A significant gap in the prevalence of these disorders persisted between individuals with and without disabilities in both sexes, even after accounting for socioeconomic status and comorbidities. However, the incidence showed mixed results, with some categories of disabilities showing lower likelihood of developing the conditions compared to individuals without disabilities.

CONCLUSIONS

Actions should also be taken to identify undiagnosed cases of anxiety and sleep disorders among individuals with disabilities. Moreover, individuals with disabilities who are diagnosed with these disorders should be more actively managed to avert the progression to the chronic stage.

Effect of the Mediterranean Diet (MeDi) on the Progression of Retinal Disease: A Narrative Review

Worldwide, the number of individuals suffering from visual impairment, as well as those affected by blindness, is about 600 million and it will further increase in the coming decades. These diseases also seriously affect the quality of life in working-age individuals. Beyond the characterization of metabolic, genetic, and environmental factors related to ocular pathologies, it is important to verify how lifestyle may participate in the induction of the molecular pathways underlying these diseases. On the other hand, scientific studies are also contributing to investigations as to whether lifestyle could intervene in modulating pathophysiological cellular responses, including the production of metabolites and neurohormonal factors, through the intake of natural compounds capable of interfering with molecular mechanisms that lead to ocular diseases. Nutraceuticals are promising in ameliorating pathophysiological complications of ocular disease such as inflammation and neurodegeneration. Moreover, it is important to characterize the nutritional patterns and/or natural compounds that may be beneficial against certain ocular diseases. The adherence to the Mediterranean diet (MeDi) is proposed as a promising intervention for the prevention and amelioration of several eye diseases. Several characteristic compounds and micronutrients of MeDi, including vitamins, carotenoids, flavonoids, and omega-3 fatty acids, are proposed as adjuvants against several ocular diseases. In this review, we focus on studies that analyze the effects of MeDi in ameliorating diabetic retinopathy, macular degeneration, and glaucoma. The analysis of knowledge in this field is requested in order to provide direction on recommendations for nutritional interventions aimed to prevent and ameliorate ocular diseases.

Functional Status in Relation to Common Geriatric Syndromes and Sociodemographic Variables - A Step Forward Towards Healthy Aging

Purpose

Geriatric syndromes (GS) are prevalent in the older population, with an impact on morbidity and disability. This study aimed to investigate the prevalence of functional dependence and ten GS in community older adults and to examine the different associations between these syndromes and sociodemographic variables and their impact on functional dependence.

Patients and Methods

A cross-sectional study of 342 outpatients seen at the geriatric clinic in the period 2015-2023.

Results

The mean age was 75±7.4. One-third had functional dependence and 96.2% had at least one GS. The mean number of GS was 3.11±1.74, ranging from 2.56±1.67 in the 60s to 3.55±1.70 in octogenarians. The most common GS found were polypharmacy (79.5%), musculoskeletal pain (49.7%), and Major Neurocognitive Disorder (MND) (32.7%). Polypharmacy was significantly associated with female sex and chronic pain, whereas sensory impairment was associated with male sex. MND, dizziness, and urinary incontinence were the only GS that significantly predicted functional dependence and were typically associated with increasing age.

Conclusion

Functional dependence increases as individuals age, paralleled by increases in MND, urinary incontinence, dizziness, sensory impairment, and constipation. Notably, only MND, incontinence, depression, and dizziness were significant predictors of functional dependence. Consequently, it is imperative to screen older adults presenting with these syndromes for early signs of functional decline to optimize their function and avert subsequent dependence, morbidity, and mortality.

Vision Impairment and Psychosocial Function in US Adults

Importance

Vision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic.

Objective

To provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older.

Design, Setting, and Participants

This was a cross-sectional analysis of the National Health and Aging Trends Study round 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and older. Binocular distance visual acuity, near visual acuity, and contrast sensitivity were tested. Objectively measured vision impairment was defined as having vision impairment in either distance visual acuity (worse than 20/40), near visual acuity (worse than 20/40), or contrast sensitivity (worse than 1.55 logCS). Self-reported vision impairment was defined based on participants' report on their vision status. Data were analyzed in May 2023.

Main Outcomes and Measures

Depressive and anxiety symptoms assessed via the Patient Health Questionnaire. Social isolation was defined based on living arrangement, communication frequency, and activity participation responses.

Results

Among 2822 community-dwelling adults sampled from a population of 26 182 090, the mean (SD) age was 78.5 (5.6) years; 1605 individuals (54.7%) were female; 1077 (32.3%) had objectively measured vision impairment, and 203 (6.4%) had self-reported vision impairment. In adjusted models, all outcomes were significantly associated with objectively measured vision impairment, including depressive symptoms (odds ratio [OR], 1.81; 95% CI, 1.26-2.58), anxiety symptoms (OR, 1.74; 95% CI, 1.13-2.67), and severe social isolation (OR, 2.01; 95% CI, 1.05-3.87). Similarly, depressive symptoms (OR, 2.37; 95% CI, 1.44-3.88) and anxiety symptoms (OR, 2.10; 95% CI, 1.09-4.05) but not severe social isolation symptoms (OR, 2.07; 95% CI, 0.78-5.49) were significantly associated with self-reported vision impairment.

Conclusions and Relevance

In this study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression and anxiety and social isolation. These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.

The effect of occupational therapy on anxiety, depression, and psychological well-being in older adults: a single-blind randomized-controlled study

PURPOSE

To evaluate the effect of occupational therapy on anxiety, depression, and psychological well-being in older adults.

METHODS

This study is a single-blind, randomized-controlled prospective experimental study conducted with 84 older adult individuals, 41 in the intervention group and 43 in the control group, in a nursing home. Occupational therapy was applied to the patients in the intervention group, and all patients were followed for a week. In the study, data were collected using the Participant Information Form, Geriatric Anxiety Scale, Psychological Well-Being Scale, and Geriatric Depression Scale.

RESULTS

The mean age of the participants was 68 years in the intervention group and 70 years in the control group. While 65.9% of the participants in the experimental group were male, 65.1% of the control group was male. The post-test anxiety scores of the participants were lower in the intervention group than in the control group (7.0 ± 4.2 vs. 16.7 ± 10.9) (p < 0.001). The post-test psychological well-being scores of the participants were higher in the intervention group than in the control group (47.9 ± 6.8 vs. 38.4 ± 6.5) (p < 0.001). There was no statistically significant difference between the depression scores of the intervention group and the control group (6.9 ± 3.7 vs. 6.2 ± 5.4) (p = 0.468).

CONCLUSIONS

In this study, it was determined that after occupational therapy was applied to older adults, their anxiety decreased and their psychological well-being increased, while there was no statistically significant difference in their depression levels. Occupational therapy, with a focus on decreasing anxiety, is a potential approach that can improve older adults' health, psychological well-being, and coping skills.

CLINICALTRIALS

GOV ID

NCT05576558.

The prevalence and determinant factors of substance use among the youth in Ethiopia: A multilevel analysis of Ethiopian Demographic and Health Survey

Background

In Ethiopia, the youth are more exposed to substances such as alcohol, Khat, and tobacco than other populations. Despite the seriousness of the situation, low- and middle-income nations, particularly Ethiopia, have intervention gaps. Service providers must be made more aware of relevant evidence to combat these problems. This research focused on finding out how common substance abuse is among teenagers and the factors that influence it.

Methods

The 2016 Ethiopian Demographic and Health Survey data were used for secondary data analysis. This survey includes all young people aged 15 to 24 years. The total sample size was 10,594 people. Due to the hierarchical nature of the survey data, a multilevel logistic regression model was employed to uncover the individual- and community-level characteristics related to substances.

Results

In Ethiopia, the overall current prevalence of occasional or daily substance use 30 days prior to the survey was 46.74%. Of the participants, 36.34, 12.56, and 0.95% were drinking alcohol, chewing Khat, and smoking cigarettes/any tobacco products, respectively. Male sex, 20-24 years of age, exposure to media, having a job, and living in large central and metropolitan regions were the factors associated with the problem.

Conclusion

According to the 2016 EDHS, substance use among young people is widespread in Ethiopia. To lower the prevalence of substance use among youth, policymakers must increase the implementation of official rules, such as restricting alcohol, Khat, and tobacco product marketing to minors, prohibiting smoking in public places, and banning mass-media alcohol advertising. Specific interventions targeting at-risk populations, such as youth, are mainly required in prominent central and metropolitan locations.

Dietary supplements in retinal diseases, glaucoma, and other ocular conditions

Environmental pollution, inadequate eating habits and unhealthy lifestyles have led to a tremendous increase in ocular diseases worldwide. Given the costly treatments that are currently available for the most common and threatening eye diseases (such as cataract, dry eye disorder, or diabetic retinopathy), curing these diseases or preventing refractive errors by taking nutraceuticals and natural compounds that are present in our daily diet is a very valuable intervention. The eyes are the most important part of our visual system and require micronutrients such as vitamins, carotenoids, trace metals, and omega-3 fatty acids in order to function properly and to protect themselves against light-induced and age-mediated degenerative disorders. The Mediterranean Diet (MedDiet) has been in the limelight since the 1980s because of the several health benefits it provides, including eye health. MedDiet is characterized by the consumption of small amounts of red meat, while emphasizing the intake of fish, eggs, nuts, legumes, citrus fruits, green vegetables, olives and their derivatives, especially olive oil, and dairy products in a proportionate manner, in order to achieve the maximum health benefits. The antioxidant, anti-inflammatory, and neuroprotective properties of these foods - both when used as an ingredient in the dietary regime or as a source of nutritional supplements - have shown promising results in the management of chronic degenerative ocular diseases, both in animal models and in human subjects. In this chapter, we will focus on the importance of MedDiet and natural compounds for the visual system and its role in slowing down age-related ocular degeneration.

Association of vision and hearing status with depressive symptoms among middle-aged and older Chinese adults

Objective

Long-term untreated vision and hearing impairments can negatively impact physical and mental wellbeing. We investigated the association of vision and hearing status with depressive symptoms among middle-aged and older Chinese adults.

Methods:

This was a prospective cohort study of 9,492 participants from the China Health and Retirement Longitudinal Study (CHARLS) carried out in 2011, 2013, 2015, and 2018. This study used self-reported vision and hearing status to determine the degree of impairment. Depressive symptoms were examined using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with a total score of ≥ 12 indicating depressive symptoms. A Cox proportional hazards model adjusted for age, sex, residence, marital status, educational level, smoking history, alcohol consumption, hypertension, diabetes, heart disease, digestive disease, arthritis, wearing glasses, and hearing aids was used to estimate the association of vision and hearing status with depressive symptoms among middle-aged and older Chinese adults.

Results:

Of the 9,492 participants [mean (SD) age at CHARLS baseline, 58.12 (9.00) years], 3,238 (34.11%) participants reported incident depressive symptoms during the 7-year follow-up period. Participants who self-reported only vision impairment [hazard ratios (HR): 1.14, 95% confidence intervals (CI): 1.05–1.24], only hearing impairment (HR: 1.24, 95% CI: 1.06–1.46), and both vision and hearing impairments (HR: 1.25, 95% CI: 1.08–1.45) were independently associated with a greater increase in the hazard risk of incident depressive symptoms compared to those without vision and hearing impairments. An increase in participants' vision and hearing scores was associated with a significant increase in the hazard risk of incident depressive symptoms (HR: 1.04, 95% CI: 1.03–1.06).

Conclusion:

Vision and hearing status was associated with increased depressive symptoms among middle-aged and older Chinese adults during the 7-year follow-up period. Participants' use of glasses and hearing aids did not improve their depressive symptoms. Our findings may facilitate the development of effective treatments to prevent and treat vision and hearing impairments, thereby enhancing the physical and mental wellbeing of middle-aged and older adults.

Associations of self-reported vision impairment with depression symptoms among middle-aged and older Chinese

BACKGROUND

Vision impairment (VI) and depression are highly prevalent among adults. However, few nationally representative studies from China on the self-reported VI and its association with depression symptoms.

AIMS

This study re-estimated the relationship between self-reported VI and depression symptoms.

METHODS

In this analysis, 62,525 respondents from the China Health and Retirement Longitudinal Study 2011-2018 were included. Based on self-reports, respondents with VI were allocated to distance VI (DVI), near VI (NVI), both distance and near VI (DNVI), or a blindness group. Multivariable pooled logistic regression models were used to evaluate the groups' odds ratios (ORs) for depression symptoms and self-reported VI.

RESULTS

Overall, 35.9% of the respondents were self-reported VI. DVI (OR: 1.51, 95% confidence interval [95% CI]: 1.28-1.79) and DNVI (OR: 1.51, 95% CI: 1.21-1.88) showed the highest ORs for depression symptoms, followed by NVI (OR: 1.31, 95% CI: 1.11-1.54). Depression symptoms were associated with a significantly increased risk of DVI (OR: 1.49, 95% CI: 1.26-1.76), DNVI (OR: 1.49, 95% CI: 1.20-1.86), and NVI (OR: 1.29, 95% CI: 1.10-1.52), respectively. However, these associations between self-reported blindness and depression symptoms were not significant. All models provided similar results by excluding respondents aged 45-59 years.

CONCLUSION

Self-reported DVI, NVI, and DNVI are associated with depression symptoms. A strong reverse association was found between depression and self-reported DVI, NVI, and DNVI, but not for blindness. Our findings emphasize the urgent need for depression screening for self-reported VI among Chinese adults.

Hearing loss, depression and social participation of older adults: Evidence from the China health and retirement longitudinal study

AIM

Hearing loss and depression in older adults are associated with a lower social participation rate. However, few studies have thoroughly analyzed the relationship between them.

METHODS

The data were obtained from the China Health and Retirement Longitudinal Study carried out in 2011, 2013 and 2015, and data from 24 306 participants ranging in age from 50 to 80 years were used in this study. Hearing loss, depression and social participation were assessed by self-reported hearing status, the 10-item Center for the Epidemiological Studies of Depression Short Form, and self-reported social participation activity types and frequency. The fixed effects logistic regression and random effects logistic regression were used to examine the relationship between hearing loss and social participation. The Sobel method was used to explore the relationship between hearing loss, depression and social participation.

RESULTS

Compared with older adults without hearing loss, persons with hearing loss engaged in significantly fewer types of activities (β = -0.070, 95% CI -0.109, -0.031, P < 0.001) and at a lower frequency (β = -0.176, 95% CI -0.260, -0.093, P < 0.001). Depression significantly existed in the relationship between hearing loss and social participation as a mediating variable, and the percentage of indirect effects in this relationship were 16.5% and 20.8%.

CONCLUSIONS

The findings of this study suggest that when facing an aging society, improving the hearing status of older adults should be considered by policymakers. More efforts should be made to help older adults cope with depression. Geriatr Gerontol Int 2022; ••: ••-••.

Visual and hearing impairment and their association with depression among middle-aged and older individuals in India: Evidence from a cross-sectional study

OBJECTIVE

The aim of the study was to determine the prevalence and associated factors of visual and hearing impairment as well as to investigate their association with depression among individuals aged 45 and above in India.

METHODS

The study utilized data from the Longitudinal Ageing Study in India (LASI) Wave 1, (2017-18). The total sample size of this study was 65,562 individuals aged 45 and above. Descriptive statistics along with bivariate and multivariable analyses were performed to fulfill the objectives.

RESULTS

The prevalence of visual impairment in the study population was 32.1 percent, whereas the prevalence of self-reported hearing impairment was 6.9 percent. In the logistic regression models, both visual impairment [Adjusted odds ratio (AOR)-1.06; 95% Confidence interval (CI):0.99-1.14] as well as hearing impairment [AOR-1.25; 95% CI:1.11-1.41] were found to be significantly associated with depression. Moreover, individuals with a single impairment were 8 percent [AOR-1.08; 95% CI: 1.01-1.16] and individuals with dual impairment were 36 percent [AOR-1.36; 95% CI:1.13-1.65] significantly more likely to have depression.

CONCLUSION

Individuals with sensory impairment were more likely to suffer from depression and the risk was significantly higher among individuals with dual impairment. Therefore, clinicians dealing with individuals with sensory impairments must be aware of the likelihood of comorbid depression in order to provide timely screening and treatment.

The Association between Vision Impairment and Depression: A Systematic Review of Population-Based Studies

We conducted a systematic review and meta-analysis to investigate whether depression is associated with vision impairment (VI) in population-based studies in adults. MEDLINE and EMBASE were searched, from inception to June 2020. Studies were included if they provided two-by-two data for calculating the OR of association between VI and depression, or crude and/or an adjusted odds ratio (OR) with a corresponding 95% confidence interval (CI) were reported. The proportion of VI and depression was also extracted. ORs were pooled using random-effect models, proportions were pooled using random intercepts logistic regression models. Overall, 29 articles (31 studies) were included: of those, 18 studies used survey data (622,312 participants), 10 used clinical examination data (69,178 participants), and 3 used administrative databases (48,162,290 participants). The proportion of depression (95%CI) was 0.17 (0.13-0.22) overall and 0.27 (0.21-0.33) in VI subjects. The proportion of VI was 0.10 (0.07-0.16) overall and 0.20 (0.13-0.29) in depressed subjects. The association between VI and depression was direct: crude ORs were 1.89 (1.51-2.37) for survey data, 2.17 (1.76-2.67) for clinical examination data, and 3.34 (1.01-11.11) for administrative databases; adjusted ORs were 1.75 (1.34-2.30), 1.59 (1.22-1.96), and 2.47 (0.97-6.33), respectively. In conclusion, VI and depression are prevalent morbidities and should be actively sought when either is identified, especially in older adults.

Longitudinal Associations of Self-Reported Visual, Hearing, and Dual Sensory Difficulties With Symptoms of Depression Among Older Adults in the United States

Evidence conflicts on the association between sensory difficulty and depression. Few studies have examined this association using longitudinal or population-based data. We used data from Rounds 1-9 of the nationally representative National Health and Aging Trends Study to evaluate the longitudinal association between self-reported visual, hearing, and dual sensory difficulties and clinically significant depressive symptoms. Multivariable Cox regression models were used to evaluate the hazard of incident depressive symptoms. Group-based trajectory modeling identified depressive symptom trajectories (DSTs). Multinomial logistic regression was used to examine the association between sensory status and DSTs. A total of 7,593 participants were included: 56.5% were female, 53.0% were 65-74 years old, 19.0% (95% CI 17.9-20.2%) had hearing, 5.6% (4.9-6.4%) had visual, and 3.3% (2.9-3.8%) had dual sensory difficulties at baseline. Hazard ratios for depressive symptoms in those with visual, hearing, and dual sensory difficulties were 1.25 (95% CI 1.00-1.56, p = 0.047), 0.98 (95% CI 0.82-1.18, p = 0.82), and 1.67 (95% CI 1.29-2.16, p < 0.001), respectively, relative to those without sensory difficulty. A model with four trajectory groups best fit the data. Group 1 (35.8% of the sample, 95% CI: 34.1-37.4) had persistently low risk of depressive symptoms; Group 2 (44.8%, 43.4-46.3) had low but increasing risk; Group 3 (7.1%, 6.2-8.3) had moderate risk; and Group 4 (12.4%, 11.5-13.3) had moderate to high risk that increased. Compared to those without sensory difficulties, individuals with each difficulty were significantly more likely to belong to a group other than Group 1. This study reveals associations between sensory difficulties and mental health that can inform public health interventions.

The prevalence of anxiety symptoms and disorders among ophthalmic disease patients

Background:

Progressive and irreversible vision loss has been shown to place a patient at risk of mental health problems such as anxiety. However, the reported prevalence of anxiety symptoms and disorders among eye disease patients vary across studies. Thus, this study aims to clarify the estimated prevalence of anxiety symptoms and disorders among ophthalmic disease patients.

Methods:

Relevant studies on the prevalence of anxiety symptoms and disorders among eye disease patients were collected through international databases, PubMed, Scopus, and Web of Science. A random-effects model was used to determine the pooled prevalence of anxiety symptoms and disorders among ophthalmic disease patients.

Results:

The 95 included studies yielded a pooled prevalence of 31.2% patients with anxiety symptoms and 19.0% with anxiety disorders among subjects with ophthalmic disease. Pediatric patients were more anxious (58.6%) than adults (29%). Anxiety symptoms were most prevalent in uveitis (53.5%), followed by dry eye disease (DED, 37.2%), retinitis pigmentosa (RP, 36.5%), diabetic retinopathy (DR, 31.3%), glaucoma (30.7%), myopia (24.7%), age-related macular degeneration (AMD, 21.6%), and cataract (21.2%) patients. Anxiety disorders were most prevalent in thyroid eye disease (TED, 28.9%), followed by glaucoma (22.2%) and DED (11.4%). When compared with healthy controls, there was a twofold increase on the prevalence of anxiety symptoms (OR = 1.912, 95% CI 1.463–2.5, p < 0.001) and anxiety disorders (OR = 2.281, 95% CI 1.168–4.454, p = 0.016).

Conclusion:

Anxiety symptoms and disorders are common problems associated with ophthalmic disease patients. Thus, comprehensive and appropriate treatments are necessary for treating anxiety symptoms and disorders among ophthalmic disease patients.

A study on stress and resilience among hearing-impaired people during the COVID-19 pandemic

AIM

The aim of the study is to determine the acute stress and psychological resilience level of people with hearing impairment during the COVID-19 pandemic and to investigate the relationship between the grade of hearing impairment, psychological resilience and perceived stress level in this period.

METHODS

A cross-sectional study. A total of 135 hearing-impaired individuals using hearing aids (study group) and 125 healthy individuals (control group) participated. The Turkish versions of the Acute Stress Symptoms Scale (ASSS) and Brief Resilience Scale (BRS) were applied to all participants. The Turkish version of Amsterdam Inventory for Auditory Disability and Handicap (T-AIADH) was also applied to the study group in addition to other scales. The presence of any difference between the groups in terms of ASSS and BRS scores was investigated.

RESULTS

There was a statistically significant difference between the control group and the study group in terms of ASSS results (Z = -4.4, P = .00). No statistically significant difference was found between the control group and the study group in terms of BRS scores (Z = -0.248, P = .804). Furthermore, T-AIADH scale was observed not to correlate either with ASSS or BRS (P > .05). In the study group, the change in income level after the pandemic, age and sex variables were determined as a significant predictor of ASSS.

CONCLUSION

Identifying risks and protective factors for hearing-impaired individuals at the early stage of the epidemic is considered to be of critical importance to predict the psychological impact of both the epidemic and the response to the COVID-19 health crisis and to reduce stress.

"Something is just not right with my hearing": early experiences of adults living with hearing loss

OBJECTIVE

To understand the psychosocial process of how adults experience hearing loss; specifically, their readiness to accept that they may have hearing loss, and the challenges and coping strategies associated with it.

DESIGN

A grounded theory methodology guided the research. A patient-orientated research approach informed the study. Thirty-nine individual interviews and six focus groups were completed.

STUDY SAMPLE

Participants included 68 individuals aged 50 years and older with self-reported hearing loss living in Newfoundland and Labrador.

RESULTS

The theoretical construct, 'Realising that something is just not quite right with my hearing' captured individuals' experiences as they gradually awakened to the fact that they had hearing loss. Three categories describe the process: (1) Rationalising suspicions, (2) Managing the invisible and (3) Reaching a turning point.

CONCLUSIONS

Many individuals do not recognise hearing loss in its early stages, although they may be already experiencing its negative effects. It is important to identify motivators to engage individuals as early as possible in their hearing health. Taking a proactive approach to hearing health can help mitigate the potential negative outcomes of hearing loss.

Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults' level of independence.

Support care needs of people with hearing and vision impairment in dementia: a European cross-national perspective

PURPOSE

Aging-related sensory impairments are among the most common and disabling comorbidities in people with dementia (PwD). This study explored the unmet support care needs (SCNs) from the perspectives of people with hearing and/or vision impairment in dementia (PwD), and their care partners in Europe.

METHODS

This was a two-phase mixed methods study. We administered standardized questionnaires of SCNs and quality of life (QoL) to PwD with hearing and/or vision impairment (n = 97), and their care partners (n = 97) in the UK, France, and Cyprus. Next, a purposive sub-sample of 34 participants (PwD and care partners) participated as focus groups (FGs) or semi-structured interviews to explore their SCNs in depth.

RESULTS

Over 94% of the participants reported unmet SCNs (median, 13 (range 5-23)). Nearly three-quarters reported SCNs in the moderate to high range, with the most prevalent unmet SCNs for PwD being in the psychological (>60%) and physical domains (>56%), followed by the need for health information (>46%). Emergent qualitative themes were: (1) the need for tailored support care interventions; (2) care burden, social isolation, and loneliness arising from the combined problems; (3) the need for adequate support from professionals from the different fields, including education around the use of sensory aids. Both study phases revealed that SCNs were highly individualized.

CONCLUSIONS

This cross-national study revealed that PwD with sensory impairment and their care partners experience a wide range of unmet SCNs, the interactions between sensory impairments, SCNs and QoL are also complex. A tailored intervention could address these unmet SCNs, including additional support with sensory aids, psychological support, more information about concurrent impairments, and joined up health systems providing care.Implications for rehabilitationA majority of participants with combined age-related hearing, vision, and cognitive impairment had unmet SCNs.The needs of care partners including the risk of loneliness and social isolation, need to be considered.Individually tailored, specific interventions for hearing, vision, and cognitive impairment should incorporate physical and psychological support, as well as education.

The Prevalence and Determinant Factors of Self-Reported Depressive Symptoms Among Elderly People with Visual Impairment Attending an Outpatient Clinic in Ethiopia

BACKGROUND

Depression among older adults with visual impairment is the commonest psychiatric problem and causes a range of effects in on disability and progression of visual health outcomes that may even end in death. In Ethiopia, there are gaps in the detection of the comorbidity of mental health problems especially depressive symptoms among those older people. This study aimed to assess the prevalence of self-reported depressive symptoms and determinant factors among the elderly people with visual impairment attending the ophthalmologic outpatient clinic.

METHODS

A group of 423 elderly people with visual impairment invited by systematic random sampling technique to took part in the interview for this cross-sectional study at Menelik II referral hospital, Addis Ababa, Ethiopia from January to June 2019. Descriptive statistics like frequency, percentage, mean and standard deviation were used to summarize the distribution of the data. Binary logistic regression analysis was employed to examine the associated factors. An adjusted odds ratio with a 95% confidence interval was used for reporting the result, and a p-value of <0.05 was considered as statistically significant.

RESULTS

The prevalence of self-reported depressive symptoms among elderly people with visual impairment was 26.7% with a 95% confidence interval (22.6-30.8). Widowhood, single and/divorced [Adjusted Odds Ratio (AOR)= 3.17, 95% CI: 1.71, 5.91]; [AOR=2.70, 95% CI: 1.35, 5.38], respectively, poor social support [AOR=4.34, 95% CI: 1.84, 10.24], severe level [AOR=2.63, 95% CI: 1.73, 6.63] and longer duration (>5 years) of the illness [AOR=3.15, 95% CI: 1.60, 6.19] were the factors significantly associated with higher odds of depressive symptoms.

CONCLUSION

The Prevalence of self-reported depressive symptoms among elderly people with visual impairment in Ethiopia was high. Public health interventions targeting risky individuals with high depressive symptoms are needed to reduce depressive symptoms and to prevent disability and poor medical illnesses outcomes related to depressive symptoms.

Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: Data From a Large Sample of Spanish Adults

OBJECTIVE

Individually, vision and hearing impairments have been linked to higher levels of anxiety and depression. We investigated the effect of dual sensory impairment (difficulty seeing and hearing) in a large representative sample of Spanish adults.

METHODS

Data from a total of 23,089 adults (age range: 15-103 years, 45.9% men) from the Spanish National Health Survey 2017 were analyzed. Self-reported difficulty of seeing and hearing (exposures), and depression and chronic anxiety (outcomes) were analyzed. Multivariable logistic regression was assessed for difficulty with vision alone, hearing alone and with difficulty with both, adjusting for gender, age, marital status, living as a couple, education, smoking, alcohol consumption, BMI, physical activity, use of glasses/contact lenses, and hearing aid.

RESULTS

Visual difficulty, hearing difficulty, and dual difficulties were all associated with significantly higher odds for depression (ORs 2.367, 2.098, and 3.852, respectively) and for chronic anxiety (ORs 1.983, 1.942, and 3.385, respectively). Dual sensory difficulty was associated with higher odds ratios for depression and anxiety when compared to either impairment alone.

CONCLUSION

Dual sensory difficulty is associated with significantly higher odds of anxiety and depression when compared to either vision or hearing difficulty alone. Appropriate interventions are needed to address any reversible causes of vision and hearing as well as anxiety and depression in people in these specific groups.

Experiences of Hearing Loss and Audiological Rehabilitation for Older Adults With Comorbid Psychological Symptoms: A Qualitative Study

Purpose There is a well-established relationship between hearing loss and psychological symptoms. To ensure audiological rehabilitation is provided appropriately for older adults with comorbid psychological symptoms, a greater understanding of their preferences and experiences is needed. This study sought to understand experiences of hearing loss and audiological rehabilitation from the perspective of older adults with comorbid psychological symptoms (e.g., depression, anxiety, psychosis). Design A qualitative study using in-depth semistructured interviews was conducted with older adults who had attended audiological rehabilitation within the last year and scored above established cutoffs on measures of depression, anxiety, and psychosis. A thematic analysis generated themes that related to participants' experiences of hearing loss and audiological rehabilitation. Results Participants included 14 older adults (eight men and six women) with an average age of 70.5 years (SD = 4.45, range: 64-80) who received hearing aids or a cochlear implant. Three major themes emerged from the analysis of participant interviews. "The cumulative impact of hearing loss and psychological symptoms" theme describes the two-way, additive relationship between hearing ability and psychological symptoms. "The experience of loss throughout hearing loss and audiological rehabilitation" captures subjective losses, the impact they have, and how participants cope with them. In contrast, "The experience of gain throughout hearing loss and audiological rehabilitation" describes the participants' reported gains, their related impacts, and coping strategies. Conclusions The experiences of participants revealed that the presence of comorbid psychological symptoms can influence the experience of hearing loss and audiological rehabilitation. These findings have implications for how audiological rehabilitation is provided to ensure optimal outcomes for adults with hearing loss and comorbid psychological symptoms. Supplemental Material https://doi.org/10.23641/asha.12985955.

Analysis on Risk Factors of Depressive Symptoms in Occupational Noise-induced Hearing Loss Patients: A Cross-sectional Study

Objective

The aim of this study was to evaluate the risk factors of depressive symptoms in occupational noise-induced hearing loss (NIHL) patients.

Methods

A total of 106 patients were divided into depressive symptoms (ONHLPD) and without depressive symptoms (non-ONHLPD) according to the Self-rating Depression Scale. Questionnaires and laboratory data were collected and analyzed. Data were analyzed with independent t-test, Wilcoxon test, Pearson correlation analysis and multiple linear regression models.

Results

The prevalence of depressive symptoms was 53.8% in occupational NIHL patients. In ONHLPD, duration of the hearing loss, level of serum cortisol, scores of Pittsburgh Sleep Quality Index and Tinnitus Handicap Inventory were all significantly higher than those of non-ONHLPD.

Conclusion

The prevalence of depressive symptoms was relatively high in occupational NIHL patients. Duration of the hearing loss, sleep quality and tinnitus severity were the risk factors for occupational NHIL patients with depressive symptoms.

Longitudinal Associations of Self-reported Vision Impairment With Symptoms of Anxiety and Depression Among Older Adults in the United States

Importance

Vision impairment (VI) and mental health conditions are highly prevalent among older adults and are major causes of morbidity and health care expenditures. However, there are few nationally representative data from the United States on the longitudinal association between VI and depressive symptoms, and no such data on anxiety symptoms.

Objective

To evaluate the longitudinal association and directionality of the association between self-reported VI and clinically significant symptoms of depression and anxiety in older US adults.

Design, Setting, and Participants

The National Health and Aging Trends Study, a nationally representative US survey administered annually from 2011 to 2016 to a cohort of Medicare beneficiaries 65 years and older. A total of 7584 participants with complete data on self-reported VI status at baseline were included. Data analysis was performed from February to October 2018.

Main Outcomes and Measures

Multivariable Cox proportional hazards regression models were used to evaluate the longitudinal associations between self-reported VI and depression and anxiety symptoms, adjusting for sociodemographics and medical comorbidities and accounting for the complex survey design.

Results

There were 7584 participants included in this study. At baseline, the survey-weighted proportion of participants who were women was 56.6%; 53.0% were aged 65 to 74 years, and 8.9% (95% CI, 8.1%-9.8%) had self-reported VI. Symptoms of depression were significantly more common in participants with self-reported VI than those without self-reported VI (31.2%; 95% CI, 27.0%-35.6% vs 12.9%; 95% CI, 11.9%-14.0%; P < .001), as were symptoms of anxiety (27.2%; 95% CI, 23.7%-30.9% vs 11.1%; 95% CI,10.2%-12.0%, P < .001). Baseline self-reported vision status was significantly associated with future report of depression (hazard ratio [HR], 1.33; 95% CI, 1.15-1.55) but not anxiety (HR, 1.06; 95% CI, 0.85-1.31) symptoms. Baseline depression (HR, 1.37; 95% CI, 1.08-1.75) and anxiety (HR, 1.55; 95% CI, 1.19-2.02) symptoms were both significantly associated with future reports of self-reported VI. In a sensitivity analysis excluding data provided by proxy respondents, statistical significance was unchanged and the effect size was similar for all statistical models.

Conclusions and Relevance

Older US adults with self-reported VI were more likely to report symptoms of depression in the future, while those who had symptoms of either depression or anxiety were more likely to report VI in the future. This investigation suggests that there is a significant bidirectional and longitudinal association between self-reported VI and mental health symptoms. Furthermore, the study suggests the need for effective strategies to screen for and address depression and anxiety among older US adults with VI.

Common mental illness in people with sensory impairment: results from the 2014 adult psychiatric morbidity survey

BACKGROUND

People with sensory impairments may be at increased risk of depression and anxiety but experience barriers to accessing treatment.

AIMS

To investigate whether people with sensory impairment have more depressive and anxiety symptoms than people without, whether this is mediated by social functioning and whether they report greater non-treatment.

METHOD

We analysed data from the English 2014 Adult Psychiatric Morbidity Survey using regression models, with the Clinical Interview Schedule-Revised (CIS-R) score as the primary outcome and self-reported hearing and vision impairment as exposures. A secondary outcome was self-reported receipt of mental health diagnosis and treatment. We used structural equation modelling to assess for mediation by social functioning.

RESULTS

A total of 19.0% of people with hearing impairment, and 30.9% and 24.5% with distance and near visual impairments, respectively, had clinically significant psychological morbidity. Adjusted mean CIS-R score was 1.86 points higher in people with hearing impairment compared with those without (95% CI 1.30-2.42, P<0.001). People with distance and near vision impairment had mean CIS-R scores 3.61 (95% CI 2.58-4.63, P<0.001) and 2.74 (95% CI 2.12-3.37, P<0.001) points higher, respectively, than those without. Social functioning accounted for approximately 50% of these relationships between sensory impairment and psychological morbidity. We found no evidence of an increased treatment gap for people with sensory impairment.

CONCLUSIONS

Social functioning, a potentially modifiable target, may mediate an association between sensory impairment and depressive and anxiety symptoms.

Assimilative and accommodative coping in older adults with and without sensory impairment: four-year change and prospective relations with affective well-being

Objectives: Sensory impaired older adults may be particularly dependent on coping strategies such as assimilation (or tenacious goal pursuit [TGP]) and accommodation (or flexible goal adjustment [FGA]) to secure high levels of well-being. We investigated if late-life changes in these coping strategies and prospective associations of TGP and FGA with affective well-being vary according to sensory impairment status. Method: Our study sample consisted of 387 adults aged 72-95 years (M = 82.50 years, SD =4.71 years) who were either visually impaired (VI; n = 121), hearing impaired (HI; n = 116), or sensory unimpaired (UI; n = 150). One hundred sixty-eight individuals were reassessed after approximately 4 years. Results: Both VI and HI revealed a decrease in TGP, whereas TGP remained stable in UI. For FGA, a significant increase in HI was observed, whereas a significant decline emerged in UI. Controlling for age, gender, and cognitive abilities, higher TGP at baseline was significantly associated with higher negative affect 4 years later in VI. Moreover, the positive association between baseline FGA and subsequent positive affect was stronger in HI than in UI older adults. Conclusion: Our findings suggest that older adults with sensory impairments reveal trajectories of assimilative and accommodative coping and associations of TGP and FGA with affective well-being that are different from sensory unimpaired individuals.

Effects of self-reported hearing or vision impairment on depressive symptoms: a population-based longitudinal study

AIMS

The aims of this study were to investigate the effects of either hearing, vision or dual sensory impairment on depressive symptoms and to identify subgroups that are vulnerable and significantly affected.

METHODS

Data from the 2006-2014 Korean Longitudinal Study of Aging (KLoSA) were used and a total of 5832 individuals were included in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D10) scale. Sensory impairment was assessed according to the levels of self-reported hearing or vision, which were categorised as either good (excellent, very good or good) or poor (fair or poor). The changes in hearing or vision from records of previous survey were investigated. Changes from good to poor, which indicates new onset, were defined as hearing impairment or vision impairment. Interactions of changes in hearing and vision were considered in the analysis. Dual sensory impairment was indicated when hearing impairment and vision impairment both developed at the same time. Demographic, socioeconomic and health-related factors were considered as potential confounders and were adjusted for in the generalised estimating equation model.

RESULTS

Individuals with hearing impairment demonstrated significantly more severe depressive symptoms [β = 0.434, standard errors (s.e.) = 0.097, p &lt; 0.001] than those who had good hearing. Those with vision impairment also showed significantly elevated depressive symptoms (β = 0.253, s.e. = 0.058, p &lt; 0.001) than those with good vision. When the interactions between hearing and vision were considered, participants with dual sensory impairment showed significantly more severe depressive symptoms (β = 0.768, s.e. = 0.197, p &lt; 0.001) than those with good hearing and vision. The effect of a single and dual sensory impairment on depressive symptoms was significant in both sexes and across age groups, except for vision impairment in male participants.

CONCLUSIONS

Hearing, vision and dual sensory impairment are significantly associated with depressive symptoms. Our results suggest that treatment or rehabilitation of either hearing or vision impairment would help prevent depression.

Self-reported participation restrictions in normal hearing individuals in thyroid ontogeny: Evidence of subclinical changes

Purpose

To verify evidence of subclinical alterations through self-reported participation restrictions in normal hearing individuals and congenital hypothyroidism patients.

Methods

An analytical, quantitative, cross-sectional exploratory study with a 1:1 ratio, consisting of a convenience sample of 86 normal hearing individuals with (n = 42) and without (n = 44) congenital hypothyroidism diagnosis. All participants underwent tonal and speech audiometry, immitance and distortion product otoacoustic emissions. The researchers excluded people with hearing loss, genetic syndromes and metabolic diseases. The instrument used for evaluate of self-reported participation restrictions was the HHIE-adapted questionnaire, composed of 25 questions, 12 of which were social domain and 13 emotional domain. Student's t-test and chi-square test were used for statistical analysis at a significance level of 5%.

Results

There was a significant (p < 0.001) self-reported participation restrictions in CH (61.9%), with a greater relevance for the social domain (p = 0.002). There was a greater frequency of mild/moderate (40.5%) and higher prevalence of association with clinical factors and adherence to treatment.

Conclusion

The findings indicate that self-reported participation restrictions in normal hearing individuals with congenital hypothyroidism was more significant than in the non-exposed group, suggesting evidence of subclinical auditory abnormalities in this population.

Health-related quality of life and related factors among older adults with visual impairments

Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group ( n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 ( SD = 0.089) and 0.827 ( SD = 0.044), respectively, ( p < .002). In the dimensions of move ( p < .05), see ( p < .001), breath ( p < .05), usual activities ( p < .001), depression ( p < .05), and distress ( p < .05), the study participants scored statistically significantly lower than the control group. However, the participants had better mental function scores (0.856 vs 0.773, p < .05). Among the participants, there was no difference in the 15D by gender (men 0.755, women 0.774, p > .05), habitation (alone 0.768, with someone 0.770, p > .05), or age ( r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.

Association of hearing loss with depression, anxiety and stress in patients suffering from Chronic Suppurative Otitis Media

OBJECTIVE

To study the correlation of hearing loss with depression, anxiety and stress in patients suffering from chronic suppurative otitis media in local population of Pakistan.

METHODS

This is a cross-sectional study conducted from May to September 2018 at tertiary care hospital of Karachi. One hundred and twenty patients of chronic suppurative otitis media were divided into three groups: Group-1 (maintained on ciprofloxacin), Group-2 (maintained on co-amoxicillin) and Group-3 (did not subject to the treatment).The measurement of hearing loss was carried out by pure tone audiometry (PTA) and the depression, anxiety and stress were scored taking depression, anxiety and stress scale (DASS) as tool. To observe the effect of hearing loss on different groups one way ANOVA was applied and Spearman correlation was used to find correlation of depression with hearing loss.

RESULTS

There was no significant difference found for hearing loss and severity among the groups treated with ciprofloxacin, co-amoxicillin and not maintained on antibiotic therapy. Positive correlations found between hearing loss and depression, anxiety and stress in patients of the three groups.

CONCLUSION

Depression induced by hearing loss as a result of CSOM in patients need to be monitored during and after treatment and scored so that can be treated by counseling and antidepressant (if required). Information regarding this topic on population of Pakistan will be helpful for health care takers and policy makers to manage mental stress with hearing loss in CSOM.

Special Populations in Implantable Auditory Devices: Geriatric

Hearing loss is common in the geriatric population. Most hearing loss is associated with presbycusis or age-related hearing loss, impacting one-third of individuals over 65 years and increasing in prevalence with age. Hearing loss impacts quality of life, psychological health, and cognition. Implantable auditory devices are an exceptional option to improve hearing and quality of life. Various implantable auditory devices have been implemented safely with significant improvement in communication and performance on auditory tasks. Counseling is essential to establishing realistic expectations. Rehabilitation may be required to optimize outcomes and auditory performance with use.

[Determinants of the quality of life of the hearing-impaired elderly]

AIM

The aim of this paper is to assess the relationships between psycho-behavioral determinants and quality of life in individuals with age-related hearing loss.

METHODS

This is a cross-sectional study performed in a French preventive health center, Marseille, France (Institut Régional d'Information et de Prévention de la Sénescence). The patients had a bilateral (mild to moderately severe) age-related hearing loss. Data collected included : sociodemographics, general health information, quality of life (Hearing Handicap Inventory for the Elderly and World Health Organization Quality of Life questionnaire), emotional status (anxiety and mood disorders), emotional intelligence (Trait Emotional Intelligence Questionnaire Short Form), and coping strategies (Brief Coping Orientation to Problems Experienced Scale).

RESULTS

Quality of life was linked to psycho-behavioral factors, such as emotional status, emotional intelligence, and coping strategies.

CONCLUSIONS

These findings would assist health authorities and clinicians in choosing targeted appropriate interventions to improve quality of life of age related hearing loss individuals.

The mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults

Vision impairment is prevalent and it is strongly associated with depressive symptoms in older adults. This study aimed to investigate the mediating roles of functional limitations and social support on the relationship between vision impairment and depressive symptoms in older adults. This study used data from a probability-based sample of 1,093 adults aged 60 and older in Shanghai, China. Structural equation models were used to examine the structural relationships among sets of variables simultaneously, including vision impairment, activities of daily living ADLs, instrumental ADLs (IADLs), friends support, family support, relatives support and depressive symptoms. The bootstrapping method and the program PRODCLIN were used to test the indirect effects of these variables. This study found that vision impairment was directly associated with a higher level of depressive symptoms, and the association was partially mediated by functional limitations (IADLs) and social support (friends support). The study demonstrates that improving social support from friends and enhancing social participation for visually impaired older adults can reduce depressive symptoms. More importantly, this study contributes to the knowledge of mediating mechanisms between vision impairment and depressive symptoms.

Bidirectional associations of vision and hearing loss with anxiety: prospective findings from the Three-City Study

OBJECTIVE

the aim of this study was to examine the bidirectional association of vision loss (VL) and hearing loss (HL) with anxiety over a 12-year period.

DESIGN

this was a prospective population-based study.

SETTING

community-dwelling French adults.

PARTICIPANTS

the study included 3,928 adults aged 65 and above from the Three-City study.

METHODS

the relationships of VL, as assessed by near visual acuity and self-reported HL to a diagnosis of generalised anxiety disorder (GAD) were assessed over 12 years. A further objective was to explore whether sensory loss has a differential relationship with GAD than with anxiety symptoms, assessed by the Spielberger's State-Trait Anxiety Inventory.

RESULTS

at baseline, HL [odds ratio (OR) = 1.41, 95% confidence interval (CI) 1.02-1.96, P = 0.04], but not mild or moderate to severe VL, was associated with self-reported anxiety symptoms (OR = 1.07 95% CI 0.63-1.83, P = 0.80; OR = 0.66 95% CI 0.12-2.22, P = 0.50, respectively). Neither vision nor HL was significantly associated with incident GAD. Baseline GAD was related to increased risk of incident HL (OR = 1.17, 95% CI 1.07-1.28, P < 0.001), but not mild or moderate to severe vision loss (OR = 1.01, 95% CI 0.96-1.06, P = 0.81; OR = 0.97, 95% CI 0.89-1.05, P = 0.45, respectively).

CONCLUSIONS

increased anxiety symptoms were observed in older adults with HL, whereas we found no evidence for an association between VL and anxiety. Anxiety was prospectively associated with increased risk of reporting HL. Improved detection of anxiety in older adults with HL may improve quality of life.

Severe-to-profound hearing impairment: demographic data, gender differences and benefits of audiological rehabilitation

Purpose: The purpose of this study was to identify and report demographic data of patients with severe-to-profound hearing loss, assess participation in audiological rehabilitation and analyze the benefits of various rehabilitation methods.Materials and methods: Data on 4286 patients with severe-to-profound hearing impairments registered in the Swedish Quality Register of Otorhinolaryngology over a period from 2006-2015 were studied. Demographic data, gender differences, audiological rehabilitation and benefits of the rehabilitation were analyzed.Results: Group rehabilitation and visits to a hearing rehabilitation educator provided the most benefits in audiological rehabilitation. Only 40.5% of the patients received extended audiological rehabilitation, of which 54.5% were women. A total of 9.5% of patients participated in group rehabilitation, with 59.5% being women. Women also visited technicians, welfare officers, hearing rehabilitation educators, psychologists and physicians and received communication rehabilitation in a group and fit with cochlea implants significantly more often than did men.Conclusions: The study emphasizes the importance of being given the opportunity to participate in group rehabilitation and meet a hearing rehabilitation educator to experience the benefits of hearing rehabilitation. There is a need to offer extended audiological rehabilitation, especially in terms of gender differences, to provide the same impact for women and men.Implications for RehabilitationSignificantly more women than men with severe-to-profound hearing impairment receive audiological rehabilitation.Hearing impairment appears to have a significantly more negative impact on women's quality of life than men's.It is important to offer extended audiological rehabilitation to all patients with severe-to-profound hearing loss to obtain an equal hearing health care regardless of gender.

The association amongst visual, hearing, and dual sensory loss with depression and anxiety over 6 years: The Tromsø Study

OBJECTIVE

To examine the longitudinal association of dual and single (vision and hearing) sensory loss on symptoms of depression and anxiety in older adults.

METHODS

Two thousand eight hundred ninety adults aged 60 years or over who participated in the longitudinal population-based Tromsø Study, Norway, were included. The impact of objective vision loss, self-report hearing loss, or dual sensory loss on symptoms of depression and anxiety, as assessed by the Hopkins Symptom Checklist 10, was examined at baseline and 6-year follow-up using linear mixed models.

RESULTS

Hearing loss had a cross-sectional relationship with increased depression (b = 0.1750, SE = 0.07, P = .02) and anxiety symptoms (b = 0.1765, SE = 0.08, P = .03); however, these relationships were not significant at the 6-year follow-up. Both vision loss only and dual sensory loss predicted increased depression scores at follow-up (b = 0.0220, SE = 0.01, P = .03; and b = 0.0413, SE = 0.02, P = .01, respectively). Adjustment for social isolation did not attenuate the main depression results.

CONCLUSION

Dual sensory loss resulted in increased depression symptomatology over time and posed an additional long-term risk to depression severity beyond having a single sensory loss only. Only hearing loss is associated with anxiety symptoms. Older adults with vision, hearing, and dual sensory loss have different mental health profiles. Therefore, management and intervention should be tailored to the type of sensory loss.

Social care and support needs of community-dwelling people with dementia and concurrent visual impairment

OBJECTIVES

This study explored the social care and support needs of people with dementia and visual impairment, and the barriers and facilitators for meeting these needs.

METHOD

Twenty-six semi-structured interviews were conducted: 21 joint and 5 individual interviews with the person with dementia and visual impairment (n=4) or their family/paid carer (n=1). Interviews were analysed thematically.

RESULTS

Three themes are presented. (1) Social care needs: having dementia can reduce an individual's ability to cope with their visual impairment, and lead to increased dependency and reduced daily stimulation. (2) Barriers to using technology to meet social care needs: difficulties were reported with learning to use unfamiliar technology and the cost of visual impairment aids, and for some, the presence of dementia made visual impairment aids unusable and vice versa. (3) Familiarity as a facilitator for meeting social care needs: living at home or taking furnishings and ornaments into a new home facilitated independence, and continuity of paid carers/volunteers facilitated the caring relationship between the individual and staff/volunteer.

CONCLUSION

Care workers will better serve older people if they are aware of the social care and support needs that arise from having both dementia and visual impairment.

Patients with severe-to-profound hearing impairment and simultaneous severe vision impairment: a quality-of-life study

CONCLUSIONS

Patients with severe vision impairment in combination with severe-to-profound hearing loss seem to have a higher risk for effects on QoL, including: mobility, the ability to provide self-care and perform usual activities, and levels of anxiety and depression, compared with patients with only severe-to-profound hearing loss.

OBJECTIVES

To study the quality-of-life (QoL) and audiological rehabilitation of the severely vision-impaired patient population among adults with severe-to-profound hearing loss in Sweden.

METHOD

A study of data collected from 543 patients with severe-to-profound hearing loss combined with severe vision impairment among the total of 2319 persons registered in the Swedish Quality Register of Otorhinolaryngology. QoL was measured with the following instruments: EQ5D, PIRS, and HADS. Audiological rehabilitation was described and evaluated.

RESULTS

The patients with dual sensory loss were younger, were more likely to live alone, and had a lower level of education than the control group. The QoL of the study group was significantly negatively affected. In total, 89% of the study group had been rehabilitated with hearing aids, while 8% had received rehabilitation with cochlear implants. A total of 32% of the study group had received extended audiological rehabilitation.

Association of Hearing Impairment and Anxiety in Older Adults

OBJECTIVE

The objective of the study is was investigate the association between hearing impairment and anxiety.

METHOD

We conducted a cross-sectional analysis of 1,732 community-based adults aged 76 to 85 years who participated in the Health Aging and Body Composition (ABC) study. Logistic regression models were adjusted for demographic and cardiovascular risk factors. Hearing impairment was defined by the speech-frequency pure tone average. Anxiety was defined as reporting two symptoms of at least "a little" or one symptom "quite a bit" on the three-item Hopkins Symptom Checklist.

RESULTS

Compared with individuals with no hearing impairment, the odds of prevalent anxiety were higher among individuals with mild hearing impairment (odds ratio [OR] = 1.32, 95% confidence interval [CI] = [1.01, 1.73]) and moderate or greater hearing impairment (OR = 1.59, 95% CI = [1.14, 2.22]). Hearing aid use was not significantly associated with lower odds of anxiety.

DISCUSSION

Hearing impairment is independently associated with greater odds of anxiety symptoms in older adults.

Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study

Background and Purpose

Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.

Methods

It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.

Results

The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress.

Conclusions

Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.

Quality of life after intervention with a cochlear implant or hearing aid

OBJECTIVES/HYPOTHESIS

To investigate the impact of hearing aid and cochlear implant use on quality of life in adults.

STUDY DESIGN

Prospective observational cohort study.

METHODS

One hundred thirteen adults aged ≥50 years with postlingual hearing loss receiving routine clinical care at a tertiary academic medical center were evaluated with the Medical Outcome Study Short Form-36 before and 6 and 12 months after intervention with hearing aids or cochlear implants. Change in score was assessed using linear mixed effect models adjusted for age, gender, education, and history of hypertension, diabetes, and smoking.

RESULTS

A significant increase in Mental Component Summary score was observed in both hearing aid and cochlear implant users from baseline to 12 months, with cochlear implant users increasing nearly twice that of hearing aid users (hearing aid: 2.49 [95% confidence interval: 0.11, 4.88], P = .041; cochlear implant: 4.20 [95% confidence interval: 1.85, 6.55], P < .001). The most substantial increases were observed in individuals with the lowest baseline scores. There was no significant difference in physical component summary score from baseline to 12 months.

CONCLUSIONS

Treatment of hearing loss with hearing aids and cochlear implants results in significant increases in mental health quality of life. The majority of the increase is observed by 6 months post-treatment, and we observed differential effects of treatment depending on the level of baseline quality of life score with the greatest gains observed in those with the lowest scores.

LEVEL OF EVIDENCE

2b. Laryngoscope, 126:2110-2115, 2016.

Development of a Comprehensive Approach for the Early Diagnosis of Geriatric Syndromes in General Practice

According to demographic projections, a significant increase in the proportion of the elderly population is anticipated worldwide. This aging of the population will lead to an increase in the prevalence of chronic diseases and functional impairment. This expected increase will result in growing use of the health care system that societies are largely unprepared to address. General practitioners (GPs) are at the front line of this huge epidemiological challenge, but appropriate tools to diagnose and manage elderly patients in routine general practice are lacking. Indeed, while primary prevention and the management of common chronic diseases, such as hypertension, diabetes, or cardiac ischemic diseases, are routinely and mostly adequately performed in primary care, the management of geriatric syndromes is often incomplete. In order to address these shortcomings, this theoretical work aims to first develop, based on the best available evidence, a brief assessment tool (BAT) specifically designed for geriatric syndromes identification in general practice and, second, to propose a conceptual framework for the management of elderly patients in general practice that integrates the BAT instrument into the usual care of GPs. To avoid proposing unachievable goals for the care of elderly patients in general practice (for example, performing all the best screening tools for geriatric conditions identification and care), this work proposes an innovative way to combine geriatric assessment with the management of common chronic diseases.

The association between suicide ideation and sensory impairment among elderly Koreans

OBJECTIVES

The purpose of this cross-sectional study was to examine the relationship between sensory impairment and suicide ideation among elderly Koreans.

METHODS

Data from the 2010-2012 Korea National Health and Nutrition Examination Survey V was used. Participants included 3636 older adults (≥65 years) who received hearing and vision tests; participants also completed assessments of covariates and suicide ideation.

RESULTS

The risk of suicide ideation was 1.43-1.65 times higher among participants with visual impairment than in those without impairment. Moreover, the risk was 1.60-1.76 times higher among those with both auditory and visual impairments than the risk for those without any impairment.

CONCLUSION

This study found an association between sensory impairment and suicide ideation in elderly individuals. Therefore, it seems necessary that interventions that reduce or prevent sensory impaired elders' suicide ideation are needed, which may be an indicator of mental health problems or poor quality of life.

The Effects of Unilateral Adaptation of Hearing Aids on Symptoms of Depression and Social Activity Constraints of Elderly

Introduction Hearing loss is one of the most common problems in the elderly population. Besides compromising oral communication, it directly affects social relations and prevents elderly patients from living actively in society, possibly leading to the onset of depression or other conditions. Objective To analyze the effects of unilateral adaptation of hearing aids on symptoms of depression and the social activity constraints of elderly subjects with hearing impairment. Methods The sample consisted of elderly subjects with hearing loss who did not use hearing aids. Data were collected in two phases. Initially, all participants underwent an audiological assessment and answered the Hearing Handicap Inventory for Elderly (summarized version) and the Geriatric Depression Scale. All subjects participated in the selection and hearing aid adaptation processes and became monaural hearing aid users. After 30 days of hearing aid use, they were assessed with the same instruments. The results of the questionnaires before and after hearing aid adaptation were compared. Results The sample consisted of 13 individuals, between 60 and 90 years old (mean 72.85 ± 11.05 years). Data analysis showed that there was significant improvement in social activity constraints (p < 0.001) and in symptoms of depression (p = 0.031). Conclusion Results show that, in the sample studied, unilateral hearing aid adaptation reduced social activity constraints and depression symptoms.

Influence of visual acuity on anxiety, panic and depression disorders among young and middle age adults in the United States

BACKGROUND

Previous research, albeit limited, has demonstrated an association of visual acuity with depression and anxiety. However, these studies are limited in that they have focused on older adults, used a convenient sample, and/or used a subjective assessment of visual function. As a result, the purpose of this study was to examine the association of objectively-measured visual acuity with depression and anxiety (and panic disorder) among a national sample of young- and middle-age U.S. adults (20-39 years).

METHODS

Using data from the 2003-2004 NHANES (n=602), the presence of anxiety, depression, and panic disorders was assessed from a diagnostic interview. Visual acuity was assessed from a vision exam using the Nidek Auto Lensmeter Model (LM-990A) and expressed as LogMAR units.

RESULTS

After adjusting for age, gender, race-ethnicity, body mass index, mean arterial pressure, cotinine, diabetes, and physical activity, visual acuity was not associated with panic disorder (p=0.71) or depression disorder (p=0.20), but for every 0.1 LogMAR unit change in vision, participants had a 14% (OR=1.14; p=0.04) higher odds of having an anxiety disorder.

LIMITATIONS

The main limitation of this study was the cross-sectional design.

CONCLUSION

Young- and middle-age U.S. adults with worse visual function are at increased odds of having an anxiety disorder. Strategies to prevent and treat anxiety among those with worse visual function are needed.

Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010

IMPORTANCE

Depression among hearing impaired US adults has not been studied previously.

OBJECTIVE

To estimate the prevalence of and risk factors for depression among adults with hearing loss.

DESIGN, SETTING, AND PARTICIPANTS

Adults aged 18 years or older (N = 18 318) who participated in the National Health and Nutrition Examination Survey (NHANES), 2005-2010, a nationally representative sample.

INTERVENTIONS

Multistage probability sampling of US population.

MAIN OUTCOMES AND MEASURES

Depression, assessed by the 9-item Patient Health Questionnaire (PHQ-9) scale, and hearing impairment (HI), assessed by self-report and audiometric examination for adults aged 70 years or older.

RESULTS

The prevalence of moderate to severe depression (PHQ-9 score, ≥10) was 4.9% for individuals reporting excellent hearing, 7.1% for those with good hearing, and 11.4% for participants who reported a little trouble or greater HI. Using excellent hearing as the reference, after adjusting for all covariates, multivariate odds ratios (ORs) for depression were 1.4 (95% CI, 1.1-1.8) for good hearing, 1.7 (1.3-2.2) for a little trouble, 2.4 (1.7-3.2) for moderate trouble, 1.5 (0.9-2.6) for a lot of trouble, and 0.6 (0.1-2.6) for deaf. Moderate HI (defined by better ear pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz within the range 35- to 49-dB hearing level) was significantly associated with depression among older women (OR, 3.9; 95% CI, 1.3-11.3), after adjusting for age, sex, race/ethnicity, lifestyle characteristics, and selected health conditions.

CONCLUSIONS AND RELEVANCE

After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. Health care professionals should be aware of an increased risk for depression among adults with hearing loss.