Study finds higher cardiovascular fitness associated with greater hearing acuity

Leisure-time physical activity and incidence of objectively assessed hearing loss: The Niigata Wellness Study

Previous cohort study reported that high physical activity was associated with a low risk of self-reported hearing loss in women. However, no studies have examined the association between physical activity and the development of hearing loss as measured using an objective assessment of hearing loss in men and women. Here, we used cohort data to examine the association between leisure-time physical activity and incidence of objectively assessed hearing loss in men and women. Participants included 27 537 Japanese adults aged 20-80 years without hearing loss, who completed a self-administered physical activity questionnaire between April 2001 and March 2002. The participants were followed up for the development of hearing loss as measured by audiometry between April 2002 and March 2008. During follow-up, 3691 participants developed hearing loss. Compared with the none physical activity group, multivariable adjusted hazard ratios (HRs) for developing hearing loss were 0.93 (95% confidence interval (CI), 0.86-1.01) and 0.87 (0.81-0.95) for the medium (<525 MET-min/week) and high (≥525 MET-min/week) physical activity groups, respectively (p for trend = 0.001). The magnitude of risk reduction was slightly greater in vigorous-intensity activity than in moderate-intensity activity (p for interaction = 0.01). Analysis by sound frequency showed that the amount of physical activity was inversely associated with high frequency hearing loss development (p for trend <0.001), but not with low frequency hearing loss development (p for trend = 0.19). Higher level of leisure-time physical activity was associated with lower incidence of hearing loss, particularly for vigorous-intensity activities and high sound frequencies.

A Prospective Cohort Study of Muscular and Performance Fitness and Risk of Hearing Loss: The Niigata Wellness Study

BACKGROUND

Several cross-sectional studies have linked higher physical fitness with better hearing sensitivity but have not established a causal relation; none have used a prospective design that is less susceptible to bias. We used a prospective cohort study to investigate the association between muscular and performance fitness and the incidence of hearing loss.

METHODS

A total of 21,907 participants without hearing loss received physical fitness assessments between April 2001 and March 2002. Muscular and performance fitness index, an age- and sex-specific summed z-score based on grip strength, vertical jump height, single-leg balance, forward bending, and whole-body reaction time was calculated. Participants were classified into quartiles according to the muscular and performance fitness index and each physical fitness test. They were followed up for the development of hearing loss, assessed by pure-tone audiometry at annual health examinations between April 2002 and March 2008. Hazard ratios and 95% confidence intervals for hearing loss incidence were estimated using Cox proportional hazards regression models.

RESULTS

During follow-up, 2765 participants developed hearing loss. The hazard ratios (95% confidence intervals) for developing hearing loss across the muscular and performance fitness index quartiles (lowest to highest) were 1.00 (reference), 0.88 (0.79-0.97), 0.83 (0.75-0.93), and 0.79 (0.71-0.88) (P_trend <.001). Among the various physical fitness components, a clear dose-response association with hearing loss incidence was observed for vertical jump height and single-leg balance (P_trend <.001 for both).

CONCLUSION

Higher muscular and performance fitness is associated with a lower incidence of hearing loss.

Relationships among measures of physical activity and hearing in African Americans: The Jackson Heart Study

OBJECTIVES/HYPOTHESIS

To evaluate the relationships among measures of physical activity and hearing in the Jackson Heart Study.

STUDY DESIGN

Prospective cohort study.

METHODS

We assessed hearing on 1,221 Jackson Heart Study participants who also had validated physical activity questionnaire data on file. Hearing thresholds were measured across frequency octaves from 250 to 8,000 Hz, and various frequency pure-tone averages (PTAs) were constructed, including PTA4 (average of 500, 1,000, 2,000, and 4,000 Hz), PTA-high (average of 4,000 and 8,000 Hz), PTA-mid (average of 1,000 and 2,000 Hz), and PTA-low (average of 250 and 500 Hz). Hearing loss was defined for pure tones and pure-tone averages as >25 dB HL in either ear and averaged between the ears. Associations between physical activity and hearing were estimated using linear regression, reporting changes in decibel hearing level, and logistic regression, reporting odds ratios (OR) of hearing loss.

RESULTS

Physical activity exhibited a statistically significant but small inverse relationship with PTA4, -0.20 dB HL per doubling of activity (95% confidence interval [CI]: -0.35, -0.04; P = .016), as well as with PTA-low and pure tones at 250, 2,000, and 4,000 Hz in adjusted models. Multivariable logistic regression modeling supported a decrease in the odds of high-frequency hearing loss among participants who reported at least some moderate weekly physical activity (PTA-high, OR: 0.69 [95% CI: 0.52, 0.92]; P = .011 and 4000 Hz, OR: 0.75 [95% CI: 0.57, 0.99]; P = .044).

CONCLUSIONS

Our study provides further evidence that physical activity is related to better hearing; however, the clinical significance of this relationship cannot be estimated given the nature of the cross-sectional study design.

LEVEL OF EVIDENCE

2b Laryngoscope, 126:2376-2381, 2016.

Music listening behavior, health, hearing and otoacoustic emission levels

This study examined the relationship between hearing levels, otoacoustic emission levels and listening habits related to the use of personal listening devices (PLDs) in adults with varying health-related fitness. Duration of PLD use was estimated and volume level was directly measured. Biomarkers of health-related fitness were co-factored into the analyses. 115 subjects ages 18-84 participated in this study. Subjects were divided into two sub-groups; PLD users and non-PLD users. Both groups completed audiological and health-related fitness tests. Due to the mismatch in the mean age of the PLD user versus the non-PLD user groups, age-adjusted statistics were performed to determine factors that contributed to hearing levels. Age was the most significant predictor of hearing levels across listening and health-related fitness variables. PLD user status did not impact hearing measures, yet PLD users who listened less than 8 hours per week with intensities of less than 80 dBA were found to have better hearing. Other variables found to be associated with hearing levels included: years listening to PLD, number of noise environments and use of ear protection. Finally, a healthy waist-to-hip ratio was a significant predictor of better hearing, while body mass index approached, but did not reach statistical significance.

Association Between Cardiorespiratory Fitness and Hearing Sensitivity

Purpose

As a follow-up to previous smaller scale studies, the purpose of the present study was to examine the link between cardiorespiratory fitness and hearing sensitivity using a nationally representative U.S. sample of adults.

Method

Data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES; U.S. Centers for Disease Control and Prevention [CDC], 2011) were used in the analyses. After exclusions, the final sample included 1,082 NHANES participants ages 20–49 years. Maximum oxygen uptake (VO 2max ) was obtained from an established nonexercise prediction equation and through heart-rate extrapolation during a treadmill-based submaximal test. Audiometry data were objectively measured to obtain estimates of low (LPTA) and high (HPTA) pure-tone frequency average.

Results

VO 2max was not associated with hearing sensitivity when using the heart-rate extrapolation method but was significantly associated with hearing sensitivity (for women) when applying the nonexercise prediction equation for both LPTA and HPTA ( p < .01). Women with higher predicted cardiorespiratory fitness were 6% more likely than women with lower predicted cardio-respiratory fitness to have good hearing compared to worse hearing.

Conclusion

Cardiorespiratory fitness was associated with hearing sensitivity when using the nonexercise prediction equation to measure VO 2max . Further studies are needed to confirm these findings. Findings suggest a potentially auditory-protective effect of cardiorespiratory fitness.

The influence of cardiovascular health on peripheral and central auditory function in adults: a research review

PURPOSE

This article provides a comparative review of research that has been conducted over the past 60+ years on the influence of cardiovascular health on the function of the peripheral and central auditory systems, and findings on the influence of improvements in cardiovascular health on those same systems.

METHOD

Research spanning the past 6 decades reviewed for this article has both hypothesized and confirmed the cardiovascular system's effects on the peripheral and central auditory systems. A review of the influence of the cardiovascular system is presented in this article, and a potential new avenue for auditory rehabilitation is postulated. The review presented in this article does not represent all studies conducted in the topic area but does provide an in-depth look into this fascinating area of research.

CONCLUSIONS

The negative influence of impaired cardiovascular health on both the peripheral and central auditory system and the potential positive influence of improved cardiovascular health on these same systems have been found through a sizable body of research that has been conducted over more than 6 decades. The most significant positive relationship between improved cardiovascular health and improvements in those auditory systems has been found among older adults. If that relationship continues to be confirmed, then a potential new avenue for auditory rehabilitation on behalf of adults who possess impaired auditory function may be discovered.

Association between cardiovascular health and hearing function: pure-tone and distortion product otoacoustic emission measures

PURPOSE

A reduction in hearing sensitivity is often considered to be a normal age-related change. Recent studies have revisited prior ways of thinking about sensory changes over time, uncovering health variables other than age that play a significant role in sensory changes.

METHOD

In this cross-sectional study, cardiovascular (CV) health, pure-tone thresholds at 1000 to 4000 Hz, and distortion product otoacoustic emissions (DPOAEs), with and without contralateral noise, were measured in 101 participants age 10-78 years.

RESULTS

Persons in the "old" age category (49-78 years) had worse pure-tone hearing sensitivity and DPOAEs than persons in the younger age categories (p < .05), affirming an age effect. Although hearing decline occurred in all persons in all CV fitness categories of every age group, those with low CV fitness in the old age group had significantly worse pure-tone hearing at 2000 and 4000 Hz (p <.05). Otoacoustic emission measurements were better for the old high-fit group but not significantly influenced by CV fitness level across age groups.

CONCLUSIONS

Results of the current study elucidate the potentially positive impact of CV health on hearing sensitivity over time. This finding was particularly robust among older adults.