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Lad M, Taylor JP, Griffiths TD. The contribution of short-term memory for sound features to speech-in-noise perception and cognition. Hear Res 2024; 451:109081. [PMID: 39004015 DOI: 10.1016/j.heares.2024.109081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/20/2024] [Accepted: 07/10/2024] [Indexed: 07/16/2024]
Abstract
Speech-in-noise (SIN) perception is a fundamental ability that declines with aging, as does general cognition. We assess whether auditory cognitive ability, in particular short-term memory for sound features, contributes to both. We examined how auditory memory for fundamental sound features, the carrier frequency and amplitude modulation rate of modulated white noise, contributes to SIN perception. We assessed SIN in 153 healthy participants with varying degrees of hearing loss using measures that require single-digit perception (the Digits-in-Noise, DIN) and sentence perception (Speech-in-Babble, SIB). Independent variables were auditory memory and a range of other factors including the Pure Tone Audiogram (PTA), a measure of dichotic pitch-in-noise perception (Huggins pitch), and demographic variables including age and sex. Multiple linear regression models were compared using Bayesian Model Comparison. The best predictor model for DIN included PTA and Huggins pitch (r2 = 0.32, p < 0.001), whereas the model for SIB included the addition of auditory memory for sound features (r2 = 0.24, p < 0.001). Further analysis demonstrated that auditory memory also explained a significant portion of the variance (28 %) in scores for a screening cognitive test for dementia. Auditory memory for non-speech sounds may therefore provide an important predictor of both SIN and cognitive ability.
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Affiliation(s)
- Meher Lad
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
| | - John-Paul Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Timothy D Griffiths
- Biosciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom
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2
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Ihler F, Brzoska T, Altindal R, Dziemba O, Völzke H, Busch CJ, Ittermann T. Prevalence and risk factors of self-reported hearing loss, tinnitus, and dizziness in a population-based sample from rural northeastern Germany. Sci Rep 2024; 14:17739. [PMID: 39085387 PMCID: PMC11291685 DOI: 10.1038/s41598-024-68577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
A close anatomical and physiological relationship is known between the senses of hearing and balance, while an additional pathophysiological interaction is supposed. The mechanisms underlying this association are not yet fully understood, especially in individuals without a known specific otologic disorder. In particular, only scarce information on the combined occurrence of audiovestibular sensory impairment is available so far. Therefore, this study aims to provide further insight into the prevalence and co-prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness. Additionally, the influence of potential risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of those symptoms is studied. Data was analyzed from 8134 individuals from the population-based Study of Health in Pomerania (SHIP). SHIP pursues a broad and comprehensive examination program in chronologically separated cohorts with longitudinal follow-up. Cohorts are sampled from Western Pomerania, a rural region of north-eastern Germany. The study population represents a cross-sectional analysis from the cohorts SHIP-START (recruited 1997-2001) and SHIP-TREND (recruited 2008-2012), sampled for baseline investigations (SHIP-START-0 and SHIP-TREND-0) at the age of 20-79 years. Audiovestibular symptoms as outcome variables were assessed by structured questionnaires. Additionally, individuals were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of their role as exposure variables. We calculated a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus, and 13.5% for dizziness in the population. Prevalence increased with age and differed among the sexes. A considerable share of 28.0% of the investigated individuals reported more than one symptom at once. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between the occurrence of hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, education was identified as a significant protective factor while only smoking was significantly associated with all three symptoms. Furthermore, several cardiovascular risk factors contributed to both hearing loss and dizziness. In conclusion, audiovestibular symptoms are highly prevalent in the investigated population. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. To clarify the underlying mechanisms, the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany.
| | - Tina Brzoska
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Reyhan Altindal
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Oliver Dziemba
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Chia-Jung Busch
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
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Tsimpida D, Rajasingam S, Panagioti M, Henshaw H. The leaky pipeline of hearing care: primary to secondary care evidence from the English Longitudinal Study of Ageing (ELSA). Int J Audiol 2024; 63:349-357. [PMID: 36951175 DOI: 10.1080/14992027.2023.2186814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/28/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE The proportions of older adults' transitions through acknowledging their hearing loss to getting access to treatment are unknown. This was examined using data from a nationally representative cohort in England. DESIGN Patient and healthcare factors associated with referrals were examined cross-sectionally, through primary to secondary care. Non-report predictors identified using multiple logistic regression models. STUDY SAMPLE 8529 adults with hearing data in the English Longitudinal Study of Ageing Wave 7. RESULTS Nearly 40% of those with acknowledged hearing loss did not tell a doctor or nurse (n = 857/2249). Women (OR 2.68, 95% CI 2.14-2.98), retirees (OR 1.30, 95% CI 1.17-1.44), those with foreign education (OR 2.74, 95% CI 2.47-3.04), lower education (OR 2.86, 95% CI 2.58-3.18), smokers (OR 4.39, 95% CI 3.95-4.87), and heavy drinkers (OR 1.67, 95% CI 1.58-1.85) were more likely to not report hearing loss. Of those who acknowledged and reported hearing difficulties, willingness to try hearing aid(s) was high (78.9%). CONCLUSIONS Unacknowledged, or acknowledged but not reported hearing loss by individuals, and non-referrals by primary healthcare professionals, are barriers to accessing hearing healthcare. Future research should report hearing aid use as the proportion of individuals who acknowledge their hearing loss, to avoid an overestimation of the non-use of hearing aids within study samples.
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Affiliation(s)
- Dialechti Tsimpida
- Department of Public Health, Policy & Systems, Institute of Population Health, The University of Liverpool, Liverpool, UK
| | - Saima Rajasingam
- School of Psychology & Sport Sciences (Vision & Hearing) Cambridge Campus, Anglia Ruskin University, Cambridge, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), School of Health Sciences, The University of Manchester, Manchester, UK
| | - Helen Henshaw
- NIHR Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Nottingham, UK
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Wang Y, Yao X, Wang D, Ye C, Xu L. A machine learning screening model for identifying the risk of high-frequency hearing impairment in a general population. BMC Public Health 2024; 24:1160. [PMID: 38664666 PMCID: PMC11044481 DOI: 10.1186/s12889-024-18636-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 04/17/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Hearing impairment (HI) has become a major public health issue in China. Currently, due to the limitations of primary health care, the gold standard for HI diagnosis (pure-tone hearing test) is not suitable for large-scale use in community settings. Therefore, the purpose of this study was to develop a cost-effective HI screening model for the general population using machine learning (ML) methods and data gathered from community-based scenarios, aiming to help improve the hearing-related health outcomes of community residents. METHODS This study recruited 3371 community residents from 7 health centres in Zhejiang, China. Sixty-eight indicators derived from questionnaire surveys and routine haematological tests were delivered and used for modelling. Seven commonly used ML models (the naive Bayes (NB), K-nearest neighbours (KNN), support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGBoost), boosting, and least absolute shrinkage and selection operator (LASSO regression)) were adopted and compared to develop the final high-frequency hearing impairment (HFHI) screening model for community residents. The model was constructed with a nomogram to obtain the risk score of the probability of individuals suffering from HFHI. According to the risk score, the population was divided into three risk stratifications (low, medium and high) and the risk factor characteristics of each dimension under different risk stratifications were identified. RESULTS Among all the algorithms used, the LASSO-based model achieved the best performance on the validation set by attaining an area under the curve (AUC) of 0.868 (95% confidence interval (CI): 0.847-0.889) and reaching precision, specificity and F-score values all greater than 80%. Five demographic indicators, 7 disease-related features, 5 behavioural factors, 2 environmental exposures, 2 hearing cognitive factors, and 13 blood test indicators were identified in the final screening model. A total of 91.42% (1235/1129) of the subjects in the high-risk group were confirmed to have HI by audiometry, which was 3.99 times greater than that in the low-risk group (22.91%, 301/1314). The high-risk population was mainly characterized as older, low-income and low-educated males, especially those with multiple chronic conditions, noise exposure, poor lifestyle, abnormal blood indices (e.g., red cell distribution width (RDW) and platelet distribution width (PDW)) and liver function indicators (e.g., triglyceride (TG), indirect bilirubin (IBIL), aspartate aminotransferase (AST) and low-density lipoprotein (LDL)). An HFHI nomogram was further generated to improve the operability of the screening model for community applications. CONCLUSIONS The HFHI risk screening model developed based on ML algorithms can more accurately identify residents with HFHI by categorizing them into the high-risk groups, which can further help to identify modifiable and immutable risk factors for residents at high risk of HI and promote their personalized HI prevention or intervention.
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Affiliation(s)
- Yi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
- Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Xinmeng Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China
| | - Dahui Wang
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Chengyin Ye
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Liangwen Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Hangzhou Normal University, Hangzhou, 311121, Zhejiang, China.
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Castro SS, Bassichetto KC, Lima MG, Cesar CLG, Goldbaum M, Barros MBDA. Impairments and related social inequalities among adults: a population-based study in São Paulo city, Brazil. CIENCIA & SAUDE COLETIVA 2024; 29:e16962022. [PMID: 38655955 DOI: 10.1590/1413-81232024294.16962022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/23/2023] [Indexed: 04/26/2024] Open
Abstract
The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.
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Affiliation(s)
- Shamyr Sulyvan Castro
- Departamento de Fisioterapia, Universidade Federal do Ceará. R. Doutor José Lourenço 816 apto 2101. 60115-281 Fortaleza CE Brasil.
| | | | | | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Universidade de São Paulo. São Paulo SP Brasil
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Wu J, Nie S, Li C, Wang X, Peng Y, Shang J, Diao L, Ding H, Si Q, Wang S, Tong R, Li Y, Sun L, Zhang J. Sound-localization-related activation and functional connectivity of dorsal auditory pathway in relation to demographic, cognitive, and behavioral characteristics in age-related hearing loss. Front Neurosci 2024; 18:1353413. [PMID: 38562303 PMCID: PMC10982313 DOI: 10.3389/fnins.2024.1353413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Background Patients with age-related hearing loss (ARHL) often struggle with tracking and locating sound sources, but the neural signature associated with these impairments remains unclear. Materials and methods Using a passive listening task with stimuli from five different horizontal directions in functional magnetic resonance imaging, we defined functional regions of interest (ROIs) of the auditory "where" pathway based on the data of previous literatures and young normal hearing listeners (n = 20). Then, we investigated associations of the demographic, cognitive, and behavioral features of sound localization with task-based activation and connectivity of the ROIs in ARHL patients (n = 22). Results We found that the increased high-level region activation, such as the premotor cortex and inferior parietal lobule, was associated with increased localization accuracy and cognitive function. Moreover, increased connectivity between the left planum temporale and left superior frontal gyrus was associated with increased localization accuracy in ARHL. Increased connectivity between right primary auditory cortex and right middle temporal gyrus, right premotor cortex and left anterior cingulate cortex, and right planum temporale and left lingual gyrus in ARHL was associated with decreased localization accuracy. Among the ARHL patients, the task-dependent brain activation and connectivity of certain ROIs were associated with education, hearing loss duration, and cognitive function. Conclusion Consistent with the sensory deprivation hypothesis, in ARHL, sound source identification, which requires advanced processing in the high-level cortex, is impaired, whereas the right-left discrimination, which relies on the primary sensory cortex, is compensated with a tendency to recruit more resources concerning cognition and attention to the auditory sensory cortex. Overall, this study expanded our understanding of the neural mechanisms contributing to sound localization deficits associated with ARHL and may serve as a potential imaging biomarker for investigating and predicting anomalous sound localization.
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Affiliation(s)
- Junzhi Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shuai Nie
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Xing Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ye Peng
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiaqi Shang
- Center of Clinical Hearing, Shandong Second Provincial General Hospital, Jinan, Shandong, China
| | - Linan Diao
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hongping Ding
- College of Special Education, Binzhou Medical University, Yantai, Shandong, China
| | - Qian Si
- School of Cyber Science and Technology, Beihang University, Beijing, China
| | - Songjian Wang
- Key Laboratory of Otolaryngology, Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing, China
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Renjie Tong
- School of Biomedical Engineering, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yutang Li
- School of Biomedical Engineering, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Liwei Sun
- School of Biomedical Engineering, Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Juan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Asakawa T, Yang Y, Xiao Z, Shi Y, Qin W, Hong Z, Ding D. Stumbling Blocks in the Investigation of the Relationship Between Age-Related Hearing Loss and Cognitive Impairment. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024; 19:137-150. [PMID: 37410696 DOI: 10.1177/17456916231178554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
The relationship between age-related hearing loss (ARHL) and cognitive impairment (CI) remains intricate. However, there is no robust evidence from experimental or clinical studies to elucidate their relationship. The key unaddressed questions are (a) whether there is a causal effect of ARHL on CI and (b) whether efficacious treatment of ARHL (such as hearing-aid use) ameliorates CI and dementia-related behavioral symptoms. Because of several methodological and systematic flaws/challenges, rigorous verification has not been conducted. Addressing these stumbling blocks is essential to unraveling the relationship between ARHL and CI, which motivated us to undertake this review. Here, we discuss the methodological problems from the perspectives of potential confounding bias, assessments of CI and ARHL, hearing-aid use, functional-imaging studies, and animal models based on the latest information and our experiences. We also identify potential solutions for each problem from the viewpoints of clinical epidemiology. We believe that "objectivity," specifically the use of more objective behavioral assessments and new computerized technologies, may be the key to improving experimental designs for studying the relationship between ARHL and CI.
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Affiliation(s)
- Tetsuya Asakawa
- Institute of Neurology, The Third People's Hospital of Shenzhen, National Clinical Research Center for Infectious Diseases, Shenzhen, China
| | - Yunfeng Yang
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University
| | - Zhenxu Xiao
- Institute of Neurology, Huashan Hospital, Fudan University
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University
- National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University
| | - Yirong Shi
- Department of Nursing, The Third People's Hospital of Shenzhen, National Clinical Research Center for Infectious Diseases,Shenzhen, China
| | - Wei Qin
- Department of Rehabilitation, Enshi Central Hospital, Enshi, China
| | - Zhen Hong
- Institute of Neurology, Huashan Hospital, Fudan University
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University
- National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University
- National Clinical Center for Neurological Disorders, Huashan Hospital, Fudan University
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Van Wier MF, Urry E, Lissenberg-Witte BI, Kramer SE. User characteristics associated with use of wrist-worn wearables and physical activity apps by adults with and without impaired speech-in-noise recognition: a cross-sectional analysis. Int J Audiol 2024; 63:49-56. [PMID: 36373621 DOI: 10.1080/14992027.2022.2135031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study weekly use of smartwatches, fitness watches and physical activity apps among adults with and without impaired speech-in-noise (SIN) recognition, to identify subgroups of users. DESIGN Cross-sectional study. STUDY SAMPLE Adults (aged 28-80 years) with impaired (n = 384) and normal SIN recognition (n = 341) as measured with a web-based digits-in-noise test, from the Netherlands Longitudinal Study on Hearing. Multiple logistic regression analyses were used to study differences and to build an association model. RESULTS Employed adults in both groups are more likely to use each type of fitness technology (all ORs >3.4, all p-values < 0.004). Specific to fitness watch use, adults living with others use it more (OR 2.5, 95%CI 1.1;5.8, p = 0.033) whereas those abstaining from alcohol (OR 0.3, 95%CI 0.1;0.6) or consuming >2 glasses/week (OR 0.4, 95%CI 0.2;0.81, overall p = 0.006) and hearing aid users (OR 0.5, 95%CI 0.2;0.9, p = 0.024) make less use. CONCLUSIONS Subgroups of adults more and less likely to use fitness technology exist, but do not differ between adults with and without impaired SIN recognition. More research is needed to confirm these results and to develop interventions to increase physical activity levels among adults with hearing loss.
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Affiliation(s)
- Marieke F Van Wier
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Birgit I Lissenberg-Witte
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Pryce H, Smith SK, Burns-O'Connell G, Knibb R, Greenwood R, Shaw R, Hussain S, Banks J, Hall A, Straus J, Noble S. Protocol for the development and validation of a patient-reported experience measure (PREM) for people with hearing loss: the PREM-HeLP. BMJ Open 2023; 13:e075229. [PMID: 38030247 PMCID: PMC10689349 DOI: 10.1136/bmjopen-2023-075229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Hearing loss is a common chronic health condition and adversely affects communication and social function resulting in loneliness, social isolation and depression. We know little about the patient experience of living with hearing loss and their views on the quality of the audiology service. In this study, we will develop and validate the first patient-reported experience measure (PREM) to understand patients' experiences of living with hearing loss and their healthcare interactions with audiology services. METHODS AND ANALYSIS We will develop the PREM in three phases: (1) development of PREM prototype (items/statements) derived from previous qualitative work and narrative review, (2) cognitive interview testing of the PREM prototype using a 'think aloud' technique to examine the acceptability and comprehensibility of the tool and refine accordingly and (3) psychometric testing of the modified PREM with 300 participants to assess the reliability and validity of the tool using Rasch analyses with sequential item reduction. Eligible participants will be young people and adults aged 16 years and over who have hearing loss. Participants will be recruited from three clinical sites located in England (Bath, Bristol) and Scotland (Tayside) and non-clinical settings (eg, lip-reading classes, residential care settings, national charity links, social media). ETHICS AND DISSEMINATION The study was approved by the West of Scotland Research Ethics Service (approval date: 6 May 2022; ref: 22/WS/0057) and the Health Research Authority and Health and Care Research Wales (HCRW) Approval (approval date: 14 June 2022; IRAS project ID: 308816). Findings will be shared with our patient and public involvement groups, academics, audiology communities and services and local commissioners via publications and presentations. The PREM will be made available to clinicians and researchers without charge.
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Affiliation(s)
- Helen Pryce
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Sian Karen Smith
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Georgina Burns-O'Connell
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Rebecca Knibb
- School of Psychology, Aston University, Birmingham, UK
| | - Rosemary Greenwood
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Rachel Shaw
- School of Psychology, Aston University, Birmingham, UK
| | - Saira Hussain
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
| | - Jonathan Banks
- Social & Community Medicine, University of Bristol, Bristol, UK
| | - Amanda Hall
- Audiology, School of Optometry, Aston University College of Health and Life Sciences, Birmingham, West Midlands, UK
- Children's Hearing Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Sian Noble
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Kong X, Han F, Li J, Wang W, Sun Y, Wu Y. Serial multiple mediation of loneliness and depressive symptoms in the relationship between pain and cognitive function among older people. Aging Ment Health 2023; 27:2102-2110. [PMID: 37278696 DOI: 10.1080/13607863.2023.2219626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/19/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Although the negative effect of pain on cognitive function has been widely reported, it is unclear how the effect is mediated. The aim of this study is to analyze the mediating role of loneliness and depressive symptoms in the association between pain and cognitive function. METHODS A total of 6,309 participants aged ≥50 years from 2012/13 (T1), 2014/15 (T2), 2016/17 (T3) and 2018/19 (T4) of the English Longitudinal Study of Aging (ELSA) were included. Of them, 55.8% were females, and the median age (rang) was 65 (50-99) years at T1. Serial mediation analysis was performed using Mplus 8.3. RESULTS The mediation model explained 10.1% of the variance in loneliness, 22.1% of the variance of depressive symptoms, and 22.7% of the variance of cognitive function. Higher level pain was associated with poorer cognitive function (c: β = -0.057; p < 0.001). The negative effect of pain on cognition was mediated separately and sequentially through loneliness and depressive symptoms, with loneliness and depressive symptoms explaining 8.8% of the total effect, respectively, and the pathway of loneliness and subsequent depression explaining 1.8%. CONCLUSIONS Diversified interventions aimed at treating pain in older adults would be beneficial for their mental health and cognitive function.
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Affiliation(s)
- Xiangjie Kong
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Fulei Han
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Jing Li
- Critical Care Medical Center, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Yanping Sun
- Department of Neurology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yili Wu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
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11
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Slade K, Davies R, Pennington CR, Plack CJ, Nuttall HE. The Impact of Age and Psychosocial Factors on Cognitive and Auditory Outcomes During the COVID-19 Pandemic. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3689-3695. [PMID: 37639541 PMCID: PMC10558140 DOI: 10.1044/2023_jslhr-22-00703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/28/2023] [Accepted: 05/21/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE In March 2020, the U.K. government announced that people should isolate to reduce the spread of the virus that causes COVID-19. Outside a pandemic, psychosocial factors, such as socialization and mental health, may impact the relationship between hearing loss and increased dementia risk. We aim to report the impact of psychosocial factors, including social isolation, depression, and engagement in activities, on hearing and cognitive function in younger and older adults during the COVID-19 pandemic. METHOD An online survey and experiment assessed self-reported psychosocial factors, self-reported hearing ability and speech-in-noise perception, and cognition. Data were collected between June 2020 and February 2021. Older (n = 112, Mage = 70.08) and younger (n = 121, Mage = 20.52) monolingual speakers of English, without any language or neurological disorders participated. Multiple linear regression models were employed to investigate hypothesized associations between psychosocial factors, and hearing and cognition, in older and younger adults. RESULTS Multiple regression analyses indicated that older adults displayed poorer speech-in-noise perception and poorer performance on one of four cognitive tasks, compared with younger adults; increased depression was associated with poorer subjective hearing. Other psychosocial factors did not significantly predict hearing or cognitive function. CONCLUSIONS Data suggest that self-reported hearing and depression are related. This conclusion is important for understanding the associations between hearing loss and cognitive decline in the long term, as both hearing loss and depression are risk factors for dementia. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23810838.
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Affiliation(s)
- Kate Slade
- Department of Psychology, Faculty of Science and Technology, Lancaster University, United Kingdom
| | - Robert Davies
- Department of Psychology, Faculty of Science and Technology, Lancaster University, United Kingdom
| | | | - Christopher J. Plack
- Department of Psychology, Faculty of Science and Technology, Lancaster University, United Kingdom
- Manchester Centre for Audiology and Deafness, School of Health Sciences, The University of Manchester, United Kingdom
| | - Helen E. Nuttall
- Department of Psychology, Faculty of Science and Technology, Lancaster University, United Kingdom
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12
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Goodwin MV, Hogervorst E, Hardy R, Stephan BCM, Maidment DW. How are hearing loss and physical activity related? Analysis from the English longitudinal study of ageing. Prev Med 2023; 173:107609. [PMID: 37423474 DOI: 10.1016/j.ypmed.2023.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Although cross-sectional studies suggest that hearing loss in middle- and older-aged adults is associated with lower physical activity, longitudinal evidence is limited. This study aimed to investigate the potential bi-directional association between hearing loss and physical activity over time. Participants were from the English Longitudinal Study of Ageing (N = 11,292) who were 50-years or older at baseline assessment (1998-2000). Individuals were followed-up biannually for up to 20-years (2018-2019) and were classified as ever reporting hearing loss (n = 4946) or not reporting hearing loss (n = 6346). Data were analysed with Cox-proportional hazard ratios and multilevel logistic regression. The results showed that baseline physical activity was not associated with hearing loss over the follow-up. Time (i.e., wave of assessment) by hearing loss interactions showed that physical activity declined more rapidly over time in those with hearing loss, compared to those without (Odds Ratios = 0.94, 95% Confidence Intervals; 0.92-0.96, p < .001). These findings highlight the importance of addressing physical activity in middle- and older-aged adults with hearing loss. As physical activity is a modifiable behaviour that can reduce the risk of developing chronic health conditions, individuals with hearing loss may need additional, tailored support to be more physically active. Mitigating the decline in physical activity could be essential to support healthy ageing for adults with hearing loss.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, UK.
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | | | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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13
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Rahimi Z, Saki N, Cheraghian B, Amini P, Solaymani Dodaran M. Association between individual, household, and area-level socioeconomic status indicators and sensorineural hearing loss in adults in southwest Iran: a population-based study. Front Public Health 2023; 11:1140500. [PMID: 37139397 PMCID: PMC10150087 DOI: 10.3389/fpubh.2023.1140500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Hearing loss is the fourth most common chronic disease, but studies on the relationship between hearing loss and socioeconomic factors are limited. We aimed to examine the association between hearing loss and socioeconomic factors among 35-70 year adults in southwest Iran. Materials and methods This population-based cross-sectional study was conducted in the baseline of Hoveyzeh cohort study in adults aged 35-70 in southwest Iran between 2017 and 2021. Information on socioeconomic factors, demographic characteristics, comorbidities, family history of hearing loss, and noise exposure was collected. We assessed the relationship between three levels of socioeconomic factors (individual, household, and area level) with sensorineural hearing loss (SNHL). Multiple logistic regression was used to adjust the potential confounders. Results Among a total of 1,365 assessed participants, 485 patients were diagnosed as having hearing loss, and the other 880 individuals were diagnosed without hearing loss, which is considered the case and the control group, respectively. At the individual level of socioeconomic, the odds of having hearing loss in the participants with high school education and diploma, [OR = 0.51 (95%CI:0.28-0.92)], and the individuals with university education [OR = 0.44 (95%CI:0.22-0.87)] were significantly lower than the illiterate participants. At the household socioeconomic level, the odds of having hearing loss were lower for those with poor [OR = 0.63 (95%CI:0.41-0.97)] and moderate [OR = 0.62 (95%CI:0.41-0.94)] wealth status vs. those with the poorest wealth status. In the area level socioeconomic, although the odds of hearing loss in the residents of affluent areas were slightly lower than the residents of deprived areas, there was no significant difference among the groups. Conclusion The individuals with hearing loss may have insufficient education and income.
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Affiliation(s)
- Zahra Rahimi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Otolaryngology–Head & Neck Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Payam Amini
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Solaymani Dodaran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- *Correspondence: Masoud Solaymani Dodaran
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14
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Tsimpida D, Panagioti M, Kontopantelis E. Forty years on: a new national study of hearing in England and implications for global hearing health policy. Int J Audiol 2023; 62:62-70. [PMID: 35080184 DOI: 10.1080/14992027.2021.2022791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE We aimed to update the prevalence estimates of hearing loss in older adults in England using a nationally representative sample of adults aged 50 years old and older. DESIGN A comparative cross-sectional study design was implemented. Hearing loss was defined as ≥35 dB HL at 3.0 kHz, as measured via Hearcheck in the better-hearing ear. STUDY SAMPLE We compared the estimates based on the English census in 2015 to estimates from psychoacoustic hearing data available for 8,263 participants in the English Longitudinal Study of Ageing (ELSA) Wave 7 (2014-2015). RESULTS Marked regional variability in hearing loss prevalence was revealed among participants with similar age profiles. The regional differences in hearing outcomes reached up to 13.53% in those belonging to the 71-80 years old group; the prevalence of hearing loss was 49.22% in the North East of England (95%CI 48.0-50.4), versus 35.69% in the South East (95%CI 34.8-36.50). CONCLUSION A socio-spatial approach in planning sustainable models of hearing care based on the actual populations' needs and not on age demographics might offer a viable opportunity for healthier lives. Regular assessment of the extent and causality of the population's different audiological needs within the country is strongly supported.
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Affiliation(s)
- Dialechti Tsimpida
- Institute for Health Policy and Organisation (IHPO), Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation (IHPO), Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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15
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Malcolm KA, Suen JJ, Nieman CL. Socioeconomic position and hearing loss: current understanding and recent advances. Curr Opin Otolaryngol Head Neck Surg 2022; 30:351-357. [PMID: 36004788 PMCID: PMC10155234 DOI: 10.1097/moo.0000000000000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to describe recent literature examining the relationship between socioeconomic position (SEP) and hearing loss, including the impact of hearing loss on several socioeconomic outcomes over the life course. Additionally, we highlight current policy advances in recent years and review alternative models of hearing care that aim to address disparities related to SEP and hearing healthcare. RECENT FINDINGS Applying a social epidemiologic lens to hearing health gives insight into the role of material and social contexts in understanding and improving hearing health outcomes. Recent studies investigating the intersection of SEP and hearing health highlight the disparities that exist for individuals with low SEP as well as the influence of hearing loss on SEP. Individuals with hearing loss are more likely to be unemployed, have lower educational attainment, lower income, and are less likely to use hearing aids and access hearing care. Legislation addressing cost and access to hearing care as well as transforming the current landscape of hearing care, is essential to creating equitable care for individuals, especially older adults, with low SEP. SUMMARY With the expected rise in prevalence of hearing loss over the next 40 years, hearing care that is affordable and accessible is a public health priority. As hearing loss is associated with negative outcomes for individuals with low SEP, advances in legislation and care delivery models are necessary in order to include populations traditionally unserved by current hearing healthcare.
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Affiliation(s)
- Kelly A. Malcolm
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health
| | - Jonathan J. Suen
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health
- Johns Hopkins School of Nursing
| | - Carrie L. Nieman
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health
- Johns Hopkins School of Nursing
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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16
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The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA). Soc Psychiatry Psychiatr Epidemiol 2022; 57:353-362. [PMID: 34383085 PMCID: PMC8784360 DOI: 10.1007/s00127-021-02155-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/30/2021] [Indexed: 11/14/2022]
Abstract
PURPOSE The adverse impact of hearing loss (HL) extends beyond auditory impairment and may affect the individuals' psychosocial wellbeing. We aimed to examine whether there exists a causal psychosocial pathway between HL and depression in later life, via socioeconomic factors and quality of life, and whether hearing aids usage alleviates depressive symptoms over time. METHODS We examined the longitudinal relationship between HL and depressive symptoms (CES-D) applying dynamic cross-lagged mediation path models. We used the full dataset of participants aged 50-89 years (74,908 person-years), from all eight Waves of the English Longitudinal Study of Ageing (ELSA). Their quality of life (CASP-19) and their wealth were examined as the mediator and moderator of this relationship, respectively. Subgroup analyses investigated differences among those with hearing aids within different models of subjectively and objectively identified HL. All models were adjusted for age, sex, retirement status and social engagement. RESULTS Socioeconomic position (SEP) influenced the strength of the relationship between HL and depression, which was stronger in the lowest versus the highest wealth quintiles. The use of hearing aids was beneficial for alleviating depressive symptoms. Those in the lowest wealth quintiles experienced a lower risk for depression after the use of hearing aids compared to those in the highest wealth quintiles. CONCLUSION HL poses a substantial risk for depressive symptoms in older adults, especially those who experience socioeconomic inequalities. The early detection of HL and provision of hearing aids may not only promote better-hearing health but could also enhance the psychosocial wellbeing of older adults, particularly those in a lower SEP.
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17
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Attitudes towards Safe Listening Measures in Entertainment Venues: Results from an International Survey among Young Venue-Goers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312860. [PMID: 34886583 PMCID: PMC8657835 DOI: 10.3390/ijerph182312860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sustained exposure to excess noise in recreational settings is among the main causes of hearing loss among young adults worldwide. Within a global effort to develop standards for safe listening in entertainment venues, this study aims at identifying modifiable factors (knowledge, attitudes, and beliefs), which can hinder or facilitate the acceptance of safe listening measures in public venues among young venue-goers. METHODS An online questionnaire was developed inspired by the Health Belief Model. It was divided into five sections: (i) socio-demographics (ii) listening habits, (iii) experiences with loud music, (iv) knowledge, attitudes, and beliefs, and (v) willingness to change. Participants were recruited through social media. RESULTS 2264 individuals aged 16-35 completed the questionnaire. Most visited entertainment venues relatively infrequently, with the majority of them only visiting once per month or less. Nevertheless, most reported having experienced the negative consequences of listening to loud music. Overall, most people were favorable towards preventive measures, especially quiet areas. CONCLUSION Our findings stress the urge to address the issue of safe listening in public venues and support an approach based on the introduction of standards. Moreover, they provide us with information on key factors to be considered when introducing and communicating preventive measures in public entertainment venues.
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18
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Wang Y, Ye C, Wang D, Li C, Wang S, Li J, Wu J, Wang X, Xu L. Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312311. [PMID: 34886032 PMCID: PMC8657277 DOI: 10.3390/ijerph182312311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/10/2021] [Accepted: 11/20/2021] [Indexed: 11/27/2022]
Abstract
Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals’ risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Liangwen Xu
- Correspondence: ; Tel./Fax: +86-0571-2886-5510
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19
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Olson A, Maidment DW, Ferguson MA. Consensus on connected hearing health technologies and service delivery models in the UK: a Delphi review. Int J Audiol 2021; 61:344-351. [PMID: 34182863 DOI: 10.1080/14992027.2021.1936223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To develop a consensus among hearing healthcare professionals in the UK on connected hearing health technologies and service delivery models. DESIGN A three-round, electronic Delphi review was developed using a participatory-design approach. This included ten open-ended questions (round one) that informed 69 Likert-scaled statements (rounds two and three). STUDY SAMPLE An expert panel of 34 hearing health professionals representing all geographic regions of the UK from either the publicly funded National Health Service (n = 22) or independent sector (n = 12). RESULTS The majority of statements (61%) showed ≥80% consensus, highlighting that there was broad agreement amongst professionals on connected hearing health technologies. For example, there was consensus that adults who report communication difficulties and have no medical contraindications would be ideal candidates. Furthermore, it was unanimously agreed that connected technologies could result in delays in diagnosis of treatable medical conditions, as well as result in inadequate amplification. Overall, the expert panel concurred that connected technologies could serve as "gateway products" that lead to earlier hearing aid uptake. CONCLUSIONS This Delphi review identified overarching areas of agreement that may serve as a blueprint for future implementation of connected hearing health technologies through either conventional or new service delivery models in the UK.
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Affiliation(s)
- Anne Olson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Department of Communication Sciences and Disorders, College of Health Sciences, University of Kentucky, Lexington, KY, USA.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - David W Maidment
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Melanie A Ferguson
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre (BRC), Nottingham, UK.,Hearing Sciences Section, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
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20
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Tsimpida D, Kontopantelis E, Ashcroft DM, Panagioti M. Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis. Trends Hear 2021; 25:23312165211002963. [PMID: 34049470 PMCID: PMC8165532 DOI: 10.1177/23312165211002963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/29/2020] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people's quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to identify literature that relates hearing loss to health inequalities as a determinant or health outcome. A total of 53 studies were selected to thematically summarize the existing literature, using a critical interpretive synthesis method, where the subjectivity of the researcher is intimately involved in providing new insights with explanatory power. The evidence provided by the literature can be summarized under four key themes: (a) There might be a vicious cycle between hearing loss and socioeconomic inequalities and lifestyle factors, (b) socioeconomic position may interact with less healthy lifestyles, which are harmful to hearing ability, (c) increasing health literacy could improve the diagnosis and prognosis of hearing loss and prevent the adverse consequences of hearing loss on people's health, and (d) people with hearing loss might be vulnerable to receiving low-quality and less safe health care. This study uses elements from theoretical models of health inequalities to formulate a highly interpretive conceptual model for examining hearing health inequalities. This model depicts the specific mechanisms of hearing health and their evolution over time. There are many modifiable determinants of hearing loss, in several stages across an individual's life span; tackling socioeconomic inequalities throughout the life-course could improve the population's health, maximizing the opportunity for healthy aging.
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Affiliation(s)
- Dialechti Tsimpida
- Centre for Primary Care and Health Services Research, Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Darren M. Ashcroft
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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21
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Tsimpida D, Kontopantelis E, Ashcroft DM, Panagioti M. Regional patterns and trends of hearing loss in England: evidence from the English longitudinal study of ageing (ELSA) and implications for health policy. BMC Geriatr 2020; 20:536. [PMID: 33319704 PMCID: PMC7737370 DOI: 10.1186/s12877-020-01945-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/02/2020] [Indexed: 11/22/2022] Open
Abstract
Background Hearing loss (HL) is a significant public health concern globally and is estimated to affect over nine million people in England. The aim of this research was to explore the regional patterns and trends of HL in a representative longitudinal prospective cohort study of the English population aged 50 and over. Methods We used the full dataset (74,699 person-years) of self-reported hearing data from all eight Waves of the English Longitudinal Study of Ageing (ELSA) (2002–2017). We examined the geographical identifiers of the participants at the Government Office Region (GOR) level and the geographically based Index of Multiple Deprivation (IMD). The primary outcome measure was self-reported HL; it consisted of a merged category of people who rated their hearing as fair or poor on a five-point Likert scale (excellent, very good, good, fair or poor) or responded positively when asked whether they find it difficult to follow a conversation if there is background noise (e.g. noise from a TV, a radio or children playing). Results A marked elevation in HL prevalence (10.2%) independent of the age of the participants was observed in England in 2002–2017. The mean HL prevalence increased from 38.50 (95%CI 37.37–39.14) in Wave 1 to 48.66 (95%CI 47.11–49.54) in Wave 8. We identified three critical patterns of findings concerning regional trends: the highest HL prevalence among samples with equal means of age was observed in GORs with the highest prevalence of participants in the most deprived (IMD) quintile, in routine or manual occupations and misusing alcohol. The adjusted HL predictions at the means (APMs) showed marked regional variability and hearing health inequalities between Northern and Southern England that were previously unknown. Conclusions A sociospatial approach is crucial for planning sustainable models of hearing care based on actual needs and reducing hearing health inequalities. The Clinical Commissioning Groups (CCGs) currently responsible for the NHS audiology services in England should not consider HL an inevitable accompaniment of older age; instead, they should incorporate socio-economic factors and modifiable lifestyle behaviours for HL within their spatial patterning in England. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-020-01945-6.
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Affiliation(s)
- Dialechti Tsimpida
- Centre for Primary Care and Health Services Research, Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, 5th floor Williamson Building, The University of Manchester, Oxford Road, Manchester, M139PL, UK.
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Darren M Ashcroft
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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22
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Slade K, Plack CJ, Nuttall HE. The Effects of Age-Related Hearing Loss on the Brain and Cognitive Function. Trends Neurosci 2020; 43:810-821. [PMID: 32826080 DOI: 10.1016/j.tins.2020.07.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 12/27/2022]
Abstract
Age-related hearing loss (ARHL) is a common problem for older adults, leading to communication difficulties, isolation, and cognitive decline. Recently, hearing loss has been identified as potentially the most modifiable risk factor for dementia. Listening in challenging situations, or when the auditory system is damaged, strains cortical resources, and this may change how the brain responds to cognitively demanding situations more generally. We review the effects of ARHL on brain areas involved in speech perception, from the auditory cortex, through attentional networks, to the motor system. We explore current perspectives on the possible causal relationship between hearing loss, neural reorganisation, and cognitive impairment. Through this synthesis we aim to inspire innovative research and novel interventions for alleviating hearing loss and cognitive decline.
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Affiliation(s)
- Kate Slade
- Department of Psychology, Lancaster University, Lancaster, UK
| | - Christopher J Plack
- Department of Psychology, Lancaster University, Lancaster, UK; Manchester Centre for Audiology and Deafness, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen E Nuttall
- Department of Psychology, Lancaster University, Lancaster, UK.
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23
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Tsimpida D, Kontopantelis E, Ashcroft D, Panagioti M. Comparison of Self-reported Measures of Hearing With an Objective Audiometric Measure in Adults in the English Longitudinal Study of Ageing. JAMA Netw Open 2020; 3:e2015009. [PMID: 32852555 PMCID: PMC7453309 DOI: 10.1001/jamanetworkopen.2020.15009] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
IMPORTANCE An effective and sustainable hearing loss (HL) screening strategy for the early detection of and intervention for HL in older adults is needed. OBJECTIVES To examine the concordance of self-reported measures of hearing difficulty with objective hearing data and the factors associated with the potential discordances among these measures across different population subgroups of a representative sample of people 50 years and older in England. DESIGN, SETTING, AND PARTICIPANTS This study was a cross-sectional analysis of wave 7 of the English Longitudinal Study of Ageing (ELSA), a large, population-based, prospective cohort study that provides a unique resource for exploring issues associated with aging in England in the 21st century. The full analytic cohort was composed of 9666 individuals participating in the ELSA wave 7, which collected information from June 1, 2014, to May 31, 2015. This study further analyzed a sample of 8529 adults 50 to 89 years of age who had an assessment of their hearing by self-reported measures, and consented to assessment by a qualified nurse via a hearing screening device, and did not have an ear infection or a cochlear implant. Bivariate analyses were performed from July 1 to December 30, 2018, and multivariate analysis from January 1 to June 30, 2019. Multiple logistic regression models examined factors associated with misclassification of hearing difficulties across several categories among those with objectively identified HL. EXPOSURES The study examined whether age, marital status, retirement status, indicators of socioeconomic position, and lifestyle factors (such as body mass index, physical activity, and tobacco and alcohol consumption) were associated with the concordance between self-reported hearing problems and manual audiometry among older adults. MAIN OUTCOMES AND MEASURES Self-reported hearing measures, including hearing in background noise, compared with objective audiometric assessments. RESULTS A total of 9666 study participants (5368 female [55.5%]; mean [SD] age, 67.4 [14.4] years) provided responses regarding their hearing difficulties, hearing in noise, quality of care in hearing, and hearing aid recommendation in ELSA wave 7. Within the cohort, 684 individuals (30.2%) with objectively measured HL greater than 35 dB HL at 3.0 kHz went undetected by the self-report measure, whereas the new constructed categories for moderate and moderately severe or severe HL resulted in 9.3% increased sensitivity. Factors associated with misreporting hearing difficulties (while they had objectively measured HL >35 dB HL at 3.0 kHz, in the better-hearing ear) were as follows: female sex (odds ratio [OR], 1.97; 95% CI, 1.18-3.28), no educational qualifications (OR, 1.37; 95% CI, 1.26-2.55), routine or manual occupation (OR, 1.43; 95% CI, 1.28-2.61), tobacco consumption (OR, 1.14; 95% CI, 1.08-1.90), alcohol intake above the low-risk-level guidelines (OR, 1.13; 95% CI, 1.11-2.34), and lack of moderate physical activity (OR, 1.25; 95% CI, 1.03-1.42). Age was largely associated with misreporting of moderately severe to severe HL; the odds were 5.75 (95% CI, 1.17-8.13) higher for those 65 to 74 years of age and 7.08 (95% CI, 1.41-9.30) higher for those 75 to 89 years of age to not report their hearing difficulties compared with those 50 to 64 years of age. In addition, socioeconomic indicators, such as educational level (OR, 1.95; 95% CI, 1.63-6.01) and occupation (OR, 2.07; 95% CI, 1.78-5.40), along with lifestyle factors, such as smoking (OR, 1.46; 95% CI, 1.25-2.48) and alcohol intake above the low-risk-level guidelines (OR, 1.86; 95% CI, 1.67-5.12), were factors associated with misreporting moderately severe or severe HL. CONCLUSIONS AND RELEVANCE The use of a screening measure for audiometric testing and a self-report measure is essential for accurately identifying older people with HL. The results of this study should be considered by HL researchers who analyze self-reported hearing data as a surrogate measurement of audiometric hearing to identify bias in their observed analytic research results.
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Affiliation(s)
- Dialechti Tsimpida
- Institute for Health Policy and Organisation, Centre for Primary Care and Health Services Research, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Darren Ashcroft
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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