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Yu RC, Proctor D, Soni J, Pikett L, Livingston G, Lewis G, Schilder A, Bamiou D, Mandavia R, Omar R, Pavlou M, Lin F, Goman AM, Gonzalez SC. Adult-onset hearing loss and incident cognitive impairment and dementia - A systematic review and meta-analysis of cohort studies. Ageing Res Rev 2024; 98:102346. [PMID: 38788800 DOI: 10.1016/j.arr.2024.102346] [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: 02/09/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND We comprehensively summarized the cohort evidence to date on adult-onset hearing loss as risk factor for incident cognitive impairment and dementia, and examined the evidence for dose-response, risk for various dementia subtypes, and other moderators. Previous meta-analyses were less comprehensive. METHODS We included cohort studies with participants without dementia and with hearing assessments at baseline, minimum 2 years follow-up and incident cognitive outcomes. We used random-effect models and subgroup and meta-regression on moderator analyses. RESULTS We identified fifty studies (N=1,548,754). Hearing loss (yes/no) was associated with incident dementia risk (HR=1.35 [95% CI = 1.26 - 1.45), mild cognitive impairment (MCI HR=1.29 [95% CI = 1.11 - 1.50]), cognitive decline not specified as MCI or dementia (HR=1.29 [95% CI = 1.17 - 1.42]), and Alzheimer's disease dementia (ADD, HR=1.56 [95% CI = 1.30 - 1.87]), but not with vascular dementia (HR, 1.30 [95% CI = 0.83 - 2.05]). Each 10-decibel worsening of hearing was associated with a 16% increase in dementia risk (95% CI = 1.07 - 1.27). The effect of hearing loss did not vary across potential moderators. CONCLUSIONS Cohort studies consistently support that adult-onset hearing loss increases the risk of incident cognitive decline, dementia, MCI, and ADD.
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Affiliation(s)
- Ruan-Ching Yu
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, England
| | - Danielle Proctor
- Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London WC1E 6BT, England
| | - Janvi Soni
- Royal Free London NHS Foundation Trust, Pond Street, Rosslyn Hill, London NW3 2QG, England
| | - Liam Pikett
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, England
| | - Gill Livingston
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, England
| | - Glyn Lewis
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, England
| | - Anne Schilder
- The Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, England
| | - Doris Bamiou
- The Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, England
| | - Rishi Mandavia
- The Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, England
| | - Rumana Omar
- The Ear Institute, University College London, 332 Grays Inn Rd, London WC1X 8EE, England
| | - Menelaos Pavlou
- Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT, England
| | - Frank Lin
- Center on Aging and Health, Johns Hopkins Medical Institutions, 2024 E Monument St suite 2-700, Baltimore, MD 21205, USA
| | - Adele M Goman
- School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Ct, Edinburgh EH11 4BN, Scotland
| | - Sergi Costafreda Gonzalez
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7NF, England.
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Park M, Jang SI, Hurh K, Park EC, Kim SH. Increased Risk of Dementia Following a Diagnosis of Hearing Impairment: A South Korean Nationwide Cohort Study. J Alzheimers Dis 2024; 97:679-686. [PMID: 38143356 DOI: 10.3233/jad-230816] [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: 12/26/2023]
Abstract
BACKGROUND Among the older adults, hearing impairment is a common problem and may contribute to dementia. OBJECTIVE Therefore, we aimed to examine the association between hearing impairment and the risk of dementia among older adults in South Korea. METHODS Using the Korean National Health Insurance Service-Senior Cohort from 2005 to 2019, we collected data of 44,728 patients. Hearing impairment was determined using the national disability registry. Propensity score matching (1:1) was performed to match patients with and without hearing impairment (case: 22,364, control: 22,364). A Cox proportional hazards regression model was built to analyze the association between hearing impairment and dementia. RESULTS Patients with hearing impairment had a higher risk of dementia than those without hearing impairment (hazard ratio [HR] = 1.28, 95% confidence interval [CI] = 1.23-1.34). Assessing the degree of disability, both severe (HR = 1.25, 95% CI = 1.16-1.35) and mild conditions (HR = 1.29, 95% CI = 1.23-1.35) had an increased risk of dementia, respectively. CONCLUSIONS Older patients with hearing impairment exhibit an increased risk of dementia, thereby warranting a new approach to dementia care among these patients regardless of the degree of hearing impairment.
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Affiliation(s)
- Minah Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyungduk Hurh
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Hoon Kim
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea
- Department of Ophthalmology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea
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Georges D, Rakusa E, Holtz AV, Fink A, Doblhammer G. Dementia in Germany: epidemiology, trends and challenges. JOURNAL OF HEALTH MONITORING 2023; 8:30-48. [PMID: 37829121 PMCID: PMC10565880 DOI: 10.25646/11667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/02/2023] [Indexed: 10/14/2023]
Abstract
Background Dementia poses a growing challenge for individuals, healthcare, social support, and society amidst the ongoing ageing of populations. To evaluate the care requirements and social implications of dementia in Germany, reliable statistics regarding its current and future occurrence are necessary. Methods Using existing data sources and recent research results, this paper compiles and analyses relevant statistics on the occurrence of dementia in Germany, presents protective and risk factors, and options for care provision. Results Recent projections indicate a potential surge in the number of dementia patients in Germany, predicted to rise from 1.7 million at present to up to 3.0 million by the year 2070. Cognitive and motor deterioration and behavioural changes associated with dementia lower the ability to live independently. These changes are often tied to social exclusion and stigma and, particularly in the severe phase of the disease, necessitate extensive medical and care requirements. This contributes to dementia being one of the most costly diseases at old age from an overall societal perspective. Currently, there are no curative treatment options available. Conclusions To reduce the increase in the number of dementia patients and associated costs in the future, preventive approaches, particularly promoting a healthy lifestyle, may prove effective. Simultaneously, the healthcare system, society, and caregivers must prepare for the increasing number of dementia patients. Improved diagnostics, new forms of therapy, and social innovations that support those who are affected and their relatives can help reduce the burden of dementia and its associated costs.
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Affiliation(s)
| | - Elena Rakusa
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | - Anne Fink
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Gabriele Doblhammer
- University Rostock, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
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Sparks S, Pinto J, Hayes G, Spitschan M, Bulte DP. The impact of Alzheimer's disease risk factors on the pupillary light response. Front Neurosci 2023; 17:1248640. [PMID: 37650103 PMCID: PMC10463762 DOI: 10.3389/fnins.2023.1248640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia, and its prevalence is increasing and is expected to continue to increase over the next few decades. Because of this, there is an urgent requirement to determine a way to diagnose the disease, and to target interventions to delay and ideally stop the onset of symptoms, specifically those impacting cognition and daily livelihood. The pupillary light response (PLR) is controlled by the sympathetic and parasympathetic branches of the autonomic nervous system, and impairments to the pupillary light response (PLR) have been related to AD. However, most of these studies that assess the PLR occur in patients who have already been diagnosed with AD, rather than those who are at a higher risk for the disease but without a diagnosis. Determining whether the PLR is similarly impaired in subjects before an AD diagnosis is made and before cognitive symptoms of the disease begin, is an important step before using the PLR as a diagnostic tool. Specifically, identifying whether the PLR is impaired in specific at-risk groups, considering both genetic and non-genetic risk factors, is imperative. It is possible that the PLR may be impaired in association with some risk factors but not others, potentially indicating different pathways to neurodegeneration that could be distinguished using PLR. In this work, we review the most common genetic and lifestyle-based risk factors for AD and identify established relationships between these risk factors and the PLR. The evidence here shows that many AD risk factors, including traumatic brain injury, ocular and intracranial hypertension, alcohol consumption, depression, and diabetes, are directly related to changes in the PLR. Other risk factors currently lack sufficient literature to make any conclusions relating directly to the PLR but have shown links to impairments in the parasympathetic nervous system; further research should be conducted in these risk factors and their relation to the PLR.
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Affiliation(s)
- Sierra Sparks
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Joana Pinto
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Genevieve Hayes
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Manuel Spitschan
- TUM Department of Sport and Health Sciences (TUM SG), Chronobiology and Health, Technical University of Munich, Munich, Germany
- TUM Institute for Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany
- Max Planck Institute for Biological Cybernetics, Translational Sensory and Circadian Neuroscience, Tübingen, Germany
| | - Daniel P. Bulte
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
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Völter C, Fricke H, Faour S, Lueg G, Nasreddine ZS, Götze L, Dawes P. Validation of the German Montreal-Cognitive-Assessment-H for hearing-impaired. Front Aging Neurosci 2023; 15:1209385. [PMID: 37539344 PMCID: PMC10394634 DOI: 10.3389/fnagi.2023.1209385] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Background Hearing loss and dementia are highly prevalent in older age and often co-occur. Most neurocognitive screening tests are auditory-based, and performance can be affected by hearing loss. To address the need for a cognitive screening test suitable for people with hearing loss, a visual version of the Montreal-Cognitive-Assessment was developed and recently validated in English (MoCA-H), with good sensitivity and specificity for identifying cases of dementia. As the MoCA is known to perform differently across languages, revalidation of the German MoCA-H was necessary. The aim of the present study was to assess the diagnostic accuracy of the German MoCA-H among those with normal cognition, mild cognitive impairment (MCI) and dementia and to determine an appropriate performance cut- off. Materials and methods A total of 346 participants aged 60-97 years (M = 77.18, SD = 9.56) were included; 160 were cognitively healthy, 79 with MCI and 107 were living with dementia based on the GPCOG and a detailed medical questionnaire as well as a comprehensive examination by a neurologist in case of cognitive impairment. Performance cut-offs for normal cognition, MCI and dementia were estimated for the MoCA-H score and z-scores using the English MoCA-H cut-off, the balanced cut-off and the Youden's Index. Results A mean score of 25.49 (SD = 3.01) points in the German MoCA-H was achieved in cognitively healthy participants, 20.08 (SD = 2.29) in the MCI and 15.80 (SD = 3.85) in the dementia group. The optimum cut-off for the detection of dementia was ≤21 points with a sensitivity of 96.3% and a specificity of 90%. In the MCI group, a cut-off range between 22 and 24 points is proposed to increase diagnostic accuracy to a sensitivity and specificity of 97.5 and 90%, respectively. Conclusion The German MoCA-H seems to be a sensitive screening test for MCI and dementia and should replace commonly used auditory-based cognitive screening tests in older adults. The choice of a cut-off range might help to better reflect the difficulty in clinical reality in detecting MCI. However, screening test batteries cannot replace a comprehensive cognitive evaluation.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Hannah Fricke
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Sarah Faour
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr University Bochum, Herne, Germany
| | | | - Lisa Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Piers Dawes
- Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
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Dawes P, Völter C. Do hearing loss interventions prevent dementia? Z Gerontol Geriatr 2023:10.1007/s00391-023-02178-z. [PMID: 37140632 DOI: 10.1007/s00391-023-02178-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/03/2023] [Indexed: 05/05/2023]
Abstract
Hearing loss has been identified as a potentially modifiable risk for dementia. This discussion paper reviews studies examining the impact of hearing loss interventions on cognitive decline and incident cognitive impairment, identified the challenges for research on the cognitive impacts of hearing interventions, and the likely benefits of hearing interventions for healthy aging and mental well-being.
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Affiliation(s)
- Piers Dawes
- University of Queensland Centre for Hearing Research (CHEAR), School of Health and Rehabilitation Sciences, The University of Queensland, 4072, Brisbane, QLD, Australia.
- Manchester Centre for Audiology and Deafness (ManCAD), The University of Manchester, Manchester, UK.
| | - Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Comprehensive Hearing Centre at Katholisches Klinikum, Ruhr-University, Bochum, Germany
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Schrag A, Bohlken J, Dammertz L, Teipel S, Hermann W, Akmatov MK, Bätzing J, Holstiege J. Widening the Spectrum of Risk Factors, Comorbidities, and Prodromal Features of Parkinson Disease. JAMA Neurol 2023; 80:161-171. [PMID: 36342675 PMCID: PMC9641600 DOI: 10.1001/jamaneurol.2022.3902] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Importance The prodromal phase of Parkinson disease (PD) may last for more than 10 years. Recognition of the spectrum and occurrence of risk factors, comorbidities, and prodromal features of PD can increase understanding of the causes and development of the disease and help identify individuals at risk. Objective To identify the association of a subsequent diagnosis of PD with a range of risk factors and prodromal features, including lifestyle factors, comorbidities, and potential extracerebral manifestations of PD. Design, Setting, and Participants This was a case-control study using insurance claims of outpatient consultations of patients with German statutory health insurance between January 1, 2011, and December 31, 2020. Included were patients with incident diagnosis of PD without a previous diagnosis of parkinsonism or dementia and controls matched 1:2 for age, sex, region, and earliest year of outpatient encounter. Exposures Exposures were selected based on previous systematic reviews, case-control and cohort studies reporting on risk factors, comorbidities, and prodromal features of PD. Main Outcomes and Measures Previously postulated risk factors and prodromal features of PD, using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding. Results A total of 138 345 patients with incident PD (mean [SD] age, 75.1 [9.8] years; 73 720 male [53.3%]) and 276 690 matched controls (mean [SD] age, 75.1 (9.8) years; 147 440 male [53.3%]) were identified. Study participants were followed up for a mean (SD) of 6.0 (2.0) years. Consistent with previous reports, risk factors and prodromal features associated with PD included traumatic brain injury, odds ratio (OR), 1.62; 95% CI, 1.36-1.92; alcohol misuse, OR, 1.32; 95% CI, 1.21-1.44; hypertension, OR, 1.29; 95% CI, 1.26-1.31; anosmia, OR, 2.16; 95% CI, 1.59-2.93; and parasomnias (including RBD), OR, 1.62; 95% CI, 1.42-1.84. In addition, there were associations with restless legs syndrome (OR, 4.19; 95% CI, 3.91-4.50), sleep apnea (OR, 1.45; 95% CI, 1.37-1.54), epilepsy (OR, 2.26; 95% CI, 2.07-2.46), migraine (OR, 1.21; 95% CI, 1.12-1.29), bipolar disorder (OR, 3.81; 95% CI, 3.11-4.67), and schizophrenia (OR, 4.48; 95% CI, 3.82-5.25). The following diagnoses were also found to be associated with PD: sensory impairments beyond anosmia, such as hearing loss (OR, 1.14; 95% CI, 1.09-1.20) and changes of skin sensation (OR, 1.31; 95% CI, 1.21-1.43). There were also positive associations with skin disorders (eg, seborrheic dermatitis, OR, 1.30; 95% CI, 1.15-1.46; psoriasis, OR, 1.13; 95% CI, 1.05-1.21), gastrointestinal disorders (eg, gastroesophageal reflux, OR, 1.29; 95% CI, 1.25-1.33; gastritis, OR, 1.28; 95% CI, 1.24-1.33), conditions with a potential inflammatory component (eg, seronegative osteoarthritis, OR, 1.21; 95% CI, 1.03-1.43), and diabetes types 1 (OR, 1.32; 95% CI, 1.21-1.43) and 2 (OR, 1.24; 95% CI, 1.20-1.27). Associations even 5 to 10 years before diagnosis included tremor (odds ratio [OR], 4.49; 95% CI, 3.98-5.06), restless legs syndrome (OR, 3.73; 95% CI, 3.39-4.09), bipolar disorder (OR, 3.80; 95% CI, 2.82-5.14), and schizophrenia (OR, 4.00; 95% CI, 3.31-4.85). Conclusions and Relevance Results of this case-control study suggest that the associations found between PD and certain risk factors, comorbidities, and prodromal symptoms in a representative population may reflect possible early extrastriatal and extracerebral pathology of PD. This may be due to shared genetic risk with PD, medication exposure, or direct causation, or represent pathophysiologically relevant factors contributing to the pathogenesis of PD.
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Affiliation(s)
- Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, London, United Kingdom
| | - Jens Bohlken
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health der Medizinischen Fakultät der Universität Leipzig, Leipzig, Germany
| | - Lotte Dammertz
- Central Research Institute of Ambulatory Health Care in Germany, Department of Epidemiology and Healthcare Atlas, Berlin, Germany
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany,Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Wiebke Hermann
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Manas K. Akmatov
- Central Research Institute of Ambulatory Health Care in Germany, Department of Epidemiology and Healthcare Atlas, Berlin, Germany
| | - Jörg Bätzing
- Central Research Institute of Ambulatory Health Care in Germany, Department of Epidemiology and Healthcare Atlas, Berlin, Germany
| | - Jakob Holstiege
- Central Research Institute of Ambulatory Health Care in Germany, Department of Epidemiology and Healthcare Atlas, Berlin, Germany
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Rech RS, Baumgarten A, Santos CMD, Bulgarelli AF, Goulart BN. Self-reported discrimination against adults with hearing loss in Brazilian health services: results of the National Health Survey. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.08322022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract This article aims to estimate the prevalence of self-reported discrimination against people with hearing loss in Brazilian health services and analyze associated factors. We conducted a cross-sectional population-based study using data from the 2013 National Health Survey. The final study sample comprised 1,464 individuals with self-reported hearing loss. Poisson regression was used to calculate crude and adjusted prevalence ratios (PR) and respective 95% confidence intervals. The overall prevalence of discrimination was 15%. Prevalence was higher among black people and respondents who reported experiencing limitations in activities of daily living. Prevalence of discrimination in Brazilian health services was highest in black people with limitations in activities of daily living. The implementation of policies and actions to address this problem is recommended, including strategies during the education and training of health professionals.
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McKee KS, Akobirshoev I, McKee M, Li FS, Mitra M. Postpartum Hospital Readmissions Among Massachusetts Women Who are Deaf or Hard of Hearing. J Womens Health (Larchmt) 2023; 32:109-117. [PMID: 36040351 PMCID: PMC10024058 DOI: 10.1089/jwh.2022.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objectives: Deaf or hard of hearing (DHH) women are at a higher risk of adverse pregnancy and birth outcomes compared with other women. However, little is known about postpartum outcomes among DHH women. The objective was to compare the risk of postpartum hospitalizations for DHH compared with non-DHH women and the leading indications for postpartum admissions. Materials and Methods: We analyzed data from the 1998-2017 Massachusetts Pregnancy to Early Life Longitudinal Data System and identified 3,546 singleton deliveries to DHH women and 1,381,439 singleton deliveries to non-DHH women. We used Cox proportional hazard models to compare the first hospital admission and ≥2 hospital admissions between DHH and non-DHH women within 1-42, 43-90, and 91-365 days after delivery. Results: DHH women had a higher risk for any hospital admissions across all periods (hazard ratios [HR] = 1.84; 95% confidence intervals [CI] 1.46-2.34 within 1-42 days; HR = 2.76; 95%CI 1.99-3.83 within 43-90 days; and HR = 3.10; 95%CI 2.66-3.60 91-365 days) after childbirth compared with non-DHH women. They had an almost seven times higher risk for repeated hospital admissions within 43-90 days (HR = 6.84; 95%CI 1.66-28.21) and nearly four times higher the risk within 91-365 days (HR = 3.63; 95%CI 2.00-6.59) after delivery compared with non-DHH women. The leading indications for readmission among DHH women included: conditions complicating the puerperium/hemorrhage and soft tissues disorders. Conclusion: Compared with other women, DHH women had significantly higher readmissions across all postpartum periods and for repeated admissions >42 days. Leading postpartum indications were distinct from those of non-DHH women.
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Affiliation(s)
- Kimberly S. McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Frank S. Li
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
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Rech RS, Baumgarten A, Santos CMD, Bulgarelli AF, Goulart BN. Self-reported discrimination against adults with hearing loss in Brazilian health services: results of the National Health Survey. CIENCIA & SAUDE COLETIVA 2023; 28:123-130. [PMID: 36629558 DOI: 10.1590/1413-81232023281.08322022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/10/2022] [Indexed: 01/11/2023] Open
Abstract
This article aims to estimate the prevalence of self-reported discrimination against people with hearing loss in Brazilian health services and analyze associated factors. We conducted a cross-sectional population-based study using data from the 2013 National Health Survey. The final study sample comprised 1,464 individuals with self-reported hearing loss. Poisson regression was used to calculate crude and adjusted prevalence ratios (PR) and respective 95% confidence intervals. The overall prevalence of discrimination was 15%. Prevalence was higher among black people and respondents who reported experiencing limitations in activities of daily living. Prevalence of discrimination in Brazilian health services was highest in black people with limitations in activities of daily living. The implementation of policies and actions to address this problem is recommended, including strategies during the education and training of health professionals.
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Affiliation(s)
- Rafaela Soares Rech
- Departamento de Fonoaudiologia, Universidade Federal de Ciências da Saúde de Porto Alegre. R. Sarmento Leite 245, 4º andar, sala 400B, Prédio 1, Centro Histórico. 90050-170 Porto Alegre RS Brasil.
| | - Alexandre Baumgarten
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Camila Mello Dos Santos
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Alexandre Fávero Bulgarelli
- Programa de Pós-Graduação em Saúde Coletiva, Escola de Enfermagem, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Bárbara Niegia Goulart
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul. Porto Alegre RS Brasil
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Patel SV, DeCarlo CM, Book SA, Schormans AL, Whitehead SN, Allman BL, Hayes SH. Noise exposure in early adulthood causes age-dependent and brain region-specific impairments in cognitive function. Front Neurosci 2022; 16:1001686. [PMID: 36312027 PMCID: PMC9606802 DOI: 10.3389/fnins.2022.1001686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022] Open
Abstract
Hearing loss is a chronic health condition that affects millions of people worldwide. In addition to age-related hearing impairment, excessive noise exposure is a leading cause of hearing loss. Beyond the devastating effects of hearing impairment itself, epidemiological studies have identified hearing loss as a major risk factor for age-related cognitive decline, including dementia. At present, we currently lack a full understanding of the brain regions and underlying molecular changes that are responsible for mediating the link between hearing loss and cognitive impairment across aging. In the present study, we exposed 6-month-old rats to an occupational-like noise (100 dB SPL, 4 h/day × 30 days) or sham exposure and investigated both hippocampal-dependent (i.e., spatial learning and memory, assessed using the Morris water maze) and striatal-dependent (i.e., visuomotor associative learning, assessed using an operant-conditioning task) cognitive function across aging at 7, 10, and 13 months of age. We also investigated brain region-specific changes in microglial expression following noise/sham exposure in order to assess the potential contribution of this cell type to noise-induced cognitive impairments. Consistent with human studies, the occupational-like noise exposure resulted in high-frequency hearing loss, evidenced by a significant increase in hearing thresholds at 20 kHz. Ultimately, our results suggest that not all higher-level cognitive tasks or their associated brain regions appear to be equally susceptible to noise-induced deficits during aging, as the occupational-like noise exposure caused an age-dependent deficit in spatial but not visuomotor associative learning, as well as altered microglial expression in the hippocampus but not the striatum. Interestingly, we found no significant relationships between spatial learning ability and the level of hearing loss or altered microglial density in the hippocampus following noise exposure, suggesting that other changes in the brain likely contribute to hippocampal-dependent cognitive dysfunction following noise exposure. Lastly, we found that a subset of younger animals also showed noise-induced deficits in spatial learning; findings which suggest that noise exposure may represent an increased risk for cognitive impairment in vulnerable subjects. Overall, our findings highlight that even a mild occupational-like noise exposure earlier in adulthood can have long lasting implications for cognitive function later in life.
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12
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Chen Y, Wong LLN, Chan SS, Yu J. Speech Perception in Noise Is Associated With Different Cognitive Abilities in Chinese-Speaking Older Adults With and Without Hearing Aids. Front Psychol 2022; 12:640300. [PMID: 35058826 PMCID: PMC8764161 DOI: 10.3389/fpsyg.2021.640300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group (i.e., medium effect sizes). Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL.
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Affiliation(s)
- Yuan Chen
- Department of Special Education and Counseling, The Education University of Hong Kong, Tai Po, Hong Kong SAR, China
| | - Lena L N Wong
- Clinical Hearing Sciences (CHearS) Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Shaina Shing Chan
- Clinical Hearing Sciences (CHearS) Laboratory, Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Joannie Yu
- Audiology Centre, Union Hospital, Tai Wai, Hong Kong SAR, China
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13
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Strutt PA, Barnier AJ, Savage G, Picard G, Kochan NA, Sachdev P, Draper B, Brodaty H. Hearing loss, cognition, and risk of neurocognitive disorder: evidence from a longitudinal cohort study of older adult Australians. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:121-138. [PMID: 33371769 DOI: 10.1080/13825585.2020.1857328] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Addressing midlife hearing loss could prevent up to 9% of new cases of dementia, the highest of any potentially modifiable risk factor identified in the 2017 commissioned report in The Lancet. In Australia, hearing loss is the second-most common chronic health condition in older people, affecting 74% of people aged over 70. Estimates indicate that people with severe hearing loss are up to 5-times more likely to develop dementia, but these estimates vary between studies due to methodological limitations. Using data from the Sydney Memory and Aging Study, in which 1,037 Australian men and women aged between 70 and 90 years were enrolled and completed biennial assessments from 2005-2017, investigations between hearing loss and baseline cognitive performance as well as longitudinal risk of neurocognitive disorder were undertaken. Individuals who reported moderate-to-severe hearing difficulties had poorer cognitive performances in the domains of Attention/Processing Speed and Visuospatial Ability, and on an overall index of Global Cognition, and had a 1.5-times greater risk for the neurocognitive disorder during 6-years' follow-up. Hearing loss independently predicted risk for MCI but not dementia. The presence of hearing loss is an important consideration for neuropsychological case formulation in older adults with cognitive impairment. Hearing loss may increase cognitive load, resulting in observable cognitive impairment on neuropsychological testing. Individuals with hearing loss who demonstrate impairment in non-amnestic domains may experience benefits from the provision of hearing devices; This study provides support for a randomized control trial of hearing devices for improvement of cognitive function in this group.
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Affiliation(s)
- Paul A Strutt
- Department of Cognitive Science, Macquarie University, Sydney, Australia.,Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - Amanda J Barnier
- Department of Cognitive Science, Macquarie University, Sydney, Australia.,Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - Greg Savage
- Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Gabrielle Picard
- Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia.,Department of Psychology, Macquarie University, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, The Prince of Wales Hospital, Randwick, Australia
| | - Brian Draper
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
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14
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Steinman BA, Tabler J, Mittlieder CM, Whitlock B, Goodman CE. Self-Reported Sensory Impairments in Older Adults and their Association with Self-Rated Health and Mortality Outcomes. J Aging Health 2021; 34:693-704. [PMID: 34939470 DOI: 10.1177/08982643211059133] [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: 11/17/2022]
Abstract
OBJECTIVES This study assessed the relationship between self-reported impairments of vision, hearing, and dual sensory impairment, and change in self-rated health/mortality status over a 5-year period. METHODS Data came from the National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries ages 65 and older. Analyses consisted of a series of ordinal logistic regressions stratified by sex. RESULTS For both women and men, self-reported sensory impairments were not statistical predictors of self-rated health/mortality, when other dimensions of health, such as physical functioning, participation, and activities of daily living functioning were included in models. DISCUSSION Understanding how self-reported sensory impairments impact self-rated health could assist in targeting rehabilitation strategies to older adults who experience sensory impairments.
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15
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Hearing Loss and Cognitive Impairment: Epidemiology, Common Pathophysiological Findings, and Treatment Considerations. Life (Basel) 2021; 11:life11101102. [PMID: 34685474 PMCID: PMC8538578 DOI: 10.3390/life11101102] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/04/2021] [Accepted: 10/15/2021] [Indexed: 12/04/2022] Open
Abstract
In recent years, there has been increasing research interest in the correlation between hearing impairment and cognitive decline, two conditions that have demonstrated a strong association. Hearing loss appears as a risk factor for cognitive impairment, especially among certain populations, notably nursing home residents. Furthermore, hearing loss has been identified as a modifiable age-related condition linked to dementia, and it has been estimated that midlife hearing loss, if eliminated, might decrease the risk of dementia in the general population. Several mechanisms have been suggested to explain the pathologic connections between hearing loss and dementia; however, clear evidence is missing, and the common pathophysiological basis is still unclear. In this review, we discussed current knowledge about the relationship between hearing loss and dementia, and future perspectives in terms of the effects of hearing rehabilitation for early prevention of cognitive decline.
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16
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A Newly Identified Impairment in Both Vision and Hearing Increases the Risk of Deterioration in Both Communication and Cognitive Performance. Can J Aging 2021; 41:363-376. [DOI: 10.1017/s0714980821000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.
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17
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Völter* C, Peter Thomas* J, Maetzler W, Guthoff R, Grunwald M, Hummel T. Sensory Dysfunction in Old Age. DEUTSCHES ARZTEBLATT INTERNATIONAL 2021; 118:512-520. [PMID: 34158149 PMCID: PMC8476826 DOI: 10.3238/arztebl.m2021.0212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/14/2020] [Accepted: 04/14/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The senses serve as the crucial interface between the individual and the environment. They are subject to aging and disease processes. METHODS This review is based on pertinent publications retrieved by a selective search in the Medline and Cochrane Library databases. RESULTS Approximately 40% of persons aged 70 to 79 manifest dysfunction in at least one, and more than 25% in multiple senses. Sensory changes are accompanied by diverse comorbidities which depend on the particular sense(s) affected. The presence of sensory deficits is associated with an increased risk of developing dementia (OR: 1.49 [95% confidence interval: 1.12; 1.98] for dysfunction in a single sensory modality, 2.85 [1.88; 4.30] for dysfunction in three or more sensory modalities). The risk of developing depressive symptoms is elevated as well (OR 3.36 [2.28; 4.96]). The individual's ability to cope with the demands of everyday life is largely determined by the ability to carry out multisensory integration, in which the perceptions of the different senses are bound together. This function itself is subject to age-related changes that can be either adaptive or maladaptive; it can, therefore, serve as an indicator for pathological aging processes. CONCLUSION Sensory dysfunction in old age should be detected as early as possible. This implies the need for close collaboration of all of the involved disciplines. It would be desirable to develop sensory screening tests as well as a procedure for testing multisensory integration in routine clinical practice.
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Affiliation(s)
- Christiane Völter*
- * Joint first authors
- Hearing Competence Center, St. Elisabeth- Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr University of Bochum
| | - Jan Peter Thomas*
- * Joint first authors
- Department of Otorhinolaryngology, Head and Neck Surgery, St.-Johannes-Hospital, Dortmund
| | - Walter Maetzler
- Department of Neurology, Faculty of Medicine, University of Kiel
| | - Rainer Guthoff
- Department of Ophthalmology, Düsseldorf University Hospital
| | - Martin Grunwald
- Haptic Research Lab, Paul Flechsig Institute of Brain Research, Medical Faculty of the Universität Leipzig
| | - Thomas Hummel
- Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Carl Gustav Carus, Dresden
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18
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Kasemsiri P, Yimtae K, Thanawirattananit P, Israsena P, Noymai A, Laohasiriwong S, Vatanasapt P, Siripaopradith P, Kingkaew P. Effectiveness of a programable body-worn digital hearing aid for older adults in a developing country: a randomized controlled trial with a cross-over design. BMC Geriatr 2021; 21:437. [PMID: 34301203 PMCID: PMC8299624 DOI: 10.1186/s12877-021-02325-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/06/2021] [Indexed: 11/25/2022] Open
Abstract
Background Hearing aids are important assistive devices for hearing rehabilitation. However, the cost of commonly available commercial hearing aids is often higher than the average monthly income of individuals in some developing countries. Therefore, there is a great need to locally produce cheaper, but still effective, hearing aids. The Thai-produced P02 hearing aid was designed to meet this requirement. Objective To compare the effectiveness of the P02 hearing aid with two common commercially available digital hearing aids (Clip-II™ and Concerto Basic®). Methods A prospective, randomized controlled trial with a cross-over design was conducted from October 2012 to September 2014 in a rural Thai community. There were 73 participants (mean age of 73.7 ± 7.3 years) included in this study with moderate to severe hearing loss who were assessed for hearing aid performance, including probe microphone real-ear measurement, functional gain, speech discrimination, and participant satisfaction with the overall quality of perceived sound and the design of the device. Results There were no statistically significant differences in functional gain or speech discrimination among the three hearing aids evaluated (p-value > 0.05). Real-ear measurements of the three hearing aids met the target curve in 93% of the participants. The best real-ear measurement of the hearing aid following the target curve was significantly lower than that of Clip-II™ and Concerto Basic® (p-value < 0.05) at high frequency. However, participants rated the overall quality of sound higher for the P02 hearing aid than that of Clip-II™ but lower than that of Concerto Basic® (p-value > 0.05). Participants revealed that the P02 hearing aid provided the highest satisfaction ratings for design and user-friendliness with statistical significance (p-value < 0.05). Conclusion The P02 hearing aid was an effective device for older Thai adults with hearing disabilities. Additionally, its modern design, simplicity of use, and ease of maintenance were attractive to this group of individuals. These benefits support the rehabilitation potential of this hearing aid model and its positive impact on the quality of life of older adults in developing countries. Trial registration This study was registered under Clinicaltrial.govNCT01902914. Date of registration: July 18, 2013.
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Affiliation(s)
- Pornthep Kasemsiri
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Khon Kaen Ear Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Kwanchanok Yimtae
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Khon Kaen Ear Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand.
| | - Panida Thanawirattananit
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Khon Kaen Ear Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Pasin Israsena
- National Electronics and Computer Technology Center (NECTEC), National Science and Technology Development Agency (NSTDA), Prathumthani, Thailand
| | - Anukool Noymai
- National Electronics and Computer Technology Center (NECTEC), National Science and Technology Development Agency (NSTDA), Prathumthani, Thailand
| | - Supawan Laohasiriwong
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Khon Kaen Ear Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Patravoot Vatanasapt
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.,Khon Kaen Ear Hearing and Balance Research Group, Khon Kaen University, Khon Kaen, Thailand
| | | | - Pritaporn Kingkaew
- Health Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand
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Vestibular Function in Older Adults With Cognitive Impairment: A Systematic Review. Ear Hear 2021; 42:1119-1126. [PMID: 33974775 DOI: 10.1097/aud.0000000000001040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
IMPORTANCE Given the rising prevalence of patients with dementia and those at risk for it, early identification is prioritized. As vestibular dysfunction is associated with Alzheimer's disease (AD) and may contribute to its onset, vestibular assessment may yield an opportunity in early dementia screening. OBJECTIVE This systematic review structures and compares the different raw outcome measures used to assess vestibular function while comparing older adults with preserved cognition to individuals with cognitive impairment, either suffering from mild cognitive impairment (MCI) or AD. DESIGN Two investigators independently and systematically searched publications performing objectively measured vestibular testing in a patient population consisting of either MCI or AD, compared with a control group of older adults with preserved cognition. No limitations regarding language or publication date were applied. References of the retrieved articles were hand searched for relevant articles. RESULTS Seven articles were included for analysis. A total of 235 older adults with impaired cognition (150 AD, 85 MCI) were compared with a control group of 481 older adults with preserved cognition. Evaluation of the peripheral vestibular function included video head impulse test (vHIT), videonystagmography (VNG), electronystagmography (ENG) including bithermal caloric irrigation and vestibular evoked myogenic potentials (VEMP). The VEMP test, assessing otolith function and the elicited vestibulocollic reflex (VCR), was able to differentiate subjects with AD and its prodromal stage from healthy controls, with p13 latency (p < 0.05) and amplitude (p < 0.05) having the most discriminating power.No correlation between cognitive decline and vestibulo-ocular reflex measurements in different frequency ranges of the semicircular canals (using vHIT, rotatory chair testing, and caloric irrigation) was found. Because of the limited number of available studies and the large heterogeneity in outcome measures, these results have to be interpreted with caution. CONCLUSIONS Measurements of the VCR, as evoked by the VEMP test, discriminate between patients with cognitive impairment (MCI and AD) and older adults with preserved cognition, whereas measurements of the vestibulo-ocular reflex do not. More studies are needed to further elaborate on these findings.
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20
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Xiao Z, Wu W, Zhao Q, Zhang J, Hong Z, Ding D. Sensory impairments and cognitive decline in older adults: A review from a population-based perspective. AGING AND HEALTH RESEARCH 2021. [DOI: 10.1016/j.ahr.2020.100002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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21
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Mamo SK, Wheeler KA. The Combined Burden of Hearing Loss and Cognitive Impairment in a Group Care Setting for Older Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:328-336. [PMID: 33561351 PMCID: PMC8632508 DOI: 10.1044/2020_jslhr-20-00068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Purpose The purpose of the current study is to better characterize the medical and social health characteristics of older adults in a long-term group care setting and consider the impact of the dual burden of hearing loss and cognitive impairment. Method This descriptive analysis of a convenience sample of 160 adults (M age = 74 years, age range: 59.8-99.7) participating in Program for All-inclusive Care for the Elderly programs in Massachusetts and Rhode Island included data from hearing testing, questionnaires, and medical chart review. Using descriptive statistics, groups are compared across a range of demographic and health variables on the categorical bases of hearing loss and cognitive status. Results Results suggest that hearing loss and cognitive impairment are highly prevalent among this sample of older adults. Forty-three percent of this sample has at least a mild hearing loss in the better hearing ear in addition to cognitive impairment. Descriptive analyses across demographic and health variables suggest there are few differences between those with and without cognitive impairment when compared within degree of hearing loss categories in this convenience sample. Across all participants, there was a high prevalence of other chronic conditions, most notably diabetes (59%), hypertension (90%), cardiovascular disease (80%), and depression (67%). Conclusions In this sample, there were not significant differences on demographic and health variables between the cognitive impairment groups when considered within their degree of hearing loss; however, the prevalence of the dual burden of hearing loss and cognitive impairment in this sample is high. Clinicians serving older adults, especially those accessing group care services, should be cognizant of the high burden of multiple chronic conditions and plan care that can be integrated into a comprehensive approach.
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Affiliation(s)
- Sara K. Mamo
- School of Public Health & Health Sciences, University of Massachusetts Amherst
| | - Kara A. Wheeler
- School of Public Health & Health Sciences, University of Massachusetts Amherst
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22
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Bucholc M, McClean PL, Bauermeister S, Todd S, Ding X, Ye Q, Wang D, Huang W, Maguire LP. Association of the use of hearing aids with the conversion from mild cognitive impairment to dementia and progression of dementia: A longitudinal retrospective study. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2021; 7:e12122. [PMID: 33614893 PMCID: PMC7882528 DOI: 10.1002/trc2.12122] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/12/2020] [Accepted: 11/11/2020] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Hearing aid usage has been linked to improvements in cognition, communication, and socialization, but the extent to which it can affect the incidence and progression of dementia is unknown. Such research is vital given the high prevalence of dementia and hearing impairment in older adults, and the fact that both conditions often coexist. In this study, we examined for the first time the effect of the use of hearing aids on the conversion from mild cognitive impairment (MCI) to dementia and progression of dementia. METHODS We used a large referral-based cohort of 2114 hearing-impaired patients obtained from the National Alzheimer's Coordinating Center. Survival analyses using multivariable Cox proportional hazards regression model and weighted Cox regression model with censored data were performed to assess the effect of hearing aid use on the risk of conversion from MCI to dementia and risk of death in hearing-impaired participants. Disease progression was assessed with Clinical Dementia Rating Sum of Boxes (CDR-SB) scores. Three types of sensitivity analyses were performed to validate the robustness of the results. RESULTS MCI participants that used hearing aids were at significantly lower risk of developing all-cause dementia compared to those not using hearing aids (hazard ratio [HR] 0.73, 95% confidence interval [CI], 0.61 to 0.89; false discovery rate [FDR] P = 0.004). The mean annual rate of change (standard deviation) in CDR-SB scores for hearing aid users with MCI was 1.3 (1.45) points and significantly lower than for individuals not wearing hearing aids with a 1.7 (1.95) point increase in CDR-SB per year (P = 0.02). No association between hearing aid use and risk of death was observed. Our findings were robust subject to sensitivity analyses. DISCUSSION Among hearing-impaired adults, hearing aid use was independently associated with reduced dementia risk. The causality between hearing aid use and incident dementia should be further tested.
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Affiliation(s)
- Magda Bucholc
- Cognitive Analytics Research LabSchool of Computing, Engineering & Intelligent SystemsUlster UniversityDerryUK
| | - Paula L. McClean
- Northern Ireland Centre for Stratified MedicineBiomedical Sciences Research InstituteClinical Translational Research and Innovation Centre (C‐TRIC)Ulster UniversityDerryUK
| | | | - Stephen Todd
- Altnagelvin Area HospitalWestern Health and Social Care TrustDerryUK
| | - Xuemei Ding
- Cognitive Analytics Research LabSchool of Computing, Engineering & Intelligent SystemsUlster UniversityDerryUK
- Fujian Provincial Engineering Technology Research Centre for Public Service Big Data Mining and ApplicationCollege of Mathematics and InformaticsFujian Normal UniversityFuzhouFujianChina
| | - Qinyong Ye
- Department of NeurologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Desheng Wang
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Wei Huang
- Department of OtolaryngologyFujian Medical University Union HospitalFuzhouFujianChina
| | - Liam P. Maguire
- Cognitive Analytics Research LabSchool of Computing, Engineering & Intelligent SystemsUlster UniversityDerryUK
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Krivanek TJ, Gale SA, McFeeley BM, Nicastri CM, Daffner KR. Promoting Successful Cognitive Aging: A Ten-Year Update. J Alzheimers Dis 2021; 81:871-920. [PMID: 33935078 PMCID: PMC8293659 DOI: 10.3233/jad-201462] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.
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Affiliation(s)
- Taylor J. Krivanek
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Seth A. Gale
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Brittany M. McFeeley
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Casey M. Nicastri
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Kirk R. Daffner
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
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Fritze T, Doblhammer G, Widmann CN, Heneka MT. Time course of dementia following sepsis in German health claims data. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 8:8/1/e911. [PMID: 33293458 PMCID: PMC7803331 DOI: 10.1212/nxi.0000000000000911] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/24/2020] [Indexed: 11/15/2022]
Abstract
Objective We evaluated the short-, medium-, and long-term effects of sepsis on dementia
incidence using German health claims data. Methods A total of 161,567 patients (65 years or older) were followed from 2004 to
2015 at quarterly intervals. Time since sepsis was categorized into 0 (the
effective quarter of sepsis diagnosis), 1–8, and ≥9 quarters
since the latest diagnosis of sepsis, taking into account admission to
intensive care unit and controlling for delirium, surgery, age, sex, and
comorbidities. Incident dementia was defined for all persons who did not
have a validated dementia diagnosis in 2004 and 2005 and who received a
first-time, valid diagnosis between 2006 and 2015. Results During the quarter of sepsis diagnosis, patients not admitted to intensive
care had a 3.14-fold (95% CI 2.83–3.49) increased risk, and those
with intensive care stay had a 2.22-fold (95% CI: 1.83–2.70)
increased risk of receiving an incident dementia diagnosis compared with
patients without sepsis. The impact of sepsis on incident dementia remained
in the following 2 years, remitting only thereafter. Conclusions For sepsis survivors, medium-term dementia risk remains elevated, whereas
long-term risk may reach the level of those without sepsis, even after
controlling for delirium. These findings encourage identifying modifiable
components of hospital and rehabilitation care.
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Affiliation(s)
- Thomas Fritze
- From the German Center for Neurodegenerative Diseases (T.F., G.D., C.N.W., M.T.H.), Bonn; Institute for Sociology and Demography (G.D.), University of Rostock; and Department of Neurodegenerative Disease and Geriatric Psychiatry (C.N.W., M.T.H.), University of Bonn, Germany
| | - Gabriele Doblhammer
- From the German Center for Neurodegenerative Diseases (T.F., G.D., C.N.W., M.T.H.), Bonn; Institute for Sociology and Demography (G.D.), University of Rostock; and Department of Neurodegenerative Disease and Geriatric Psychiatry (C.N.W., M.T.H.), University of Bonn, Germany
| | - Catherine N Widmann
- From the German Center for Neurodegenerative Diseases (T.F., G.D., C.N.W., M.T.H.), Bonn; Institute for Sociology and Demography (G.D.), University of Rostock; and Department of Neurodegenerative Disease and Geriatric Psychiatry (C.N.W., M.T.H.), University of Bonn, Germany
| | - Michael T Heneka
- From the German Center for Neurodegenerative Diseases (T.F., G.D., C.N.W., M.T.H.), Bonn; Institute for Sociology and Demography (G.D.), University of Rostock; and Department of Neurodegenerative Disease and Geriatric Psychiatry (C.N.W., M.T.H.), University of Bonn, Germany.
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Mitchell BL, Thorp JG, Evans DM, Nyholt DR, Martin NG, Lupton MK. Exploring the genetic relationship between hearing impairment and Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12108. [PMID: 33005726 PMCID: PMC7517507 DOI: 10.1002/dad2.12108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Hearing loss has been identified as the potentially largest modifiable risk factor for Alzheimer's disease (AD), estimated to account for a similar increase in AD risk as the apolipoprotein E (APOE) gene. METHODS We investigated the genetic relationship between hearing loss and AD, and sought evidence for a causal relationship. RESULTS We found a significant genetic overlap between hearing impairment and AD and a polygenic risk score for AD was able to significantly predict hearing loss in an independent cohort. Additionally, regions of the genome involved in inflammation were identified to be shared between hearing difficulty and AD. However, causality tests found no significant evidence of a causal relationship between these traits in either direction. DISCUSSION Overall, these results show that the relationship between hearing difficulty and AD may, in part, be due to shared genes and immune response pathways between the traits. However, currently available data do not support a causal relationship.
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Affiliation(s)
- Brittany L. Mitchell
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Jackson G. Thorp
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
| | - David M. Evans
- The University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneQueenslandAustralia
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUnited Kingdom
| | - Dale R. Nyholt
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
| | - Nicholas G. Martin
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
| | - Michelle K. Lupton
- School of Biomedical Science and Institute of Health and Biomedical Innovation, Faculty of HealthQueensland University of Technology (QUT)BrisbaneQueenslandAustralia
- Department of Genetics and Computational BiologyQIMR Berghofer Medical Research InstituteBrisbaneQueenslandAustralia
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26
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Croll PH, Vinke EJ, Armstrong NM, Licher S, Vernooij MW, Baatenburg de Jong RJ, Goedegebure A, Ikram MA. Hearing loss and cognitive decline in the general population: a prospective cohort study. J Neurol 2020; 268:860-871. [PMID: 32910252 PMCID: PMC7914236 DOI: 10.1007/s00415-020-10208-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 12/02/2022]
Abstract
Background Previous studies identifying hearing loss as a promising modifiable risk factor for cognitive decline mostly adjusted for baseline age solely. As such a faster cognitive decline at a higher age, which is expected considering the non-linear relationship between cognition and age, may have been overlooked. Therefore it remains uncertain whether effects of hearing loss on cognitive decline extend beyond age-related declines of cognitive function. Methods 3,590 non-demented participants were eligible for analysis at baseline, and a maximum of 837 participants were eligible for the longitudinal analysis. Hearing loss was defined at baseline. Cognitive function was measured at baseline and at follow-up (4.4 years [SD: 0.2]). Multivariable linear regression analysis was used for the cross-sectional analysis. Linear mixed models were used to assess the longitudinal association between hearing loss and cognitive decline over time while adjusting for confounders and the interaction of age and follow-up time. Results Hearing loss was associated with lower cognitive function at baseline. Moreover, hearing loss was associated with accelerated cognitive decline over time on a memory test. After additionally adjusting for the interaction between age and follow-up time, we found that hearing loss did not accelerate cognitive decline anymore. Conclusions Hearing loss was associated with lower cognitive function at baseline and accelerated cognitive decline on a memory test. The association between hearing loss and accelerated cognitive decline was non-significant after additional adjustment for non-linear age effects. More evidence is needed to ensure the role of hearing loss as a modifiable risk factor for cognitive decline. Electronic supplementary material The online version of this article (10.1007/s00415-020-10208-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pauline H Croll
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth J Vinke
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nicole M Armstrong
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Silvan Licher
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
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27
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Topic Modeling for Analyzing Patients' Perceptions and Concerns of Hearing Loss on Social Q&A Sites: Incorporating Patients' Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176209. [PMID: 32867035 PMCID: PMC7503893 DOI: 10.3390/ijerph17176209] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/09/2020] [Accepted: 08/24/2020] [Indexed: 11/16/2022]
Abstract
Hearing loss is the most common human sensory deficit, affecting normal communication. Recently, patients with hearing loss or at risk of hearing loss are increasingly turning to the online health community for health information and support. Information on health-related topics exchanged on the Internet is a useful resource to examine patients' informational needs. The ability to understand the patients' perspectives on hearing loss is critical for health professionals to develop a patient-centered intervention. In this paper, we apply Latent Dirichlet Allocation (LDA) on electronic patient-authored questions on social question-and-answer (Q&A) sites to identify patients' perceptions, concerns, and needs on hearing loss. Our results reveal 21 topics, which are both representative and meaningful, and mostly correspond to sub-fields established in hearing science research. The latent topics are classified into five themes, which include "sudden hearing loss", "tinnitus", "noise-induced hearing loss", "hearing aids", "dizziness", "curiosity about hearing loss", "otitis media" and "complications of disease". Our topic analysis of patients' questions on the topic of hearing loss allows achieving a thorough understanding of patients' perspectives, thereby leading to better development of the patient-centered intervention.
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28
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Lopez-Juarez A, Gonzalez-Vega A, Kleinert-Altamirano A, Piazza V, Garduno-Robles A, Alata M, Villaseñor-Mora C, Eguibar JR, Cortes C, Padierna LC, Hernandez VH. Auditory impairment in H-ABC tubulinopathy. J Comp Neurol 2020; 529:957-968. [PMID: 32681585 DOI: 10.1002/cne.24990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/12/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022]
Abstract
Hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) is a neurodegenerative disease due to mutations in TUBB4A. Patients suffer from extrapyramidal movements, spasticity, ataxia, and cognitive deficits. Magnetic resonance imaging features are hypomyelination and atrophy of the striatum and cerebellum. A correlation between the mutations and their cellular, tissue and organic effects is largely missing. The effects of these mutations on sensory functions have not been described so far. We have previously reported a rat carrying a TUBB4A (A302T) mutation and sharing most of the clinical and radiological signs with H-ABC patients. Here, for the first time, we did a comparative study of the hearing function in an H-ABC patient and in this mutant model. By analyzing hearing function, we found that there are no significant differences in the auditory brainstem response (ABR) thresholds between mutant rats and WT controls. Nevertheless, ABRs show longer latencies in central waves (II-IV) that in some cases disappear when compared to WT. The patient also shows abnormal AEPs presenting only Waves I and II. Distortion product of otoacoustic emissions and immunohistochemistry in the rat show that the peripheral hearing function and morphology of the organ of Corti are normal. We conclude that the tubulin mutation severely impairs the central hearing pathway most probably by progressive central white matter degeneration. Hearing function might be affected in a significant fraction of patients with H-ABC; therefore, screening for auditory function should be done on patients with tubulinopathies to evaluate hearing support therapies.
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Affiliation(s)
| | - Arturo Gonzalez-Vega
- Division of Sciences and Engineering, University of Guanajuato, Guanajuato, Mexico
| | | | | | - Angeles Garduno-Robles
- Division of Sciences and Engineering, University of Guanajuato, Guanajuato, Mexico.,Center of Research in Optics, Leon, Mexico
| | | | | | - Jose R Eguibar
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico.,Vicerrectoría de Investigación y Estudios de Posgrado, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Carmen Cortes
- Institute of Physiology, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Luis Carlos Padierna
- Division of Sciences and Engineering, University of Guanajuato, Guanajuato, Mexico
| | - Victor H Hernandez
- Division of Sciences and Engineering, University of Guanajuato, Guanajuato, Mexico
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29
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Meyer C, Hickson L. Nursing Management of Hearing Impairment in Nursing Facility Residents. J Gerontol Nurs 2020; 46:15-25. [DOI: 10.3928/00989134-20200605-04] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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30
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Tjandra D, Migrino RQ, Giordani B, Wiens J. Cohort discovery and risk stratification for Alzheimer's disease: an electronic health record-based approach. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12035. [PMID: 32548236 PMCID: PMC7293993 DOI: 10.1002/trc2.12035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/18/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND We sought to leverage data routinely collected in electronic health records (EHRs), with the goal of developing patient risk stratification tools for predicting risk of developing Alzheimer's disease (AD). METHOD Using EHR data from the University of Michigan (UM) hospitals and consensus-based diagnoses from the Michigan Alzheimer's Disease Research Center, we developed and validated a cohort discovery tool for identifying patients with AD. Applied to all UM patients, these labels were used to train an EHR-based machine learning model for predicting AD onset within 10 years. RESULTS Applied to a test cohort of 1697 UM patients, the model achieved an area under the receiver operating characteristics curve of 0.70 (95% confidence interval = 0.63-0.77). Important predictive factors included cardiovascular factors and laboratory blood testing. CONCLUSION Routinely collected EHR data can be used to predict AD onset with modest accuracy. Mining routinely collected data could shed light on early indicators of AD appearance and progression.
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Affiliation(s)
- Donna Tjandra
- Department of Electrical Engineering and Computer ScienceUniversity of MichiganAnn ArborMichiganUSA
| | - Raymond Q. Migrino
- Phoenix Veterans Affairs Health Care SystemPhoenixArizonaUSA
- Department of MedicineUniversity of Arizona College of Medicine‐PhoenixPhoenixArizonaUSA
| | - Bruno Giordani
- Department of Psychiatry, Neuropsychology ProgramUniversity of Michigan Ann ArborAnn ArborMichiganUSA
| | - Jenna Wiens
- Department of Electrical Engineering and Computer ScienceUniversity of MichiganAnn ArborMichiganUSA
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31
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Long-Term Feeding of a High-Fat Diet Ameliorated Age-Related Phenotypes in SAMP8 Mice. Nutrients 2020; 12:nu12051416. [PMID: 32423039 PMCID: PMC7285040 DOI: 10.3390/nu12051416] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/01/2020] [Accepted: 05/11/2020] [Indexed: 01/08/2023] Open
Abstract
High-fat diets (HFD) have been thought to increase the risk of obesity and metabolic syndrome, as well as shorten lifespan. On the other hand, chrono-nutritional studies have shown that time-restricted feeding during active phase significantly suppresses the induction of HFD-induced obesity in mouse model. However, the long-term effects of time-restricted HFD feeding on aging are unknown. Therefore, in this study, we set up a total of four groups: mutual combination of ad libitum feeding or night-time-restricted feeding (NtRF) and an HFD or a control diet. We examined their long-term effects in a senescence-accelerated mouse strain, SAMP8, for over a year. Hearing ability, cognitive function, and other behavioral and physiological indexes were evaluated during the study. Unexpectedly, SAMP8 mice did not show early onset of death caused by the prolonged HFD intake, and both HFD and NtRF retarded age-related hearing loss (AHL). NtRF improved grip strength and cognitive memory scores, while HFD weakly suppressed age-related worsening of the appearance scores associated with the eyes. Notably, the HFD also retarded the progression of AHL in both DBA/2J and C57BL/6J mice. These results suggest that HFD prevents aging unless metabolic disorders occur and that HFD and NtRF are independently effective in retarding aging; thus, the combination of HFD and chrono-nutritional feeding may be an effective anti-aging strategy.
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32
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Bondurant LM. Breaking Down Silos: Interprofessional Collaborative Practice in Humanitarian Audiology. Semin Hear 2020; 41:92-99. [PMID: 32269413 DOI: 10.1055/s-0040-1708506] [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: 10/24/2022] Open
Abstract
The goal of humanitarian healthcare is to improve health outcomes and patient quality of life in under-resourced areas. One avenue for improvement may be via interprofessional collaborative practice, which allows providers from multiple specialties to work together to promote positive interventions for the communities they serve. The purpose of this article is to provide a general framework for incorporating interprofessional collaborative practice within a humanitarian audiology project.
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Gregory S, Billings J, Wilson D, Livingston G, Schilder AG, Costafreda SG. Experiences of hearing aid use among patients with mild cognitive impairment and Alzheimer's disease dementia: A qualitative study. SAGE Open Med 2020; 8:2050312120904572. [PMID: 32166027 PMCID: PMC7054731 DOI: 10.1177/2050312120904572] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/26/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives: Hearing aid usage supports communication and independence; however, many do
not use their hearing aids. This study explored the experiences of hearing
aid use in adults with mild cognitive impairment or Alzheimer’s disease. Methods: Participants completed semi-structured interviews which were analysed using
thematic analysis. Ten people (six males, age range 75–86 years old) with
mild cognitive impairment or Alzheimer’s disease who had been fitted with
hearing aids were recruited to the study. Results: We identified four major themes: (1) memory and other cognitive barriers to
using hearing aids, (2) practical aspects of hearing aids, (3) benefits of
hearing aids, and (4) ambivalence towards hearing aids. Conclusions: Participants perceived a significant impact of cognitive impairment on the
experience of using hearing aids. This population may benefit from targeted
strategies to support use of hearing aids. The findings from this study can
inform future research to optimise use of hearing aids in this
population.
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Affiliation(s)
- Sarah Gregory
- Centres for Dementia Prevention and Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Danielle Wilson
- Oxford Imaging Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, USA
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
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Dodel R, Völter C. Demenzerkrankungen: Relevantes für den HNO-Arzt. HNO 2020; 68:143-149. [DOI: 10.1007/s00106-020-00814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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35
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Shan A, Lin FR, Nieman CL. Age-related Hearing Loss: Recent Developments in Approaching a Public Health Challenge. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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36
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Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev 2019; 56:100963. [PMID: 31557539 DOI: 10.1016/j.arr.2019.100963] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/20/2019] [Accepted: 09/18/2019] [Indexed: 01/07/2023]
Abstract
Age-related hearing loss (ARHL) or presbycusis, as the third leading cause of chronic disability in older adults, has been shown to be associated with predisposing cognitive impairment and dementia. Tinnitus is also a chronic auditory disorder demonstrating a growth rate with increasing age. Recent evidence stands for the link between bothersome tinnitus and impairments in various aspects of cognitive function. Both ARHL and age-related tinnitus affect mental health and contribute to developing anxiety, stress, and depression. The present review is a comprehensive multidisciplinary study on diverse interactions among ARHL, tinnitus, and cognitive decline in older adults. This review incorporates the latest evidence in prevalence and risk factors of ARHL and tinnitus, the neural substrates of tinnitus-related cognitive impairments, hypothesized mechanisms concerning the association between ARHL and increased risk of dementia, hearing amplification outcomes in cases with ARHL and cognitive decline, and preliminary findings on the link between ARHL and cognitive impairment in animal studies. Given extensive evidence that demonstrates advantages of using auditory amplification in the alleviation of hearing handicap, depression, and tinnitus, and the improvement of cognition, social communication, and quality of life, regular hearing screening programs for identification and management of midlife hearing loss and tinnitus is strongly recommended.
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37
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Anzivino R, Conti G, Di Nardo W, Fetoni AR, Picciotti PM, Marra C, Guglielmi V, Fortunato S, Forli F, Paludetti G, Berrettini S. Prospective Evaluation of Cognitive Functions After Rehabilitation With Cochlear Implant or Hearing Aids: Preliminary Results of a Multicentric Study on Elderly Patients. Am J Audiol 2019; 28:762-774. [PMID: 32271124 DOI: 10.1044/2019_aja-heal18-18-0176] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective Recent literature has shown a growing interest in the relationship between presbycusis and cognitive decline, but significant evidence about the long-term benefit of rehabilitation on cognitive functions has not been reported yet. The aim of the study was to analyze audiological and neuropsychological performances in patients with cochlear implant (CI) or hearing aids (HAs) over time. Materials and Method Forty-four bilaterally deaf patients aged more than 60 years (25 with CI candidacy and 19 with HA candidacy) were enrolled. Patients were subjected to audiological evaluation, to a battery of neuropsychological tests (Mini-Mental State Examination [MMSE], Rey Auditory Verbal Learning Task [RAVLT], Rey-Osterreith Complex Figure Test, Digit/Corsi Span Forward and Backward, Multiple Features Target Cancellation, Trail-Making Test, Stroop Test, and Phonological and Semantic Word Fluency), and to a quality of life assessment (Short Form 36, Glasgow Benefit Inventory, Glasgow Health Status Inventory) at the baseline and after a long-term follow-up (6-12 months). Results Speech recognition scores in quiet and in noise were significantly improved even 6 months after auditory rehabilitation. Significant differences between pre- and post-rehabilitation scores were reported in physical and emotional impacts in life, general global health, vitality, and social activities. MMSE and RAVLT scores were significantly improved in both groups after 6 months of follow-up, suggesting a global involvement of memory domain. Mnesic performances remained unchanged between the first and second follow-up, but a further significant improvement in executive functions (Stroop Test) was detected in patients with CI reevaluated 12 months after implantation. A significant correlation of the RAVLT with signal-to-noise ratio at +10 dB speech-in-noise scores and the MMSE with signal-to-noise ratio at 0 dB speech-in-noise scores suggests the pivotal role of executive functions in recognition in noisy environment. Conclusions Our preliminary data confirm that hearing deprivation in aged patients represents a truly modifiable risk factor for cognitive decline, which can be positively faced by acoustic rehabilitation. The improvement of short- and long-term memory performances and the amelioration of executive and attentive functions suggest that hearing restoration with both HAs and CI may provide a recovery of superior cognitive domains probably through a reallocation of cortical resources altered by hearing deprivation.
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Affiliation(s)
- Roberta Anzivino
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Guido Conti
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Walter Di Nardo
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Anna Rita Fetoni
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Pasqualina Maria Picciotti
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Camillo Marra
- Memory Clinic, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
| | - Valeria Guglielmi
- Neurology Unit, Catholic University of Sacred Heart, Fondazione Policlinico “A. Gemelli,” IRCCS Rome, Italy
| | - Susanna Fortunato
- ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Italy
| | - Francesca Forli
- ENT Audiology and Phoniatrics Unit, University Hospital of Pisa, Italy
| | - Gaetano Paludetti
- Institute of Otorhinolaryngology, Catholic University of Sacred Heart, Fondazione Policlinico “A Gemelli,” IRCCS Rome, Italy
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38
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β-Secretase BACE1 Is Required for Normal Cochlear Function. J Neurosci 2019; 39:9013-9027. [PMID: 31527119 DOI: 10.1523/jneurosci.0028-19.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 08/30/2019] [Accepted: 09/04/2019] [Indexed: 12/20/2022] Open
Abstract
Cleavage of amyloid precursor protein (APP) by β-secretase BACE1 initiates the production and accumulation of neurotoxic amyloid-β peptides, which is widely considered an essential pathogenic mechanism in Alzheimer's disease (AD). Here, we report that BACE1 is essential for normal auditory function. Compared with wild-type littermates, BACE1-/- mice of either sex exhibit significant hearing deficits, as indicated by increased thresholds and reduced amplitudes in auditory brainstem responses (ABRs) and decreased distortion product otoacoustic emissions (DPOAEs). Immunohistochemistry revealed aberrant synaptic organization in the cochlea and hypomyelination of auditory nerve fibers as predominant neuropathological substrates of hearing loss in BACE1-/- mice. In particular, we found that fibers of spiral ganglion neurons (SGN) close to the organ of Corti are disorganized and abnormally swollen. BACE1 deficiency also engenders organization defects in the postsynaptic compartment of SGN fibers with ectopic overexpression of PSD95 far outside the synaptic region. During postnatal development, auditory fiber myelination in BACE1-/- mice lags behind dramatically and remains incomplete into adulthood. We relate the marked hypomyelination to the impaired processing of Neuregulin-1 when BACE1 is absent. To determine whether the cochlea of adult wild-type mice is susceptible to AD treatment-like suppression of BACE1, we administered the established BACE1 inhibitor NB-360 for 6 weeks. The drug suppressed BACE1 activity in the brain, but did not impair hearing performance and, upon neuropathological examination, did not produce the characteristic cochlear abnormalities of BACE1-/- mice. Together, these data strongly suggest that the hearing loss of BACE1 knock-out mice represents a developmental phenotype.SIGNIFICANCE STATEMENT Given its crucial role in the pathogenesis of Alzheimer's disease (AD), BACE1 is a prime pharmacological target for AD prevention and therapy. However, the safe and long-term administration of BACE1-inhibitors as envisioned in AD requires a comprehensive understanding of the various physiological functions of BACE1. Here, we report that BACE1 is essential for the processing of auditory signals in the inner ear, as BACE1-deficient mice exhibit significant hearing loss. We relate this deficit to impaired myelination and aberrant synapse formation in the cochlea, which manifest during postnatal development. By contrast, prolonged pharmacological suppression of BACE1 activity in adult wild-type mice did not reproduce the hearing deficit or the cochlear abnormalities of BACE1 null mice.
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Moberly AC, Mattingly JK, Castellanos I. How Does Nonverbal Reasoning Affect Sentence Recognition in Adults with Cochlear Implants and Normal-Hearing Peers? Audiol Neurootol 2019; 24:127-138. [PMID: 31266013 DOI: 10.1159/000500699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/30/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous research has demonstrated an association of scores on a visual test of nonverbal reasoning, Raven's Progressive Matrices (RPM), with scores on open-set sentence recognition in quiet for adult cochlear implant (CI) users as well as for adults with normal hearing (NH) listening to noise-vocoded sentence materials. Moreover, in that study, CI users demonstrated poorer nonverbal reasoning when compared with NH peers. However, it remains unclear what underlying neurocognitive processes contributed to the association of nonverbal reasoning scores with sentence recognition, and to the poorer scores demonstrated by CI users. OBJECTIVES Three hypotheses were tested: (1) nonverbal reasoning abilities of adult CI users and normal-hearing (NH) age-matched peers would be predicted by performance on more basic neurocognitive measures of working memory capacity, information-processing speed, inhibitory control, and concentration; (2) nonverbal reasoning would mediate the effects of more basic neurocognitive functions on sentence recognition in both groups; and (3) group differences in more basic neurocognitive functions would explain the group differences previously demonstrated in nonverbal reasoning. METHOD Eighty-three participants (40 CI and 43 NH) underwent testing of sentence recognition using two sets of sentence materials: sentences produced by a single male talker (Harvard sentences) and high-variability sentences produced by multiple talkers (Perceptually Robust English Sentence Test Open-set, PRESTO). Participants also completed testing of nonverbal reasoning using a visual computerized RPM test, and additional neurocognitive assessments were collected using a visual Digit Span test and a Stroop Color-Word task. Multivariate regression analyses were performed to test our hypotheses while treating age as a covariate. RESULTS In the CI group, information processing speed on the Stroop task predicted RPM performance, and RPM scores mediated the effects of information processing speed on sentence recognition abilities for both Harvard and PRESTO sentences. In contrast, for the NH group, Stroop inhibitory control predicted RPM performance, and a trend was seen towards RPM scores mediating the effects of inhibitory control on sentence recognition, but only for PRESTO sentences. Poorer RPM performance in CI users than NH controls could be partially attributed to slower information processing speed. CONCLUSIONS Neurocognitive functions contributed differentially to nonverbal reasoning performance in CI users as compared with NH peers, and nonverbal reasoning appeared to partially mediate the effects of these different neurocognitive functions on sentence recognition in both groups, at least for PRESTO sentences. Slower information processing speed accounted for poorer nonverbal reasoning scores in CI users. Thus, it may be that prolonged auditory deprivation contributes to cognitive decline through slower information processing.
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Affiliation(s)
- Aaron C Moberly
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA,
| | - Jameson K Mattingly
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Irina Castellanos
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Meyer CJ, Koh SSH, Hill AJ, Conway ER, Ryan BJ, McKinnon ER, Pachana NA. Hear–Communicate–Remember: Feasibility of delivering an integrated intervention for family caregivers of people with dementia and hearing impairment via telehealth. DEMENTIA 2019; 19:2671-2701. [DOI: 10.1177/1471301219850703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose To evaluate the feasibility of Hear–Communicate–Remember, a training programme developed for family caregivers of people with dementia and hearing impairment that integrated hearing, communication and memory strategies, which was intended to be delivered via telehealth. Materials and methods Participants included six dyads consisting of adults with dementia and hearing impairment and their family caregivers. Data collection involved a combination of semi-structured interviews, self-report questionnaires and field notes. Results Analysis of the qualitative interviews revealed four themes: appropriateness of intervention resources, considerations for the delivery of intervention via telehealth, knowledge and application of intervention strategies, and impact of the intervention on day-to-day life. Results from the satisfaction survey indicated that caregiver participants were mostly satisfied with all aspects of the intervention except the use of some technological components. The field notes described challenges with implementation via telehealth. Conclusions Future research involving a cohort comparison study with a larger cohort of dyads is needed to establish treatment efficacy.
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Affiliation(s)
- Carly J Meyer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sheena SH Koh
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Annie J Hill
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Erin R Conway
- School of Allied Health, Australian Catholic University, Brisbane, Australia
| | - Brooke J Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Eril R McKinnon
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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de la Torre-Luque A, de la Fuente J, Prina M, Sanchez-Niubo A, Haro JM, Ayuso-Mateos JL. Long-term trajectories of depressive symptoms in old age: Relationships with sociodemographic and health-related factors. J Affect Disord 2019; 246:329-337. [PMID: 30594876 DOI: 10.1016/j.jad.2018.12.122] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/19/2018] [Accepted: 12/24/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND This study aimed at depicting the course of depression symptoms over the old age, with a special interest in a) uncovering its relationships with sociodemographic and health-related factors; b) analysing its predictive role on healthy-ageing outcomes later in life. METHODS The sample comprised 8317 older adults (46.02% men) from the English Longitudinal Study of Ageing. Robust structural equation modelling was used to identify symptom trajectories and their relationships with time-varying factors. Trajectory class and covariates were used to predict outcomes (quality of life, satisfaction with life, and daily living functioning) in a 2-year follow-up. RESULTS Three trajectory classes (so-called, normative, subclinical, chronic symptom trajectories) were identified for both sexes. Rising hearing difficulties and history of psychiatric problems were consistently associated with the chronic symptom trajectory. Lower education level, history of psychiatric problems, and increasing visual difficulties were connected with the subclinical trajectories. Finally, participants with either a subclinical or a chronic symptom trajectory showed worse outcomes than the remaining participants in the follow-up. CONCLUSION This study highlighted the presence of varying courses of depression symptoms (each showing some distinctive features from other another) over the old age, pointing to some relevant implications for clinical assessment and treatment prescription.
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Affiliation(s)
- Alejandro de la Torre-Luque
- Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain.
| | - Javier de la Fuente
- Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
| | - Matthew Prina
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Albert Sanchez-Niubo
- Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Spain
| | - Josep Maria Haro
- Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Universitat de Barcelona, Spain
| | - Jose Luis Ayuso-Mateos
- Centre for Biomedical Research on Mental Health (CIBERSAM), Spain; Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain
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McPherson B. Self-Reported Benefit and Satisfaction with a Beamforming Body-Worn Hearing Aid for Elderly Adults. Int J Otolaryngol 2018; 2018:2046894. [PMID: 30515217 PMCID: PMC6236654 DOI: 10.1155/2018/2046894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/17/2018] [Accepted: 10/11/2018] [Indexed: 11/18/2022] Open
Abstract
Hearing impairment is a leading cause of disability globally and is particularly prevalent in elderly populations. Hearing aids are commonly recommended to mitigate the adverse effects on communication associated with hearing loss. However, the acceptability of hearing aids to elderly individuals is low and the majority of potential users do not wear hearing aids. Most hearing aids are designed with a discreet form factor in mind, to minimize device visibility. Given the range of comorbidities associated with hearing loss in the elderly, this conventional form factor may not always be optimal. The present study examined the experiences of elderly individuals with a recently developed, unconventional, body-worn hearing instrument, the EasyHear™ Grand (Logital Co. Ltd., Hong Kong). The bilaterally fitted instrument incorporates large controls, a color display, beamforming sound processing, and Bluetooth capabilities. Forty-three elderly participants (mean age=71; range 46-88 years) were surveyed to gauge level of benefit and satisfaction with the device and opinions regarding the hearing aid. They were assessed using three standardized questionnaires (the International Outcome Inventory-Hearing Aids, the Profile of Hearing Aid Benefit, and the Client Oriented Scale of Improvement) and through open-ended, structured interviews. Participants rated their EasyHear device fitting highly for hours of use and improved quality of life and rated the device favorably for improved communication and benefit in background noise. A majority of users felt the device improved listening ability in their expressed area of greatest need, and also for their second highest prioritized area of greatest need. Less than 10% of users felt their listening was only occasionally or hardly ever improved when using the body-worn device. Benefit and satisfaction ratings with the EasyHear Grand were comparable to those in studies involving conventional form factor devices. Interviews highlighted areas where users felt the device could be improved-extra noise reduction, changes to device dimensions, receiver/eartip fit, and cableless technology were among the areas mentioned. Many participants valued smartphone linkage and Bluetooth capability. The EasyHear Grand, with its body-worn design and large, simple controls, was well accepted by the majority of participants. Hearing aids that break from conventional design formats may benefit many elderly individuals with hearing impairment and promote increased user acceptability.
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Besser J, Stropahl M, Urry E, Launer S. Comorbidities of hearing loss and the implications of multimorbidity for audiological care. Hear Res 2018; 369:3-14. [DOI: 10.1016/j.heares.2018.06.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/18/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022]
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Abstract
Hearing loss is the third most common chronic condition but can be secondary to a range of conditions encountered in primary care. This article reviews the presentation, evaluation, differential diagnosis, and associated treatments for both acute and chronic causes of hearing loss. As the most common cause of hearing loss, this article provides an overview of age-related hearing loss, its consequences, and pragmatic treatment approaches, including over-the-counter hearing technology.
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Affiliation(s)
- Carrie L Nieman
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205, USA.
| | - Nicholas S Reed
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205, USA
| | - Frank R Lin
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21287, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Suite 2-700, Baltimore, MD 21205, USA; Department of Medicine, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Baltimore, MD 21234, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
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Kramer S, Vasil KJ, Adunka OF, Pisoni DB, Moberly AC. Cognitive Functions in Adult Cochlear Implant Users, Cochlear Implant Candidates, and Normal-Hearing Listeners. Laryngoscope Investig Otolaryngol 2018; 3:304-310. [PMID: 30186962 PMCID: PMC6119791 DOI: 10.1002/lio2.172] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 04/25/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Increasing evidence suggests that hearing loss may be linked to cognitive decline, and that cochlear implantation may lead to improvements in cognition. The goal of this study was to examine the effects of severe-to-profound hearing loss and cochlear implantation in post-lingually deafened adults, compared with age-matched normal-hearing (NH) peers. Participants were tested on several non-auditory measures of cognition: working memory (WM) (digit span, object span, symbol span), non-verbal reasoning (Raven's progressive matrices), information-processing speed and inhibitory control (Stroop test), speed of phonological and lexical access (Test of Word Reading Efficiency), and verbal learning and memory (California Verbal Learning Test). Demographic measures were also collected. METHODS Cohort study at tertiary neurotology center. Forty-three post-lingually deafened experienced CI users, 19 post-lingually deafened CI candidates, and 40 age-matched NH controls with no cognitive impairment were enrolled. Comparisons among the groups on the cognitive measures were performed. RESULTS Adult CI users and CI candidates demonstrated worse (or a trend towards worse) performance as compared with NH peers on non-verbal reasoning, information-processing speed, speed of lexical access, and verbal learning and memory. However, after controlling for gender, socioeconomic status (SES), and vocabulary knowledge among groups, some of these differences were no longer significant. Similarly, large differences were not found in most cognitive abilities between experienced CI users and CI candidates. CONCLUSIONS Adult CI users, CI candidates, and NH peers generally demonstrated equivalent non-auditory cognitive abilities, after controlling for gender, SES, and vocabulary knowledge. These findings provide support for a link between cognitive decline and hearing loss, but this association may be partly attributable to group differences in SES and vocabulary knowledge. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Scott Kramer
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University Wexner Medical CenterColumbusOhioU.S.A.
| | - Kara J. Vasil
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University Wexner Medical CenterColumbusOhioU.S.A.
| | - Oliver F. Adunka
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University Wexner Medical CenterColumbusOhioU.S.A.
| | - David B. Pisoni
- Department of Psychological and Brain Sciences Indiana UniversityBloomingtonIndianaU.S.A.
| | - Aaron C. Moberly
- Department of Otolaryngology–Head and Neck Surgery The Ohio State University Wexner Medical CenterColumbusOhioU.S.A.
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Lim MYL, Loo JHY. Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Int J Geriatr Psychiatry 2018; 33:972-979. [PMID: 29575215 DOI: 10.1002/gps.4880] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/31/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To determine if there is an association between hearing loss and poorer cognitive scores on Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) and to determine if poor hearing acuity affects scoring on the cognitive screening tests of MMSE and MoCA. METHODS One hundred fourteen elderly patients (Singapore residents) aged between 55 and 86 years were sampled. Participants completed a brief history questionnaire, pure tone audiometry, and 2 cognitive screening tests-the MMSE and MoCA. Average hearing thresholds of the better ear in the frequencies of 0.5, 1, 2, and 4 kHz were used for data analysis. RESULTS Hearing loss was significantly associated with poorer cognitive scores in Poisson regression models adjusted for age. Mini-Mental State Examination scores were shown to decrease by 2.8% (P = .029), and MoCA scores by 3.5% (P = .013) for every 10 dB of hearing loss. Analysis of hearing-sensitive components of "Registration" and "Recall" in MMSE and MoCA using chi-square tests showed significantly poorer performance in the hearing loss group as compared to the normal hearing group. Phonetic analysis of target words with high error rates shows that the poor performance was likely contributed by decreased hearing acuity, on top of a possible true deficit in cognition in the hearing impaired. CONCLUSIONS Hearing loss is associated with poorer cognitive scores on MMSE and MoCA, and cognitive scoring is likely confounded by poor hearing ability. This highlights an important, often overlooked aspect of sensory impairment during cognitive screening. Provisions should be made when testing for cognition in the hearing-impaired population to avoid over-referral and subsequent misdiagnoses of cognitive impairment.
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Affiliation(s)
- Magdalene Yeok Leng Lim
- Department of Otolaryngology, Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Otolaryngology, Head and Neck Surgery, National University Hospital, Singapore
| | - Jenny Hooi Yin Loo
- Department of Otolaryngology, Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Otolaryngology, Head and Neck Surgery, National University Hospital, Singapore
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Hearing loss and the risk of dementia in later life. Maturitas 2018; 112:1-11. [DOI: 10.1016/j.maturitas.2018.03.004] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/07/2018] [Accepted: 03/12/2018] [Indexed: 01/27/2023]
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Yuan J, Sun Y, Sang S, Pham JH, Kong WJ. The risk of cognitive impairment associated with hearing function in older adults: a pooled analysis of data from eleven studies. Sci Rep 2018; 8:2137. [PMID: 29391476 PMCID: PMC5794920 DOI: 10.1038/s41598-018-20496-w] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/09/2018] [Indexed: 01/03/2023] Open
Abstract
Impaired hearing and cognition are disabling conditions among older adults. Research has presented inconsistent conclusions regarding hearing impairment posing a risk for cognitive impairment. We aimed to assess this from published evidence via searching PubMed and Embase, from the inception of the databases indexed to December 2, 2016. For those high-quality studies retrieved, relative risk (RR) and 95% confidence intervals (CIs) were combined to estimate the risk of cognitive impairment. Eleven cohort studies were included in the present study. Pooled results found that elderly people with disabled peripheral and central hearing function had a higher risk of cognitive impairment (for moderate/severe peripheral hearing impairment: RR = 1.29, 95% CI: 1.04-1.59 during a follow-up ≤6 years. RR = 1.57, 95% CI: 1.13-2.20 during a follow-up >6 years; for severe central hearing impairment, RR = 3.21, 95% CI: 1.19-8.69) compared to those with normal hearing function. We also recorded a dose-response trend for cognitive impairment as hearing thresholds rose. No evident bias from potential confounding factors was found with one exception: the length for clinical follow-up. Although results are preliminary because qualifying studies were few, statistical findings were consistent with older people identified as having greater levels of hearing loss, having a corresponding higher risk of cognitive impairment.
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Affiliation(s)
- Jing Yuan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China
| | - Shuping Sang
- School of Medicine, Yunnan University, Kunming, Yunan, 650031, PR China
| | - Jessica Huynh Pham
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, 44106, United States
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, PR China.
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Golub JS. Brain changes associated with age-related hearing loss. Curr Opin Otolaryngol Head Neck Surg 2018; 25:347-352. [PMID: 28661962 DOI: 10.1097/moo.0000000000000387] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To discuss brain changes associated with age-related hearing loss (ARHL), including cognitive abilities and neuroimaging findings. This information will be helpful to hypothesize and ultimately understand how ARHL may be mechanistically related to changes in brain structure and function. It will also be helpful to guide the strength of treatment recommendations. RECENT FINDINGS ARHL has recently been associated with cognitive impairment and dementia. This observation is present in both cross-sectional and longitudinal analyses, in diverse patient populations, and after controlling for a variety of potential confounders. Preliminary brain imaging studies show smaller brain volumes as well as white matter tract dysfunction in adults with hearing loss. SUMMARY ARHL is related to cognitive impairment and dementia. More study is needed to determine if the association is causal, and if treatment efforts could reduce the risk of cognitive impairment and dementia. Given the low risk of treating ARHL and the potential health benefit for the aging brain, it is recommended to proactively discuss ARHL and treatment with patients.
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Affiliation(s)
- Justin S Golub
- Department of Otolaryngology - Head and Neck Surgery, Columbia University College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA
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Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care. Lancet 2017; 390:2673-2734. [PMID: 28735855 DOI: 10.1016/s0140-6736(17)31363-6] [Citation(s) in RCA: 3417] [Impact Index Per Article: 488.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/20/2017] [Accepted: 01/25/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Gill Livingston
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK.
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, UK
| | - Sergi G Costafreda
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Jonathan Huntley
- Division of Psychiatry, University College London, London, UK; Department of Old Age Psychiatry, King's College London, London, UK
| | - David Ames
- National Ageing Research Institute, Parkville, VIC, Australia; Academic Unit for Psychiatry of Old Age, University of Melbourne, Kew, VIC, Australia
| | | | - Sube Banerjee
- Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Alistair Burns
- Centre for Dementia Studies, University of Manchester, Manchester, UK
| | - Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Heczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Nick Fox
- Dementia Research Centre, University College London, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK; Camden and Islington NHS Foundation Trust, London, UK
| | - Helen C Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
| | - Karen Ritchie
- Inserm, Unit 1061, Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, University of Montpellier, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Kenneth Rockwood
- Centre for the Health Care of Elderly People, Geriatric Medicine Dalhousie University, Halifax, NS, Canada
| | - Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Quincy Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview, Johns Hopkins University, Baltimore, MD, USA
| | - Lon S Schneider
- Department of Neurology and Department of Psychiatry and the Behavioural Sciences, Keck School of Medicine, Leonard Davis School of Gerontology of the University of Southern California, Los Angeles, CA, USA
| | - Geir Selbæk
- Norwegian National Advisory Unit on Aging and Health, Vestfold Health Trust, Tønsberg, Norway; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway; Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Linda Teri
- Department Psychosocial and Community Health, School of Nursing, University of Washington, Seattle, WA, USA
| | - Naaheed Mukadam
- Division of Psychiatry, University College London, London, UK
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