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Welch V, Mathew CM, Babelmorad P, Li Y, Ghogomu ET, Borg J, Conde M, Kristjansson E, Lyddiatt A, Marcus S, Nickerson JW, Pottie K, Rogers M, Sadana R, Saran A, Shea B, Sheehy L, Sveistrup H, Tanuseputro P, Thompson‐Coon J, Walker P, Zhang W, Howe TE. Health, social care and technological interventions to improve functional ability of older adults living at home: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2021; 17:e1175. [PMID: 37051456 PMCID: PMC8988637 DOI: 10.1002/cl2.1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background By 2030, the global population of people older than 60 years is expected to be higher than the number of children under 10 years, resulting in major health and social care system implications worldwide. Without a supportive environment, whether social or built, diminished functional ability may arise in older people. Functional ability comprises an individual's intrinsic capacity and people's interaction with their environment enabling them to be and do what they value. Objectives This evidence and gap map aims to identify primary studies and systematic reviews of health and social support services as well as assistive devices designed to support functional ability among older adults living at home or in other places of residence. Search Methods We systematically searched from inception to August 2018 in: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, PsycINFO, AgeLine, Campbell Library, ASSIA, Social Science Citation Index and Social Policy & Practice. We conducted a focused search for grey literature and protocols of studies (e.g., ProQuest Theses and Dissertation Global, conference abstract databases, Help Age, PROSPERO, Cochrane and Campbell libraries and ClinicalTrials.gov). Selection Criteria Screening and data extraction were performed independently in duplicate according to our intervention and outcome framework. We included completed and on-going systematic reviews and randomized controlled trials of effectiveness on health and social support services provided at home, assistive products and technology for personal indoor and outdoor mobility and transportation as well as design, construction and building products and technology of buildings for private use such as wheelchairs, and ramps. Data Collection and Analysis We coded interventions and outcomes, and the number of studies that assessed health inequities across equity factors. We mapped outcomes based on the International Classification of Function, Disability and Health (ICF) adapted categories: intrinsic capacities (body function and structures) and functional abilities (activities). We assessed methodological quality of systematic reviews using the AMSTAR II checklist. Main Results After de-duplication, 10,783 records were screened. The map includes 548 studies (120 systematic reviews and 428 randomized controlled trials). Interventions and outcomes were classified using domains from the International Classification of Function, Disability and Health (ICF) framework. Most systematic reviews (n = 71, 59%) were rated low or critically low for methodological quality.The most common interventions were home-based rehabilitation for older adults (n = 276) and home-based health services for disease prevention (n = 233), mostly delivered by visiting healthcare professionals (n = 474). There was a relative paucity of studies on personal mobility, building adaptations, family support, personal support and befriending or friendly visits. The most measured intrinsic capacity domains were mental function (n = 269) and neuromusculoskeletal function (n = 164). The most measured outcomes for functional ability were basic needs (n = 277) and mobility (n = 160). There were few studies which evaluated outcome domains of social participation, financial security, ability to maintain relationships and communication.There was a lack of studies in low- and middle-income countries (LMICs) and a gap in the assessment of health equity issues. Authors' Conclusions There is substantial evidence for interventions to promote functional ability in older adults at home including mostly home-based rehabilitation for older adults and home-based health services for disease prevention. Remotely delivered home-based services are of greater importance to policy-makers and practitioners in the context of the COVID-19 pandemic. This map of studies published prior to the pandemic provides an initial resource to identify relevant home-based services which may be of interest for policy-makers and practitioners, such as home-based rehabilitation and social support, although these interventions would likely require further adaptation for online delivery during the COVID-19 pandemic. There is a need to strengthen assessment of social support and mobility interventions and outcomes related to making decisions, building relationships, financial security, and communication in future studies. More studies are needed to assess LMIC contexts and health equity issues.
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Affiliation(s)
- Vivian Welch
- Methods CentreBruyère Research InstituteOttawaCanada
| | | | | | - Yanfei Li
- Evidence‐Based Social Science Research Center, School of Public HealthLanzhou UniversityLanzhouChina
| | | | | | - Monserrat Conde
- Cochrane Campbell Global Ageing Partnership FieldFaroPortugal
| | | | | | - Sue Marcus
- Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | | | | | - Morwenna Rogers
- NIHR ARC, South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | | | | | - Beverly Shea
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Lisa Sheehy
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
| | - Heidi Sveistrup
- Bruyère Research InstituteUniversity of OttawaOttawaCanada
- Faculty of Health SciencesUniversity of OttawaOttawaCanada
| | | | - Joanna Thompson‐Coon
- NIHR ARC South West Peninsula (PenARC)University of Exeter Medical SchoolExeterUK
| | - Peter Walker
- Faculty of MedicineUniversity of OttawaOttawaCanada
| | - Wei Zhang
- Access to Medicines, Vaccines and Health ProductsWorld Health OrganizationGenevaSwitzerland
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Braz CH, Gonçalves LF, Paiva KM, Haas P, Patatt FSA. Implications of musical practice in central auditory processing: a systematic review. Braz J Otorhinolaryngol 2021; 87:217-226. [PMID: 33309194 PMCID: PMC9422430 DOI: 10.1016/j.bjorl.2020.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/16/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Recent studies have shown that musical practice and training are effective and have the potential to assist in the acquisition and improvement of auditory skills. OBJECTIVE To verify the scientific evidence on the implications of musical practice in central auditory processing. METHODS A systematic review was carried out in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the Medline (Pubmed), LILACS, SciELO, BIREME, Scopus and Web of Science databases. The search period for the articles covered the last 5 years (2015-2020), without restriction of language and location. The quality of the articles was assessed, and the review included articles with a minimum score of 6 in a modified literature quality scale. RESULTS Initially, 1362 publications were found, of which 1338 were excluded after the title screening, 15 were excluded due to the abstract, with nine articles being analyzed in full and four of them excluded after the analysis, as they did not answer the guiding question proposed for this research. Five articles that met the proposed inclusion criteria were admitted for this research. It was found that in adults, musical ability is associated with better performance of several auditory processing skills, as well as the fact that musical training in children promoted an accelerated maturity of auditory processing and exposure to music facilitated the learning of auditory information in newborns. CONCLUSION Considering the scientific evidence, it was found that the musical experience can improve specific skills of the central auditory processing, regardless of age, optimizing children's linguistic development.
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Affiliation(s)
- Cinthya Heloisa Braz
- Universidade Federal de Santa Catarina (UFSC), Curso de Fonoaudiologia, Florianópolis, SC, Brazil
| | - Laura Faustino Gonçalves
- Universidade Federal de Santa Catarina (UFSC), Curso de Fonoaudiologia, Florianópolis, SC, Brazil
| | - Karina Mary Paiva
- Universidade Federal de Santa Catarina (UFSC), Curso de Fonoaudiologia, Florianópolis, SC, Brazil
| | - Patricia Haas
- Universidade Federal de Santa Catarina (UFSC), Curso de Fonoaudiologia, Florianópolis, SC, Brazil
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Göthberg H, Rosenhall U, Tengstrand T, Rydén L, Wetterberg H, Skoog I, Sadeghi A. Prevalence of hearing loss and need for aural rehabilitation in 85-year-olds: a birth cohort comparison, almost three decades apart. Int J Audiol 2020; 60:539-548. [PMID: 32129119 DOI: 10.1080/14992027.2020.1734878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Many individuals >80 years have difficulties with speech communication due to age-related hearing loss and would benefit from aural rehabilitation. As the proportion of older people increases, there is a need to investigate the prevalence of "disabling hearing loss" to calculate future rehabilitation need. The aims are to determine the prevalence of hearing loss in an unscreened birth cohort of 85-year olds, and to identify differences in audiometric results between two birth cohorts, born 28-29 years apart. DESIGN This is a population-based, cross-sectional study that is part of the Gothenburg H70 Birth Cohort Studies. STUDY SAMPLE Hearing thresholds were measured and compared between 85-year olds born in 1930 (n = 286) and 1901-1902 (n = 249). RESULTS Based on the WHO criteria, the prevalence of "disabling hearing loss" was 45% for men and 43% for women in the latest birth cohort. Hearing thresholds (0.5-4 kHz) for men improved compared with the earlier birth cohort. No such difference was observed for women. CONCLUSION The prevalence of age-related hearing loss over three decades has decreased among 85-year-old men, but has been retained in women. The improvement for men occurred predominantly in the low-mid frequencies. An increased need for aural rehabilitation is expected due to demographic changes.
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Affiliation(s)
- Hanna Göthberg
- Department of Health and Rehabilitation, Unit of Audiology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Habilitation and Health, Hearing Organization, Gothenburg, Sweden
| | - Ulf Rosenhall
- Department of Health and Rehabilitation, Unit of Audiology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Habilitation and Health, Hearing Organization, Gothenburg, Sweden
| | - Tomas Tengstrand
- Region Västra Götaland, Habilitation and Health, Hearing Organization, Gothenburg, Sweden
| | - Lina Rydén
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit (EPINEP), Institute of Neuroscience and Physiology, Sahlgrenska academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Hanna Wetterberg
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit (EPINEP), Institute of Neuroscience and Physiology, Sahlgrenska academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit (EPINEP), Institute of Neuroscience and Physiology, Sahlgrenska academy, Centre for Ageing and Health (AgeCap) at the University of Gothenburg, Gothenburg, Sweden
| | - André Sadeghi
- Department of Health and Rehabilitation, Unit of Audiology, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Region Västra Götaland, Habilitation and Health, Hearing Organization, Gothenburg, Sweden
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Peixe BP, Sanguebuche TR, Malavolta VC, Garcia MV. The study of responses to auditory processing tests in the elderly. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921613818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: to generate reference values for different central auditory processing tests, investigating the influence of peripheral hearing and considering education and cognition, in the elderly. Methods: a prospective, quantitative and cross-sectional study. The casuistry consisted of 23 elderly, aged between 60 and 81 years old, being 8 men and 14 women. Regarding the audiological characteristics, the elderly were included with normal auditory thresholds or mild and moderate sensorineural hearing loss, classified by the quadritonal average, proposed by the World Health Organization. All elderly underwent Basic Audiological Evaluation, Edinburgh Handedness Inventory, Mini Mental State Examination, and seven central auditory behavioral tests. Statistical analysis was performed using the nonparametric Mann-Whitney U test. Results: the Adapted Time-Compressed Speech Test was influenced by the peripheral hearing loss, in both ears (p-value = 0,000), and no significant differences were found in the other data analyzed. Conclusion: reference values were generated for the different behavioral tests. Hearing loss influenced the results of the Adapted Time-Compressed Speech Test, suggesting that it should not be applied in the elderly with peripheral alteration. Regarding education and cognition, there was a similarity among the elderly with normal hearing thresholds and those presented with hearing loss.
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Vielsmeier V, Kreuzer PM, Haubner F, Steffens T, Semmler PRO, Kleinjung T, Schlee W, Langguth B, Schecklmann M. Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis. Front Aging Neurosci 2016; 8:293. [PMID: 28018209 PMCID: PMC5156732 DOI: 10.3389/fnagi.2016.00293] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 11/21/2016] [Indexed: 11/23/2022] Open
Abstract
Objective: Many tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1) estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2) compare subjective reports of speech comprehension difficulties with behavioral measurements in a standardized speech comprehension test and to (3) explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram), as well as with co-morbid hyperacusis as a central auditory processing disorder. Subjects and Methods: Speech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessments (pure tone audiometry, tinnitus pitch, and loudness matching), the Goettingen sentence test (in quiet) for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments (“How would you rate your ability to understand speech?”; “How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?”). Results: Subjectively-reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation). 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test). Subjective speech comprehension complaints (both for general and in noisy environment) were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated with speech comprehension difficulties in noisy environments, but not with speech comprehension difficulties in general. Conclusion: Speech comprehension deficits are frequent among tinnitus patients. Whereas speech comprehension deficits in quiet environments are primarily due to peripheral hearing loss, speech comprehension deficits in noisy environments are related to both peripheral hearing loss and dysfunctional central auditory processing. Disturbed speech comprehension in noisy environments might be modulated by a central inhibitory deficit. In addition, attentional and cognitive aspects may play a role.
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Affiliation(s)
- Veronika Vielsmeier
- Department of Otorhinolaryngology, University of RegensburgRegensburg, Germany; Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany
| | - Peter M Kreuzer
- Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany; Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
| | - Frank Haubner
- Department of Otorhinolaryngology, University of Regensburg Regensburg, Germany
| | - Thomas Steffens
- Department of Otorhinolaryngology, University of RegensburgRegensburg, Germany; Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany
| | - Philipp R O Semmler
- Department of Otorhinolaryngology, University of RegensburgRegensburg, Germany; Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University of Zurich Switzerland
| | - Winfried Schlee
- Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany; Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
| | - Berthold Langguth
- Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany; Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
| | - Martin Schecklmann
- Interdisciplinary Tinnitus Center of the University of RegensburgRegensburg, Germany; Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
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Barker F, Mackenzie E, Elliott L, Jones S, de Lusignan S. Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database Syst Rev 2016; 2016:CD010342. [PMID: 27537242 PMCID: PMC6463949 DOI: 10.1002/14651858.cd010342.pub3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Acquired adult-onset hearing loss is a common long-term condition for which the most common intervention is hearing aid fitting. However, up to 40% of people fitted with a hearing aid either fail to use it or may not gain optimal benefit from it. This is an update of a review first published in The Cochrane Library in 2014. OBJECTIVES To assess the long-term effectiveness of interventions to promote the use of hearing aids in adults with acquired hearing loss fitted with at least one hearing aid. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 13 June 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs) of interventions designed to improve or promote hearing aid use in adults with acquired hearing loss compared with usual care or another intervention. We excluded interventions that compared hearing aid technology. We classified interventions according to the 'chronic care model' (CCM). The primary outcomes were hearing aid use (measured as adherence or daily hours of use) and adverse effects (inappropriate advice or clinical practice, or patient complaints). Secondary patient-reported outcomes included quality of life, hearing handicap, hearing aid benefit and communication. Outcomes were measured over the short (</= 12 weeks), medium (> 12 to < 52 weeks) and long term (one year plus). DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. MAIN RESULTS We included 37 studies involving a total of 4129 participants. Risk of bias across the included studies was variable. We judged the GRADE quality of evidence to be very low or low for the primary outcomes where data were available.The majority of participants were over 65 years of age with mild to moderate adult-onset hearing loss. There was a mix of new and experienced hearing aid users. Six of the studies (287 participants) assessed long-term outcomes.All 37 studies tested interventions that could be classified using the CCM as self-management support (ways to help someone to manage their hearing loss and hearing aid(s) better by giving information, practice and experience at listening/communicating or by asking people to practise tasks at home) and/or delivery system design interventions (just changing how the service was delivered). Self-management support interventions We found no studies that investigated the effect of these interventions on adherence, adverse effects or hearing aid benefit. Two studies reported daily hours of hearing aid use but we were unable to combine these in a meta-analysis. There was no evidence of a statistically significant effect on quality of life over the medium term. Self-management support reduced short- to medium-term hearing handicap (two studies, 87 participants; mean difference (MD) -12.80, 95% confidence interval (CI) -23.11 to -2.48 (0 to 100 scale)) and increased the use of verbal communication strategies in the short to medium term (one study, 52 participants; MD 0.72, 95% CI 0.21 to 1.23 (0 to 5 scale)). The clinical significance of these statistical findings is uncertain. It is likely that the outcomes were clinically significant for some, but not all, participants. Our confidence in the quality of this evidence was very low. No self-management support studies reported long-term outcomes. Delivery system design interventionsThese interventions did not significantly affect adherence or daily hours of hearing aid use in the short to medium term, or adverse effects in the long term. We found no studies that investigated the effect of these interventions on quality of life. There was no evidence of a statistically or clinically significant effect on hearing handicap, hearing aid benefit or the use of verbal communication strategies in the short to medium term. Our confidence in the quality of this evidence was low or very low. Long-term outcome measurement was rare. Combined self-management support/delivery system design interventionsOne combined intervention showed evidence of a statistically significant effect on adherence in the short term (one study, 167 participants, risk ratio (RR) 1.06, 95% CI 1.00 to 1.12). However, there was no evidence of a statistically or clinically significant effect on daily hours of hearing aid use over the long term, or the short to medium term. No studies of this type investigated adverse effects. There was no evidence of an effect on quality of life over the long term, or short to medium term. These combined interventions reduced hearing handicap in the short to medium term (15 studies, 728 participants; standardised mean difference (SMD) -0.26, 95% CI -0.48 to -0.04). This represents a small-moderate effect size but there is no evidence of a statistically significant effect over the long term. There was evidence of a statistically, but not clinically, significant effect on long-term hearing aid benefit (two studies, 69 participants, MD 0.30, 95% CI 0.02 to 0.58 (1 to 5 scale)), but no evidence of an effect over the short to medium term. There was evidence of a statistically, but not clinically, significant effect on the use of verbal communication strategies in the short term (four studies, 223 participants, MD 0.45, 95% CI 0.15 to 0.74 (0 to 5 scale)), but not the long term. Our confidence in the quality of this evidence was low or very low.We found no studies that assessed the effect of other CCM interventions (decision support, the clinical information system, community resources or health system changes). AUTHORS' CONCLUSIONS There is some low to very low quality evidence to support the use of self-management support and complex interventions combining self-management support and delivery system design in adult auditory rehabilitation. However, effect sizes are small. The range of interventions that have been tested is relatively limited. Future research should prioritise: long-term outcome assessment; development of a core outcome set for adult auditory rehabilitation; and study designs and outcome measures that are powered to detect incremental effects of rehabilitative healthcare system changes.
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Affiliation(s)
- Fiona Barker
- University of SurreyDepartment of Clinical and Experimental MedicineGuildfordUK
| | - Emma Mackenzie
- University of SouthamptonHearing and Balance Centre, Institute of Sound and Vibration ResearchHighfieldSouthamptonUK
| | | | - Simon Jones
- University of SurreyDepartment of Healthcare Management and PolicyGuildfordSurreyUKGU2 7XH
| | - Simon de Lusignan
- University of SurreyDepartment of Healthcare Management and PolicyGuildfordSurreyUKGU2 7XH
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Beier LO, Pedroso F, Costa-Ferreira MIDD. Benefícios do treinamento auditivo em usuários de aparelho de amplificação sonora individual - revisão sistemática. REVISTA CEFAC 2015. [DOI: 10.1590/1982-0216201517422614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo:O presente estudo consiste em uma revisão sistemática de literatura com o objetivo de verificar se o treinamento auditivo produz benefícios aos pacientes usuários de aparelho de amplificação sonora individual. Os estudos foram selecionados a partir de critérios de inclusão previamente estabelecidos e a partir deste, os dados de interesse foram extraídos. Na busca, foram avaliados e selecionados apenas os estudos cujo título, resumo ou corpo do artigo tivesse relação com o objeto do presente estudo. Os artigos pesquisados demonstraram que o treinamento auditivo aplicado nas suas diferentes concepções, sendo formal, informal, com leitura orofacial ou estratégias de comunicação, analítico ou sintético, beneficia os usuários de aparelho de amplificação sonora individual, principalmente quando associado às tarefas com demanda cognitiva.
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Morais AA, Rocha-Muniz CN, Schochat E. Efficacy of auditory training in elderly subjects. Front Aging Neurosci 2015; 7:78. [PMID: 26042031 PMCID: PMC4434904 DOI: 10.3389/fnagi.2015.00078] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 04/26/2015] [Indexed: 12/26/2022] Open
Abstract
Auditory training (AT) has been used for auditory rehabilitation in elderly individuals and is an effective tool for optimizing speech processing in this population. However, it is necessary to distinguish training-related improvements from placebo and test-retest effects. Thus, we investigated the efficacy of short-term AT [acoustically controlled auditory training (ACAT)] in elderly subjects through behavioral measures and P300. Sixteen elderly individuals with auditory processing disorder (APD) received an initial evaluation (evaluation 1 - E1) consisting of behavioral and electrophysiological tests (P300 evoked by tone burst and speech sounds) to evaluate their auditory processing. The individuals were divided into two groups. The Active Control Group (n = 8) underwent placebo training. The Passive Control Group (n = 8) did not receive any intervention. After 12 weeks, the subjects were revaluated (evaluation 2 - E2). Then, all of the subjects underwent ACAT. Following another 12 weeks (eight training sessions), they underwent the final evaluation (evaluation 3 - E3). There was no significant difference between E1 and E2 in the behavioral test [F(9.6) = 0.06, p = 0.92, λ de Wilks = 0.65)] or P300 [F(8.7) = 2.11, p = 0.17, λ de Wilks = 0.29] (discarding the presence of placebo effects and test-retest). A significant improvement was observed between the pre- and post-ACAT conditions (E2 and E3) for all auditory skills according to the behavioral methods [F(4.27) = 0.18, p = 0.94, λ de Wilks = 0.97]. However, the same result was not observed for P300 in any condition. There was no significant difference between P300 stimuli. The ACAT improved the behavioral performance of the elderly for all auditory skills and was an effective method for hearing rehabilitation.
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Affiliation(s)
- Aline Albuquerque Morais
- Auditory Processing Laboratory, Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Caroline Nunes Rocha-Muniz
- Auditory Processing Laboratory, Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Eliane Schochat
- Auditory Processing Laboratory, Department of Physical Therapy, Speech Therapy and Occupational Therapy, University of São Paulo, São Paulo, Brazil
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Barker F, Mackenzie E, Elliott L, Jones S, de Lusignan S. Interventions to improve hearing aid use in adult auditory rehabilitation. Cochrane Database Syst Rev 2014:CD010342. [PMID: 25019297 DOI: 10.1002/14651858.cd010342.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Acquired adult-onset hearing loss is a common long-term condition for which the most common intervention is hearing aid fitting. However, up to 40% of people fitted with a hearing aid either fail to use it or may not gain optimal benefit from it. OBJECTIVES To assess the long-term effectiveness of interventions to promote the use of hearing aids in adults with acquired hearing loss fitted with at least one hearing aid. SEARCH METHODS We searched the Cochrane ENT Disorders Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the search was 6 November 2013. SELECTION CRITERIA We included randomised controlled trials (RCTs) of interventions designed to improve or promote hearing aid use in adults with acquired hearing loss compared with usual care or another intervention. We excluded interventions that compared hearing aid technology. We classified interventions according to the 'chronic care model' (CCM). The primary outcomes were hearing aid use (measured as adherence or daily hours of use) and adverse effects (inappropriate advice or clinical practice, or patient complaints). Secondary patient-reported outcomes included quality of life, hearing handicap, hearing aid benefit and communication. Outcomes were measured over the short (</= 12 weeks), medium (> 12 to < 52 weeks) and long term (one year plus). DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by The Cochrane Collaboration. MAIN RESULTS We included 32 studies involving a total of 2072 participants. The risk of bias across the included studies was variable. We judged the GRADE quality of evidence to be very low or low for the primary outcomes where data were available.The majority of participants were over 65 years of age with mild to moderate adult-onset hearing loss. There was a mix of new and experienced hearing aid users. Six of the studies (1018 participants) were conducted in a military veteran population. Six of the studies (287 participants) assessed long-term outcomes.All 32 studies tested interventions that could be classified as self management support (ways to help someone to manage their hearing loss and hearing aid(s) better by giving information, practice and experience at listening/communicating or by asking people to practise tasks at home) and/or delivery system design interventions (just changing how the service was delivered) according to the CCM. Self management support interventions We found no studies that investigated the effect of these interventions on adherence, adverse effects or hearing aid benefit. Two studies reported daily hours of hearing aid use but we were unable to combine these in a meta-analysis. There was no evidence of a statistically significant effect on quality of life over the medium term. Self management support reduced short- to medium-term hearing handicap (two studies, 87 participants; mean difference (MD) -12.80, 95% confidence interval (CI) -23.11 to -2.48 (0 to 100 scale)) and increased the use of verbal communication strategies in the short to medium term (one study, 52 participants; MD 0.72, 95% CI 0.21 to 1.23 (0 to 5 scale)). The clinical significance of these statistical findings is uncertain but it is likely that the outcomes were clinically significant for some, but not all, participants. Our confidence in the quality of this evidence was very low. No self management support studies reported long-term outcomes. Delivery system design interventions These interventions did not significantly affect adherence or daily hours of hearing aid use in the short to medium term, or adverse effects in the long term. We found no studies that investigated the effect of these interventions on quality of life. There was no evidence of a statistically or clinically significant effect on hearing handicap, hearing aid benefit or the use of verbal communication strategies in the short to medium term. Our confidence in the quality of this evidence was low or very low. Long-term outcome measurement was rare. Combined self management support/delivery system design interventions We found no studies that investigated the effect of complex interventions combining components of self management support and delivery system design on adherence or adverse effects. There was no evidence of a statistically or clinically significant effect on daily hours of hearing aid use over the long term, or the short to medium term. Similarly, there was no evidence of an effect on quality of life over the long term, or short to medium term. These combined interventions reduced hearing handicap in the short to medium term (13 studies, 485 participants, standardised mean difference (SMD) -0.27, 95% CI -0.49 to -0.06). This represents a small-moderate effect size but there is no evidence of a statistically significant effect over the long term. There was evidence of a statistically, but not clinically, significant effect on long-term hearing aid benefit (two studies, 69 participants, MD 0.30, 95% CI 0.02 to 0.58 (1 to 5 scale)), but no evidence of effect over the short to medium term. There was evidence of a statistically, but not clinically, significant effect on the use of verbal communication strategies in the short term (four studies, 223 participants, MD 0.45, 95% CI 0.15 to 0.74 (0 to 5 scale)), but not the long term. Our confidence in the quality of this evidence was low or very low.We found no studies that assessed the effect of other CCM interventions (decision support, the clinical information system, community resources or health system changes). AUTHORS' CONCLUSIONS There is some low to very low quality evidence to support the use of self management support and complex interventions combining self management support and delivery system design in adult auditory rehabilitation. However, effect sizes are small and the range of interventions that have been tested is relatively limited. Priorities for future research should be assessment of long-term outcome a year or more after the intervention, development of a core outcome set for adult auditory rehabilitation and development of study designs and outcome measures that are powered to detect incremental effects of rehabilitative healthcare system changes over and above the provision of a hearing aid.
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Affiliation(s)
- Fiona Barker
- Department of Healthcare Management and Policy, University of Surrey, Guildford, UK
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