Middle ear disease in samples from the general population. II. History of otitis and otorrhea in relation to tympanic membrane pathology. The study of men born in 1913 and 1923

Effect of Multicomponent Exercise on Cognition, Physical Function and Activities of Daily Life in Older Adults With Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-analysis

OBJECTIVE

To review the evidence for the effectiveness of multicomponent exercise (an exercise program combining aerobic, endurance, balance, and flexibility exercises) on cognition, physical function, and activities of daily living in people with dementia and mild cognitive impairment (MCI).

DATA SOURCES AND STUDY SELECTION

We conducted this study under the guidance of a designated protocol (PROSPERO CRD42022324641). Pertinent randomized controlled trials were selected from PubMed, Embase, Web of Science, and the Cochrane Library by 2 independent authors through May 2022.

DATA EXTRACTION

Two authors independently extracted the data and assessed the quality of the included studies following the Cochrane Risk of Bias tool. Outcome data were extracted in a random effects model and estimated as Hedges' g and 95% confidence interval (CI). To validate specific results, the Egger test combined the Duval and Tweedie "trim and fill" method and sensitivity analysis with study removed were performed.

DATA SYNTHESIS

A total of 21 publications were eligible for the quantitative analysis. In dementia, estimates of Hedges' g showed effects on global cognition (g=0.403; 95% CI, 0.168-0.638; P<.05), especially executive function (g=0.344; 95% CI, 0.111-0.577; P<.05), flexibility (g=0.671; 95% CI, 0.353-0.989; P<.001), agility and mobility (g=0.402; 95% CI, 0.089-0.714; P<.05), muscle strength (g=1.132; 95% CI, 0.420-1.845; P<.05), and activities of daily living (g=0.402; 95% CI, 0.188-0.615; P<.05). Also, a positive trend was observed in gait speed. Additionally, multicomponent exercise had positive effects on global cognition (g=0.978; 95% CI, 0.298-1.659; P<.05) and executive function (g=0.448; 95% CI, 0.171-0.726; P<.05) in patients with MCI.

CONCLUSIONS

Our findings confirm the viability of multicomponent exercise as a management strategy for patients with dementia and MCI.

Auditory function and hearing loss in children and adults with Williams syndrome: cochlear impairment in individuals with otherwise normal hearing

Hearing loss is common in school-age individuals with Williams syndrome (WS) and extensive in adults. Prior studies with relatively small sample sizes suggest that hearing loss in WS has an early onset and may be progressive, yet the auditory phenotype and the scope of the hearing loss have not been adequately characterized. We used standard audiometric tools: Otoscopy, tympanometry, air-conduction (bone conduction when available) behavioral testing, and distortion product otoacoustic emissions (DPOAEs) to measure hearing sensitivity and outer hair cell function. We tested 81 individuals with WS aged 5.33-59.50 years. Sixty-three percent of the school-age and 92% of the adult participants had mild to moderately-severe hearing loss. The hearing loss in at least 50% was sensorineural. DPOAE testing corroborated behavioral results. Strikingly, 12 of 14 participants with hearing within normal limits bilaterally had 4,000-Hz DPOAE input/output (DPOAE IO) functions indicative of outer hair cell damage and impaired cochlear compression. Our results indicate that hearing loss is very common in WS. Furthermore, individuals with WS who have "normal" hearing as defined by behavioral thresholds may actually have sub-clinical impairments or undetected cochlear pathology. Our findings suggest outer hair cell dysfunction in otherwise normal hearing individuals. The DPOAE IO in this same group revealed growth functions typically seen in groups with noise-induced damage. Given this pattern of findings, individuals with WS may be at increased risk of noise-induced hearing loss. Recommendations regarding audiological testing for individuals with WS and accommodations for these individuals in both academic and nonacademic settings are provided.

The aging of the middle ear in 129S6/SvEvTac and CBA/CaJ mice: measurements of umbo velocity, hearing function, and the incidence of pathology

Measurements of umbo velocity and auditory brainstem response (ABR) were made on two different strains of mice, 129S6/SvEvTac (129S6) and CBA/CaJ (CB), within three different age ranges. The velocity measurements were made with a laser Doppler vibrometer using a semiclosed sound delivery system; the frequency range of accurate velocity measurements is from 1 to 21 kHz. The visual detection threshold of the ABR was determined at selected frequencies between 2 and 32 kHz. The velocity results suggest a small but significant change in umbo velocity with age in both strains, between the youngest (1.5-3 months) and mid-aged (12-14 months) groups. There is also a clear difference in the umbo velocity in the youngest animals of the two strains, with the 129S6 having more sensitive middle-ear function than the CB. These results support the existence of a small age-related loss in middle-ear sensitivity in the mouse that was first described in the BALB/6J strain. The age-related changes in middle-ear function observed in both CB and 129S6 are much smaller than the age-related decreases in ABR. Our results also describe a statistically significant increase in the incidence of middle-ear pathology with age in the 129S6.

Prevalence of eardrum pathology in a cohort born in 1955

The aim of this study was to compare the prevalence of the different types of eardrum pathology in a cohort of adults not previously treated by grommet insertion with corresponding findings obtained in a cohort previously treated with grommet insertion. A cohort born in 1955 were invited to a screening examination including otomicroscopy. In the untreated cohort, retraction of Shrapnell's membrane was found in four per cent of the ears compared to 20 per cent in the cohort treated with grommets. Tensa pathology, including atrophy and myringosclerosis, was found in six per cent of the ears in the untreated cohort and in 17 per cent in the treated cohort. Normal eardrums were found in 91 per cent of the ears. Despite the increased awareness of secretory otitis, as well as the increased rate of surgical treatment, the prevalence of eardrum pathology seems to be increasing. The reasons for this are discussed.

Chronic otitis media and sequelae in the population of Greenland

It is generally recognized that chronic otitis media and sequelae of this disease are frequently encountered among the native population of Greenland, but the prevalence of chronic otitis in Greenland has not previously been systematically traced. Treatment for this disease has improved and we expect an increased demand for treatment of this disease among Greenland natives. To evaluate the need of treatment the prevalence of chronic otitis media in two large Greenland towns was assessed. The study population included 303 persons aged 11-20 years and 305 aged 41-50 years. Medical histories were recorded and objective examinations were performed using e.g. oto-microscopy. Among the young participants, 8% had chronic suppurative otitis and 14% sequelae of chronic otitis media. Among the older participants, 2% had suppurative otitis and 13% sequelae of chronic otitis. It is estimated, using Scandinavian criteria, that 8.6% of the participants would have benefitted from an ear operation either to stop otorrhea and/or to improve the hearing. The launching of an oto-surgical effort in Greenland is considered justifiable on the grounds of the importance of hearing to communication and the isolation in point of the native Greenland population.

Otitis media and well-being in a male population in Gothenburg. The study of men born in 1913

In a sample of 767 60-year-old men and 220 50-year-old men from the general population of Gothenburg, Sweden, the possible influence of otitis media, suffered in the past, on various measures of well-being was studied. Men with a history of otitis media required more medical care, measured as number of appointments with a doctor during the last 10 years, number of drugs taken during the last 14 days, and early retirement due to illness, than men with no such history. They also had lower grade of self-estimated perceived health, hearing, memory, physical fitness, appetite, mental energy and patience. There was no correlation between a history of otitis and a number of socio-economic factors. In addition, otitis infections in the past were measured as a hearing loss in the low-frequency range (greater than 20 dB loss in the 250 Hz and 500 Hz register). Such a hearing loss was related to the same variables as the otitis history. In addition, men with a low-frequency hearing loss were less well educated, were heavier, had more days and more periods of sickness benefit than other men. They also had spent more time as an in-patient in hospital and were less active during their leisure time. These results indicate that otitis infections affect the health and the well-being of the patients even long after the actual incident.