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Lewis CT, Toman J, Sanchez VA, Corvin J, Arnold ML. Examining the Relationship Between Hearing Health Beliefs and Social Determinants of Health in Black Adults. Ear Hear 2024:00003446-990000000-00321. [PMID: 39106324 DOI: 10.1097/aud.0000000000001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVES Hearing loss is a highly prevalent condition; however, it is widely under-treated, and Black Americans have been found to have significantly lower rates of hearing aid utilization than other ethnic/racial groups. In this exploratory study, we aimed to identify hearing health beliefs among Black adults, guided by the Health Belief Model, with social determinants of health, and examine individual differences in these perspectives. DESIGN The Hearing Beliefs Questionnaire (HBQ) was administered online to measure constructs of the Health Belief Model among 200 Black adults aged 18 to 75 (M = 39.14, SD = 14.24). Approximately 13% reported hearing difficulty. In addition, 11 social determinants of health questions were included. Participants were recruited from a university otolaryngology clinic and local Black congregations, meeting inclusion criteria of being 18 or older and Black/African American. Mean scores and SDs for HBQ subscales were calculated. Analysis included analysis of variance and t tests to explore relationships with demographic variables and social determinants of health. Multiple regression analyses predicted HBQ subscale scores from sociodemographic variables. RESULTS Mean HBQ subscale scores ranged from 3.88 (SD = 2.28) for Perceived Barriers to 6.76 (SD = 1.93) for Perceived Benefits. Positive correlations were observed between Perceived Severity, Perceived Benefits, and Perceived Self-Efficacy scores and participant educational attainment. Lower economic stability was correlated with poorer scores in Perceived Self-Efficacy, Perceived Severity, and Perceived Benefits. Black adults' willingness to purchase a hearing aid was heavily influenced by their Perceived Benefit, Perceived Severity, and Perceived Self-Efficacy scores, with lower scores correlating with unwillingness to purchase devices. Higher frequency of racism/discrimination and financial hardship correlated with increased Perceived Barriers scores for accessing hearing healthcare. In addition, hearing health beliefs between participants with self-reported hearing difficulty and those without trouble only exhibited differences in the Perceived Susceptibility subscale, with those experiencing hearing difficulty having higher scores in this subscale; no other distinctions were identified. CONCLUSIONS The Health Belief Model, used with social determinants of health, revealed associations, and variations, in the hearing health beliefs held by Black adults. The present investigation reveals heterogeneity within this group and pinpoints individuals at higher risk for untreated hearing loss, stemming from their negative perceptions about hearing healthcare. These beliefs are influenced by demographics and social determinants of health, underscoring areas ripe for intervention.
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Affiliation(s)
- Charity T Lewis
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julia Toman
- Department of Otolaryngology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Victoria A Sanchez
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- Department of Otolaryngology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Jaime Corvin
- Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Michelle L Arnold
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- Department of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
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Chen HK, Hsieh YW, Hsu HY, Liu TY, Zhang YT, Lin CD, Tsai FJ. Increased risk of hearing loss associated with MT-RNR1 gene mutations: a real-world investigation among Han Taiwanese Population. BMC Med Genomics 2024; 17:155. [PMID: 38840095 PMCID: PMC11155076 DOI: 10.1186/s12920-024-01921-8] [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: 04/14/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Previous studies have implicated inherited mutations in mitochondrial DNA (mtDNA) in sensorineural hearing loss (SNHL). However, the definitive association between mitochondrial 12S rRNA (MT-RNR1) variants and hearing loss in the population has not been well established, particularly in Asia. The objective of this retrospective cohort study was to assess the association between MT-RNR1 variants and the risk of SNHL in patients in Taiwan. METHODS The cohort included 306,068 participants from Taiwan between January 2003 and December 2020. Participants were classified based on genetic variants, particularly mitochondrial mutations (rs267606618, rs267606619, rs267606617). MT-RNR1 variant cases were matched 1:10 with non-mutant patients by age, gender, and visit year, excluding those with pre-existing hearing loss. The primary endpoint was SNHL, identified using specific ICD-TM codes with a 90% positive predictive value. Medication exposure history was determined via self-report or electronic medical records in the hospital. Cox proportional hazard regression models were used to assess the association between MT-RNR1 variants and hearing loss, adjusting for various covariates. Kaplan-Meier survival curves and log-rank tests compared hearing loss incidence between groups. RESULTS The mean age of the mtDNA variants group is 32.4 years, with a standard deviation of 19.2 years. The incidence density of hearing loss for the mutation group was 36.42 per 10,000 person-years (95% Confidence Interval [CI], 27.21-47.73), which was higher than the 23.77per 10,000 person-years (95% CI, 21.32-26.42) in the wild-type group (p = 0.0036). Additionally, diabetes mellitus was associated with an increased risk of developing SNHL in individuals with MT-RNR1 variants (adjusted hazard ratio = 1.76 [95% CI, 1.00-3.09], p < 0.05). CONCLUSION This study highlights the increased risk of hearing loss in patients carrying MT-RNR1 variants, particularly those with diabetes mellitus. Future research that integrates genetic and clinical data is crucial for developing more precise interventions to monitor and treat hearing loss in this vulnerable population.
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Affiliation(s)
- Hou-Kuang Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Yow-Wen Hsieh
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- School of Pharmacy, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Hsing-Yu Hsu
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ting-Yuan Liu
- Million-person precision medicine initiative, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Ting Zhang
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan.
| | - Fuu-Jen Tsai
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
- Division of Pediatric Genetics, Children's Hospital of China Medical University, Taichung, Taiwan.
- Department of Biotechnology and Bioinformatics, Asia University, Taichung, Taiwan.
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Jansen LA, van Wier MF, Vernimmen FPJ, Goderie T, van de Berg R, Lemke U, Lissenberg-Witte BI, Kramer SE. Ten-year association between change in speech-in-noise recognition and falls due to balance problems: a longitudinal cohort study. BMC Public Health 2024; 24:732. [PMID: 38454406 PMCID: PMC10919036 DOI: 10.1186/s12889-024-18187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study examined the relationship between speech-in-noise recognition and incident/recurrent falls due to balance problems ten years later (RQ-1); 10-year change in speech-in-noise recognition and falls (RQ-2a), as well as the role of dizziness in this relationship (RQ-2b). The association between hearing aid use and falls was also examined (RQ-3). METHODS Data was collected from the Netherlands Longitudinal Study on Hearing between 2006 and December 2022. Participants completed an online survey and digits-in-noise test every five years. For this study, data was divided into two 10-year follow-up time intervals: T0 (baseline) to T2 (10-year follow-up), and T1 (5-years) to T3 (15-years). For all RQs, participants aged ≥ 40 years at baseline, without congenital hearing loss, and non-CI users were eligible (n = 592). Additionally, for RQ-3 participants with a speech reception threshold in noise (SRTn) ≥ -5.5 dB signal-to-noise ratio were included (n = 422). Analyses used survey variables on hearing, dizziness, falls due to balance problems, chronic health conditions, and psychosocial health. Logistic regressions using General Estimating Equations were conducted to assess all RQs. RESULTS Among individuals with obesity, those with poor baseline SRTn had a higher odds of incident falls ten years later (odds ratio (OR):14.7, 95% confidence interval (CI) [2.12, 103]). A 10-year worsening of SRTn was significantly associated with a higher odds of recurrent (OR: 2.20, 95% CI [1.03, 4.71]) but not incident falls. No interaction was found between dizziness and change in SRTn. Hearing aid use (no use/ < 2 years use vs. ≥ 2 years) was not significantly associated with incident nor recurrent falls. Although there was a significant interaction with sex for this association, the effect of hearing aid use on incident/recurrent falls was not statistically significant among males nor females. CONCLUSIONS A longitudinal association between the deterioration in SRTn and recurrent falls due to balance problems after 10 years was confirmed in this study. This result stresses the importance of identifying declines in hearing earlier and justifies including hearing ability assessments within fall risk prevention programs. Mixed results of hearing aid use on fall risk warrant further investigation into the temporality of this association and possible differences between men and women.
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Affiliation(s)
- Lotte A Jansen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
| | - Marieke F van Wier
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Freek P J Vernimmen
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Thadé Goderie
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Vestibular Disorders, Maastricht University Medical Centre, P. Debyelaan 25, Maastricht, The Netherlands
| | - Ulrike Lemke
- Research & Development, Sonova AG, Staefa, Switzerland
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology - Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
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Grush LD, Reavis KM, Griest SE, Thapa S, Helt WJ, Henry JA, Theodoroff SM. Associations between medical conditions and auditory dysfunction in US Veterans. Int J Audiol 2023; 62:608-616. [PMID: 35533676 DOI: 10.1080/14992027.2022.2068081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/13/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine associations between non-otologic medical conditions and auditory dysfunction. DESIGN Cross-sectional analysis of baseline data from the Noise Outcomes in Service members Epidemiology (NOISE) study. Logistic regression was used to estimate the association between medical conditions (0, 1, and 2 or more conditions) and auditory dysfunction (hearing loss pure tone average ≥20 dB HL and tinnitus), adjusting for key confounders including noise exposure. Secondarily, the association between specific medical conditions and auditory dysfunction was examined. All variables were self-reported. STUDY SAMPLE United States military Veterans (n = 580) with mean age 34.1 years (standard deviation = 9.2), who were within approximately 2.5 years of separation from service. RESULTS Compared to Veterans reporting no medical conditions, Veterans reporting two or more had increased odds on low-frequency hearing loss and on tinnitus but not on high or extended-high frequency hearing loss. Furthermore, specific conditions sleep disorder and arthritis were associated with auditory dysfunction. CONCLUSIONS Non-otologic medical conditions were associated with low-frequency hearing loss and tinnitus in this sample of young Veterans. This suggests medical conditions may play a role in Veterans' hearing health. Whether management of medical conditions earlier in life reduces the risk of hearing loss and tinnitus requires further study.
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Affiliation(s)
- Leslie D Grush
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - Kelly M Reavis
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Susan E Griest
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Samrita Thapa
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Wendy J Helt
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
| | - James A Henry
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, OR, USA
- Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR, USA
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van Wier MF, Jansen LA, Goderie T, Stam M, Nachtegaal J, van Beek JHM, Lemke U, Anema JR, Lissenberg-Witte BI, Smits C, Kramer SE. Cohort profile: Netherlands Longitudinal Study on Hearing (NL-SH). BMJ Open 2023; 13:e070180. [PMID: 37068904 PMCID: PMC10111885 DOI: 10.1136/bmjopen-2022-070180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
PURPOSE The Netherlands Longitudinal Study on Hearing (NL-SH) was set up to examine associations of hearing ability with psychosocial, work and health outcomes in working age adults. PARTICIPANTS Inclusion started in 2006 and is ongoing. Currently the sample comprises 2800 adults with normal and impaired hearing, aged 18-70 years at inclusion. Five-year follow-up started in 2011, 10-year follow-up in 2016 and 15-year follow-up in 2021. All measurements are web-based. Participants perform a speech-in-noise recognition test to measure hearing ability and fill out questionnaires about their hearing status, hearing aid use, self-reported hearing disability and coping, work status and work-related outcomes (work performance, need for recovery), physical and psychosocial health (depression, anxiety, distress, somatisation, loneliness), healthcare usage, lifestyle (smoking, alcohol), and technology use. FINDINGS TO DATE The NL-SH has shown the vast implications of reduced hearing ability for the quality of life and health of working-age adults. A selection of results published in 27 papers is presented. Age-related deterioration of hearing ability accelerates after the age of 50 years. Having a history of smoking is associated with a faster decline in hearing ability, but this relationship is not found for other cardiovascular risk factors. Poorer hearing ability is associated with increased distress, somatisation, depression and loneliness. Adults with impaired hearing ability are more likely to be unemployed or unfit for work, and need more time to recuperate from work effort. FUTURE PLANS Participant data will be linked to a national database to enable research on the association between hearing ability and mortality. Linking to environmental exposure data will facilitate insight in relations between environmental factors, hearing ability and psychosocial outcomes. The unique breadth of the NL-SH data will also allow for further research on other functional problems, for instance, hearing ability and fall risk. TRIAL REGISTRATION NUMBER NL12015.029.06.
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Affiliation(s)
- Marieke F van Wier
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lotte A Jansen
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Thadé Goderie
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mariska Stam
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Janneke Nachtegaal
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Johannes H M van Beek
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ulrike Lemke
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Johannes R Anema
- Public and Occupational health, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cas Smits
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Baiduc RR, Sun JW, Berry CM, Anderson M, Vance EA. Relationship of cardiovascular disease risk and hearing loss in a clinical population. Sci Rep 2023; 13:1642. [PMID: 36717643 PMCID: PMC9886989 DOI: 10.1038/s41598-023-28599-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/20/2023] [Indexed: 02/01/2023] Open
Abstract
Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA0.5,1,2,4) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated.
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Affiliation(s)
- Rachael R Baiduc
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder, 2501 Kittredge Loop Drive, 409 UCB, Boulder, CO, 80309, USA.
| | - Joshua W Sun
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Caitlin M Berry
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO, 80309, USA
| | - Melinda Anderson
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Eric A Vance
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO, 80309, USA
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Tseng YC, Gau BS, Hsieh YS, Liu TC, Huang GS, Lou MF. Physical function mediates the effects of sensory impairment on quality of life in older adults: Cross-sectional study using propensity-score weighting. J Adv Nurs 2023; 79:101-112. [PMID: 36017542 DOI: 10.1111/jan.15423] [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: 12/23/2021] [Revised: 06/24/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022]
Abstract
AIMS To investigate the effect of sensory impairment on quality of life in older adults and to assess the role of physical function as a mediator of the effect of the sensory impairment on quality of life. DESIGN A cross-sectional study. METHODS Older adults aged ≥65 years (N = 600) were recruited from January 2019 to May 2020. Hearing and visual function were measured with pure-tone audiometry and Snellen visual acuity tests, respectively. Quality of life (World Health Organization Quality of Life Scale Brief Version), physical function (Multidimensional Functional Assessment Questionnaire) and sociodemographic characteristics were reported by participants using interviewer-administered questionnaires. Propensity score weighting analysis was conducted based on generalized propensity scores via multinominal logistic regression for age, gender, education, income, and comorbidities. The difference in the quality of life was tested by applying a one-way analysis of variance. Multiple mediation analysis was conducted to explore the direct, indirect, and total effects of sensory impairment on quality of life through physical function. RESULTS After propensity score weighting adjustment, when compared with participants with no sensory impairment, participants with dual sensory impairment had the worst quality of life, followed by visual impairment and then hearing impairment. Physical function statistically significantly mediated the effect of hearing impairment, visual impairment and dual sensory impairment on quality of life in older adults. CONCLUSION Our findings demonstrated that the negative effect of the sensory impairment on quality of life in older adults was mediated through physical function. IMPACT The convergence of an increasing ageing population and the prevalence of sensory impairment presents a significant global health burden. This study demonstrated that physical function was a mediator of quality of life in older adults. Designing appropriate physical activity interventions for older adults with sensory impairment could serve to enhance physio-psychological health and improve quality of life.
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Affiliation(s)
- Ya-Chuan Tseng
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Bih-Shya Gau
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yeu-Sheng Hsieh
- Department of Bio-Industry Communication & Development, College of Bio-Resources & Agriculture, National Taiwan University, Taipei, Taiwan
| | - Tien-Chen Liu
- Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan
| | - Guey-Shiun Huang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meei-Fang Lou
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
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Goodwin MV, Hogervorst E, Maidment DW. Test Your Health at Home: Comparing Online Screening Tests of Hearing, Cognition, and Cardiovascular Health. Am J Audiol 2022; 31:950-960. [PMID: 35239423 DOI: 10.1044/2021_aja-21-00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the extent to which validated online screening measures of cognitive impairment, psychosocial well-being, and cardiovascular health are associated with a validated hearing screener in a sample of adults based in the United Kingdom. METHOD Sixty-one adults (43 female; M age = 44.7 years) participated in a cross-sectional study delivered remotely. Participants completed the hearWHO smartphone application, a digits-in-noise hearing screener, and the Modified Telephone Interview for Cognitive Status (TICS-M), a screening tool for cognitive impairment. Psychosocial well-being (social isolation and loneliness) and cardiovascular health were assessed through self-report. RESULTS Separate independent analyses of variance, with age, gender, and education as covariates, demonstrated participants who failed the hearWHO screener had poorer scores on the TICS-M, engaged in less physical activity, and reported more sedentary behavior and greater social isolation. Multivariate regression analyses revealed that lower TICS-M scores, having obtained less education, identifying as female, and reporting greater sedentary behavior and social isolation were the strongest predictors of lower hearWHO scores. CONCLUSIONS The results from this study suggest that poorer hearing, as measured by the hearWHO screener, is independently associated with having worse cognitive function, more time spent being sedentary, and greater social isolation. Thus, this study demonstrates the potential of online screening measures to identify additional health conditions that confer risk to chronic disease as hearing loss manifests. This could help to inform the development of tailored treatment and support to improve an individual's readiness to seek help for and manage both their general and hearing health. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19251956.
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Affiliation(s)
- Maria V. Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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Stephan Y, Sutin AR, Terracciano A. Subjective Aging and Objectively Assessed Hearing Function: A Prospective Study of Older Adults. J Gerontol B Psychol Sci Soc Sci 2022; 77:1637-1644. [PMID: 35092438 PMCID: PMC9757156 DOI: 10.1093/geronb/gbac018] [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: 09/28/2021] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Subjective aging is consistently related to a range of health-related outcomes, but little is known about its relationship with sensory functioning. The present prospective study tested whether subjective age and self-perceptions of aging (SPA) are associated with objective hearing function. METHODS Participants were 7,085 individuals aged 50-93 years (60% women, mean = 65.15, standard deviation [SD] = 8.71) from the Health and Retirement Study. Measures of subjective age, SPA, and information on demographic factors were obtained in 2008/2010. Objective hearing function was assessed 8 years later in 2016/2018. Furthermore, potential mediating variables (C-reactive protein, body mass index, physical inactivity, and chronic conditions) were assessed in 2012/2014. RESULTS In regression analyses that accounted for demographic factors, older subjective age and negative SPA were associated with lower hearing acuity 8 years later. In addition, 1 SD older subjective age and negative SPA were related to a 9% and 7% higher likelihood of hearing impairment. Mediation analyses revealed that physical inactivity and chronic conditions partially mediated subjective age and SPA associations with hearing acuity. There was little evidence that the link between subjective aging and hearing was moderated by hearing aids and partial support for a moderating role of age. DISCUSSION This study provides new evidence that subjective aging is prospectively related to hearing function. Individuals with older subjective age or negative SPA have unfavorable behavioral and clinical profiles that explain part of their lower hearing function. Individuals' experience with their aging process is a marker of risk for impaired hearing.
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Affiliation(s)
- Yannick Stephan
- Address correspondence to: Yannick Stephan, PhD, Euromov, University of Montpellier, UFRSTAPS, 700, Avenue du Pic St Loup, 34090 Montpellier, France. E-mail:
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, Florida, USA
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Reed M, Freedman M, Mark Fraser AE, Bromwich M, Santiago AT, Gallucci CE, Frank A. Enhancing Clinical Visibility of Hearing Loss in Cognitive Decline. J Alzheimers Dis 2022; 86:413-424. [DOI: 10.3233/jad-215377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background: Hearing loss is the largest potentially modifiable risk factor for dementia and is highly prevalent among older adults, yet it goes largely unreported, unidentified, and untreated, at great cost to health and quality of life. Hearing screening is a proven cost-effective solution to overcome delays in its identification and management yet is not typically recommended by physicians for older adults. Objective: To demonstrate the feasibility and value of hearing screening for older adults at risk for dementia in order to enhance physicians’ awareness of hearing loss and improve access to timely hearing care. Methods: Patients referred to two academic medical clinics for memory disorders were offered hearing screening as part of clinic protocol. Patients with hearing loss were recruited to the study if they consented to a post-appointment telephone interview and chart review. Memory Clinic physicians were surveyed about the usefulness of the screening information and referral of patients with hearing loss to audiology. Results: Hearing loss was reliably detected in Memory Clinic patients with both in-office and online screening tools. Physicians reported that screening enhanced their awareness of hearing loss and increased the referral rate to audiology. Conclusion: Hearing screening in Memory Clinic patients is a useful component of clinic protocol that facilitates timely access to management and addresses an important risk factor for dementia.
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Affiliation(s)
- Marilyn Reed
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - Morris Freedman
- Baycrest Health Sciences, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
- Mt. Sinai Hospital, Toronto, ON, Canada
| | | | - Matthew Bromwich
- SHOEBOX Ltd., Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | | | | | - Andrew Frank
- University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
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Hearing difficulty is linked to Alzheimer's disease by common genetic vulnerability, not shared genetic architecture. NPJ Aging Mech Dis 2021; 7:17. [PMID: 34294723 PMCID: PMC8298411 DOI: 10.1038/s41514-021-00069-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/02/2021] [Indexed: 02/07/2023] Open
Abstract
Age-related hearing loss was recently established as the largest modifiable risk factor for Alzheimer's disease (AD), however, the reasons for this link remain unclear. We investigate shared underlying genetic associations using results from recent large genome-wide association studies (GWAS) on adult hearing difficulty and AD. Genetic correlation and Mendelian randomization (MR) analysis do not support a genetic correlation between the disorders, but suggest a direct causal link from AD genetic risk to hearing difficulty, driven by APOE. Systematic MR analyses on the effect of other traits revealed shared effects of glutamine, gamma-glutamylglutamine, and citrate levels on reduced risk of both hearing difficulty and AD. In addition, pathway analysis on GWAS risk variants suggests shared function in neuronal signalling pathways as well as etiology of diabetes and cardiovascular disease. However, after multiple testing corrections, neither analysis led to statistically significant associations. Altogether, our genetic-driven analysis suggests hearing difficulty and AD are linked by a shared vulnerability in molecular pathways rather than by a shared genetic architecture.
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Hsu AK, Bassett SM, O'Dwyer LC, McHugh M, Heinemann AW, Jordan N, Dhar S. Cost-Effectiveness of Hearing Screening in Older Adults: A Scoping Review. Res Aging 2021; 44:186-204. [PMID: 33973495 DOI: 10.1177/01640275211008583] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Age is the most common predictor of hearing loss; however, many older adults are not screened. Hearing screening could improve healthcare access, participation, and outcomes. Establishing whether hearing screening in older adults is cost-effective could improve the availability and utilization of screening. METHODS We searched nine databases in January 2020. Studies with populations aged 50+ and provided data on the cost-effectiveness of hearing screening were included in the review. RESULTS Five studies met the inclusion criteria and all found hearing screening programs to be cost-effective compared to no hearing screening, regardless of screening method (i.e., instrument or strategy). The maximum number of repeated screenings, coupled with younger ages, was most cost-effective. DISCUSSION This review suggests that hearing screening in older adults is cost-effective, however, the evidence is limited. There is pressing need for research focused on economic impacts of hearing healthcare in older adults to inform research, policy and practice.
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Goderie T, van Wier MF, Stam M, Lissenberg-Witte BI, Merkus P, Smits C, Kramer SE. Association between Speech Recognition in Noise and Risk Factors of Cardiovascular Disease. Audiol Neurootol 2021; 26:368-377. [PMID: 33652431 DOI: 10.1159/000513551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 11/18/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Risk factors for cardiovascular disease (CVD) are associated with sensorineural hearing loss. CVD risk factors are known to cluster and interact, thereby increasing the cumulative risk for CVD. Previously, using the database of the Netherlands Longitudinal Study on Hearing (NL-SH), an association was found between a history of smoking and an increased decline in speech recognition in noise over 10 years of follow-up. Prospectively limited data are available on the association between CVD risk factors, interactions of these risk factors, and hearing loss. In this study, data from the NL-SH were used to study the association between CVD risk factors and speech recognition in noise longitudinally. METHODS Baseline, 5-year, and 10-year follow-up data of the NL-SH were included. The NL-SH is a web-based prospective cohort study which started in 2006. Participants were aged 18-70 years at baseline. Speech recognition in noise was determined with an online digit-triplet speech-in-noise test. In addition, participants completed online questionnaires on demographic, lifestyle, and health-related characteristics. The association of the ability to recognize speech in noise with CVD risk factors (i.e., obesity, rheumatoid arthritis [RA], hypertension, diabetes mellitus, and dyslipidemia) was analyzed longitudinally. We also analyzed the interaction between these risk factors (including age, sex, and history of smoking) and speech recognition in noise. RESULTS None of the CVD risk factors or interactions of 2 CVD risk factors was significantly associated with a decline in SRT over time. Obesity (p = 0.016), RA (p = 0.027), and hypertension (p = 0.044) were associated with overall higher (more unfavorable) SRTs. No overall interactions between CVD risk factors were found. CONCLUSION Obesity, RA, and hypertension were overall associated with a higher SRT, but no longitudinal associations between these or other CVD factors with SRTs were found. Also, no interactions between 2 CVD risk factors and SRTs were found. Although no longitudinal associations between CVD risk factors and decline in SRTs were found, clinicians should be alert about the concurrent association between CVD risk factors and hearing loss.
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Affiliation(s)
- Thadé Goderie
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands,
| | - Marieke F van Wier
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mariska Stam
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Paul Merkus
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cas Smits
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Department of Otolaryngology-Head and Neck surgery, Section Ear and Hearing, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Glenister KM, Simmons D. Hearing loss and access to audiology services in rural victoria: Findings from the crossroads study. Noise Health 2020; 21:217-222. [PMID: 32820744 PMCID: PMC7650848 DOI: 10.4103/nah.nah_5_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Context: Rural residents can be exposed to high levels of agricultural machinery noise and are at risk of hearing loss. Aims: This study aimed to determine audiology service use and rates of hearing loss in a regional area of Australia, using both self-report and audiology testing. Setting and Design: A survey of randomly selected households was undertaken and 6432 participants were interviewed face to face about their health, hearing, and use of audiology services. A total of 1454 participants were randomly selected to undertake standard audiology testing. Material and Methods: Material Hearing was evaluated using conventional audiometry. Statistical Analysis Used: Independent t-tests, Chi-squared tests, and logistic regression were used to examine the association amongbetween hearing loss, use of audiology services, and demographic factors. Results: Hearing issues were present in 12.5% of the survey participants. The rate of hearing loss increased significantly with age. Males were significantly more likely to have hearing loss than females (9.5% vs. 5.2%, pP << 0.01). The majority of people who reported accessing audiology services in the past 12 months were satisfied with the care they received (85.2%), and experienced short waiting times for these services (68.2% waited ≤≤ 7 days). Conclusions: Males had higher rates of hearing issues than females in this rural area. Audiology services in the region were accessible within short waiting times, and clients were satisfied with the service.
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Affiliation(s)
| | - David Simmons
- Western Sydney University, Sydney, New South Wales, Australia
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Deal JA, Reed NS, Kravetz AD, Weinreich H, Yeh C, Lin FR, Altan A. Incident Hearing Loss and Comorbidity: A Longitudinal Administrative Claims Study. JAMA Otolaryngol Head Neck Surg 2019; 145:36-43. [PMID: 30419134 DOI: 10.1001/jamaoto.2018.2876] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Importance Because hearing loss is highly prevalent and treatable, determining its association with morbidity has major public health implications for disease prevention and the maintenance of health in adults with hearing loss. Objective To investigate the association between the diagnosis of incident hearing loss and medical comorbidities in adults 50 years or older. Design, Setting, and Participants Retrospective, propensity-matched cohort study using administrative claims data from commercially insured and Medicare Advantage members in a geographically diverse US health plan. Adults 50 years or older with claims for services rendered from January 1, 2000, to December 31, 2016, were observed for 2 (n = 154 414), 5 (n = 44 852), and 10 (n = 4728) years. This research was conceptualized and data were analyzed between September 2016 and November 2017. Exposures A claim for incident hearing loss is defined as 2 claims for hearing loss within 2 consecutive years without evidence of hearing device use, excluding claims for sudden hearing loss or hearing loss secondary to medical conditions. Main Outcomes and Measures Incident claims for dementia, depression, accidental falls, nonvertebral fractures, acute myocardial infarction, and stroke. Results After cohort matching, 48% of participants were women (n = 74 464), 61% were white (n = 93 442), and 31% (n = 48 056) were Medicare Advantage insured, with a mean (SD) age of 64 (10) years. In a multivariate-adjusted modified Poisson regression with robust standard errors, relative associations were strongest for dementia (relative risk at 5 years, 1.50; 95% CI, 1.38-1.64) and depression (relative risk at 5 years, 1.41; 95% CI, 1.26-1.58). The absolute risk of all outcomes was greater in persons with hearing loss than in those without hearing loss at all times, with the greatest risk difference observed at 10 years for all outcomes. The 10-year risk attributable to hearing loss was 3.20 per 100 persons (95% CI, 1.76-4.63) for dementia, 3.57 per 100 persons (95% CI, 1.67-5.47) for falls, and 6.88 per 100 persons (95% CI, 4.62-9.14) for depression. Conclusions and Relevance In this large observational study using administrative claims data, incident untreated hearing loss was associated with greater incident morbidity than no hearing loss across a range of health conditions. Future studies are needed to elucidate the mechanisms underlying these associations and to determine if treatment for hearing loss could reduce the risk of comorbidity.
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Affiliation(s)
- Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicholas S Reed
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Heather Weinreich
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago
| | | | - Frank R Lin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Assunção AÁ, Abreu MNS, Souza PSN. [Prevalence of exposure to occupational noise in Brazilian workers: results of the Brazilian National Health Survey, 2013]. CAD SAUDE PUBLICA 2019; 35:e00094218. [PMID: 31596395 DOI: 10.1590/0102-311x00094218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 04/18/2019] [Indexed: 12/20/2022] Open
Abstract
The objectives were to describe the prevalence of occupational exposure to noise and to analyze associated factors in the Brazilian population. This cross-sectional population-based study used data from the Brazilian National Health Survey (PNS, 2013). The sample consisted of 36,442 Brazilians 18 years or older. The outcome variable was self-reported exposure to noise during work. To assess possible factors associated with exposure to noise, we used Pearson's chi-square test and the univariate and multivariate Poisson model with robust variance. The results showed 32.1% prevalence of exposure to noise, varying from 40.9% (Santa Catarina, Brazil) to 21.9% (Piauí, Brazil). Prevalence was lower in women (PR = 0.57; 95%CI: 0.55-0.59) and in individuals 55 years or older (PR = 0.70; 95%CI: 0.65-0.76). Higher prevalence was associated with the 25-54-year age bracket (PR = 1.00; 95%CI: 0.95-1.06), middle schooling level (PR = 1.36; 95%CI: 1.29-1.44), self-reported fatigue (PR = 1.35; 95%CI: 1.30-1.40), hearing impairment (PR = 1.27; 95%CI: 1.19-1.35), and history of work-related accident (PR = 1.37; 95%CI: 1.25-1.50). Prevalence of self-reported exposure to occupational noise was higher than in three other Latin American countries. Higher prevalence among men, younger workers, and those with less schooling was expected. The associations with auditory and non-auditory problems suggest the need for systemic interventions. Adjustments to the questions in the PNS are desirable to favor comparability and monitoring.
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Associations among hearing loss, hospitalization, readmission and mortality in older adults: A systematic review. Geriatr Nurs 2019; 40:367-379. [DOI: 10.1016/j.gerinurse.2018.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/26/2022]
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Dupuis K, Reed M, Bachmann F, Lemke U, Pichora-Fuller MK. The Circle of Care for Older Adults With Hearing Loss and Comorbidities: A Case Study of a Geriatric Audiology Clinic. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1203-1220. [PMID: 31026196 DOI: 10.1044/2018_jslhr-h-ascc7-18-0140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Older adults seeking audiologic rehabilitation often present with medical comorbidities, yet these realities of practice are poorly understood. Study aims were to examine (a) the frequency of identification of selected comorbidities in clients of a geriatric audiology clinic, (b) the influence of comorbidities on audiology practice, and (c) the effect of comorbidities on rehabilitation outcomes. Method The records of 135 clients ( M age = 86 years) were examined. Information about comorbidities came from audiology charts (physical paper files) and hospital electronic health records (EHRs). Data about rehabilitation recommendations and outcomes came from the charts. Focus groups with audiologists probed their views of how comorbidities influenced their practice. Results The frequency of identification was 68% for visual, 50% for cognitive, and 42% for manual dexterity issues; 84% had more than one comorbidity. Also noted were hypertension (43%), falls (33%), diabetes (13%), and depression (16%). Integrating information from the audiology chart and EHR provided a more complete understanding of comorbidities. Information about hearing in the EHR included logs of outpatient audiology visits (75% of 135 cases), audiologists' care notes for inpatients and long-term care residents (25%), and entries by other health professionals (60%). Modifications to audiology practice were common and varied depending on comorbidity. High rates of success were achieved regardless of comorbidities. Conclusions In this clinic, successful outcomes were achieved by modifying audiology practice for clients with comorbidities. Increased interprofessional communication among clinicians in the circle of care could improve care planning and outcomes for older adults with hearing loss.
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Affiliation(s)
- Kate Dupuis
- Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Ontario, Canada
- Sheridan Centre for Elder Research, Sheridan College, Oakville, Ontario, Canada
| | - Marilyn Reed
- Hearing Services, Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | | | - M Kathleen Pichora-Fuller
- Department of Psychology, University of Toronto, Ontario, Canada
- Rotman Research Institute, Toronto, ON, Canada
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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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Wettstein M, Wahl HW, Heyl V. Four-year reciprocal relationships between personality and functional ability in older adults with and without sensory impairment: focus on neuroticism and agreeableness. Aging Ment Health 2018; 22:834-843. [PMID: 28447472 DOI: 10.1080/13607863.2017.1318259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Personality traits have been found to influence health and functional ability (FA) via multiple pathways. However, personality traits may also change in reaction to constraints in FA, particularly in more vulnerable individuals with high risk of decline in independent functioning in daily life (e.g. older adults with sensory impairment). Therefore, conceptually anchored in the World Health Organization's International Classification of Functioning, Disability and Health (ICF model), this study investigated reciprocal relationships between personality, focusing on neuroticism and agreeableness, and indicators of FA (i.e. activities of daily living and subjective autonomy) as well as the potentially moderating role of sensory impairment status. METHOD The study sample consisted of 387 older adults (mean age at T1: M = 82.50 years, SD = 4.71 years) who were either sensory impaired (SI; i.e. visually or hearing impaired) or sensory unimpaired (UI). A total of 168 individuals were reassessed four years later. RESULTS Depending on sensory status, personality acted both as predictor and as outcome of FA. Neuroticism was more strongly related with later FA outcomes in SI than in UI individuals. FA variables, in turn, were significant predictors of later neuroticism in UI older adults only and of later agreeableness in SI individuals only. CONCLUSION These findings suggest that the late-life personality-FA interplay needs to be considered bidirectional, and the direction of associations varies systematically as a function of sensory impairment status.
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Affiliation(s)
- Markus Wettstein
- a Department of Psychological Aging Research , Heidelberg University , Germany
| | - Hans-Werner Wahl
- a Department of Psychological Aging Research , Heidelberg University , Germany
| | - Vera Heyl
- b Institute of Special Education, University of Education , Heidelberg , Germany
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A Deterioration in Hearing Is Associated With Functional and Cognitive Impairments, Difficulty With Communication, and Greater Health Instability. J Appl Gerontol 2018; 39:159-171. [DOI: 10.1177/0733464818755312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: To examine the relationship between hearing deterioration and several health-related outcomes among home care clients in Ontario. Design: Longitudinal analysis was completed for clients with at least two comprehensive assessments. Hearing status, based on a single item, ranged from zero (no impairment) to three (highly impaired). Hearing deterioration was defined as at least a 1-point decline between subsequent assessments. Results: Seven percent experienced a 1-point deterioration in hearing and roughly 1% had a 2/3-point decline. After adjusting for other covariates, increasing age (odds ratio = 1.94; 95% confidence intervals [CIs] = [1.45, 2.61]) and a diagnosis of Alzheimer’s disease (1.37; CI = [1.04, 1.80]) and other dementias (1.32; CI = [1.07, 1.63]) increased the risk of a 2/3-point deterioration. Conclusion: These findings can assist home care professionals and policy makers in creating and refining interventions to meet the needs of older adults with hearing difficulties.
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Change in Psychosocial Health Status Over 5 Years in Relation to Adults’ Hearing Ability in Noise. Ear Hear 2016; 37:680-689. [DOI: 10.1097/aud.0000000000000332] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weber A, Weber U. Erwerbstätig mit Hörschädigung in Sachsen, Sachsen-Anhalt und Thüringen. HNO 2016; 64:743-50. [DOI: 10.1007/s00106-016-0174-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Raeve L. Cochlear implants in Belgium: Prevalence in paediatric and adult cochlear implantation. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133 Suppl 1:S57-60. [PMID: 27246742 DOI: 10.1016/j.anorl.2016.04.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 01/16/2016] [Accepted: 04/28/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Belgium, and especially the northern region called Flanders, has been a centre of expertise in cochlear implants and early hearing screening for many years. Cochlear implants are reimbursed by the Belgian National Institute for Health and Disability (BNIHD) Insurance in adults and in children since October 1994. More than 20 years later, we would like to measure the prevalence of cochlear implants in adults and in children till now. MATERIALS AND METHODS Based on scientific research data on the prevalence of severe to profound hearing loss in adults and in children and on the number of implantations from the data of the BNIHD, we could measure the percentages of paediatric and adult CI users in comparing to the number of CI candidates. RESULTS The degree of utilisation of cochlear implantation varies considerably between the paediatric and the adult population. On average, 78% of deaf children are receiving cochlear implants, but in adults only 6.6% of CI candidates are receiving one. CONCLUSION There are big differences in Belgium in utilisation of cochlear implants between adults and children. Because of the underutilisation of cochlear implants, especially in adults, we have to work on raising the general awareness of the benefits of cochlear implants, and its improvement in quality of life, based on cost-effectiveness data and on guidelines for good clinical practice.
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Affiliation(s)
- L De Raeve
- Independent Information and Research Centre on Cochlear Implants, Zonhoven, Belgium; KIDS - Royal Institute for the Deaf, Hasselt, Belgium; University College Leuven-Limburg, Leuven, Belgium.
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Boeschen Hospers JM, Smits N, Smits C, Stam M, Terwee CB, Kramer SE. Reevaluation of the Amsterdam Inventory for Auditory Disability and Handicap Using Item Response Theory. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:373-383. [PMID: 27115096 DOI: 10.1044/2015_jslhr-h-15-0156] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 09/10/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum. METHOD Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18-70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study "Netherlands Longitudinal Study on Hearing." A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted. RESULTS The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability. CONCLUSIONS This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability.
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Jiam NTL, Li C, Agrawal Y. Hearing loss and falls: A systematic review and meta-analysis. Laryngoscope 2016; 126:2587-2596. [DOI: 10.1002/lary.25927] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/04/2016] [Accepted: 01/26/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Nicole Tin-Lok Jiam
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland
| | - Carol Li
- Department of Otolaryngology; New York-Presbyterian Hospital; New York New York U.S.A
| | - Yuri Agrawal
- Department of Otolaryngology-Head and Neck Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland
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Stam M, Spooren A, Merkus P, Festen JM, Smits C, Kramer SE. Medication Use in Adults with and without Hearing Impairment. Audiol Neurootol 2015; 20:354-9. [DOI: 10.1159/000433512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/21/2015] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to determine whether hearing ability in adults is associated with medication use in general, the use of specific types of medication, or polypharmacy. In this exploratory study, data of the National Longitudinal Study on Hearing (NL-SH; n = 2,160) were used. In total, 62% of the participants reported using any medication in the past 28 days. Hearing ability in noise, as determined with an online digit-triplet speech-in-noise test, was significantly associated with (1) medication acting on the alimentary tract and metabolism (including diabetes and acid-related disorders), (2) use of calcium blockers, and (3) medication used for sensory organs.
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Lemke U, Scherpiet S. Oral communication in individuals with hearing impairment-considerations regarding attentional, cognitive and social resources. Front Psychol 2015; 6:998. [PMID: 26236268 PMCID: PMC4505078 DOI: 10.3389/fpsyg.2015.00998] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 07/02/2015] [Indexed: 11/13/2022] Open
Abstract
Traditionally, audiology research has focused primarily on hearing and related disorders. In recent years, however, growing interest and insight has developed into the interaction of hearing and cognition. This applies to a person's listening and speech comprehension ability and the neural realization thereof. The present perspective extends this view to oral communication, when two or more people interact in social context. Specifically, the impact of hearing impairment and cognitive changes with age is discussed. In focus are executive functions, a group of top-down processes that guide attention, thought and action according to goals and intentions. The strategic allocation of the limited cognitive processing capacity among concurrent tasks is often effortful, especially under adverse communication conditions and in old age. Working memory, a sub-function extensively discussed in cognitive hearing science, is here put into the context of other executive and cognitive functions required for oral communication and speech comprehension. Finally, taking an ecological view on hearing impairment, activity limitations and participation restrictions are discussed regarding their psycho-social impact and third-party disability.
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Affiliation(s)
- Ulrike Lemke
- Cognitive and Ecological Audiology, Science and Technology, Phonak AG , Stäfa, Switzerland
| | - Sigrid Scherpiet
- Cognitive and Ecological Audiology, Science and Technology, Phonak AG , Stäfa, Switzerland
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