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Iliadou VM, Bamiou DE, Keith W, Purdy SC, Thai-Van H. It is time to change the way we think about hearing evaluation. Eur Arch Otorhinolaryngol 2024; 281:3261-3264. [PMID: 38573509 PMCID: PMC11065902 DOI: 10.1007/s00405-024-08620-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024]
Affiliation(s)
| | - Doris-Eva Bamiou
- Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - William Keith
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Suzanne C Purdy
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Hung Thai-Van
- Hospices Civils de Lyon, Service d'Audiologie & Explorations Oto-Neurologiques, Lyon, France
- Institut de L'Audition, Institut Pasteur, Paris, France
- Université, Claude Bernard Lyon 1, Villeurbanne, France
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Ademoyegun AB, Ogundiran O, Kayode AJ, Olaosun AO, Awotidebe TO, Mbada CE. Hearing loss, gait and balance impairments and falls among individuals with sub-acute stroke: A comparative cross-sectional study. Heliyon 2024; 10:e26880. [PMID: 38486770 PMCID: PMC10937590 DOI: 10.1016/j.heliyon.2024.e26880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/17/2024] Open
Abstract
Background The impact of hearing loss in stroke is less explored. This study aimed to compare hearing loss in patients with sub-acute stroke with healthy controls and evaluate its association with gait and balance impairments and falls. Methods This study involved 78 ambulant sub-acute stroke patients and 78 age-sex-matched controls. Hearing loss was assessed with pure tone average, while gait and balance impairments were assessed with the Timed Up and Go test, Berg Balance Scale, Functional Gait Assessment and 10-m walk test (gait speed). Fall occurrence was evaluated by a self-report questionnaire. Results The prevalence of hearing loss (pure tone average of >25 dB) was higher in stroke patients than in controls (64.1% vs. 35.9%; p < 0.001). The mean pure tone average of stroke patients showed a significant positive correlation with Timed Up and Go test (r = 0.357; p = 0.001) and fall occurrence (r = 0.253; p = 0.025), and a significant negative correlation with Berg Balance Scale (r = -0.299; p = 0.008) and Functional Gait Assessment (r = -0.452; p < 0.001). There was a non-significant negative correlation with gait speed (r = -0.166; p = 0.147). Multiple regression showed that mean pure tone average was associated with Timed Up and Go test (B = 0.096; 95%CI: 0.010, 0.183) and Functional Gait Assessment (B = -0.087; 95%CI: -0.157, -0.017), but not with gait speed (B = -0.003; 95%CI: -0.007, 0.001) and Berg Balance Scale (B = -0.058; 95%CI: -0.165, 0.049). Conclusion Hearing loss is more prevalent among patients with sub-acute stroke compared with age-sex-matched controls. Hearing loss is also associated with gait and balance impairments and falls among sub-acute stroke patients. We recommend that hearing screening and rehabilitation be incorporated into post-stroke rehabilitation programmes as part of strategies to improve balance and gait and reduce or prevent falls.
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Affiliation(s)
- Adekola B. Ademoyegun
- Department of Physiotherapy, Osun State University Teaching Hospital, Osogbo, Nigeria
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olawale Ogundiran
- Department of Speech, Language and Hearing Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Adepoju J. Kayode
- Department of Ear, Nose and Throat, Osun State University Teaching Hospital, Osogbo, Nigeria
| | - Adedayo O. Olaosun
- Department of Otorhinolaryngology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Taofeek O. Awotidebe
- Department of Medical Rehabilitation, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Chidozie E. Mbada
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, United Kingdom
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Samara M, Thai-Van H, Ptok M, Glarou E, Veuillet E, Miller S, Reynard P, Grech H, Utoomprurkporn N, Sereti A, Bamiou DE, Iliadou VM. A systematic review and metanalysis of questionnaires used for auditory processing screening and evaluation. Front Neurol 2023; 14:1243170. [PMID: 37621857 PMCID: PMC10446894 DOI: 10.3389/fneur.2023.1243170] [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: 06/20/2023] [Accepted: 07/19/2023] [Indexed: 08/26/2023] Open
Abstract
The recognition of Auditory Processing Disorder (APD) as a distinct clinical condition that impacts hearing capacity and mental health has gained attention. Although pure tone audiometry is the gold standard for assessing hearing, it inadequately reflects everyday hearing abilities, especially in challenging acoustic environments. Deficits in speech perception in noise, a key aspect of APD, have been linked to an increased risk of dementia. The World Health Organization emphasizes the need for evaluating central auditory function in cases of mild hearing loss and normal audiometry results. Specific questionnaires play a crucial role in documenting and quantifying the difficulties faced by individuals with APD. Validated questionnaires such as the Children's Auditory Processing Performance Scale, the Fisher's Auditory Problems Checklist, and the Auditory Processing Domains Questionnaire are available for children, while questionnaires for adults include items related to auditory functions associated with APD. This systematic review and meta-analysis identified six questionnaires used for screening and evaluating APD with a total of 783 participants across 12 studies. The questionnaires exhibited differences in domains evaluated, scoring methods, and evaluation of listening in quiet and noise. Meta-analysis results demonstrated that individuals with APD consistently exhibited worse scores compared to healthy controls across all questionnaires. Additionally, comparisons with clinical control groups showed varying results. The study highlights (i) the importance of standardized questionnaires in identifying and assessing APD, aiding in its diagnosis and management, and (ii) the need to use sub-scores as well as overall scores of questionnaires to elaborate on specific hearing and listening situations. There is a need to develop more APD specific questionnaires for the adult population as well as for more focused research on APD diagnosed individuals to further establish the validity and reliability of these questionnaires.
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Affiliation(s)
- Myrto Samara
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larisa, Greece
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Hung Thai-Van
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Martin Ptok
- Department of Phoniatrics and Pedaudiology, Hannover Medical School, Hannover, Germany
| | - Eleni Glarou
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Evelyne Veuillet
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Simone Miller
- Department of Phoniatrics and Pedaudiology, Hannover Medical School, Hannover, Germany
| | - Pierre Reynard
- Institut de l'audition, Institut Pasteur, Inserm, Paris, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
- Service d’Audiologie et d’Explorations Otoneurologiques, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Helen Grech
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Nattawan Utoomprurkporn
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ear Institute, University College London, London, United Kingdom
- Chula Neuroscience Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Afroditi Sereti
- Clinical Psychoacoustics Laboratory, 3rd Psychiatric Department, Neurosciences Sector, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Doris-Eva Bamiou
- Ear Institute, University College London, London, United Kingdom
- National Institute for Health and Care Research, University College London Hospitals, UK Biomedical Research Centre, Deafness and Hearing Problems Theme, London, United Kingdom
- Department of Neuro-otology, University College London Hospitals, London, United Kingdom
| | - Vasiliki Maria Iliadou
- Clinical Psychoacoustics Laboratory, 3rd Psychiatric Department, Neurosciences Sector, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Mayerhofer E, Zaba NO, Parodi L, Ganbold AS, Biffi A, Rosand J, Yechoor N, Anderson CD. Disparities in brain health comorbidity management in intracerebral hemorrhage. Front Neurol 2023; 14:1194810. [PMID: 37360335 PMCID: PMC10285101 DOI: 10.3389/fneur.2023.1194810] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background Intracerebral hemorrhage (ICH) disproportionally affects underserved populations, and coincides with risk factors for cardiovascular events and cognitive decline after ICH. We investigated associations between social determinants of health and management of blood pressure (BP), hyperlipidemia, diabetes, obstructive sleep apnea (OSA), and hearing impairment before and after ICH hospitalization. Methods Survivors of the Massachusetts General Hospital longitudinal ICH study between 2016 and 2019 who received healthcare at least 6 months after ICH were analyzed. Measurements of BP, LDL and HbA1c and their management in the year surrounding ICH and referrals for sleep studies and audiology up to 6 months after ICH were gathered from electronic health records. The US-wide area deprivation index (ADI) was used as proxy for social determinants of health. Results The study included 234 patients (mean 71 years, 42% female). BP measurements were performed in 109 (47%) before ICH, LDL measurements were performed in 165 (71%), and HbA1c measurements in 154 (66%) patients before or after ICH. 27/59 (46%) with off-target LDL and 3/12 (25%) with off-target HbA1c were managed appropriately. Of those without history of OSA or hearing impairment before ICH, 47/207 (23%) were referred for sleep studies and 16/212 (8%) to audiology. Higher ADI was associated with lower odds of BP, LDL, and HbA1c measurement prior to ICH [OR 0.94 (0.90-0.99), 0.96 (0.93-0.99), and 0.96 (0.93-0.99), respectively, per decile] but not with management during or after hospitalization. Conclusion Social determinants of health are associated with pre-ICH management of cerebrovascular risk factors. More than 25% of patients were not assessed for hyperlipidemia and diabetes in the year surrounding ICH hospitalization, and less than half of those with off-target values received treatment intensification. Few patients were evaluated for OSA and hearing impairment, both common among ICH survivors. Future trials should evaluate whether using the ICH hospitalization to systematically address co-morbidities can improve long-term outcomes.
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Affiliation(s)
- Ernst Mayerhofer
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Natalie O. Zaba
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Livia Parodi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
| | - Alena S. Ganbold
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Alessandro Biffi
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Nirupama Yechoor
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Christopher D. Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, United States
- Henry and Allison McCance Center for Brain Health, Massachusetts General Hospital, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Neurology, Brigham and Women’s Hospital, Boston, MA, United States
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Hazelton C, Thomson K, Todhunter-Brown A, Campbell P, Chung CS, Dorris L, Gillespie DC, Hunter SM, McGill K, Nicolson DJ, Williams LJ, Brady MC. Interventions for perceptual disorders following stroke. Cochrane Database Syst Rev 2022; 11:CD007039. [PMID: 36326118 PMCID: PMC9631864 DOI: 10.1002/14651858.cd007039.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Perception is the ability to understand information from our senses. It allows us to experience and meaningfully interact with our environment. A stroke may impair perception in up to 70% of stroke survivors, leading to distress, increased dependence on others, and poorer quality of life. Interventions to address perceptual disorders may include assessment and screening, rehabilitation, non-invasive brain stimulation, pharmacological and surgical approaches. OBJECTIVES To assess the effectiveness of interventions aimed at perceptual disorders after stroke compared to no intervention or control (placebo, standard care, attention control), on measures of performance in activities of daily living. SEARCH METHODS: We searched the trials registers of the Cochrane Stroke Group, CENTRAL, MEDLINE, Embase, and three other databases to August 2021. We also searched trials and research registers, reference lists of studies, handsearched journals, and contacted authors. SELECTION CRITERIA We included randomised controlled trials (RCTs) of adult stroke survivors with perceptual disorders. We defined perception as the specific mental functions of recognising and interpreting sensory stimuli and included hearing, taste, touch, smell, somatosensation, and vision. Our definition of perception excluded visual field deficits, neglect/inattention, and pain. DATA COLLECTION AND ANALYSIS One review author assessed titles, with two review authors independently screening abstracts and full-text articles for eligibility. One review author extracted, appraised, and entered data, which were checked by a second author. We assessed risk of bias (ROB) using the ROB-1 tool, and quality of evidence using GRADE. A stakeholder group, comprising stroke survivors, carers, and healthcare professionals, was involved in this review update. MAIN RESULTS We identified 18 eligible RCTs involving 541 participants. The trials addressed touch (three trials, 70 participants), somatosensory (seven trials, 196 participants) and visual perception disorders (seven trials, 225 participants), with one (50 participants) exploring mixed touch-somatosensory disorders. None addressed stroke-related hearing, taste, or smell perception disorders. All but one examined the effectiveness of rehabilitation interventions; the exception evaluated non-invasive brain stimulation. For our main comparison of active intervention versus no treatment or control, one trial reported our primary outcome of performance in activities of daily living (ADL): Somatosensory disorders: one trial (24 participants) compared an intervention with a control intervention and reported an ADL measure. Touch perception disorder: no trials measuring ADL compared an intervention with no treatment or with a control intervention. Visual perception disorders: no trials measuring ADL compared an intervention with no treatment or control. In addition, six trials reported ADL outcomes in a comparison of active intervention versus active intervention, relating to somatosensation (three trials), touch (one trial) and vision (two trials). AUTHORS' CONCLUSIONS: Following a detailed, systematic search, we identified limited RCT evidence of the effectiveness of interventions for perceptual disorders following stroke. There is insufficient evidence to support or refute the suggestion that perceptual interventions are effective. More high-quality trials of interventions for perceptual disorders in stroke are needed. They should recruit sufficient participant numbers, include a 'usual care' comparison, and measure longer-term functional outcomes, at time points beyond the initial intervention period. People with impaired perception following a stroke should continue to receive neurorehabilitation according to clinical guidelines.
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Affiliation(s)
- Christine Hazelton
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Katie Thomson
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
- Department of Occupational Therapy, Human Nutrition & Dietetics, Glasgow Caledonian University, Glasgow, UK
| | - Alex Todhunter-Brown
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Charlie Sy Chung
- Rehabilitation Services, Fife Health and Social Care Partnership, Dunfermline, UK
| | - Liam Dorris
- Paediatric Neurosciences, Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - David C Gillespie
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Susan M Hunter
- School of Allied Health Professions, Faculty of Medicine and Health Sciences, Keele University, Keele, UK
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - Linda J Williams
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
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Sharma S, Prajapati V, Sharma A, Tan BYQ, Sharma VK. Hearing Impairment in Stroke Patients- Findings from a Pilot Study Conducted in India. Indian J Otolaryngol Head Neck Surg 2022; 74:651-657. [PMID: 36032885 PMCID: PMC9411442 DOI: 10.1007/s12070-021-02474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/16/2021] [Indexed: 10/22/2022] Open
Abstract
Auditory processing difficulties and hearing loss have been reported among stroke survivors, but is largely neglected. Post-stroke hearing impairment may affect communication between stroke survivors and healthcare professionals, thereby restricting rehabilitation and long-term patient outcome. In this prospective pilot study, we sought to determine the prevalence and pattern of hearing loss in stroke patients when compared to age and sex matched controls. 50 consecutive patients with first-ever stroke, both hemorrhagic and ischemic, and a comparison cohort of 50 age and sex matched controls were assessed. Pure Tone Audiogram was performed in all patients within 15 days of stroke onset and mean hearing loss was determined. Mean audiometric threshold was significantly higher in both ears in stroke patients (mean 44.0 ± 12.1 dB) when compared to the control subjects (36.1 ± 11.4 dB; p = 0.001). After adjusting for Diabetes mellitus and hypertension, sensorineural hearing loss was more common and severe in stroke compared to controls (p < 0.005). Most of the strokes were ischemic and involved middle cerebral artery territory. A modest correlation between hearing threshold and stroke severity in both ears was seen (mean B 0.775, R2 0.54, CI 0.122-1.427, p = 0.020). Our pilot study shows significant hearing impairment in patients with stroke, compared to age and sex matched controls with similar prevalence of cardiovascular risk factors, interestingly seen in a predominantly anterior circulation stroke population. Undetected hearing loss may impact post stroke functional recovery. Hence, current rehabilitation guidelines should include auditory screening in all patients of stroke for detection of hearing loss.
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Utoomprurkporn N, Stott J, Costafreda SG, Bamiou DE. Lack of Association between Audiogram and Hearing Disability Measures in Mild Cognitive Impairment and Dementia: What Audiogram Does Not Tell You. Healthcare (Basel) 2021; 9:769. [PMID: 34203041 PMCID: PMC8234005 DOI: 10.3390/healthcare9060769] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 12/25/2022] Open
Abstract
(1) Introduction: The validity of self-reported hearing disability measures has been assessed using their correlation with the pure-tone average (PTA) hearing loss for non-cognitively impaired adults. However, for people with cognitive impairment, factors in addition to the PTA can play a role in their self-reported difficulties. Patients with cognitive impairment may experience more hearing difficulties due to their brain processing sounds abnormally, irrespective of PTA. (2) Methods: Three groups of hearing aid users who had normal cognition, mild cognitive impairment and dementia were recruited. Self-reported hearing abilities were assessed with the modified Amsterdam inventory for auditory disability (mAIAD) and the speech, spatial and qualities of hearing scale (SSQ). (3) Results: The SSQ and mAIAD scores were highly correlated with each other for all three groups. However, a correlation with objective PTA was found in the normal cognition but not the cognitively impaired groups. Self-reported hearing scores were associated with cognitive scores for the dementia group (4) Discussion: In people with combined cognitive and hearing impairment, PTA alone may be a poor predictor of hearing abilities. Subjective hearing questionnaires together with hearing tests may provide a better understanding of their hearing difficulties.
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Affiliation(s)
- Nattawan Utoomprurkporn
- UCL Ear Institute, 332 Grays Inn Road, London WC1X 8EE, UK;
- Faculty of Medicine, Chulalongkorn University, 1873 Rama IV road, Pathumwan, Bangkok 10330, Thailand
| | - Joshua Stott
- Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, Gower Street, London WC1E 6BT, UK;
| | - Sergi Gonzalez Costafreda
- Division of Psychiatry, Faculty of Brain Sciences, University College London, Gower Street, London WC1E 6BT, UK;
| | - Doris Eva Bamiou
- UCL Ear Institute, 332 Grays Inn Road, London WC1X 8EE, UK;
- NIHR Biomedical Research Centre Hearing and Deafness, Maple House Suite A 1st Floor, 149 Tottenham Court Road, London W1T 7DN, UK
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