The Effect of Auditory Cues on Static Postural Control: A Systematic Review and Meta-Analysis

INTRODUCTION

The purpose of this systematic review and meta-analysis was to summarize the results related to the effects of auditory cues on static postural control.

METHODS

MEDLINE/PubMed, EMBASE, SCOPUS, LILACS, CINAHL, CENTRAL, Web of Science, PEDro, and Google Scholar were searched from inception until September 2020. Risk of bias was evaluated by both reviewers using Newcastle-Ottawa Quality Assessment Scale (NOS).

RESULTS

Twelve studies with 403 participants were included in the review and 9 studies with 305 participants in the meta-analysis. Results show that auditory cues have significant effects on postural sway in the anterior-posterior direction (p = 0.001), postural sway in the medial-lateral direction (p = 0.001), and static balance (p = 0.001). A low to high heterogeneity was observed across all comparisons.

CONCLUSIONS

Results of this meta-analysis revealed that auditory cues decrease postural sway in the anterior-posterior and medial-lateral direction; it also improves static balance. Thus, it can be concluded that auditory cues improve static postural control. Our results suggest that the auditory system can be a determinant of static postural control along with other sensory systems including visual, vestibular, and proprioception systems. Also, this study implies that auditory cues can be a significant therapeutic approach to improve static postural control.

Sense of Purpose in Life and Markers of Hearing Function: Replicated Associations across Two Longitudinal Cohorts

INTRODUCTION

A sense of purpose in life is a psychological resource that is associated with healthier outcomes. The present research examines whether a greater sense of purpose in life is associated with subjective and objective markers of hearing health and whether hearing acuity contributes to the association between purpose and episodic memory. We sought to evaluate whether these associations were replicable across 2 independent samples.

METHODS

Participants in the Health and Retirement Study (N = 14,291) and the English Longitudinal Study of Ageing (N = 8,844) reported on their purpose in life and perceived hearing quality at baseline. Hearing acuity was measured using an audiometer 2-4 years later, and episodic memory was measured at baseline and 6-8 years later.

RESULTS

In both samples, higher purpose in life was associated with better hearing quality measured concurrently, lower risk of either subjective or objective hearing impairment, and hearing acuity accounted for some of the longitudinal relation between sense of purpose and better episodic memory.

DISCUSSION

Across samples, measures, and analytical approaches, the present research indicates replicable associations between sense of purpose in life and hearing health. It further indicates that hearing may be one factor that associates purpose with better episodic memory.

Subjective Aging and Objectively Assessed Hearing Function: A Prospective Study of Older Adults

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.

Synergistic associations of visual and self-reported hearing acuity with low handgrip strength in older adults: a population-based cross-sectional study

BACKGROUND

It is unclear whether visual and hearing acuity are independently or synergistically associated with muscle strength. We aimed to examine the associations of visual and self-reported hearing acuity with low handgrip strength and the additive interaction between visual and hearing acuity on low handgrip strength in people over 60 years.

METHOD

Data of 3,075 individuals aged over 60 years from the 2017 and 2018 Korea National Health and Nutrition Examination Survey were used for this cross-sectional study. Low handgrip strength was defined based on the 20th percentile of the study population (< 30.4 kg for male and < 17.7 kg for female). Visual and self-reported hearing acuity were each divided into three categories: good, moderate, and impaired. Multiple logistic regression and relative excess risk due to interaction (RERI) were performed.

RESULTS

Of the 3,075 participants, 993 (32.3 %) demonstrated low handgrip strength. Low handgrip strength was more prevalent in participants with moderate (adjusted odds ratio [AOR] = 1.54, 95 % confidence interval [CI] = 1.12-2.12) and impaired visual acuity (AOR = 2.00, 95 % CI = 1.34-2.96). Both moderate and impaired self-reported hearing acuity were significantly associated with low handgrip strength (moderate: AOR = 1.25, 95 % CI = 1.01-1.55; impaired: AOR = 1.66, 95 % CI = 1.15-2.38). The more severe the sensory function decline, the higher the association with muscle weakness. Moreover, combined sensory impairments were associated with deteriorating low handgrip strength (AOR = 8.38), with significantly strong additive interactions (RERI = 2.61, 95 % CI = 2.52-2.70).

CONCLUSIONS

Awareness is needed regarding the risk of reduced muscle strength in individuals with moderate and impaired sensory function. Older people with sensory function decline in clinical settings may benefit from programs such as exercise prescription to prevent muscle weakness.

White-matter integrity and hearing acuity decline in healthy subjects: Magnetic resonance tractography

AIM

The association between hearing acuity and white-matter (WM) microstructure integrity was evaluated in a normal healthy population with a variety of hearing acuity using an automated tractography technique known as TRACULA (TRActs Constrained by UnderLying Anatomy) in order to investigate whether hearing acuity decline is correlated with brain structural connectivity.

METHODS

Forty healthy controls were recruited to this study, which used a Siemens 3T Trio with a standard eight-channel head coil. Hearing acuity was assessed using pure-tone air conduction audiometry (Amplivox 2160, with Audiocups to eliminate noise and allow accurate pure-tone audiometry). Handedness and anxiety and depression were assessed for all participants in this study using the Edinburgh Handedness Inventory and the Hospital Anxiety and Depression Scale, respectively.

RESULTS

This study showed a significant reduction in WM volume of the left cingulum angular bundle (CAB; t = 2.32, p = 0.02) in the mild to moderate hearing-loss group (238 ± 223 mm²) compared to the group with normal hearing (105  ± 121 mm²). The WM integrity of the left CAB was found to be significantly different (t = 2.06, p = 0.04) in the mild to moderate hearing-loss group (0.18 ± 0.06 mm²/s) compared to the group with normal hearing (0.22 ± 0.05 mm²/s). The WM integrity of the left anterior thalamic radiation (ATR) was found to be significantly different (t = 2.58, p = 0.014) in the mild to moderate hearing-loss group (0.33 ± 0.05 mm²/s) compared to the group with normal hearing (0.37 ± 0.03 mm²/s). A significant negative correlation was found between age and the WM integrity of the right ATR (r = -0.33, p = 0.038), and between hearing acuity and the WM integrity of the right ATR (r = -0.38, p = 0.013) and left CAB (r = -0.36, p = 0.019). Discussion and conclusion: An important finding in this study is that brain structural connectivity changes in the left hemisphere seem to be associated with age-related hearing loss found mainly in the ATR and CAB tracts.

A survey on hearing acuity of centenarians in Hainan Province

Objective

This study aimed to investigate hearing acuity of centenarians in Hainan Province and provide basis for interventional considerations.

Method

Door-to-door follow-up was conducted to investigate hearing acuity of centenarians (aged 100 years or above) in Hainan Province. Physical examination, pure tone audiometry and acoustic impedance test were performed, and the results were analyzed.

Result

A total of 460 centenarians (920 ears) were tested by pure tone audiometry. The rate of normal hearing was 0.2%, the rate of mild hearing loss was 1.5%, 12% for moderate hearing loss, 33.9% for moderate to severe hearing loss, 37.4% for severe hearing loss is and 15% for profound hearing loss. Acoustic impedance test was performed in 340 centenarians (668 ears). Tympanogram was type A in 41.2% of the ears, type As in 34.1% ears, type Ad in 6.4%, type B in 11.8%, and type C in 4.9% of the ears, while no response was elicited in 1.5% of the ears.

Conclusion

Age related sensorineural hearing loss is prevalent among centenarians in Hainan Province. A probably beneficial intervention may be the use of hearing aids for effective communication.