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Urbanski DP, Wolf JM, Langworthy BW, Parikh RR, Jutkowitz E, Shippee TP. Reported Unmet Hearing Aid Need in Older People With Dementia: The US National Core Indicators Survey. J Am Med Dir Assoc 2024; 25:853-859. [PMID: 38643971 DOI: 10.1016/j.jamda.2024.03.107] [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: 10/19/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Hearing aids have important health benefits for older adults with Alzheimer disease and related dementias (ADRD); however, hearing aid adoption in this group is low. This study aimed to determine where to target hearing aid interventions for American long-term care recipients with ADRD by examining the association of ADRD and residence type with respondent-reported unmet hearing aid need. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the United States National Core Indicators-Aging and Disabilities survey (2015-2019) for long-term care recipients aged ≥65 years. METHODS We used multivariable logistic regression to model the likelihood of reporting unmet hearing aid need conditional on ADRD status and residence type (own/family house or apartment, residential care, or nursing facility/home), adjusting for sociodemographic factors and response type (self vs proxy). RESULTS Of the 25,492 respondents [median (IQR) age, 77 (71, 84) years; 7074 (27.8%) male], 5442 (21.4%) had ADRD and 3659 (14.4%) owned hearing aids. Residence types were 17,004 (66.8%) own/family house or apartment, 4966 (19.5%) residential care, and 3522 (13.8%) nursing home. Among non-hearing aid owners, ADRD [adjusted odds ratio (AOR) 0.90, 95% CI 0.80-1.0] and residence type were associated with respondent-reported unmet hearing aid need. Compared to the nursing home reference group, respondents in their own/family home (AOR 1.85, 95% CI 1.61-2.13) and residential care (AOR 1.30, 95% CI 1.10-1.53) were more likely to report unmet hearing aid need. This pattern was significantly more pronounced in people with ADRD than in those without, stemming from an interaction between ADRD and residence type. CONCLUSIONS AND IMPLICATIONS American long-term care recipients with ADRD living in their own/family home are more likely to report unmet hearing aid need than those with ADRD in institutional and congregate settings. This information can inform the design and delivery of hearing interventions for older adults with ADRD.
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Affiliation(s)
- Dana P Urbanski
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
| | - Jack M Wolf
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Benjamin W Langworthy
- Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Romil R Parikh
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Eric Jutkowitz
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA; Center of Innovation in Long Term Services and Supports, Providence VA Medical Center, Providence, RI, USA; Evidence Synthesis Program Center Providence VA Medical Center, Providence, RI, USA
| | - Tetyana P Shippee
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
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McKee MM, Zhang J, Akobirshoev I, McKee K, Mitra M. Antenatal Hospital Use among Deaf and Hard of Hearing Women. Am J Perinatol 2024; 41:e1560-e1569. [PMID: 36918163 DOI: 10.1055/a-2053-7439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVE Hearing loss is increasingly prevalent among younger adults, impacting health and health care use. Deaf and hard of hearing (DHH) women have a higher risk of chronic diseases, pregnancy complications, and adverse birth outcomes compared with hearing women. Health care utilization patterns during the perinatal period remain not well understood. The objective of this study was to examine differences in antenatal emergency department and inpatient utilization among DHH and non-DHH women. STUDY DESIGN We conducted a retrospective cohort study design to analyze 2002 to 2013 Massachusetts Pregnancy to Early Life Longitudinal data to compare antenatal inpatient and emergency department use between DHH (N = 925) and hearing (N = 2,895) women with singleton deliveries. Matching was done based on delivery year, age at delivery, and birth parity in 1:3 case-control ratio. Demographic, socioeconomic, clinical, and hospital characteristics were first compared for DHH mothers and the matched control group using chi-squared tests and t-tests. Multivariable models were adjusted for sociodemographic and clinical characteristics. RESULTS Among DHH women (N = 925), 49% had at least one emergency department visit, 19% had an observational stay, and 14% had a nondelivery hospital stay compared with 26, 14, and 6%, respectively, among hearing women (N = 28,95) during the antenatal period (all ps < 0.001). The risk of nondelivery emergency department visits (risk ratio [RR] 1.58; p < 0.001) and inpatient stays (RR = 1.89; p < 0.001) remained higher among DHH women compared with hearing women even after adjustment. Having four or more antenatal emergency department visits (7 vs. 2%) and two or more nondelivery hospital stays (4 vs. 0.4%) were more common among pregnant DHH women compared with their controls (all p-values < 0.001). CONCLUSION The findings demonstrate that DHH women use emergency departments and inpatient services at a significantly higher rate than their hearing controls during the antenatal period. A systematic investigation of the mechanisms for these findings are needed. KEY POINTS · Antenatal emergency department use is significantly higher among deaf and hard of hearing women.. · Antenatal hospitalizations are significantly higher among deaf and hard of hearing women.. · Hearing loss screening may identify those at risk for adverse pregnancy and birth outcomes..
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Affiliation(s)
- Michael M McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Jianying Zhang
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Ilhom Akobirshoev
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Kimberly McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Monika Mitra
- The Lurie Institute for Disability Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
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Hickey E, Man B, Helm KVT, Lockhart S, Duffecy J, Morris MA. Preferred Communication Strategies for People with Communication Disabilities in Health Care Encounters: a Qualitative Study. J Gen Intern Med 2024; 39:790-797. [PMID: 38010462 PMCID: PMC11043277 DOI: 10.1007/s11606-023-08526-4] [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: 06/20/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND People with communication disabilities (CDs), which includes disabilities in speech, language, voice and/or hearing, experience health and healthcare disparities. A barrier to accessing high-quality, equitable care is the lack of effective communication between patients and their providers. OBJECTIVE In designing a patient-prompted tool to facilitate communication, we analyzed qualitative feedback on communication strategies and the experience of people with CDs, caregivers, and providers in healthcare encounters. We aimed to describe communication strategies that patients with CDs find most useful and optimize a tool for patients to share their communication strategy preferences during clinical encounters. While patient-provider communication is paramount in every interaction, we aimed to highlight the intricacies of optimizing communication for this population. DESIGN We performed a qualitative study utilizing focus groups and interviews with patients with CDs, their caregivers, and healthcare providers. PARTICIPANTS A total of 46 individuals participated in focus groups or interviews; 26 participants self-reported a CD, nine were caregivers, and 11 were providers. Participants represented diverse types of CDs, including stuttering, aphasia, hearing loss, and people with autism or cerebral palsy who use assistive technology to communicate. APPROACH Analysis of qualitative interview and focus group data was guided by a qualitative content analysis approach. KEY RESULTS We identified three themes: (1) While communication strategies should be individualized, participants agreed upon a consolidated list of best strategies and accommodations. We used this consolidated list to finalize tool development. (2) Patients and providers preferred disclosure of the CD and desired communication strategies before the appointment. (3) Providers often do not use communication strategies and accommodations during clinical encounters. CONCLUSIONS For patients with CDs, it is critical to acknowledge and document the CD and individualize communication strategies during healthcare visits to facilitate communication. Studies are needed to evaluate whether improved communication strategy usage leads to improved health outcomes for this population.
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Affiliation(s)
- Erin Hickey
- University of Illinois at Chicago, Chicago, IL, USA.
| | - Bernice Man
- University of Illinois at Chicago, Chicago, IL, USA
| | - Kaila V T Helm
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Steven Lockhart
- Adult and Child Center for Health Outcomes Research and Delivery Service, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
| | | | - Megan A Morris
- Adult and Child Center for Health Outcomes Research and Delivery Service, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA
- Divisions of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Center for Bioethics and Humanities, University of Colorado School of Medicine, Aurora, CO, USA
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Tan CJW, Koh JWT, Tan BKJ, Woon CY, Teo YH, Ng LS, Loh WS. Association Between Hearing Loss and Cardiovascular Disease: A Meta-analysis. Otolaryngol Head Neck Surg 2024; 170:694-707. [PMID: 38063267 DOI: 10.1002/ohn.599] [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: 03/14/2023] [Revised: 10/11/2023] [Accepted: 11/02/2023] [Indexed: 02/28/2024]
Abstract
OBJECTIVE Hearing loss (HL) has been postulated to be linked to cardiovascular diseases (CVDs) via vascular mechanisms, but epidemiological associations remain unclear. The study aims to clarify the association between HL and stroke, coronary artery disease (CAD), and any CVD. DATA SOURCES PubMed, Embase, and SCOPUS from inception until April 27, 2022. REVIEW METHODS Three blinded reviewers selected observational studies reporting stroke, CAD, and any CVD in patients with HL, compared to individuals without HL. We extracted data, evaluated study bias using the Newcastle-Ottawa scale, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and a PROSPERO-registered protocol (CRD42022348648). We used random-effects inverse variance meta-analyses to pool the odds ratios (ORs) for the association of HL with stroke, CAD, and any CVD. RESULTS We included 4 cohort studies (N = 940,771) and 6 cross-sectional studies (N = 680,349). Stroke, CAD, and any CVD were all strongly associated with HL. The overall pooled OR of the association between HL and stroke was 1.26 (95% confidence interval [CI] = 1.16-1.37, I2 = 78%), and was 1.33 (95% CI = 1.12-1.58) and 1.29 (95% CI = 1.14-1.45) for low- and high-frequency HL, respectively. Minimal publication bias was observed, with minimal change to pooled effect size following trim and fill. Similarly, the pooled OR of the association between HL and CAD was 1.36 (95% CI = 1.13-1.64, I2 = 96%), while that between HL and any CVD was 1.38 (95% CI = 1.07-1.77, I2 = 99%). CONCLUSION Our findings suggest that HL and CVD are closely related. Physicians treating patients with HL should be cognizant of this association and view HL in the broader context of general health and aging.
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Affiliation(s)
- Claire Jing-Wen Tan
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore
| | - Jia Wen Tricia Koh
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore
| | - Benjamin Kye Jyn Tan
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore
| | - Chang Yi Woon
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore
| | - Yao Hao Teo
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore
| | - Li Shia Ng
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore City, Singapore
| | - Woei Shyang Loh
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Singapore City, Singapore
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Kim K, Choi SH. Cardiometabolic diseases according to the type and degree of hearing loss in noise-exposed workers. Ann Occup Environ Med 2024; 36:e3. [PMID: 38501044 PMCID: PMC10948219 DOI: 10.35371/aoem.2024.36.e3] [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: 01/12/2024] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
Background This study aimed to determine the association between cardiometabolic diseases, including metabolic syndrome, hypertension, and diabetes, and the type and degree of hearing loss in noise-exposed workers. Methods A total of 237,028 workers underwent air conduction pure tone audiometry in 2015 to assess their health and diagnose cardiometabolic diseases. The study defined metabolic syndrome, hypertension, and diabetes using blood pressure, fasting blood sugar, cholesterol, and triglyceride levels. Mid-frequency hearing loss was defined as ≥ 30 dB at 2,000 Hz, whereas high-frequency hearing loss was ≥ 40 dB at 4,000 Hz. The average air conduction hearing thresholds at these frequencies were used to determine hearing loss degrees. Results The odds ratio (OR) of combined exposure to noise and night-shift work in all cardiometabolic diseases was higher than that of noise exposure alone. The risk of cardiometabolic diseases was dose-response, with higher hearing loss causing higher ORs. The ORs of hypertension compared with the normal group were 1.147 (1.098-1.198), 1.196 (1.127-1.270), and 1.212 (1.124-1.306), and those of diabetes were 1.177 (1.119-1.239), 1.234 (1.154-1.319), and 1.346 (1.241-1.459) for mild, moderate, and moderate-severe hearing loss, respectively. Conclusions Workers who are exposed to noise tend to demonstrate high risks of hearing loss and cardiometabolic diseases; thus, bio-monitoring of cardiometabolic diseases, as well as auditory observation, is necessary.
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Affiliation(s)
- KyooSang Kim
- Department of Occupational and Environmental Medicine, Seoul Medical Center, Seoul, Korea
- Medical Research Institute, Seoul Medical Center, Seoul, Korea
| | - Sun-Haeng Choi
- Department of Occupational and Environmental Medicine, Chungbuk National University Hospital, Chungju, Korea
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Graves EA, Sajjadi A, Hughes ML. A Comparison of Montreal Cognitive Assessment Scores among Individuals with Normal Hearing and Cochlear Implants. Ear Hear 2024:00003446-990000000-00247. [PMID: 38334699 DOI: 10.1097/aud.0000000000001483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
OBJECTIVES The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool that has 4 of 10 test items heavily dependent on auditory input, potentially leaving hearing-impaired (HI) individuals at a disadvantage. Previous work found that HI individuals scored lower than normal-hearing (NH) individuals on the MoCA, potentially attributed to the degraded auditory signals negatively impacting the ability to commit auditory information to memory. However, there is no research comparing how cochlear implant (CI) recipients perform on the MoCA relative to NH and HI individuals. This study aimed to (1) examine the effect of implementing three different hearing-adjusted scoring methods for a group of age-matched CI recipients and NH individuals, (2) determine if there is a difference between the two groups in overall scores and hearing-adjusted scores, and (3) compare scores across our CI and NH data to the published HI data for all scoring methods. We hypothesized that (1) scores for CI recipients would improve with implementation of the hearing-adjusted scoring methods over the original method, (2) CI recipients would score lower than NH participants for both original and adjusted scoring methods, and (3) the difference in scores between NH and CI listeners for both adjusted and unadjusted scores would be greater than that reported in the literature between NH and HI individuals due to the greater severity of hearing loss and relatively poor spectral resolution of CIs. DESIGN A total of 94 adults with CIs and 105 adults with NH were initially enrolled. After age-matching the two groups and excluding those who self-identified as NH but failed a hearing screening, a total of 75 CI participants (mean age 61.2 y) and 74 NH participants (mean age 58.8 y) were administered the MoCA. Scores were compared between the NH and CI groups, as well as to published HI data, using the original MoCA scoring method and three alternative scoring methods that excluded various auditory-dependent test items. RESULTS MoCA scores improved for all groups when two of the three alternative scoring methods were used, with no significant interaction between scoring method and group. Scores for CI recipients were significantly poorer than those for age-matched NH participants for all scoring methods. CI recipients scored better than the published data for HI individuals; however, the HI group was not age matched to the CI and NH groups. CONCLUSIONS MoCA scores are only partly affected by the potentially greater cognitive processing required to interpret degraded auditory signals. Even with the removal of the auditory-dependent items, CI recipients still did not perform as well as the age-matched NH group. Importantly, removing auditory-dependent items significantly and fundamentally alters the test, thereby reducing its sensitivity. This has important limitations for administration and interpretation of the MoCA for people with hearing loss.
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Affiliation(s)
- Emily A Graves
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Autefeh Sajjadi
- Creighton University School of Medicine, Omaha, Nebraska, USA
| | - Michelle L Hughes
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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Keck M, Hübner J, Büntzel J. "I do not hear you!": hearing-impaired cancer patients report their communication experiences. J Cancer Res Clin Oncol 2023; 149:6557-6567. [PMID: 36780054 PMCID: PMC9924207 DOI: 10.1007/s00432-023-04634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/04/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE Hearing impairment has a high impact on communication between cancer patients and their oncologists. What is the patient's perspective on this problem and how can physicians draw lessons from it? METHODS Together with otorhinolaryngologists and hearing-impaired patients, we developed a questionnaire including the sections: WHO (Five) Well-Being Index (5 items), Abbreviated Profile of Hearing Aid Benefit (APHAB) as established self-estimation of hearing function (24 items), use of hearing aid (4 items) as well as patients' experiences (15 items), difficulties (9 items) and wishes (7 items) regarding the communication with physicians. The experiences, difficulties, wishes, and life satisfaction of cancer patients were analyzed between groups based on participants' APHAB scores, well-being and use of hearing aids. A total of 104 cancer survivors (median age 76.5 years, range 32-90 years) were included. RESULTS Between the groups of subjectively hearing-impaired and normal hearing participants, we registered a significant difference in difficulties in conversation, wishes for physician-patient communication and psychological well-being. Depending on participants' well-being, wishes and difficulties differed. Differences were also found between participants with and without hearing aids in terms of difficulties in conversation, but not in terms of their wishes and well-being. A large proportion of participants classified as subjectively hearing-impaired according to APHAB already had a hearing aid. CONCLUSIONS Cancer patients with hearing loss are very restricted in their understanding of given information and hearing aid use cannot completely compensate for this. Consequently, communication guidelines should be considered and specific educational tools need to be developed for these groups.
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Affiliation(s)
- Maximilian Keck
- Department of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Jutta Hübner
- Department of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Jens Büntzel
- Department of Otolaryngology, Südharz Klinikum Nordhausen, Dr.-Robert-Koch-Str. 39, 99734 Nordhausen, Germany
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Goodwin MV, Hogervorst E, Hardy R, Stephan BCM, Maidment DW. How are hearing loss and physical activity related? Analysis from the English longitudinal study of ageing. Prev Med 2023; 173:107609. [PMID: 37423474 DOI: 10.1016/j.ypmed.2023.107609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Although cross-sectional studies suggest that hearing loss in middle- and older-aged adults is associated with lower physical activity, longitudinal evidence is limited. This study aimed to investigate the potential bi-directional association between hearing loss and physical activity over time. Participants were from the English Longitudinal Study of Ageing (N = 11,292) who were 50-years or older at baseline assessment (1998-2000). Individuals were followed-up biannually for up to 20-years (2018-2019) and were classified as ever reporting hearing loss (n = 4946) or not reporting hearing loss (n = 6346). Data were analysed with Cox-proportional hazard ratios and multilevel logistic regression. The results showed that baseline physical activity was not associated with hearing loss over the follow-up. Time (i.e., wave of assessment) by hearing loss interactions showed that physical activity declined more rapidly over time in those with hearing loss, compared to those without (Odds Ratios = 0.94, 95% Confidence Intervals; 0.92-0.96, p < .001). These findings highlight the importance of addressing physical activity in middle- and older-aged adults with hearing loss. As physical activity is a modifiable behaviour that can reduce the risk of developing chronic health conditions, individuals with hearing loss may need additional, tailored support to be more physically active. Mitigating the decline in physical activity could be essential to support healthy ageing for adults with hearing loss.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, UK.
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
| | | | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, UK
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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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Dillard LK, Nelson-Bakkum E, Schultz A, Merten N, Malecki K. Associations of Dietary Intake With Self-Reported Hearing Loss: Findings From the Survey of the Health of Wisconsin. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-12. [PMID: 37263020 DOI: 10.1044/2023_jslhr-22-00473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The purpose of this study was to evaluate associations of dietary intake components with hearing loss. METHOD Participants were from the population-based Survey of the Health of Wisconsin. The Block food frequency questionnaire measured dietary intake of carbohydrates, fiber, protein, free (added) sugars, fruits, vegetables, saturated and trans fats, and glycemic index. Intake was categorized into quintiles (Q). Hearing loss was self-reported. Logistic regression models were used to evaluate associations of dietary determinants with hearing loss. Results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (95% CIs). Final models were adjusted for age, sex, total energy intake, race/ethnicity, education, smoking, and regular physical activity. RESULTS There were 2,839 participants (56% women; Mage = 48.2 [SD = 14.5] years) included. Higher consumption of trans fat (Q5: OR = 1.83, 95% CI [1.27, 2.64]) and higher glycemic index (Q5: OR = 1.34, 95% CI [1.00, 1.80]) were associated with increased odds of hearing loss. Hearing loss was associated with fruit, saturated- and trans-fat intake in women, and trans-fat intake and glycemic index in men. CONCLUSIONS Dietary intake was associated with self-reported hearing loss. Research on mechanistic pathways of associations and public health interventions to prevent hearing loss is needed.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston
| | - Erin Nelson-Bakkum
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Amy Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Kristen Malecki
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago
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Xie Z, Tanner R, Striley CL, Sheffield SW, Marlow NM. Hearing Impairment, Mental Health Services Use, and Perceived Unmet Needs Among Adults With Serious Mental Illness: A Cross-Sectional Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-11. [PMID: 37257284 DOI: 10.1044/2023_jslhr-22-00385] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Individuals with hearing impairment have higher risks of mental illnesses. We sought to develop a richer understanding of how the presence of any hearing impairment affects three types (prescription medication, outpatient services, and inpatient services) of mental health services utilization (MHSU) and perceived unmet needs for mental health care; also, we aimed to identify sociodemographic factors associated with outpatient mental health services use among those with hearing impairment and discuss potential implications under the U.S. health care system. METHOD Using secondary data from the 2015-2019 National Survey on Drug Use and Health, our study included U.S. adults aged ≥ 18 years who reported serious mental illnesses (SMIs) in the past year. Multivariable logistic regression was used to examine associations of hearing impairment with MHSU and perceived unmet mental health care needs. RESULTS The study sample comprised 12,541 adults with SMIs. Prevalence of MHSU (medication: 55.5% vs. 57.5%; outpatient: 37.1% vs. 44.2%; inpatient: 6.6% vs.7.1%) and unmet needs for mental health care (47.5% vs. 43.3%) were estimated among survey respondents who reported hearing impairment and those who did not, respectively. Those with hearing impairment were significantly less likely to report outpatient MHSU (OR = 0.73, 95% CI [0.60, 0.90]). CONCLUSIONS MHSU was low while perceived unmet needs for mental health care were high among individuals with SMIs, regardless of hearing status. In addition, patients with hearing impairment were significantly less likely to report outpatient MHSU than their counterparts. Enhancing communication is essential to improve access to mental health care for those with hearing impairment.
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Affiliation(s)
- Zhigang Xie
- Department of Public Health, University of North Florida, Jacksonville
| | - Rebecca Tanner
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville
| | | | - Sterling W Sheffield
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville
| | - Nicole M Marlow
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville
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12
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Eberhard JM, Matthews LJ, Vaden KI, Dubno JR, Eckert MA. Probability Distributions for Associations Between Cognitive Screening and Pure-tone Thresholds in Older Adults. Ear Hear 2023; 44:641-654. [PMID: 36607744 PMCID: PMC10101874 DOI: 10.1097/aud.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Lower general cognitive function is frequently reported in older adults with elevated pure-tone thresholds. Here, we examined reason(s) for this association, including whether this relationship is dependent on the frequency range or extent of hearing loss and cognitive screening performance. DESIGN Linear regression was used to examine associations between better-ear pure-tone thresholds and Mini-Mental Status Exam (MMSE) performance in a cross-sectional sample of relatively healthy older adults (N = 508; 68% women, 60-89+ years; M age = 72). Quantile regression was also used to identify the ranges of 0.5 and 4.0 kHz thresholds and MMSE scores where these variables exhibited significant associations. RESULTS MMSE scores and pure-tone thresholds exhibited small but significant associations, particularly for better-ear 0.5 kHz thresholds. This hearing threshold and cognitive screening association was present among participants with better hearing, including the oldest older adults. There was limited evidence for mediating health condition effects on this association. An item analysis of the MMSE revealed that the MMSE and pure-tone threshold associations were largely due to the delayed recall item of the MMSE. CONCLUSIONS Together, the small effect results are consistent with the extant literature and suggest that there are multiple reasons for modest pure-tone threshold and cognitive screening performance associations.
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Affiliation(s)
- Jacqueline M. Eberhard
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Lois. J. Matthews
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth I. Vaden
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Judy R. Dubno
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Mark A. Eckert
- Department of Otolaryngology - Head & Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
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13
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Oshita JY, Gell NM, Stransky ML, Reed NS, MacLean CD. Prevalence and sociodemographic characteristics of US community-dwelling older adults with communication disabilities, using the national health and aging trends survey. JOURNAL OF COMMUNICATION DISORDERS 2023; 102:106316. [PMID: 36870271 PMCID: PMC10236317 DOI: 10.1016/j.jcomdis.2023.106316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/13/2023] [Accepted: 02/16/2023] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Identifying the population-level prevalence of a disability group is a prerequisite to monitoring their inclusion in society. The prevalence and sociodemographic characteristics of older adults with communication disabilities (CDs) are not well established in the literature. In this study we sought to describe the prevalence and sociodemographic characteristics of community-dwelling older adults experiencing difficulties with understanding others or being understand when communicating in their usual language. METHODS We conducted a cross-sectional analysis of the National Health and Aging Trends Survey (2015), a nationally representative survey of Medicare beneficiaries ages ≥ 65 years old (N = 7,029). We calculated survey weight-adjusted prevalence estimates by mutually exclusive subgroups of no, hearing only, expressive-only, cognitive only, multiple CDs, and an aggregate any-CD prevalence. We described race/ethnicity, age, gender, education, marital status, social network size, federal poverty status, and supplemental insurance for all groups. Pearson's chi-squared statistic was used to compare sociodemographic characteristics between the any-CD and no-CD groups. RESULTS An estimated 25.3% (10.7 million) of community-dwelling older adults in the US experienced any-CDs in 2015; approximately 19.9% (8.4 million) experienced only one CD while 5.6% (2.4 million) had multiple. Older adults with CDs were more likely to be of Black race or Hispanic ethnicity as compared to older adults without CDs (Black 10.1 vs. 7.6%; Hispanic: 12.5 vs. 5.4%; P < 0.001). They also had lower educational attainment (Less than high school: 31.0 vs 12.4%; P < 0.001), lower poverty levels (<100% Federal poverty level: 23.5% vs. 11.1%; P < 0.001) and less social supports (Married: 51.3 vs. 61.0%; P < 0.001; Social network ≤ 1 person: 45.3 vs 36.0%; P < 0.001). CONCLUSIONS The proportion of the older adult population experiencing any-CDs is large and disproportionately represented by underserved sociodemographic groups. These findings support greater inclusion of any-CDs into population-level efforts like national surveys, public health goals, health services, and community research aimed at understanding and addressing the access needs of older adults who have disabilities in communication.
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Affiliation(s)
- Jennifer Y Oshita
- Clinical and Translational Sciences Program, University of Vermont, 14 Adsit Court, Burlington, VT 05401, United States.
| | - Nancy M Gell
- Department of Rehabilitation and Movement Science, University of Vermont, United States
| | - Michelle L Stransky
- Center for the Urban Child and Healthy Family, Boston Medical Center, United States
| | - Nicholas S Reed
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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14
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West JS, Smith SL, Dupre ME. The impact of hearing loss on trajectories of depressive symptoms in married couples. Soc Sci Med 2023; 321:115780. [PMID: 36801754 PMCID: PMC10478395 DOI: 10.1016/j.socscimed.2023.115780] [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: 08/25/2022] [Revised: 12/29/2022] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
Hearing loss is a prevalent chronic stressor among older adults and is associated with numerous adverse health outcomes. The life course principle of linked lives highlights that an individual's stressors can impact the health and well-being of others; however, there are limited large-scale studies examining hearing loss within marital dyads. Using 11 waves (1998-2018) of the Health and Retirement Study (n = 4881 couples), we estimate age-based mixed models to examine how 1) one's own hearing, 2) one's spouse's hearing, or 3) both spouses' hearing influence changes in depressive symptoms. For men, their wives' hearing loss, their own hearing loss, and both spouses having hearing loss are associated with increased depressive symptoms. For women, their own hearing loss and both spouses having hearing loss are associated with increased depressive symptoms, but their husbands' hearing loss is not. The connections between hearing loss and depressive symptoms within couples are a dynamic process that unfolds differently by gender over time.
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Affiliation(s)
- Jessica S West
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA.
| | - Sherri L Smith
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA; Department of Head and Neck Surgery and Communication Sciences, Duke University, Durham, NC, USA
| | - Matthew E Dupre
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA; Department of Population Health Sciences, Duke University, Durham, NC, USA; Department of Sociology, Duke University, Durham, NC, USA
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15
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Humes LE. U.S. Population Data on Self-Reported Trouble Hearing and Hearing-Aid Use in Adults: National Health Interview Survey, 2007-2018. Trends Hear 2023; 27:23312165231160967. [PMID: 36947453 PMCID: PMC10083510 DOI: 10.1177/23312165231160967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
The National Health Interview Survey (NHIS) data on self-reported trouble hearing and the use of hearing aids were examined for the 12 recent surveys from 2007 to 2018 for adults from 18 to 85+ years of age. The aggregate dataset for all years included data from 357,714 adult respondents. Sample size for annual data ranged from 22,058 (2008) to 36,798 (2014). The prevalence of self-reported trouble hearing and hearing aid use, both current use and ever-using hearing aids, are reported for males and females for each age decade. Measures of unmet hearing healthcare (HHC) need were derived from estimates of the prevalence of hearing aid use among those with self-reported trouble hearing. Logistic-regression analyses identified variables affecting the odds of having self-reported trouble hearing, of using or rejecting hearing aids, and of having unmet HHC needs. The results largely corroborate and extend the findings of recent analyses of data from the National Health and Nutrition Examination Survey (NHANES) for a similar period (2011-2020). Overall, for males, 18.5% (95% CI [18.2%-18.8%]) had self-reported trouble hearing and 76.6% [76.0%-77.2%] of these individuals had never used hearing aids and, for females 13.1% [12.9%-13.4%] had trouble hearing and 79.5% [78.9%-80.1%] of these individuals had never used hearing aids. Unmet HHC needs are highly prevalent in the United States and have been so for many years.
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Affiliation(s)
- Larry E Humes
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
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16
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Dillard LK, Nelson-Bakkum ER, Walsh MC, Schultz A. Self-reported hearing loss is associated with poorer perceived health care access, timeliness, satisfaction, and quality: Findings from the Survey of the Health of Wisconsin. Disabil Health J 2023; 16:101394. [PMID: 36335067 DOI: 10.1016/j.dhjo.2022.101394] [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: 08/09/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hearing loss is a highly prevalent chronic condition impacting communication and may negatively influence patients' health care experiences. OBJECTIVE Determine associations of hearing loss with perceived health care access, timeliness, satisfaction, and quality in a representative sample of the general population. METHODS The Survey of the Health of Wisconsin (SHOW) is a household-based examination survey that collects data from a representative sample of Wisconsin residents. SHOW participants from years 2008-2013 with data on self-reported hearing loss and health care access, timeliness, satisfaction, and quality were included in this study. Age- and sex- and multivariable-adjusted (additionally adjusted for race/ethnicity, education, marital status, public health region, smoking, chronic disease, self-reported health, and insurance coverage) logistic regression models were used to evaluate associations of hearing loss with participants' health care experiences. Results are presented as odds ratios (OR) with corresponding 95% confidence intervals. RESULTS There were 2438 individuals (42.1% men) included in this study with an average age of 48.3 (range 21-74; standard deviation [SD] 14.4) years. The number of participants who self-reported hearing loss was 642 (26.3%). After multivariable adjustment, hearing loss was associated with increased odds of perceived difficulties with health care access (OR 1.47 [1.05, 2.05]), timeliness (OR 1.69 [1.23, 2.32]), quality (OR 2.54 [1.50, 4.32]), and satisfaction (OR 2.50 [1.51, 4.13]). CONCLUSIONS Given the high prevalence of hearing loss and the growing aging population, there is an urgent need to prioritize interventions to improve health care provision for individuals with hearing loss.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, USA.
| | - Erin R Nelson-Bakkum
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, USA
| | - Matthew C Walsh
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, USA
| | - Amy Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, USA
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17
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McKee KS, Akobirshoev I, McKee M, Li FS, Mitra M. Postpartum Hospital Readmissions Among Massachusetts Women Who are Deaf or Hard of Hearing. J Womens Health (Larchmt) 2023; 32:109-117. [PMID: 36040351 PMCID: PMC10024058 DOI: 10.1089/jwh.2022.0068] [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] [Indexed: 01/13/2023] Open
Abstract
Objectives: Deaf or hard of hearing (DHH) women are at a higher risk of adverse pregnancy and birth outcomes compared with other women. However, little is known about postpartum outcomes among DHH women. The objective was to compare the risk of postpartum hospitalizations for DHH compared with non-DHH women and the leading indications for postpartum admissions. Materials and Methods: We analyzed data from the 1998-2017 Massachusetts Pregnancy to Early Life Longitudinal Data System and identified 3,546 singleton deliveries to DHH women and 1,381,439 singleton deliveries to non-DHH women. We used Cox proportional hazard models to compare the first hospital admission and ≥2 hospital admissions between DHH and non-DHH women within 1-42, 43-90, and 91-365 days after delivery. Results: DHH women had a higher risk for any hospital admissions across all periods (hazard ratios [HR] = 1.84; 95% confidence intervals [CI] 1.46-2.34 within 1-42 days; HR = 2.76; 95%CI 1.99-3.83 within 43-90 days; and HR = 3.10; 95%CI 2.66-3.60 91-365 days) after childbirth compared with non-DHH women. They had an almost seven times higher risk for repeated hospital admissions within 43-90 days (HR = 6.84; 95%CI 1.66-28.21) and nearly four times higher the risk within 91-365 days (HR = 3.63; 95%CI 2.00-6.59) after delivery compared with non-DHH women. The leading indications for readmission among DHH women included: conditions complicating the puerperium/hemorrhage and soft tissues disorders. Conclusion: Compared with other women, DHH women had significantly higher readmissions across all postpartum periods and for repeated admissions >42 days. Leading postpartum indications were distinct from those of non-DHH women.
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Affiliation(s)
- Kimberly S. McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Ilhom Akobirshoev
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Frank S. Li
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA
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18
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Cui X, Lu Z, Guo X, Dai N, Huang C, Liu Y, Lin R, Yu Y, Qin G, Chen J. Association of nocturnal sleep duration and midday napping with subjective poor hearing among middle-aged and older adults in China. Front Public Health 2023; 11:1160294. [PMID: 37113168 PMCID: PMC10127254 DOI: 10.3389/fpubh.2023.1160294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/15/2023] [Indexed: 04/29/2023] Open
Abstract
Background Hearing loss has occurred as a critical concern for aging and health. However, it remains unknown whether nocturnal sleep and midday napping duration are associated with hearing loss in middle-aged and older adults. Methods The study comprised 9,573 adults from China Health and Retirement Longitudinal Study, who have completed the survey for sleep characteristics and subjective functional hearing. We collected self-reported nocturnal sleep duration (<5, 5 to <6, 6 to <7, 7 to <9, ≥9 h/night) and midday napping duration (≤5, 5 to ≤30, and >30 min). The sleep information was classified into different sleep patterns. The primary outcome was self-reported hearing loss events. Multivariate Cox regression models and restricted cubic splines were used to investigate the longitudinal association of sleep characteristics with hearing loss. We applied Cox generalized additive models and bivariate exposure-response surface diagrams to visualize the effects of different sleep patterns on hearing loss. Results We confirmed 1,073 cases of hearing loss (55.1% female) during the follow-up. After adjusting for demographic characteristics, lifestyle factors and health condition, nocturnal sleep with < 5 h was positively associated with hearing loss [hazard ratio (HR): 1.45, 95% confidence interval [CI]: 1.20, 1.75]. Individuals with napping for 5 to ≤30 min had a 20% (HR: 0.80, 95%CI: 0.63, 1.00) lower risk of hearing loss compared with those with napping ≤ 5 min. Restrictive cubic splines showed the reverse J-shaped association between nocturnal sleep and hearing loss. Moreover, we found significant joint effects of sleeping < 7 h/night and midday napping ≤ 5 min (HR: 1.27, 95% CI: 1.06, 1.52) on hearing loss. Bivariate exposure-response surface diagrams also reflected the finding that short sleep without napping existed the highest risk of hearing loss. Compared with persistently sleeping moderately (7-9 h/night), those who persistently slept < 7 h/night or shifted from < 7 h/night to moderate or > 9 h/night had higher risks of hearing loss. Conclusion Inadequate nocturnal sleep was associated with an elevated risk of poor subjective hearing in middle-aged and older adults, while moderate napping decreased the risk of hearing loss. Keeping sleep stable within recommendation duration may be a useful strategy for preventing poor hearing loss.
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Affiliation(s)
- Xiaorui Cui
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Zixuan Lu
- Department of Health Management, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xinyue Guo
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Neng Dai
- Department of Cardiology, Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan University, Shanghai, China
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Chen Huang
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yahang Liu
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Ruilang Lin
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yongfu Yu
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- Yongfu Yu,
| | - Guoyou Qin
- Department of Biostatistics, The Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China
- *Correspondence: Guoyou Qin,
| | - Jiaohua Chen
- Department of Health Management, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Jiaohua Chen,
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Tsimpida D, Panagioti M, Kontopantelis E. Forty years on: a new national study of hearing in England and implications for global hearing health policy. Int J Audiol 2023; 62:62-70. [PMID: 35080184 DOI: 10.1080/14992027.2021.2022791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE We aimed to update the prevalence estimates of hearing loss in older adults in England using a nationally representative sample of adults aged 50 years old and older. DESIGN A comparative cross-sectional study design was implemented. Hearing loss was defined as ≥35 dB HL at 3.0 kHz, as measured via Hearcheck in the better-hearing ear. STUDY SAMPLE We compared the estimates based on the English census in 2015 to estimates from psychoacoustic hearing data available for 8,263 participants in the English Longitudinal Study of Ageing (ELSA) Wave 7 (2014-2015). RESULTS Marked regional variability in hearing loss prevalence was revealed among participants with similar age profiles. The regional differences in hearing outcomes reached up to 13.53% in those belonging to the 71-80 years old group; the prevalence of hearing loss was 49.22% in the North East of England (95%CI 48.0-50.4), versus 35.69% in the South East (95%CI 34.8-36.50). CONCLUSION A socio-spatial approach in planning sustainable models of hearing care based on the actual populations' needs and not on age demographics might offer a viable opportunity for healthier lives. Regular assessment of the extent and causality of the population's different audiological needs within the country is strongly supported.
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Affiliation(s)
- Dialechti Tsimpida
- Institute for Health Policy and Organisation (IHPO), Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation (IHPO), Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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20
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Lee HJ, Lee J, Yoon C, Park Y, Joo YH, Park JO, Seo YJ, Park KH. Association of dietary factors with noise-induced hearing loss in Korean population: A 3-year national cohort study. PLoS One 2022; 17:e0279884. [PMID: 36584228 PMCID: PMC9803270 DOI: 10.1371/journal.pone.0279884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022] Open
Abstract
Noise-induced hearing loss (NIHL) is a hearing impairment (HI) caused by various clinical factors. Identifying the relationship between NIHL and nutrient consumption could help in reducing the prevalence of hearing loss. The aim of this study was to analyze the relationship between NIHL and dietary factors using data of the Korea National Health and Nutrition Examination survey (KNHANES). The data were collected from The Fifth KNHANES 2010-2012. The survey was taken by a total of 10,850 participants aged 20-65 years. Air conduction audiometry was measured at 500, 1000, 2000, and 4000 Hz in both ears. Metabolic syndrome, noise exposure, alcohol consumption, smoking, income level, marital status, and nutritional intake were evaluated. The differences between non-HI and HI participants in the noise-exposed group showed statistically significant differences in age, sex, marital and smoking status, alcohol consumption, and fasting glucose and triglyceride levels (p<0.05). In a multiple regression analysis of the noise-exposed group, age showed a significant association with HI (OR: 0.604; 95% CI: 0.538-0.678) after adjusting for confounders. In multivariate analysis for dietary factors affecting HI in noise-exposed groups, retinol (OR: 1.356; 95% CI: 1.068-1.722), niacin (OR: 1.5; 95% CI: 1.022-2.201), and carbohydrates (OR: 0.692; 95% CI: 0.486-0.985) showed a significant association with NIHL. Age was identified as the only factor significantly affecting NIHL. When the dietary factors of the noise-exposed group were analyzed, high intake of niacin and retinol and low intake of carbohydrates appeared to reduce the risk of hearing loss.
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Affiliation(s)
- Hyun Jin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Juhyung Lee
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Chulyoung Yoon
- Department of biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yesai Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jun-Ook Park
- Department of Otolaryngology-Head and Neck Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Young Joon Seo
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Kyoung Ho Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
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21
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McKee M, James TG, Helm KVT, Marzolf B, Chung DH, Williams J, Zazove P. Reframing Our Health Care System for Patients With Hearing Loss. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3633-3645. [PMID: 35969852 PMCID: PMC9802570 DOI: 10.1044/2022_jslhr-22-00052] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 06/04/2023]
Abstract
PURPOSE Nearly 20% of U.S. Americans report a hearing loss, yet our current health care system is poorly designed and equipped to effectively care for these individuals. Individuals with hearing loss report communication breakdowns, inaccessible health information, reduced awareness and training by health care providers, and decreased satisfaction while struggling with inadequate health literacy. These all contribute to health inequities and increased health care expenditures and inefficiencies. It is time to reframe the health care system for these individuals using existing models of best practices and accessibility to mitigate inequities and improve quality of care. METHOD A review of system-, clinic-, provider-, and patient-level barriers, along with existing and suggested efforts to improve care for individuals with hearing loss, are presented. RESULTS These strategies include improving screening and identification of hearing loss, adopting universal design and inclusion principles, implementing effective communication approaches, leveraging assistive technologies and training, and diversifying a team to better care for patients with hearing loss. Patients should also be encouraged to seek social support and resources from hearing loss organizations while leveraging technologies to help facilitate communication. CONCLUSIONS The strategies described introduce actionable steps that can be made at the system, clinic, provider, and patient levels. With implementation of these steps, significant progress can be made to more proactively meet the needs of patients with hearing loss. Presentation Video: https://doi.org/10.23641/asha.21215843.
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Affiliation(s)
- Michael McKee
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Tyler G. James
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Kaila V. T. Helm
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Brianna Marzolf
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - Dana H. Chung
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
| | - John Williams
- Department of Population Health Science, University of Mississippi Medical Center, Jackson
| | - Philip Zazove
- Department of Family Medicine, University of Michigan/Michigan Medicine, Ann Arbor
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22
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Wändell P, Li X, Carlsson A, Sundquist J, Sundquist K. Hearing impairment among adult foreign-born and Swedish-born individuals: A national Swedish study. PLoS One 2022; 17:e0273406. [PMID: 36001613 PMCID: PMC9401125 DOI: 10.1371/journal.pone.0273406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives To analyze the risk of hearing impairment in adult first-generation immigrants, i.e., foreign-born individuals as compared to Swedish-born individuals. Study design A register-based study follow-up study. Methods A nationwide study of individuals 25 years of age and older (N = 5 464 245; 2 627 364 men and 2 836 881 women) in Sweden. Hearing impairment was defined as at least one registered diagnosis in the National Patient Register between January 1st, 1998 and December 31st, 2015. Cox regression analysis was used to estimate the relative risk (hazard ratios (HR) with 95% confidence intervals (CI)) of incident hearing impairment in foreign-born compared to Swedish-born individuals. Cox regression models were stratified by sex and adjusted for age, comorbidities, and socioeconomic status. Results A total of 244 171 cases (124 349 men and 119 822 women) of hearing impairment were registered. Hearing impairment risk expressed as fully adjusted HRs (99% CI) was somewhat lower among immigrant men 0.95 (0.92–97) but not among immigrant women 0.97 (0.95–1.00), with significantly higher fully adjusted HRs among men and women from Asia, and Eastern Europe, and women from Africa. Conclusions We observed a somewhat lower risk of hearing impairment among foreign-born men, but there was a higher risk among men and women from some regions.
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Affiliation(s)
- Per Wändell
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Axel Carlsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Academic Primary Health Care Centre, Stockholm Region, Stockholm, Sweden
- * E-mail:
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, United States of America
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, United States of America
- Department of Functional Pathology, Center for Community-Based Healthcare Research and Education (CoHRE), School of Medicine, Shimane University, Matsue, Japan
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Park J, Lee O, McKee M. Association between hearing loss and suicidal ideation among middle-aged and older adults. Aging Ment Health 2022; 26:1287-1294. [PMID: 33979563 DOI: 10.1080/13607863.2021.1919991] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Hearing loss (HL) is regarded as a major risk factor for late-life depression. This study aims to further examine the association between HL and suicidal ideation (SI) among middle-aged and older adults using a nationally representative sample. METHOD The study sample comprised 34,142 adults (aged 50+) drawn from the 2015 to 2018 National Survey on Drug Use and Health. SI was measured by response to the question, 'At any time in the past year, did you seriously think about trying to kill yourself?' HL was assessed by asking respondents whether they were deaf or had serious difficulty hearing. Multivariate logistic regression analyses were conducted to examine the association between HL and SI after adjusting for a comprehensive list of covariates. RESULTS Compared to those without HL, middle-aged and older adults with HL experienced significant health disparities regarding history of hospitalization, poor perceived health, higher prevalence of chronic diseases, depression, substance use, and SI. HL was positively associated with SI in the past year in both middle-aged (aOR = 1.59, 95% CI [1.14, 2.21], p < .001) and older adult groups (aOR = 1.58, 95% CI [1.07, 2.33], p < .001), controlling for depression, substance use, health status, and sociodemographic variables. CONCLUSION Given the high prevalence of hearing loss (HL) in aging populations, this study aimed to expand our knowledge of the relative strength of association between HL and SI. Findings implied that healthcare providers should consider screening for SI in those with HL.
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Affiliation(s)
- Junghyun Park
- Silver School of Social Work, New York University, New York, NY, USA
| | - Othelia Lee
- School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Michael McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
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24
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Dillard LK, Walsh MC, Merten N, Cruickshanks KJ, Schultz A. Prevalence of Self-Reported Hearing Loss and Associated Risk Factors: Findings From the Survey of the Health of Wisconsin. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2016-2028. [PMID: 35486882 DOI: 10.1044/2022_jslhr-21-00580] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to determine the prevalence of self-reported hearing loss and associated risk factors in a representative population-based study of Wisconsin residents. METHOD Survey of the Health of Wisconsin participants with data on self-reported hearing loss were included. We reported prevalence of self-reported hearing loss with corresponding 95% confidence intervals (CIs), overall, and stratified by age and sex. Age- and sex-adjusted and multivariable logistic regression models were used to evaluate determinants of self-reported hearing loss, and results are presented as odds ratios with corresponding 95% CIs. RESULTS There were 2,767 participants (50.7% men) with a mean age of 46 years (range: 21-74) in this study. Prevalence of self-reported hearing loss was 26.8% (24.4, 28.4) and was higher in men (30.3% [27.1, 33.4]) than in women (22.5% [19.9, 25.0]). Prevalence increased with age. After multivariable adjustment, age (per +1 year increase; 1.05 [1.04, 1.06]), male sex (1.57 [1.18, 2.08]), having two chronic diseases (vs. 0; 1.93 [1.16, 3.23]), occupational (2.47 [1.91, 3.19]) and recreational (1.58 [1.22, 2.04]) noise exposure, and poor diet (1.88 [1.28, 2.78]) were associated with higher odds of self-reported hearing loss. CONCLUSIONS Hearing loss is a highly prevalent public health concern and may be at least partially modifiable via interventions to reduce noise exposure and promote health. Statewide prevalence and risk factor data can be used to inform public health practice and promote hearing loss prevention. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19661130.
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Affiliation(s)
- Lauren K Dillard
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison
| | - Matthew C Walsh
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Natascha Merten
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Division of Geriatrics, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison
| | - Karen J Cruickshanks
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Amy Schultz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison
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25
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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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26
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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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27
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Yuan L, Li D, Tian Y, Sun Y. The Risk of Hearing Impairment From Ambient Air Pollution and the Moderating Effect of a Healthy Diet: Findings From the United Kingdom Biobank. Front Cell Neurosci 2022; 16:856124. [PMID: 35465613 PMCID: PMC9018982 DOI: 10.3389/fncel.2022.856124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/24/2022] [Indexed: 11/26/2022] Open
Abstract
The link between hearing impairment and air pollution has not been established, and the moderating effect of a healthy diet has never been investigated before. The purpose of this study was to investigate the association between air pollution and hearing impairment in British adults aged 37-73 years, and whether the association was modified by a healthy diet. We performed a cross-sectional population-based study with 158,811 participants who provided data from United Kingdom Biobank. A multivariate logistic regression model was used to investigate the link between air pollution and hearing impairment. Subgroup and effect modification analyses were carried out according to healthy diet scores, gender, and age. In the fully adjusted model, we found that exposure to PM10, NOX, and NO2 was associated with hearing impairment [PM10: odds ratio (OR) = 1.15, 95% confidence interval (95% CI) 1.02-1.30, P = 0.023; NOX: OR = 1.02, 95% CI 1.00-1.03, P = 0.040; NO2: OR = 1.03, 95% CI 1.01-1.06, P = 0.044], while PM2.5 and PM2.5 absorbance did not show similar associations. We discovered an interactive effect of age and air pollution on hearing impairment, but a healthy diet did not. The findings suggested that exposure to PM10, NOX and NO2 was linked to hearing impairment in British adults, whereas PM2.5 and PM2.5 absorbance did not show similar associations. These may help researchers focus more on the impact of air pollution on hearing impairment and provide a basis for developing effective prevention strategies.
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Affiliation(s)
- Lanlai Yuan
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dankang Li
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaohua Tian
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Ministry of Education Key Laboratory of Environment and Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sebothoma B, Khoza-Shangase K. Investigation of the Interaction between Hearing Function and Comorbidities in Adults Living with Human Immunodeficiency Virus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212177. [PMID: 34831932 PMCID: PMC8623667 DOI: 10.3390/ijerph182212177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/13/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022]
Abstract
Adults living with the human immunodeficiency virus (HIV) have a high prevalence of co-existing comorbidities. While research indicates that adults living with HIV are at risk of developing hearing impairment, limited research exists on the interaction between hearing function and comorbidities in this population. The objective of this study was to determine and compare the hearing function of a group of adults living with HIV and comorbidities and those without comorbidities. A sample of 132 adults living with HIV underwent a basic audiological test battery to assess their hearing function. Participants with comorbidities were 1.23 times more likely to develop hearing loss, with crude odds of 1.236 (95%CI 0.5467 to 2.795), while those with three comorbidities were 2.52 times more likely to develop hearing loss. Participants with hypertension were 93% more likely to develop hearing loss when compared to nonhypertensive participants (OR = 1.928; 95%CI: 0.7856 to 4.7345). There was only a marginal association between hypercholesterolemia and sensorineural hearing loss (SNHL), with no association between other comorbidities and the type of hearing loss. The current findings raise a need for prioritizing patients with comorbidities in audiological assessment and monitoring in resource-constrained contexts, where capacity versus demand challenges might prevent the provision of audiological services to all adults living with HIV. These findings also highlight the importance of preventive care in this population with regard to the burden of the disease, as it may lead to worse ear and hearing outcomes for affected individuals.
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Xu D, Yan C, Zhao Z, Weng J, Ma S. External Communication Barriers among Elderly Deaf and Hard of Hearing People in China during the COVID-19 Pandemic Emergency Isolation: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111519. [PMID: 34770033 PMCID: PMC8583539 DOI: 10.3390/ijerph182111519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 01/04/2023]
Abstract
The COVID-19 pandemic poses a great risk to older people with hearing impairment, who face a higher threshold of external communication after the implementation of the emergency isolation policy. As part of a study on the optimization of external communication among the deaf and hard of hearing (DHH) population in central China, this study employed a qualitative research method based on in-depth interviews to explore the needs and difficulties faced by the older DHH group in external communication during public health emergencies in Wuhan, China, in the context of the COVID-19 pandemic. The results showed that older DHH people had weak reception of critical information about the epidemic, and had suboptimal access to medical care during emergency quarantine, which increased interpersonal communication barriers to this group. The current findings highlight the urgent need for targeted strengthening of the original emergency communication and coordination mechanisms in public health emergencies, and for improving policy inclusiveness for older DHH individuals during the COVID-19 pandemic and emergencies alike.
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Affiliation(s)
- Di Xu
- School of Journalism and Information Communication, Huazhong University of Science and Technology, Wuhan 430074, China; (C.Y.); (Z.Z.); (S.M.)
- Correspondence:
| | - Chu Yan
- School of Journalism and Information Communication, Huazhong University of Science and Technology, Wuhan 430074, China; (C.Y.); (Z.Z.); (S.M.)
| | - Ziqing Zhao
- School of Journalism and Information Communication, Huazhong University of Science and Technology, Wuhan 430074, China; (C.Y.); (Z.Z.); (S.M.)
| | - Jiaying Weng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;
| | - Shiwen Ma
- School of Journalism and Information Communication, Huazhong University of Science and Technology, Wuhan 430074, China; (C.Y.); (Z.Z.); (S.M.)
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30
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The Association Between Hearing Loss and Surgical Complications in Older Adults. Ear Hear 2021; 43:961-971. [PMID: 34711743 DOI: 10.1097/aud.0000000000001152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In this study, we sought to evaluate whether older patients with hearing loss who underwent surgery were at greater risk of postsurgical complications, increased inpatient length-of-stay (LOS), and hospital readmission. DESIGN This was a retrospective cohort study of patients receiving surgery at a tertiary medical center. Utilizing electronic health record data from two merged datasets, we identified patients 65 years and older, undergoing major surgery between January 1, 2014 and January 31, 2017, and who had audiometric evaluation before surgery. Patients were classified as having either normal hearing or hearing loss based on pure-tone average in the better ear. A Generalized Estimating Equations approach was used to fit multivariable regression models for outcome variables of interest. RESULTS Of patients ≥65 years undergoing major surgery in our time frame, a total of 742 surgical procedures were performed on 621 patients with available audiometric data. After adjusting for age, sex, race, and comorbidities, hearing loss was associated with an increase in the odds of developing postoperative complications. Every 10 dB increase in hearing loss was associated with a 14% increase in the odds of developing a postoperative complication (odds ratio = 1.14, 95% confidence interval = 1.01-1.29, p = 0.031). Hearing loss was not significantly associated with increased hospital LOS, 30-day readmission, or 90-day readmission. CONCLUSION Hearing loss was significantly associated with developing postoperative complications in older adults undergoing major surgery. Screening for hearing impairment may be a useful addition to the preoperative assessment and perioperative management of older patients undergoing surgery.
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Wells TS, Rush SR, Nickels LD, Wu L, Bhattarai GR, Yeh CS. Limited Health Literacy and Hearing Loss Among Older Adults. Health Lit Res Pract 2021; 4:e129-e137. [PMID: 32510569 PMCID: PMC7274562 DOI: 10.3928/24748307-20200511-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Effective communications between health care providers and patients are critical for high-quality health care. OBJECTIVE This study sampled adults age 65 years and older to explore (1) characteristics associated with limited health literacy (LHL) and (2) medical costs and gaps in care based on health literacy, hearing loss, and hearing aid use status. METHODS The study included 19,223 adults age 65 years and older who completed a health survey that was linked to his or her medical claims that were generated after medical care provided in the year prior to survey completion. Health literacy, hearing loss, and hearing aid use were assessed through self-reports. Health literacy was coded as limited and adequate. Hearing loss and hearing aid use were coded into five categories: no hearing loss, unaided mild, aided mild, unaided severe, and aided severe hearing loss. KEY RESULTS Seven percent reported LHL and 41% reported hearing loss. Hearing loss, especially unaided severe, was associated with LHL, as were memory loss, depression, loneliness, older age, and male gender. People with aided severe hearing loss and LHL had higher annual medical costs than those with adequate health literacy. Similarly, those with no hearing loss and LHL had higher annual medical costs than those with adequate health literacy. CONCLUSIONS Unaided mild, aided severe, and unaided severe hearing loss were positively associated with LHL, although the association was reduced among hearing aid users. Specifically, aided mild or severe hearing loss had lower odds of LHL, compared to unaided mild or severe hearing loss, respectively. We also observed that people with both hearing loss and LHL were more likely to have higher medical costs. Continued focus on solutions to address both LHL and hearing loss remains warranted. [HLRP: Health Literacy Research and Practice. 2020;4(2):e129-e137.] PLAIN LANGUAGE SUMMARY: Health survey and medical claims data were used for this study. Hearing loss, especially unaided severe, was associated with limited health literacy, as were memory loss, depression, loneliness, older age, and male gender. Those with both limited health literacy and hearing loss had the highest medical costs. Health literacy and hearing loss can affect health care communications, warranting further study.
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Affiliation(s)
- Timothy S. Wells
- Address correspondence to Timothy S. Wells, PhD, Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108;
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Fogelson D, Brown BB, Gustin T, Goode V. Hearing impaired older adults in the acute care setting: An innovation solution to improve care. Geriatr Nurs 2021; 44:272-274. [PMID: 34099277 DOI: 10.1016/j.gerinurse.2021.04.028] [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: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 11/24/2022]
Abstract
Hearing loss is prevalent in the geriatric population. Healthcare systems and providers are challenged to meet communication needs in hearing impaired adults in the acute care setting. Patients with impaired-hearing pose risk to themselves and the healthcare system. Healthcare systems can utilize the expertise of advanced practice nurses, especially those with a geriatric focus to develop strategic imperatives aimed at addressing the unique needs of older adults patients with hearing impairments. Instituting a practice change using the personal amplifier device for older adult patients with hearing impairment is an innovative approach to enhancing effective communication and care delivery between patients and the healthcare interprofessional team. Innovative strategies include understanding personal amplifier devices, developing methods to identify patients who present with hearing loss, and provide interdisciplinary education and training to providers. Advanced practice nurses are ideal to function as change agents in the improvement of care for the hearingimpaired older adult.
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Affiliation(s)
- Donna Fogelson
- Old Dominion University, 1881 University Dr., VA Beach, VA 23453, United States
| | - Beatrice B Brown
- Old Dominion University, 1881 University Dr., VA Beach, VA 23453, United States
| | - Tina Gustin
- Old Dominion University, 1881 University Dr., VA Beach, VA 23453, United States.
| | - Victoria Goode
- Old Dominion University, 1881 University Dr., VA Beach, VA 23453, United States.
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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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West JS. Hearing Impairment and Mental Health Among Married Couples. J Gerontol B Psychol Sci Soc Sci 2021; 76:933-943. [PMID: 32052050 DOI: 10.1093/geronb/gbaa023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Disablement is a significant health problem and chronic stressor for older adults and is associated with negative mental health outcomes. Although some research has explored how disability extends beyond individuals to influence the mental health of their support networks, less population-based research has assessed the consequences of hearing impairment, a growing public health concern that affects 72.4% of people aged 65 and older. Moreover, although much research has examined the negative individual impact of hearing impairment, less population-based research has assessed its consequences on spouses. To fill this gap, the current study builds on gender, marriage, and stress proliferation research to examine (a) the association between own hearing impairment and spouses' depressive symptoms, and (b) whether this association varies by the gender of the spouse. METHOD Fixed-effects regression models were conducted using data from 5,485 couples (10,970 individuals) from 10 waves of the Health and Retirement Study (1998-2016). RESULTS Wives' fair or poor hearing is significantly associated with an increase in husbands' depressive symptoms, net of controls. However, husbands' fair or poor hearing is not associated with an increase in wives' depressive symptoms. DISCUSSION These findings suggest that hearing impairment can proliferate from one spouse to the other, but that this proliferation depends on gender. Health care providers need to be aware of the implications for husbands when treating women with hearing impairment.
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Affiliation(s)
- Jessica S West
- Department of Sociology, Duke University, Durham, North Carolina
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Mitra M, McKee MM, Akobirshoev I, Ritter GA, Valentine AM. Pregnancy and Neonatal Outcomes Among Deaf or Hard of Hearing Women: Results From Nationally Representative Data. Womens Health Issues 2021; 31:470-477. [PMID: 33888398 DOI: 10.1016/j.whi.2021.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 01/05/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although the literature suggests that women with disabilities are at increased risk for pregnancy complications and adverse birth outcomes, there are few population-based studies of the pregnancy outcomes among deaf and hard of hearing (DHH) women in the United States. OBJECTIVE To compare pregnancy complications and neonatal outcomes between deliveries to DHH and non-DHH women using national hospitalization discharge record data. STUDY DESIGN We used the 2007-2016 Healthcare Cost and Utilization Project National Inpatient Sample to compare pregnancy complications and outcomes among deliveries to DHH women with deliveries to non-DHH women using bivariate and Poisson regressions, controlling for sociodemographic, hospital, and clinical characteristics. RESULTS DHH women had an increased risk of adverse pregnancy outcomes and chronic medical conditions, including preexisting diabetes (relative risk [RR], 2.01; 95% confidence interval, 1.68-2.42; p < .001), gestational diabetes (RR, 1.31; 95% CI, 1.19-1.44; p < .001), chronic hypertension (RR, 1.51; 95% CI, 1.33-1.72; p < .001), preeclampsia and eclampsia (RR, 1.35; 95% CI, 1.21-1.51; p < .01), placenta previa (RR, 1.62; 95% CI, 1.22-2.16; p < .01), placental abruption (RR, 1.43; 95% confidence interval, 1.15-1.78; p < .01), labor induction (RR, 1.16; 95% CI, 1.05-1.27; p < .01), chorioamnionitis (RR, 1.43; 95% CI, 1.22-1.69; p < .001), cesarean delivery (RR, 1.09; 95% CI, 1.04-1.14; p < .001), premature rupture of membranes (RR, 1.34; 95% CI, 1.20-1.50; p < .001), antepartum hemorrhage (RR, 1.36; 95% CI, 1.13-1.64; p < .001), and postpartum hemorrhage (RR, 1.30; 95% CI, 1.13-1.49; p < .001). After adjustment for socioeconomic and hospital characteristics, the risk for gestational diabetes, preeclampsia and eclampsia, placenta previa, and chorioamnionitis remained unexplained. CONCLUSIONS DHH women are at an increased risk for adverse pregnancy, fetal, and neonatal outcomes, illuminating the need for awareness among obstetric and primary care providers as well as the need for systematic investigation of outcomes and evidence-based guidelines.
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Affiliation(s)
- Monika Mitra
- The Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, 02453.
| | - Michael M McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Ilhom Akobirshoev
- The Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, 02453
| | - Grant A Ritter
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Anne M Valentine
- The Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, 02453
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Maidment DW, Wege TE. The association between non-communicable disease and hearing aid adoption in older adults with hearing loss. Int J Audiol 2021; 61:220-227. [PMID: 33870834 DOI: 10.1080/14992027.2021.1910740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: To assess whether specific non-communicable diseases are associated with hearing aid adoption in older adults with hearing loss.Design: A cross-sectional, observational study.Study sample: Data was obtained from one of the largest pharmacy-led health and beauty retailers in the United Kingdom. In total, 17,172 older adults were included.Results: Greater odds of adopting hearing aids were associated with being older (Odds ratio [OR] = 1.03; 95% confidence interval [CI] = 1.02, 1.03), having fewer self-reported hearing difficulties (OR = 0.61; 95% CI = 0.58, 0.64), and greater audiometric hearing loss (OR = 1.68; 95% CI = 1.54, 1.83). The odds of adopting hearing aids were lower if individuals self-reported hypertension (OR = 0.87; 95% CI = 0.79, 0.97) and diabetes (OR = 0.83; 95% CI = 0.72, 0.95). Using a decision tree model, self-reported hearing difficulties, audiometric hearing loss, and age were the best combination of variables to differentiate between individuals that did and did not adopt hearing aids.Conclusions: This study demonstrates that hearing aid adoption is lower in older adults with cardiovascular disease risk factors. Thus, there is a need for healthcare professionals to identify older adults living with hearing loss and cardiovascular ill-health, ensuring that they receive appropriate patient-centred support to manage their health.
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Affiliation(s)
- D W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - T E Wege
- Mathematics Education Centre, Loughborough University, Loughborough, UK
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Mahmoudi E, Zazove P, Pleasant T, Meeks L, McKee MM. Hearing Loss and Healthcare Access among Adults. Semin Hear 2021; 42:47-58. [PMID: 33883791 DOI: 10.1055/s-0041-1726000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Hearing loss (HL) is common among individuals aged 50 and older and is associated with increased healthcare costs. Whether HL is associated with less access to healthcare is unclear. In this study, we examined the association between HL and access to medical care and prescription drugs among individuals 50+ with and without HL. We used nationally representative 2013-2014 Medical Expenditure Panel Survey data, consisting of 1,977 adults with HL and 17,399 without. We applied an inverse propensity score weighting and regression modeling to adjust for any potential differences in health and socioeconomic conditions between the two groups. Adults with HL were more likely to be white, less educated, poorer, and with public insurance ( p < 0.001). They were also likely to have hypertension, heart disease, stroke, emphysema, high cholesterol, diabetes, joint pain, and arthritis ( p < 0.001). The odds of reporting unmet medical needs (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.29-2.66), delay in getting medical needs met (OR = 1.37; 95% CI = 1.00-1.87), and having unfilled prescriptions (OR = 1.81; 95% CI = 1.27-2.59) were higher among individuals with HL compared with their counterparts without HL. Individuals with HL have less access to care and prescription drugs. To ensure equitability in access, public health policies should address specific needs of people with HL.
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Affiliation(s)
- Elham Mahmoudi
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Philip Zazove
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Terrence Pleasant
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Lisa Meeks
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
| | - Michael M McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan
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Moreland CJ, Ruffin CV, Morris MA, McKee M. Unmasked: How the COVID-19 Pandemic Exacerbates Disparities for People With Communication-Based Disabilities. J Hosp Med 2021; 16:185-188. [PMID: 33617440 DOI: 10.12788/jhm.3562] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/02/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Christopher J Moreland
- Department of Internal Medicine, Dell Medical School, University of Texas, Austin, Texas
| | - Chad V Ruffin
- Proliance South Seattle Otolaryngology, Burien, Washington
| | - Megan A Morris
- Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michael McKee
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
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Tsimpida D, Kontopantelis E, Ashcroft DM, Panagioti M. Conceptual Model of Hearing Health Inequalities (HHI Model): A Critical Interpretive Synthesis. Trends Hear 2021; 25:23312165211002963. [PMID: 34049470 PMCID: PMC8165532 DOI: 10.1177/23312165211002963] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/29/2020] [Accepted: 02/25/2021] [Indexed: 11/16/2022] Open
Abstract
Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people's quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to identify literature that relates hearing loss to health inequalities as a determinant or health outcome. A total of 53 studies were selected to thematically summarize the existing literature, using a critical interpretive synthesis method, where the subjectivity of the researcher is intimately involved in providing new insights with explanatory power. The evidence provided by the literature can be summarized under four key themes: (a) There might be a vicious cycle between hearing loss and socioeconomic inequalities and lifestyle factors, (b) socioeconomic position may interact with less healthy lifestyles, which are harmful to hearing ability, (c) increasing health literacy could improve the diagnosis and prognosis of hearing loss and prevent the adverse consequences of hearing loss on people's health, and (d) people with hearing loss might be vulnerable to receiving low-quality and less safe health care. This study uses elements from theoretical models of health inequalities to formulate a highly interpretive conceptual model for examining hearing health inequalities. This model depicts the specific mechanisms of hearing health and their evolution over time. There are many modifiable determinants of hearing loss, in several stages across an individual's life span; tackling socioeconomic inequalities throughout the life-course could improve the population's health, maximizing the opportunity for healthy aging.
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Affiliation(s)
- Dialechti Tsimpida
- Centre for Primary Care and Health Services Research, Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Evangelos Kontopantelis
- Institute for Health Policy and Organisation (IHPO), School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Darren M. Ashcroft
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Maria Panagioti
- NIHR Greater Manchester Patient Safety Translational Research Centre, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
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Maidment DW, Amlani AM. Argumentum ad Ignorantiam: Smartphone-Connected Listening Devices. Semin Hear 2020; 41:254-265. [PMID: 33364675 DOI: 10.1055/s-0040-1718711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
In this article, we review the current literature assessing the application and benefits of connected hearing technologies, as well as their potential to improve accessibility to and affordability of hearing healthcare. Over the past decade, there has been a proliferation of hearing devices that connect wirelessly to smartphone technologies via Bluetooth. These devices include (1) smartphone-connected hearing aids that must be obtained from a licensed audiologist or hearing aid dispenser; (2) direct-to-consumer devices, such as personal sound amplification products; and (3) smartphone-based hearing aid applications (or apps). Common to all these connected devices is that they permit the user to self-adjust and customize their device programs via an accompanying smartphone app. There has been a growing body of literature assessing connected hearing devices in adults living with hearing loss. Overall, the evidence to date supports the notion that all connected hearing devices can improve accessibility to and affordability of amplification. It is unclear, however, whether connected technologies are a clinically effective alternative to traditional hearing aids. Even so, the impact of connectivity is especially pertinent given the sudden disruption caused by the recent global COVID-19 pandemic, whereby connected technologies enable patients to receive treatment through mobile-based, tele-audiology platforms.
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Affiliation(s)
- David W Maidment
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, United Kingdom
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41
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Machado-Fragua MD, Struijk EA, Yévenes-Briones H, Caballero FF, Rodríguez-Artalejo F, Lopez-Garcia E. Coffee consumption and risk of hearing impairment in men and women. Clin Nutr 2020; 40:3429-3435. [PMID: 33298331 DOI: 10.1016/j.clnu.2020.11.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/21/2020] [Accepted: 11/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hearing loss is the fifth leading cause of disability in the world. Coffee consumption might have a beneficial effect on hearing function because of the antioxidant and anti-inflammatory properties of some of its compounds. However, no previous longitudinal study has assessed the association between coffee consumption and the risk of hearing impairment. OBJECTIVE To assess the prospective association between coffee consumption and risk of disabling hearing impairment in middle and older men and women from the UK Biobank study. METHODS Analytical cohort with 36,923 participants (16,142 men and 20,781 women) [mean (SD): 56.6 (7.8) years, 1.6 (1.4) cups/d, and -7.6 (1.3) dB for age, total coffee consumption and speech reception threshold in noise at baseline, respectively]. At baseline, coffee consumption was measured with 3-5 multiple-pass 24-h food records. Hearing function was measured with a digit triplet test, and disabling hearing impairment was defined as a speech reception threshold in noise > -3.5 dB in any physical exam during the follow-up. Analyses were stratified by sex and Cox regression models were used to assess the prospective association proposed. RESULTS Over 10 years of follow-up, 343 men and 345 women developed disabling hearing impairment. Among men, compared with those who consumed <1 cup/d of coffee, those who consumed 1, and ≥2 cups/d had a lower risk of hearing impairment (hazard ratio [95% confidence interval]: 0.72 [0.54-0.97] and 0.72 [0.56-0.92], respectively; P-trend: 0.01). This association was similar for caffeinated and decaffeinated coffee, and for filtered and non-filtered coffee, and was stronger in those with obesity (hazard ratio [95% confidence interval] for consumption of ≥2 vs. <1 cups/d: 0.39 [0.21-0.74]). No association was found between coffee and hearing function among women. CONCLUSIONS Coffee consumption was associated with lower risk of disabling hearing impairment in men but not in women. The association appeared to be independent of the coffee type and the preparation method.
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Affiliation(s)
- Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), and CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.; IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
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Yang D, Liu J, Yang Q, Lin Q, Zhang X, Wang M, Li X, Tu J, Wang J, Ning X. Hearing impairment prevalence and risk factors among adults in rural China: a population-based cross-sectional study. Postgrad Med 2020; 133:369-376. [PMID: 33301366 DOI: 10.1080/00325481.2020.1855852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Over the past few decades, the prevalence of hearing impairment (HI) has rapidly increased, making HI one of the most common causes of disability, globally. The burden of HI is particularly heavy in low socioeconomic status populations. Despite extensive research into the range of HI prevalence in low socioeconomic status populations, worldwide, population-based studies have been rare. Thus, we explored HI prevalence and risk factors among low-income, middle-aged and elderly individuals in Tianjin, China.Method: Between September and November 2013, 2351 rural residents in Tianjin, China were recruited into the study. All participants completed questionnaire surveys, physical examinations, laboratory examinations, and hearing tests. HI was measured using pure-tone audiometry, and audiologists determined the final diagnoses.Results: Among the 2351 participants, ≥45 years old, the prevalence of HI was 49.3%, including 54.3% among men and 46.0% among women. Slight HI accounted for the largest proportion of individuals (40.7%). The risk of HI among men was 32.9% higher than among women. Moreover, the risk of HI increased with increasing age. Compared with the 45-54-year-old group, the risk of HI in individuals in the 55-64-year-old, 65-74-year-old, and ≥75-year-old groups were 25.8%, 109.9%, and 373.7% higher, respectively. Moreover, increased with each 1-mmHg SBP, the risk of HI increase 0.7% (95%CI: 1.001-1.013; P = 0.017); while increased with each 1-mmHg DBP, the risk of HI decrease 1.7% (95%CI: 0.973-0.993; P = 0.001)Conclusions: The burden of HI in rural northern China is heavy, especially among elderly men and people with elevated systolic blood pressure (SBP). Addressing HI prevention is critical for reducing the HI burden and improving quality of life.
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Affiliation(s)
- Dong Yang
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin China
| | - Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin China
| | - Xin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingxin Wang
- Department of Otorhinolaryngology, Tianjin Medical University General Hospital, Tianjin China
| | - Xin Li
- Department of Otorhinolaryngology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin China
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Zazove P, Plegue MA, McKee MM, DeJonckheere M, Kileny PR, Schleicher LS, Green LA, Sen A, Rapai ME, Mulhem E. Effective Hearing Loss Screening in Primary Care: The Early Auditory Referral-Primary Care Study. Ann Fam Med 2020; 18:520-527. [PMID: 33168680 PMCID: PMC7708285 DOI: 10.1370/afm.2590] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/04/2020] [Accepted: 05/11/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes. METHODS A multiple baseline design was implemented to assess a screening paradigm for identifying and referring patients aged ≥55 years with hearing loss at 10 family medicine clinics in 2 health systems. Patients completed a consent form and the Hearing Handicap Inventory for the Elderly (HHI). An electronic alert prompted clinicians to screen for hearing loss during visits. RESULTS The 14,877 eligible patients during the study period had 36,701 encounters. Referral rates in the family medicine clinics increased from a baseline rate of 3.2% to 14.4% in 1 health system and from a baseline rate of 0.7% to 4.7% in the other. A general medicine comparison group showed referral rate increase from the 3.0% baseline rate to 3.3%. Of the 5,883 study patients who completed the HHI 25.2% (n=1,484) had HHI scores suggestive of hearing loss; those patients had higher referral rates, 28% vs 9.2% (P <.001). Of 1,660 patients referred for hearing testing, 717 had audiology data available for analysis: 669 (93.3%) were rated appropriately referred and 421 (58.7%) were considered hearing aid candidates. Overall, 71.5% of patients contacted felt their referral was appropriate. CONCLUSION An electronic alert used to remind clinicians to ask patients aged ≥55 years about hearing loss significantly increased audiology referrals for at-risk patients. Audiologic and audiogram data support the effectiveness of the prompt. Clinicians should consider adopting this method to identify patients with hearing loss to reduce its known and adverse sequelae.
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Affiliation(s)
- Philip Zazove
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Melissa A Plegue
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Michael M McKee
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | | | - Paul R Kileny
- Otorhinolaryngology Department, University of Michigan, Ann Arbor, Michigan
| | | | - Lee A Green
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Ananda Sen
- Department of Family Medicine and Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Mary E Rapai
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan
| | - Elie Mulhem
- Department of Family Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
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Coprevalence of Presbycusis and Its Effect on Outcome of Voice Therapy in Patients With Presbyphonia. J Voice 2020; 36:877.e9-877.e14. [PMID: 33067119 DOI: 10.1016/j.jvoice.2020.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/28/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To identify the coprevalence of presbycusis and presbycusis and analyze the effect of presbycusis on compliance and result of voice therapy in presbycusis patients. METHODS This cross-sectional, prospective cohort study initially screened patients aged ≥65 years who visited our hospital from February 2019 to January 2020. Unaided pure tone audiometry was performed in these subjects to determine the presence of presbycusis. Perceptual voice assessment by an examiner was conducted for screening of presbycusis, and its diagnosis was confirmed through the voice handicap index-10 (VHI-10) questionnaire and a laryngoscopic exam. Patients with presbycusis underwent voice therapy and were assessed for their compliance and outcomes of the treatment according to the coexistence of presbycusis. RESULTS Among the 221 patients, presbycusis and presbycusis were diagnosed in 125 (56.6%) and 110 (49.8%) patients, respectively. The copresence of these two disorders were identified in 87 (39.4%) patients, and there was a significant correlation between presbycusis and presbycusis. The effects of voice therapy were examined in the consecutive 40 patients who were diagnosed with presbycusis. There were 21 patients without presbycusis and 19 patients with presbycusis. The average pretreatment voice handicap index-10 score was significantly higher in presbycusis patients; there was no significant difference in the incidence of dropout from voice therapy between the groups. The patients without presbycusis showed a significant improvement in the functional communication measurement (FCM) level and maximum phonation time (MPT) compared with those of patients with presbycusis after voice therapy. CONCLUSIONS Presbyphonia and presbycusis coexisted in many elderly people. The improvement in the FCM level and MPT after voice therapy was relatively low if patients with presbycusis accompanied by presbycusis. The copresence of presbycusis did not significantly affect compliance with voice therapy in the patients.
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Increase Risk of Dementia in Patients With Sudden Hearing Loss: A Population-Based Cohort Study With 7-Year Follow-Up in Taiwan. Otol Neurotol 2020; 41:1334-1340. [PMID: 32810013 DOI: 10.1097/mao.0000000000002795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk of subsequent dementia in subjects with sudden hearing loss during a 7-year follow-up period through comparisons with cohorts matched by sex, age group, and year of index date. STUDY DESIGN A retrospective matched-cohort study. SETTING The Longitudinal Health Insurance Database 2000 (LHID2000) in Taiwan. PATIENTS This study included a total of 11,148 subjects, including 1,858 in the study group and 9,290 in the comparison cohort group. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) We analyzed the differences in sociodemographic characteristics and comorbidities between subjects with sudden hearing loss and the comparison cohort group. Then, we estimated the risk of dementia and also plotted the survival outcomes to evaluate differences in dementia-free survival rates between the two groups. RESULTS The dementia incidence rates per 1000 person-years were 20.45 and 8.15 for the subjects with sudden hearing loss and comparison cohorts, respectively. When we adjusted for the subjects' characteristics, the hazard ratio for dementia was 1.69 (95% confidence interval [CI] = 1.06-2.68, p < 0.01) for subjects with sudden hearing loss compared with comparison cohorts during the follow-up period, and subjects with sudden hearing loss had lower 7-year dementia-free survival rates compared with comparison cohorts by using a log-rank test. Furthermore, male subjects with sudden hearing loss had a higher risk of dementia (adjusted hazard ratio [HR] = 2.11) than did the male comparison cohorts. CONCLUSIONS This study revealed a relationship between sudden hearing loss and dementia in an Asian country. The risk of dementia was higher among patients with sudden hearing loss compared with matched cohorts during the 7-year follow-up period.
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Park J. Unraveling the Invisible but Harmful Impact of COVID-19 on Deaf Older Adults and Older Adults with Hearing Loss. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:598-601. [PMID: 32744477 DOI: 10.1080/01634372.2020.1799282] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 05/23/2023]
Affiliation(s)
- Junghyun Park
- Silver School of Social Work, New York University , New York, NY, United States
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Impact of hearing loss on clinical interactions between older adults and health professionals: a systematic review. Eur Geriatr Med 2020; 11:919-928. [DOI: 10.1007/s41999-020-00358-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
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Bigelow RT, Reed NS, Brewster KK, Huang A, Rebok G, Rutherford BR, Lin FR. Association of Hearing Loss With Psychological Distress and Utilization of Mental Health Services Among Adults in the United States. JAMA Netw Open 2020; 3:e2010986. [PMID: 32687587 PMCID: PMC7372323 DOI: 10.1001/jamanetworkopen.2020.10986] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Psychological distress affects health and health care utilization. Hearing loss (HL) is highly prevalent and undertreated, and it may be a potentially modifiable risk factor for psychological distress. OBJECTIVE To investigate the association between HL, psychological distress, and mental health care utilization among adults in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 25 665 individuals aged 18 years and older who participated in the 2017 National Health Interview Survey, a home-based nationally representative cross-sectional survey of noninstitutionalized US adults conducted by trained interviewers. EXPOSURES Self-reported hearing and hearing aid use. MAIN OUTCOMES AND MEASURES Kessler psychological distress scale (scores ≥5 indicating moderate distress), self-reported use of medication to treat depression or anxiety symptoms, and use of mental health services in the past year. RESULTS A total of 25 665 adults (mean [SD] age 47.0 [18.1] years, 51.7% [95% CI, 51.0%-52.5%] women, weighted to be representative of the US adult population) were included in the analysis. Compared with 11 558 participants (49.3%; 95% CI, 48.2%-50.5%) with no HL, the 9390 (35.3%; 95% CI, 34.4%-36.2%) with mild HL and 4717 (15.4%; 95% CI, 14.8%-16.0%) with moderate or worse HL had increased odds of moderate psychological distress (mild HL: odds ratio [OR], 1.49; 95% CI, 1.35-1.62; moderate HL: OR, 2.12; 95% CI, 1.87-2.41) and were more likely to report antidepressant medication use (mild HL: OR, 1.39; 95% CI, 1.17-1.67; moderate HL: OR, 2.07; 95% CI, 1.70-2.57), and antianxiety medication use (mild HL: OR, 1.39; 95% CI, 1.16-1.67; moderate HL: OR, 1.94; 95% CI, 1.57-2.39). Moderate HL was associated with increased odds of use of mental health services (moderate HL: OR, 1.53; 95% CI, 1.30-1.79). Among individuals with moderate HL, those with hearing aids (1066 [22.6%]) were less likely to experience psychological distress than those without hearing aids (3651 [77.4%]; OR, 0.66; 95% CI, 0.53-0.83). CONCLUSIONS AND RELEVANCE In a large nationally representative sample of US adults, self-reported HL was associated with both greater psychological distress and increased rates of antidepressant and antianxiety medication use and utilization of mental health services. Further research is needed to investigate whether HL may be a modifiable risk factor for these outcomes.
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Affiliation(s)
- Robin T. Bigelow
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicholas S. Reed
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Katharine K. Brewster
- Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York
| | - Alison Huang
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - George Rebok
- Department of Mental Health and Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | - Bret R. Rutherford
- Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York
| | - Frank R. Lin
- Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Cochlear Center for Hearing and Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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Yang JR, Hidayat K, Chen CL, Li YH, Xu JY, Qin LQ. Body mass index, waist circumference, and risk of hearing loss: a meta-analysis and systematic review of observational study. Environ Health Prev Med 2020; 25:25. [PMID: 32590951 PMCID: PMC7320546 DOI: 10.1186/s12199-020-00862-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/18/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Emerging evidence implicates excess weight as a potential risk factor for hearing loss. However, this association remained inconclusive. Therefore, we aimed to systematically and quantitatively review the published observational study on the association between body mass index (BMI) or waist circumference (WC) and hearing loss. METHODS The odds ratios (ORs) or relative risks (RRs) with their 95% confidence intervals (CIs) were pooled under a random-effects model. Fourteen observational studies were eligible for the inclusion in the final analysis. RESULTS In the meta-analysis of cross-sectional studies, the ORs for prevalent hearing loss were 1.10 (95% CI 0.88, 1.38) underweight, 1.14 (95% CI 0.99, 1.32) for overweight, OR 1.40 (95% CI 1.14, 1.72) for obesity, 1.14 (95% CI 1.04, 1.24) for each 5 kg/m2 increase in BMI, and 1.22 (95% CO 0.88. 1.68) for higher WC. In the meta-analysis of longitudinal studies, the RRs were 0.96 (95% CI 0.52, 1.79) for underweight, 1.15 (95% CI 1.04, 1.27) for overweight, 1.38 (95% CI 1.07, 1.79) for obesity, 1.15 (95% CI 1.01, 1.30) for each 5 kg/m2 increase in BMI, and 1.11 (95% CI 1.01, 1.22) for higher WC. CONCLUSIONS In summary, our findings add weight to the evidence that elevated BMI and higher WC may be positively associated with the risk of hearing loss.
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Affiliation(s)
- Jin-Rong Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Khemayanto Hidayat
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Cai-Long Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
- Children's Hospital of Soochow University, Suzhou, 215025, China
| | - Yun-Hong Li
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China
| | - Jia-Ying Xu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, 215123, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.
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Löhler J, Cebulla M, Shehata-Dieler W, Volkenstein S, Völter C, Walther LE. Hearing Impairment in Old Age. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:301-310. [PMID: 31196393 DOI: 10.3238/arztebl.2019.0301] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 12/17/2018] [Accepted: 03/21/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hearing impairment associated with old age (presbycusis) is becoming more common because the population is aging. METHODS This review is based on publications retrieved by a selective search in Medline and Google Scholar, including individual studies, meta-analyses, guidelines, Cochrane reviews, and other reviews. RESULTS The cardinal symptom of presbycusis is impaired communication due to bilateral hearing impairment. Patients may be unaware of the problem for a long time because of its insidious progression. Evidence suggests that untreated hearing impair- ment in old age can have extensive adverse effects on the patient's mental, physical, and social well-being. Early detection is possible with the aid of simple diagnostic tests or suitable questionnaires. In most cases, bilateral hearing aids are an effective treatment. Surgery is rarely indicated. For patients with uni- or bilateral deafness, a cochlear implant is the treatment of choice. These treatments can improve many patients' quality of life. CONCLUSION The small amount of evidence that is currently available suggests that presbycusis is underdiagnosed and under- treated in Germany. Early detection by physicians of all specialties, followed in each case by a specialized differential diagnostic evaluation, is a desirable goal.
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Affiliation(s)
- Jan Löhler
- Department of Ear, Nose and Throat Medicine, Universitätsklinikum Schleswig-Holstein, Campus Lübeck; German Center of Oto-Rhino-Laryngology, Head and Neck Surgery (DSZ HNO), Bonn; Otolaryngological practice, Bad Bramstedt; Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Division of Pedaudiology, Phoniatrics and Electrophysiology, University Hospital of Würzburg, CHC, Würzburg; St. Elisabeth- Hospital, Clinics of the Ruhr University of Bochum, Ear, Nose and Throat Clinic, Head and Throat Surgery, Ruhr University of Bochum; Otolaryngological group practice, Sulzbach (Taunus); Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Disorders Center, University Hospital Mannheimm
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