Greater Hearing Loss Research Articles

Joint Association of Combined Healthy Lifestyle Factors and Hearing Loss With Cognitive Impairment in China.

Hearing loss and lifestyle factors have been associated with cognitive impairment. We aimed to explore the joint association of combined healthy lifestyle factors and hearing loss with cognitive impairment, which has been scarcely studied. This baseline study used data from the CHOICE-Cohort study (Chinese Hearing Solution for Improvement of Cognition in Elders). Hearing loss was assessed by the better-ear pure-tone average. A composite healthy lifestyle score was built based on never smoking, never drinking, regular physical activity, and a balanced diet. Cognitive impairment was diagnosed by the Mini-Mental State Examination score of less than 24. We included 17057 participants aged 60 years or older in China (mean age 69.8 [standard deviation 6.2] years, 55.7% female). Among the participants, 48.3% (n = 8 234) had mild hearing loss, and 25.8% (n = 4 395) had moderate or greater hearing loss. The proportion of participants with healthy lifestyle scores of 0-1, 2, 3, and 4 was 14.9% (n = 2 539), 29.3% (n = 5 000), 37.4% (n = 6 386), and 18.4% (n = 3 132), respectively. About 29.6% (n = 5 057) participants had cognitive impairment. When compared to those with normal hearing and healthy lifestyle (scores of 3-4), participants with hearing loss plus unhealthy lifestyle (scores of 0-2) exhibited approximately twofold increased risk of cognitive impairment (odds ratio [OR] = 1.92, 95% confidence interval [CI] 1.70-2.18). Conversely, the risk was greatly attenuated by adherence to healthy lifestyle in individuals with hearing loss (OR = 1.57, 95% CI 1.40-1.76). Our findings demonstrated adherence to a broad range of healthy lifestyle factors was associated with a significantly lower risk of cognitive impairment among participants with hearing loss.

Hearing Loss, Hearing Aids, and Functional Status

Hearing loss may contribute to poor functional status via cognitive impairment and social isolation. Hearing aids may play a protective role by attenuating these downstream outcomes. However, population-based evidence is lacking. To examine the association of hearing loss and hearing aids with functional status. This cross-sectional (2016-2017) and longitudinal (2016-2022) analysis of data from the Atherosclerosis Risk in Communities cohort study included older, community-dwelling adults with complete data. Data were analyzed from June to December 2023. The better-hearing ear's pure tone average (BPTA) at speech frequencies (0.5-4 kHz) was modeled categorically (no [BPTA ≤25 dB], mild [26-40 dB], and moderate or greater hearing loss [>40 dB]). Hearing aid use was self-reported. Difficulties in activities of daily living (ADLs; eg, dressing and eating), instrumental activities of daily living (IADLS; eg, household chores and meal preparation), and heavier tasks (eg, walking a quarter of a mile) were self-reported at visit 6. The ability to perform usual activities, walk a half mile, walk up and down stairs, and do heavy housework without help were collected in follow-up surveys. Linear and logistic regression models were used that were adjusted for sociodemographic and health covariates. Among 3142 participants (mean [SD] age, 79.3 [4.6] years; 1828 women [58.2%]), 1013 (32.2%) had no hearing loss, 1220 (38.8%) had mild hearing loss, and 909 (29.0%) had moderate or greater hearing loss. Moderate or greater hearing loss was cross-sectionally associated with difficulty in 1 or more ADLs (odds ratio [OR], 1.27; 95% CI, 1.02-1.58), IADLs (OR, 1.34; 95% CI, 1.05-1.71), and heavier tasks (OR, 1.29; 95% CI, 1.04-1.62) compared with no hearing loss. Over time (mean [SD] follow-up, 1.9 [1.8] years), moderate or greater hearing loss was associated with a faster decline in the number of activities participants were able to do (β = -0.07 per year; 95% CI, -0.09 to -0.06) and greater odds of reporting inability to do 1 or more of the 4 activities (OR, 1.14; 95% CI, 1.05-1.24). Hearing aid users and nonusers did not differ. The results of this study suggest that moderate or greater hearing loss was associated with functional difficulties and may contribute to a faster decline in function longitudinally independent of sociodemographic and health covariates. Hearing aids did not change the association among those with hearing loss.

THE ASSOCIATION OF HEARING LOSS AND FRAILTY AMONG OLDER ADULTS IN THE US

Abstract Frailty is common in older adults and increases the risk of functional limitations and death. Hearing loss affects ~2/3 of older adults in the U.S. and is associated with poorer physical and cognitive function and social isolation, which may increase the risk for frailty. We aimed to determine if hearing loss is associated with higher odds of being frail or pre-frail versus robust and if hearing aid use is protective. We analyzed data from 2,361 participants from the National Health and Aging Trends Study (NHTAS), a U.S. nationally representative sample of older adults, collected in 2021. Hearing was assessed by pure-tone audiometric testing, and we used a speech-frequency (0.5-4 kHz) better hearing ear’s pure-tone average (BPTA) to categorize participants into no hearing loss (BPTA≤25 dB HL), mild (26-40), and moderate or greater (>40) hearing loss. Physical frailty was categorized according to the presence of the frailty phenotype components (unintentional weight loss, exhaustion, low physical activity, weakness, slow walking speed) into robust (0), pre-frail (1-2), and frail (≥3). In our study population (mean age=81, 56% female, 19% Black), there were 1,724 (73%) participants with hearing loss. Using multinomial logistic regression, we found that participants with moderate or greater hearing loss (vs. those without) had higher odds of being frail versus robust (OR=1.82, 95% CI 1.11, 2.99, p-trend=0.016). Hearing loss may be a risk factor for frailty. Future studies on the impact of hearing interventions in preventing and managing frailty will have significant public health and clinical importance.

POPULATION ATTRIBUTABLE FRACTIONS FOR THE CONTRIBUTION OF HEARING LOSS ON DEMENTIA RISK ACROSS COHORT STUDIES

Abstract Estimates range from 2-8% of dementia cases in the US are attributable to hearing loss. Here, we investigate measurement considerations in quantifying the population attributable fraction (PAF) of dementia from hearing loss to highlight how differences in methodology can underestimate the PAF. We use two cohort studies of older adults in the US: the National Health and Aging Trends Study (NHATS), a nationally-representative sample of older Medicare beneficiaries; and the Atherosclerosis Risk in Communities (ARIC) Study, a large, community-based cohort study with longitudinal follow-up. Each study collects reference-standard hearing measures on participants. We have two specific aims. First, we compare two valid, formula-based approaches to quantifying the PAF. The advantages of quantifying a PAF using a well-characterized, biracial, community-based sample with a longitudinal design are weighed against those of using a nationally-representative sample with a cross-sectional design (moderate or greater hearing loss: PAF in NHATS, 16.9% [95% CI: 4.1-28.7%]; PAF in ARIC, 13.2% [95% CI: 2.2-20.9%]), highlighting the need for longitudinal designs in studies of the PAF from hearing loss. Second, we describe the impact of subjective versus objective measures of hearing loss on the PAF. In ARIC, subjective hearing loss was not associated with incident dementia (hazard ratio <1.0). PAFs of dementia from objective hearing loss were 6- to 8-fold greater than PAFs previously quantified using self-reported hearing measures in population-based studies. Our findings have broad implications for the inclusion of hearing loss as a potentially modifiable risk factor in clinical and public health initiative for dementia prevention.

The association of hearing loss with frailty among community-dwelling older adults: findings from the National Health and Aging Trends Study

BackgroundThe identification of modifiable risk factors is crucial for the prevention and/or reversal of frailty, which is associated with significant morbidity and mortality. Hearing loss affects two-thirds of older adults in the United States (U.S.) and is associated with physical and cognitive decline which may increase frailty risk. We investigated the association of hearing loss and hearing aid use with frailty and pre-frailty in a nationally representative sample of older adults in the U.S.MethodsCross-sectional analysis of the National Health and Aging Trends Study (2021 round). The better-hearing ear pure-tone average (BPTA) at speech-frequencies (0.5–4 kHz) was modeled continuously (per 10 dB) and categorically (no ≤ 25 dB, mild 26–40 dB, moderate or greater > 40 dB hearing loss). Hearing aid use was self-reported. The physical frailty phenotype (frail, pre-frail, robust) was determined based on Fried criteria: unintentional weight loss, exhaustion, low physical activity, weakness, slow walking speed. We used multinomial multivariable regression adjusted for sociodemographic and health characteristics (odds ratios [95% Confidence Intervals]).ResultsAmong 2,361 participants (mean age = 81 years, 56% female, 19% Black), 860 (36%) had mild and 864 (37%) had moderate or greater hearing loss. Worse hearing was associated with greater odds of being frail versus robust (OR = 1.20 [1.05–1.38] per 10 dB difference). Categorically, moderate or greater hearing loss was associated with greater odds of being frail (OR = 1.84 [1.01–3.08]) and pre-frail (OR = 1.46 [1.01–2.10]) versus robust. Among 1,724 participants with hearing loss, compared to hearing aid users (N = 522), nonusers had greater odds of being frail (OR = 2.54 [1.54–4.18]) and pre-frail (OR = 1.51 [1.05–2.17]) versus robust, and frail versus pre-frail (OR = 1.68 [1.04–2.72]).ConclusionsIn a nationally representative sample of older adults in the U.S., using gold-standard hearing measures and a validated frailty phenotype, hearing loss and lack of hearing aid use was cross-sectionally associated with frailty and pre-frailty. Future longitudinal studies are needed to establish if hearing loss is a risk factor for frailty, which may have significant clinical importance.

Hearing Loss and Frailty among Older Adults: The Atherosclerosis Risk in Communities Study

ObjectivesHearing loss may contribute to frailty through cognitive and physical decline, but population-based evidence using validated measures remains scarce. We investigated the association of hearing loss with phenotypic frailty and its individual components and explored the potential protective role of hearing aid use. DesignCross-sectional study of community-dwelling older adults at visit 6 (2016–2017) of the Atherosclerosis Risk in Communities (ARIC) study, a cohort study of older adults from 4 U.S. communities (Washington County, MD; Forsyth County, NC; Jackson, MS; and Minneapolis, MN). Setting and ParticipantsPopulation-based study of 3179 participants (mean age = 79.2 years, 58.9% female). MethodsPure-tone audiometry at 0.5–4 kHz was used to assess unaided hearing, and the better-hearing ear's pure-tone average was categorized as follows: no [≤25 dB hearing level (HL)], mild (26–40 dB HL), and moderate or greater (>40 dB HL) hearing loss. Hearing aid use was self-reported. The Fried/physical frailty phenotype was used to categorize frailty status (robust, pre-frail, or frail). Multivariable multinomial and logistic regression models were used to study the association of hearing loss/hearing aid use with frailty status and individual frailty components, respectively. ResultsIn our sample, 40% had mild and 27% had moderate or greater hearing loss (12% and 55% reported hearing aid use, respectively). Moderate or greater hearing loss was associated with greater odds of being pre-frail [odds ratio (OR), 1.25; 95% CI, 1.01–1.57] and frail (OR, 1.62; 95% CI, 1.06–2.47) vs robust, and greater odds of having slow gait, low physical activity, and exhaustion, compared with no hearing loss. Among those with hearing loss (>25 dB HL), compared with hearing aid users, nonusers had greater odds of being frail vs robust, and having unintentional weight loss, slow gait, and low physical activity. Conclusions and ImplicationsHearing loss is associated with pre-frailty and frailty. Longitudinal studies are warranted to establish if hearing aid use may prevent or delay frailty onset.

Satisfaction with life in a sample of prelingually deaf cochlear implant users with a good command of spoken Polish as the primary language

IntroductionThis study investigated the level of satisfaction with life (SWL) in a group of cochlear implant (CI) users who had been prelingually deaf but were orally educated. They had received one or two CIs (as a child, adolescent, or adult) and were highly competent Polish speakers. This study looked at three factors that may affect SWL – psychosocial, deafness/hearing and communication related, and sociodemographic. MethodsThe participants were prelingually deaf CI users who had learned highly competent spoken Polish as their primary language. They had been educated in mainstream or integrated schools (not schools for the deaf), and had no other disability or severe illness. Measurements were done with 5 questionnaires: the Satisfaction With Life Scale (SWLS), the I–Others Questionnaire, the Patient Health Questionnaire (PHQ-9), the Deaf Identity Development Scale (DIDS), and the Nijmegen Cochlear Implant Questionnaire (NCIQ). ResultsThe SWL level of the group was similar to that of the standard Polish population. SWL was positively related to positive self-perception, acceptance of oneself as a deaf person, and to perceiving the benefits of having a CI (as measured by three NCIQ domains: self-esteem, activity limitations, and social interactions). On the other hand, negative self-perception, marginal deaf identity, and depressive symptoms were negatively related to SWL. There was no relationship between SWL and knowledge of sign language. Lower depressive symptoms and greater hearing loss were both significant predictors of SWL, although those who used two CIs generally had a lower SWL. ConclusionsPrelingually deaf CI users with low SWL require psychological support in many spheres, including working through problems of deaf identity, self-acceptance, and depression. Additional research should involve diverse DHH CI users, including those with limited spoken Polish competency or sign language skills, as well as members of the Polish Deaf community.

A Closer Look at Hearing Loss, Dementia, and Stigma

A Closer Look at Hearing Loss, Dementia, and Stigma

Hearing Impairment and Allostatic Load in Older Adults

Allostatic load, the cumulative strain that results from the chronic stress response, is associated with poor health outcomes. Increased cognitive load and impaired communication associated with hearing loss could potentially be associated with higher allostatic load, but few studies to date have quantified this association. To investigate if audiometric hearing loss is associated with allostatic load and evaluate if the association varies by demographic factors. This cross-sectional survey used nationally representative data from the National Health and Nutrition Examination Survey. Audiometric testing was conducted from 2003 to 2004 (ages 20-69 years) and 2009 to 2010 (70 years or older). The study was restricted to participants aged 50 years or older, and the analysis was stratified based on cycle. The data were analyzed between October 2021 and October 2022. A 4-frequency (0.5-4.0 kHz) pure tone average was calculated in the better-hearing ear and modeled continuously and categorically (<25 dB hearing level [dB HL], no hearing loss; 26-40 dB HL, mild hearing loss; ≥41 dB HL, moderate or greater hearing loss). Allostatic load score (ALS) was defined using laboratory measurements of 8 biomarkers (systolic/diastolic blood pressure, body mass index [calculated as weight in kilograms divided by height in meters squared], and total serum and high-density lipoprotein cholesterol, glycohemoglobin, albumin, and C-reactive protein levels). Each biomarker was assigned a point if it was in the highest risk quartile based on statistical distribution and then summed to yield the ALS (range, 0-8). Linear regression models adjusted for demographic and clinical covariates. Sensitivity analysis included using clinical cut points for ALS and subgroup stratification. In 1412 participants (mean [SD] age, 59.7 [5.9] years; 293 women [51.9%]; 130 [23.0%] Hispanic, 89 [15.8%] non-Hispanic Black, and 318 [55.3%] non-Hispanic White individuals), a modest association was suggested between hearing loss and ALS (ages 50-69 years: β = 0.19 [95% CI, 0.02-0.36] per 10 dB HL; 70 years or older: β = 0.10 [95% CI, 0.02-0.18] per 10 dB HL) among non-hearing aid users. Results were not clearly reflected in the sensitivity analysis with clinical cut points for ALS or modeling hearing loss categorically. Sex-based stratifications identified a stronger association among male individuals (men 70 years or older: β = 0.22 [95% CI, 0.12-0.32] per 10 dB HL; women: β = 0.08 [95% CI, -0.04 to 0.20] per 10 dB HL). The study findings did not clearly support an association between hearing loss and ALS. While hearing loss has been shown to be associated with increased risk for numerous health comorbidities, its association with the chronic stress response and allostasis may be less than that of other health conditions.

The Population Attributable Fraction of Dementia From Audiometric Hearing Loss Among a Nationally Representative Sample of Community-Dwelling Older Adults.

The population attributable fraction (PAF) of dementia from hearing loss (HL) in the United States is ~2% when incorporating self-reported HL measures. However, self-report might underestimate clinically significant audiometric HL among older adults. Here, we quantified PAFs of dementia from audiometric HL overall and by age, sex, and race/ethnicity groups among a nationally representative sample of community-dwelling older adults in the United States. We used cross-sectional data from Round 11 (2021) of the National Health and Aging Trends Study, a prospective cohort study representing the U.S. Medicare population aged 65+ years (N = 2 470). We estimated model-adjusted PAFs of prevalent dementia by audiometric HL (pure-tone averages: normal hearing, <26 dB HL; mild HL, 26-40 dB HL; moderate or greater HL, ≥41 dB HL). Among eligible participants (34.8% aged ≥80 years; 55.3% female; 82.4% non-Hispanic White), 37.5% had mild, and 28.8% had moderate or greater HL. Dementia prevalence overall was 10.6%, with the PAF predominately driven by moderate or greater HL (PAF = 16.9%; 95% confidence interval [CI]: 4.1-28.7%). The PAF from any degree of HL was larger but with a wider CI (PAF = 18.7%, 95% CI: -5.3% to 40.1%). There was evidence associations differed by sex but not age or race/ethnicity; moderate or greater HL exhibited stronger associations among males (PAF = 40.5%; 95% CI: 19.5% to 57.2%) than females (PAF = 3.2%; 95% CI: -12.7% to 17.9%). In a nationally representative sample of community-dwelling older adults in the United States, 17% of dementia cases were attributable to moderate or greater audiometric HL, an estimate that is eightfold higher relative to studies relying on self-reported hearing measures only.

Degree of Hearing Loss in Association with Site of Tympanic Membrane Perforation: A Systematic Review

Background: Tympanic Membrane perforation is commonly seen in a middle ear pathology called chronic otitis media that affects at least 0.5% of the total world population. Aim: To evaluate the nature of hearing loss in tympanic membrane perforation (TMP) based on the site of perforation. Study design: Systemic review. Methodology: All the articles were taken from Google Scholar, Cochrane Library, Pub Med, NCBI (NLM Catalog) and HEC Digital Library within five years range: 2017-2021. All the researchers were screened widely by a well-intentioned peer review group. Results: Articles (n=19) were included in the review. In case of site of perforation, most of the articles compared anterior site with posterior and central, depicting that posterior site causes more hearing loss than anterior site, while central perforations had greater hearing loss than anterior/posterior site. The total sample size of these 19 articles collectively was (n=1,650). Most severe hearing loss with respect to site of TM perforation was demonstrated in only 1 study (5.26%) out of 19 and that was 61-80 decibels. One study (5.26%) showed no correlation between hearing loss and site of TM perforation. Practical Implication: Sometimes, it is seen in ENT practices that there was a dilemma regarding the severity of hearing loss with respect to site of perforation. It benefited otolaryngologists to find a systematic review on the provided topic, to learn and know more about the association between hearing loss and site of TMP. Conclusion: We concluded that anterior sites of perforations cause less hearing loss than posterior, central or marginal. Keywords: Hearing loss; Tympanic membrane perforation; Site of TM perforation.

Tracking Early Atherosclerosis by Audiometry; A Review of Studies in a High Risk Population

Objectives: Increasing levels of atherosclerosis correlate with increasing degrees of hearing loss. We hypothesized that arterial inflammation observed on FDG-PET/CT scans correlates with audiogram test results and that Major Adverse Cardiovascular Events occur in subjects with severe hearing loss (&gt;40 dB). Methods: A FDG-PET/CT imaging prospective study was performed in an NIH trial including 115 rheumatoid arthritis subjects over age 50 without a history of cardiovascular disease, and 22 subjects were selected for concurrent audiograms. All were evaluated by 18-fluorodeoxyglucose positron emission tomography computed tomography scans and audiogram tests, at baseline and 6 months. In our institution, 320 similar RA subjects were identified over age 50 with no prior cardiovascular disease and chart review completed for 10 years to evaluate MACE occurrence. Audiograms were available for the 320 retrospective patients. Results: In the imaging study, at baseline there was a strong correlation between arterial inflammation on FDG-PET/CT and hearing test results (p&lt;0.002). Hearing loss over 30 decibels was strongly associated with high levels of inflammation on FDG-PET/CT imaging. In the larger 320 retrospective group, there were 11 MACE (3.4%) in the 10 years period which occurred in subjects with even greater hearing loss (average measurement was over 50 dB). Conclusion: Atherosclerosis was identified through FDG-PET/CT imaging studies and hearing tests. All MACE occurred in patients with significant hearing loss. Testing comprised a unique population with systemic inflammation from RA. If confirmed in larger studies in the general population, audiograms might provide a cost- effective substitute for FDG-PET/CT imaging and provide potentially an improved individual patient cardiovascular risk assessment. Audiograms may infer cardiovascular

RELATIONSHIP OF THE SIZE AND LOCATION OF THE TYMPANIC MEMBRANE PERFORATION IN CHRONIC SUPPURATIVE OTITIS MEDIA WITH THE MAGNITUDE OF HEARING LOSS

Chronic suppurative otitis media is a severe health condition that affects people worldwide. Perforation in the tympanic membrane reduces the surface area of the membrane available for sound transmission. It’s important to identify and treat tympanic membrane perforation as soon as possible, since untreated tympanic membrane perforation contributes to chronic disruptive changes in the middle ear, resulting in further hearing loss, which is a major physical and psychological issue that affects people’s lives. The study has been conducted to compare the relationship between the location and size of perforation of the tympanic membrane in chronic suppurative otitis media with the magnitude of hearing loss. The cross-sectional prospective study was conducted among 67 patients who visited the Otorhinolaryngology department for myringoplasty. The study period was from January to April 2021, the age group of patients was between 8 and 43 years old. The number of female participants was 35 (52.2%) and males – 32(47.8%) respectively. Average age ±SD was 21.93±9.47 years. Fifty (74.6%) patients had right ear perforation and seventeen (25.4%) with left ear perforation/ It was not statistically significant (χ2=22.891; p-value=0.290). Most of the patients were with subtotal of (all quadrants) 30 (44.77%), 2-3 quadrants, and one quadrant perforation were 23 (34.32%) and 14 (20.89%) respectively. Most of the patients, i.e.37 (55.22%), had hearing loss between 26-40dB. There was a significant connection between the perforation size and degree of hearing, (χ2=22.891; p-value &lt;0.0001). In one quadrant perforation, greatest hearing loss was on the post inferior quadrant 29.97±4.32 dB. For 2-3 quadrants perforation the hearing loss was greatest inpostero-superior combined with postero-inferior perforation 37.42±9,59dB. The most significant hearing loss was in subtotal perforation mean ±SD was 42.13±7.07dB. Hearing loss increases in proportion to the extent of the perforation, post inferior quadrant alone and combined with the post-super were observed with the greatest hearing loss according to the findings of this study.

Susceptibility to signal distortion in older listeners with hearing loss

Older adults show significant individual variability in hearing aid benefit. Our recent work has identified factors contributing to this individual variability including age, degree of hearing loss, and working memory. Specifically, older adults with greater hearing loss and poorer working memory are disadvantaged (poorer speech recognition) by signal distortions arising from adverse listening conditions and aggressive hearing aid signal processing settings. In this presentation, we focus on the range of signal distortions (quantified by a cepstral correlation metric) due to hearing aid signal processing such as amplitude compression, frequency lowering, and digital noise reduction, combined with different amounts and types of background noise. Across studies, we characterized individual susceptibility to signal distortions with a comprehensive set of conditions ranging from laboratory simulations to realistic listening conditions. Earlier studies considered omnidirectional settings and co-located speech and noise conditions, whereas recent work has focused on clinically realistic conditions such as wearable hearing aids, microphone directionality, and spatially-separated speech and multi-talker babble. We will discuss the clinical implications of these findings, particularly the impact on customizing hearing aid fittings to maximize benefit for older individuals. [Work is funded by NIDCD.]

Hearing loss is associated with increased risk of incident stroke but not coronary heart disease among middle-aged and older Chinese adults: the Dongfeng-Tongji cohort study.

Hearing loss has been associated with increased risk of cardiovascular disease (CVD) prevalence in cross-sectional studies. However, little is known about the prospective association between hearing loss and CVD incidence. We aimed to examine the associations of hearing loss with risk of incident CVD, coronary heart disease (CHD), and stroke in a Chinese population. We included 13,880 individuals aged 63.3years from the Dongfeng-Tongji cohort study (2013-2018). Hearing loss was categorized into normal, mild, moderate, severe, or greater by the pure-tone average of thresholds at speech and high frequency in both ears. Cox proportional hazard models and linear regression models were used for multivariate longitudinal analyses. After multivariate adjustments, we observed suggestive dose-response associations of increased high-frequency hearing loss with elevated risk of CVD and stroke incidence. Compared with normal hearing loss at high frequency, those with moderate and severe or greater hearing loss had a 4% (95% CI: 0.92, 1.18) or 13% (95% CI: 0.98, 1.30) higher risk of CVD and 52% (95% CI: 1.06, 2.17) or 51% (95% CI: 1.03, 2.20) higher risk of stroke, while the associations were almost consistent across most subgroups. No significant associations were observed for CHD and high-frequency hearing loss, as well as CVD and speech-frequency hearing loss. In addition, higher high-frequency hearing loss was related to unfavorably altered lipid profiles and fasting glucose. Our data suggested that increased hearing loss might increase the risk of incident CVD and stroke among middle-aged and older Chinese, which was partially explained by altered CVD-related biomarkers.

Examining the Combined Estimated Effects of Hearing Loss and Depressive Symptoms on Risk of Cognitive Decline and Incident Dementia.

Late-life depression is a comorbidity that may co-occur in older adults with hearing loss-each has prevalent and independent modifiable risk factors for dementia. Using data from 1,820 Health, Aging and Body Composition study participants (74 ± 2.8 years, 38% Black race), we compared the hearing loss-dementia/cognitive decline relationship between those with normal hearing/mild hearing loss and those with moderate or greater hearing loss. Using linear mixed-effects and Cox proportional hazard models, we investigated if the associations between hearing loss and cognitive decline or dementia (Modified Mini-Mental State [3MS] Examination and Digit Symbol Substitution Test [DSST]) differed by the presence or absence of depressive symptoms. Depressive symptoms were defined as Center for Epidemiologic Study-Depression scale 10 ≥10 at one or more visits from Years 1-5. Algorithmic incident dementia was defined using medication use, hospitalizations, and cognitive test scores. Audiometric hearing loss was measured at Year 5 and categorized as normal/mild versus moderate or greater hearing loss. Having both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS Examination (β = -0.30; 95% confidence interval [CI]: -0.78, -0.19) and DSST (β = -0.35; 95% CI: -0.67, -0.03) over 10 years of follow-up. Having both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio [HR]: 2.91; 95% CI: 1.59, 5.33 vs. HR: 1.54; 95% CI: 1.10, 2.15 hearing loss only and HR: 2.35; 95% CI: 1.56, 3.53 depressive symptoms only) of incident dementia in multivariable-adjusted Cox proportional hazards models. Comorbid conditions among hearing-impaired older adults should be considered and may aid in dementia prevention and management strategies.

Conductive Hearing Loss: A Case Report

Abstract In this case report, osteopathic manipulative treatment restored hearing to an 8-year-old female suffering from conductive hearing loss. Numerous factors can result in hearing loss. In children and adolescents, mild or greater hearing loss occurs with a prevalence of 3.1%.1 Current osteopathic literature focuses on conductive hearing loss due to middle ear effusion (MEE).This case report examines an 8-year-old female presumed to have permanent conductive hearing loss without MEE after a traumatic ATV accident. The use of osteopathic manipulative treatment (OMT) resulted in complete resolution of the patient’s conductive hearing loss. To the authors’ knowledge, this is the first case report documenting the successful use of OMT to treat conductive hearing loss without MEE. Being able to recognize and understand the connection between the primary respiratory mechanism (PRM), which includes the cranial bones and nerves, allows an osteopathic physician to provide a unique approach to patient care and the use of OMT as a treatment modality for conductive hearing loss should be considered.

An effectively causal deep learning algorithm to increase intelligibility in untrained noises for hearing-impaired listeners

Real-time operation is critical for noise reduction in hearing technology. The essential requirement of real-time operation is causality-that an algorithm does not use future time-frame information and, instead, completes its operation by the end of the current time frame. This requirement is extended currently through the concept of "effectively causal," in which future time-frame information within the brief delay tolerance of the human speech-perception mechanism is used. Effectively causal deep learning was used to separate speech from background noise and improve intelligibility for hearing-impaired listeners. A single-microphone, gated convolutional recurrent network was used to perform complex spectral mapping. By estimating both the real and imaginary parts of the noise-free speech, both the magnitude and phase of the estimated noise-free speech were obtained. The deep neural network was trained using a large set of noises and tested using complex noises not employed during training. Significant algorithm benefit was observed in every condition, which was largest for those with the greatest hearing loss. Allowable delays across different communication settings are reviewed and assessed. The current work demonstrates that effectively causal deep learning can significantly improve intelligibility for one of the largest populations of need in challenging conditions involving untrained background noises.

Effect of noise and ototoxicants on developing standard threshold shifts at a U.S. Air Force depot level maintenance facility

Noise exposure has traditionally been considered the primary risk factor for hearing loss. However, ototoxicants commonly found in occupational settings could affect hearing loss independently, additively, or synergistically when combined with noise exposures. The purpose of this investigation was to determine the combined effect of metal and solvent ototoxicants, continuous noise, and impulse noise on hearing loss. Noise and ototoxicant exposure and pure-tone audiometry results were analyzed for U.S. Air Force personnel (n = 2,372) at a depot-level aircraft maintenance activity at Tinker Air Force Base, Oklahoma. Eight similar exposure groups based on combinations of ototoxicant and noise exposure were created including: (1) Continuous noise (reference group); (2) Continuous noise + Impulse noise; (3) Metal exposures + Continuous noise; (4) Metal exposures + Continuous noise + Impulse noise; (5) Solvent exposure + Continuous noise; (6) Solvent exposures + Continuous noise + Impulse noise; (7) Metal exposure + Solvent exposures + Continuous noise; and (8) Metal exposure + Solvent exposures + Continuous noise + Impulse noise. Hearing loss was assessed at center octave band frequencies of 500–6,000 Hz and using National Institute for Occupational Safety and Health Standard Threshold Shift (STS) criteria. Hearing changes were significantly worse at 2,000 Hz in the Metal exposure + Solvent exposure + Continuous noise group compared to the Continuous noise only reference group (p = 0.023). The Metal exposure + Solvent exposure + Continuous noise group had a significantly greater relative risk (RR) of 2.44; 95% CI [1.24, 4.83] for developing an STS at 2,000 Hz. While not statistically significant, the Solvent exposure + Continuous noise group had a RR of 2.32; 95%CI [1.00, 5.34] for developing an STS at 1,000 Hz. These results indicate that noise exposure may dominate hearing loss at ≥3,000 Hz while combined effects of concomitant exposure to ototoxic substances and noise are only noticeable at ≤2,000 Hz. These results also suggest combined exposures to ototoxicants and noise presents a greater hearing loss risk than just noise.

ASSESSMENT OF OUTCOME OF TYMPANOPLASTY TYPE-1 ON HEARING AND CONTRIBUTING FACTORS

Aim:To assess the effect of size of perforation on the hearing loss and on the degree of improvement after myringoplasty. Materials and methods: In the present study a series of 100 patients of Tympanoplasty Type I, done by postaural underlay technique using temporalis fascia were studied over a period of 18 months (May 2019 to May 2020). Age of the patient ranged from 10-50 years with an average of 24.9 years. Out of 100 cases 41 were males and 59 were females. The average length of time the ear remained dry prior to surgery was 14 months ranging from 2 months to 6 years. Result:It was seen that the size of the perforation signicantly affects the degree of hearing loss and degree of subsequent improvement after Tympanoplasty Type I; large and medium size perforation had greater hearing loss and greater postoperative hearing improvement compared to small perforations which was statistically signicant (P&lt;0.05). Conclusion: The only factor which signicantly inuenced the hearing outcome post operatively is the size of the perforation. The size of the perforation affects the degree of hearing loss and degree of subsequent improvement after Type I Tympanoplasty; large and medium sized perforations had a greater hearing loss and greater post operative hearing improvement compared to small perforations.