Hearing In Older Adults Research Articles

Association Between Retinal Pathology and Hearing in Older Adults

AbstractWe investigated the association between retinal microvascular changes and hearing loss based on the hypothesis that both may result from shared microvascular pathology. Data from 536 older adults from the National Health and Nutritional Examination Survey 2005 to 2006 including sociodemographic and health characteristics, pure‐tone hearing thresholds, and retinal pathologies were collected and analyzed. Associations between retinal and hearing pathologies were modeled with multivariable‐adjusted linear regressions. 75% of participants had hearing loss and 15% of participants had retinopathy. The association between retinopathy, microaneurysms, and blot hemorrhages with better speech‐frequency pure tone average was −2.81 (95% confidence interval [CI]: −5.72 to 0.10), −4.75 (95% CI: −8.73 to −0.78), and −5.34 (95% CI: −8.68 to −2.00), respectively. The presence of retinopathy, microaneurysms, and blot hemorrhages was inversely associated with hearing loss. Further studies are needed to better understand the potential relationship between microvascular pathologies of the eye and ear.

Assessment of Vision and Hearing in Older Adults.

Alicia Naccarato, BS, SPT, is a Student Physical Therapist, Physical Therapy Program, Human Movement Science Program, School of Health Science, Oakland University, Rochester, Michigan. Christopher Wilson, PT, DPT, DScPT, is a Board-Certified Geriatric Clinical Specialist, and Associate Professor, Physical Therapy Program, School of Health Sciences, Oakland University, Rochester, Michigan. The authors declare no conflicts of interest. Address for correspondence: Christopher Wilson, PT, DPT, DScPT, Physical Therapy Program, 433 Meadow Brook Dr., Oakland University, Rochester, MI 48301-4401 ([email protected]).

Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review.

Background:Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed.Objective:To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs.Methods:Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O’Malley’s scoping review and appraisal process was followed.Results:There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs.Conclusion:Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.

Decoding Hearing-Related Changes in Older Adults' Spatiotemporal Neural Processing of Speech Using Machine Learning.

Speech perception in noisy environments depends on complex interactions between sensory and cognitive systems. In older adults, such interactions may be affected, especially in those individuals who have more severe age-related hearing loss. Using a data-driven approach, we assessed the temporal (when in time) and spatial (where in the brain) characteristics of cortical speech-evoked responses that distinguish older adults with or without mild hearing loss. We performed source analyses to estimate cortical surface signals from the EEG recordings during a phoneme discrimination task conducted under clear and noise-degraded conditions. We computed source-level ERPs (i.e., mean activation within each ROI) from each of the 68 ROIs of the Desikan-Killiany (DK) atlas, averaged over a randomly chosen 100 trials without replacement to form feature vectors. We adopted a multivariate feature selection method called stability selection and control to choose features that are consistent over a range of model parameters. We use parameter optimized support vector machine (SVM) as a classifiers to investigate the time course and brain regions that segregate groups and speech clarity. For clear speech perception, whole-brain data revealed a classification accuracy of 81.50% [area under the curve (AUC) 80.73%; F1-score 82.00%], distinguishing groups within ∼60 ms after speech onset (i.e., as early as the P1 wave). We observed lower accuracy of 78.12% [AUC 77.64%; F1-score 78.00%] and delayed classification performance when speech was embedded in noise, with group segregation at 80 ms. Separate analysis using left (LH) and right hemisphere (RH) regions showed that LH speech activity was better at distinguishing hearing groups than activity measured in the RH. Moreover, stability selection analysis identified 12 brain regions (among 1428 total spatiotemporal features from 68 regions) where source activity segregated groups with >80% accuracy (clear speech); whereas 16 regions were critical for noise-degraded speech to achieve a comparable level of group segregation (78.7% accuracy). Our results identify critical time-courses and brain regions that distinguish mild hearing loss from normal hearing in older adults and confirm a larger number of active areas, particularly in RH, when processing noise-degraded speech information.

Carotid Atherosclerosis Is Associated With Poorer Hearing in Older Adults

ObjectivesCardiovascular disease may be linked to hearing loss through narrowing of the nutrient arteries of the cochlea, but large-scale population-based evidence for this association remains scarce. We investigated the association of carotid atherosclerosis as a marker of generalized cardiovascular disease with hearing loss in a population-based cohort. DesignCross-sectional. SettingA population-based cohort study. Participants3724 participants [mean age: 65.5 years, standard deviation (SD): 7.5, 55.4% female]. MethodsUltrasound and pure-tone audiograms to assess carotid atherosclerosis and hearing loss. ResultsWe investigated associations of carotid plaque burden and carotid intima-media thickness (IMT) (overall and side-specific carotid atherosclerosis) with hearing loss (in the best hearing ear and side-specific hearing loss) using multivariable linear and ordinal regression models. We found that higher maximum IMT was related to poorer hearing in the best hearing ear [difference in decibel hearing level per 1-mm increase in IMT: 2.09 dB, 95% confidence interval (CI): 0.08, 4.10]. Additionally, third and fourth quartile plaque burden as compared to first quartile was related to poorer hearing in the best hearing ear (difference: 1.06 dB, 95% CI: 0.04, 2.08; and difference: 1.55 dB, 95% CI: 0.49, 2.60, respectively). Larger IMT (difference: 2.97 dB, 95% CI: 0.79, 5.14), third quartile plaque burden compared to first quartile (difference: 1.24 dB, 95% CI: 0.14, 2.35), and fourth plaque quartile compared to first quartile (difference: 2.12 dB, 95% CI: 0.98, 3.26) in the right carotid were associated with poorer hearing in the right ear. Conclusions and ImplicationsCarotid atherosclerosis is associated with poorer hearing in older adults, almost exclusively with poorer hearing in the right ear. Based on our results, it seems that current therapies for the prevention of cardiovascular disease may also prove beneficial for hearing loss in older adults by promoting and maintaining inner ear health.

Hot topics in speech, language & Hearing in older adults - special issue 2019

Hot topics in speech, language & Hearing in older adults - special issue 2019

The Association between Hearing Loss, Postural Control, and Mobility in Older Adults: A Systematic Review.

Degraded hearing in older adults has been associated with reduced postural control and higher risk of falls. Both hearing loss (HL) and falls have dramatic effects on older persons' quality of life (QoL). A large body of research explored the comorbidity between the two domains. The aim of the current review is to describe the comorbidity between HL and objective measures of postural control, to offer potential mechanisms underlying this relationship, and to discuss the clinical implications of this comorbidity. PubMed and Google Scholar were systematically searched for articles published in English up until October 15, 2015, using combinations of the following strings and search words: for hearing: Hearing loss, "Hearing loss," hearing, presbycusis; for postural control: postural control, gait, postural balance, fall, walking; and for age: elderly, older adults. Of 211 screened articles, 7 were included in the systematic review. A significant, positive association between HL and several objective measures of postural control was found in all seven studies, even after controlling for major covariates. Severity of hearing impairment was connected to higher prevalence of difficulties in walking and falls. Physiological, cognitive, and behavioral processes that may influence auditory system and postural control were suggested as potential explanations for the association between HL and postural control. There is evidence for the independent relationship between HL and objective measures of postural control in the elderly. However, a more comprehensive understanding of the mechanisms underlying this relationship is yet to be elucidated. Concurrent diagnosis, treatment, and rehabilitation of these two modalities may reduce falls and increase QoL in older adults.

Hearing in older adults with exfoliation syndrome/exfoliation glaucoma or primary open-angle glaucoma.

To determine whether adults, aged 66-96 years, with exfoliation syndrome (XFS)/exfoliation glaucoma (XFG), or primary open-angle glaucoma (POAG) have poorer hearing than controls of similar age. Case (XFS/XFG and POAG) and control status was diagnosed in the Reykjavik Glaucoma Studies (RGS) using slit-lamp examination, visual field testing and optic disc photographs; the RGS data were merged with the Age, Gene/Environment Susceptibility-Reykjavik Study that collected hearing data using air-conduction, pure-tone thresholds obtained at 0.5, 1, 2, 3, 4, 6 and 8 kHz categorized by better ear and worse ear, based on pure-tone averages (PTAs) calculated separately for low and middle frequencies (PTA512 - mean of thresholds at 0.5, 1 and 2 kHz) and high frequencies (PTA3468 - mean of thresholds at 3, 4, 6 and 8 kHz). Multivariable linear regression was used to test for differences in PTAs between cases and controls. The mean age for 158 XFS/XFG cases (30.4% male) was 77.4 years, 95 POAG cases (35.8% male) was 77.9 years, and 123 controls (46.3% male) was 76.8 years. Using multivariable linear regression analysis, there were no consistent, statistically significant differences in PTAs between the two case groups and controls in either the low- or high-frequency range, even when stratified by age group. Among the older individuals examined in this study hearing loss is highly prevalent and strongly associated with male gender and increasing age. As we did not find consistent statistically significant difference in hearing between cases and controls the diagnosis of XFS/XFG or POAG does not as such routinely call for audiological evaluation.

Introduction to the AJA Research Forum on Intervention and Rehabilitation Strategies for Adults and Older Adults

PURPOSE To give an overview of the third in a series of research forums emerged from the second International Conference on Adult Hearing Screening (AHS 2012), which was held in Cernobbio (Lake Como, Italy) in June 2012. The first two research forums, published in the previous and current issues of this journal, included several key contributions from the AHS meeting in 2 major topic areas, "Hearing Screening in Adults and Older Adults" (Vol. 22, June 2013) and "Aging and Hearing: Mechanisms and Effects" (this issue). In the 7 articles showcased in this Research Forum on "Intervention and Rehabilitation Strategies for Adults and Older Adults," the authors provide a multifaceted view on recent advancements in intervention strategies for adults with hearing loss, with ample emphasis on auditory training; discuss the research challenges that need to be tackled in this field; and explore new ways to take into account the individual needs and obtain a deeper understanding of the peculiar attributes of hearing in older adults.

White Matter Hyperintensities Predict Low Frequency Hearing in Older Adults

Vascular disease has been proposed as a contributing factor for presbyacusis (age-related hearing loss). While this hypothesis is supported by pathological evidence of vascular decline in post-mortem human and animal studies, evidence in human subjects has been mixed with associations typically reported between a measure of vascular health and low frequency hearing in older women. Given the difficulty of characterizing the in vivo health of the cochlear artery in humans, an estimate of cerebral small vessel disease was used to test the prediction that age-related change in low frequency hearing and not high frequency hearing is related to a global decline in vascular health. We examined the extent to which these associations were specific to women and influenced by a history of high blood pressure in 72 older adults (mean age 67.12 years, SD = 8.79). Probability estimates of periventricular white matter hyperintensities (WMH) from T1- and fluid attenuated T2-weighted magnetic resonance images were significantly associated with a low frequency hearing metric across the sample, which were independent of age, but driven by women and people with a history of high blood pressure. These results support the premise that vascular declines are one mechanism underlying age-related changes in low frequency hearing.

Aging and the Perception of Temporally Interleaved Words

The purpose of this study was to examine differences between older and younger listeners in the ability to sequentially attend to and ignore words. Participants (n = 13 older adults and 13 younger adults) completed a temporally interleaved word recognition task. On each trial, 10 words were presented, and participants were instructed to repeat back every other word while ignoring the intervening words. Three variables were examined: (1) whether the word strings that were to be attended and to be ignored created syntactically correct sentences; (2) whether the to-be-attended and to-be-ignored words were presented from the same or from different spatial locations; and (3) whether the five target words in each trial (and the five distractor words in each trial) were spoken by a single talker or by five different talkers. In addition, digit-span forward and digit-span backward were measured and used as variables in correlation analyses. As a group, the younger participants outperformed the older listeners, particularly when the to-be-attended and to-be-ignored words were presented from the same spatial location (versus when they were presented with spatial separation). Compared with the younger participants, older listeners also made more error responses that were to-be-ignored words, although the proportion of errors that were not responses involving masking words did not significantly differ between groups. Scores on the digit-span-forward test (but not digit-span-backward scores or the degree of hearing loss) were associated with older individuals' performance on this temporally interleaved speech-recognition task. The overall pattern of results suggests that factors other than threshold elevation contribute to speech-understanding problems experienced by older listeners. However, although younger adults outperformed older listeners on this interleaved sentence task, older and younger adults benefited, to a similar extent, from spatial separation of the to-be-attended and to-be-ignored words, and from having a consistent target talker within a trial.

Effects of Folic Acid Supplementation on Hearing in Older Adults

Age-related hearing loss is a common chronic condition of elderly persons. Low folate status has been associated with poor hearing. To determine whether folic acid supplementation slows age-related hearing loss. Double-blind, randomized, placebo-controlled trial conducted from September 2000 to December 2004. The Netherlands. 728 older men and women recruited from municipal and blood bank registries with plasma total homocysteine concentrations 13 micromol/L or greater serum and vitamin B12 concentrations 200 pmol/L or greater at screening, and no middle ear dysfunction, unilateral hearing loss, or pathologic ear conditions unrelated to aging. Daily oral folic acid (800 microg) or placebo supplementation for 3 years. 3-year change in hearing thresholds, assessed as the average of the pure-tone air conduction thresholds of both ears of the low (0.5-kHz, 1-kHz, and 2-kHz) and high (4-kHz, 6-kHz, and 8-kHz) frequencies. Initial median hearing thresholds were 11.7 dB (interquartile range, 7.5 to 17.5 dB) for low frequencies and 34.2 dB (interquartile range, 22.5 to 50.0 dB) for high frequencies. Sixteen participants (2%) were lost to follow-up. After 3 years, thresholds of the low frequencies increased by 1.0 dB (95% CI, 0.6 to 1.4 dB) in the folic acid group and by 1.7 dB (CI, 1.3 to 2.1 dB) in the placebo group (difference, -0.7 dB [CI, -1.2 to -0.1 dB]; P = 0.020). Folic acid supplementation did not affect the decline in hearing high frequencies. The strict criterion for participation on the basis of serum homocysteine concentrations limits extrapolation to the general population. Folic acid fortification of food was prohibited in the Netherlands during the study, so baseline folate levels in participants were about half of those found in the U.S. population. Folic acid supplementation slowed the decline in hearing of the speech frequencies associated with aging in a population from a country without folic acid fortification of food. The effect requires confirmation, especially in populations from countries with folic acid fortification programs. Clinicaltrials.gov identifier: NCT00110604.

The Effect of Folic Acid on Hearing in Older Adults

The Effect of Folic Acid on Hearing in Older Adults