Related Hearing Loss Research Articles

ASSESSMENT OF RISK FACTORS AND FOLLOW-UP OUTCOMES FOR HEARING LOSS IN HIGH-RISK NEONATES

Objective: Hearing loss in neonates, particularly those in high-risk categories such as NICU graduates, can significantly impede speech, cognitive, and psychosocial development. Early detection and management are pivotal to mitigating these risks. Methods: A prospective observational study was conducted on 425 neonates at SDM Medical College and Hospital, utilizing Otoacoustic Emissions (OAE) for initial auditory screening. This study assessed the incidence of hearing loss in relation to neonatal risk factors, including birth weight, ABO incompatibility, and maternal health conditions. Results: A majority of the neonates (58.82%) were screened within 3-7 d post-birth. Notable risk factors impacting hearing outcomes included low birth weight, with 11.53% of neonates weighing between 1.0 and 1.50 kg. The initial failure rates in OAE screenings were low, with 2.59% failing in the right ear, 1.18% in the left, and 0.94% in both ears. Conclusion: The study underscores the efficacy of early hearing screenings in identifying potential hearing loss in neonates, especially those exposed to multiple risk factors. Continuous and comprehensive monitoring is crucial for these high-risk groups to facilitate timely and effective interventions.

A TBC1D24 gene variant coincides with STRC compound heterozygosity in a family with hearing loss: a case report

BackgroundHearing loss is a common inborn neurosensory condition. Hearing loss is very heterogeneous, and while screening programs exist for children, adolescents and adults with late-onset hearing loss often do not get referrals to geneticists.ObjectiveTo diagnose the cause of hearing impairment in two related late-onset hearing loss patients—father and son—on a molecular level. Both underwent audiological examinations, and both had moderate hearing loss.Case presentation.We used massive parallel sequencing, Sanger sequencing, MLPA, and standard audiological methods. We identified an inherited autosomal dominant likely causative variant in the TBC1D24 gene of both patients. They did not show any other TBC1D24 spectrum-related symptoms. Furthermore, the younger patient was found to be compound heterozygous for two variants in STRC gene.ConclusionsOnly a few dozen TBC1D24 hearing loss patients have been reported. On the contrary, STRC is a common hearing loss cause. We speculate that in the younger patient, the phenotype is caused by a combination of effects of both genes. The older patient’s phenotype is more likely caused only by the TBC1D24 variant. We believe that more attention should be paid to adolescent and adult-onset hearing loss patients, and more frequent referrals to geneticists are warranted.

Natural history of otitis media with effusion-related hearing loss in children under 12 years: a systematic review

ObjectiveTo assess natural history of otitis media with effusion (OME)-related hearing loss and OME causing hearing loss in children under 12 years.MethodsEmbase, MEDLINE, CINAHL, INAHTA database, CENTRAL, CDSR, Epistemonikos and...

Auditory Prognosis of Patients With Sudden Sensorineural Hearing Loss in Relation to the Presence of Acute Vestibular Syndrome: A Systematic Literature Review and Meta-Analysis.

Hearing recovery following idiopathic sudden sensorineural hearing loss (ISSNHL) is influenced by various prognostic factors, and the presence of acute vestibular syndrome (AVS) may adversely impact auditory outcomes. Evaluating vestibular function in SSNHL patients could offer insights into predicting hearing recovery. This systematic review aims to assess whether the presence of AVS exacerbates the audiological prognosis of ISSNHL. A comprehensive systematic review was conducted using databases such as PubMed, Cochrane Library, EMBASE, and Scopus, encompassing articles published in the last decade. Included were retrospective and prospective case-control and cohort studies, as well as randomized clinical trials. Meta-analysis was performed based on the findings from these studies. Among 386 articles identified, six addressed the systematic review's question, all being retrospective studies. These articles collectively involved 393 patients for the meta-analysis. Vestibular function assessment methods varied widely, posing challenges for direct comparisons. The likelihood of unfavorable hearing outcomes was 2.29 times higher in patients with associated AVS. Hearing recovery was 3.22 times more likely to be worse in patients with altered cervical vestibular evoked myogenic potentials-air-conducted sound. Abnormal caloric test results showed no significant association with worse hearing prognosis, although patients with unaltered caloric tests demonstrated a significantly greater improvement in pure-tone audiometry. Hearing recovery from ISSNHL appears to be diminished in patients with associated AVS and abnormal vestibular test results.

Risk of hearing loss in the opposite ear after tympanomastoidectomy.

The definitive treatment for chronic suppurative otitis media is surgery. Surgical technique and procedure varies according to individual case findings and pathology and may require mastoidectomies in which the canal wall is preserved or lowered to eradicate disease from mastoid air cells. Surgical treatment of chronic middle ear disease carries a risk of damage to the inner ear. The aim of this study was to investigate whether the noise produced by the tour system following chronic ear surgery causes sensorineural hearing loss, a condition for which not many studies have been published in the literature. The study consisted of a total of 49 patients with type I, type II and type III canal wall preservation and 62 patients with tympanoplasty with canal wall preservation and lowering. Bone and air thresholds were compared before and after middle ear surgery. Changes in bone and air thresholds were compared according to the type of tympanoplasty. In the ICW-I, ICW-II and ICW-III tympanoplasties, and in the ICW and CWD tympanoplasties, the preoperative and postoperative values of the opposite ear hearing measurements were performed, and did not differ according to the type of surgery. There is no correlation drilling duration and hearing for the opposite ear. The prevention of postoperative sensorineural hearing loss depends on multiple factors, and assessing the magnitude of hearing loss in relation to these factors is important in determining the success of the surgery.

Understanding pediatric inpatient conductive hearing loss: An analysis of patient demographics

ObjectiveHearing loss is a common sensory impairment in children that affects quality of life and development. Early intervention, such as hearing aids and communication therapies, can help children overcome these challenges and lessen the impact on their development. The objective of this study was to identify specific patient demographic factors correlated with the prevalence of pediatric conductive hearing loss. Study designThe study utilized the Kids' Inpatient Database (KID) by the Agency for Healthcare Research and Quality which collects inpatient information from hospitals for patients under 21 years old. We included all patients discharged in 2016 diagnosed with conductive hearing loss, and excluded neonatal patients discharged within 28 days of birth. MethodsStatistical analyses were performed using R Studio and IBM SPSS Statistics. Weighted odds ratios were calculated for conductive hearing loss in relation to race and income, and a multivariate regression analysis examined associations between demographic variables and race categories in conductive hearing loss. ResultsThe prevalence of conductive hearing loss (CHL) in pediatric patients in 2016 was 51.62 cases per 100,000 patients. Non-Hispanic White patients had the highest prevalence, while Black patients had the highest likelihood of CHL compared to the overall population. Lower income levels were associated with a decreased probability of CHL diagnosis. After adjusting for age, sex, hospital region, insurance, and income on multivariate analysis, White and Black patients were less likely to be diagnosed with CHL. Furthermore, patients in specific income quartiles also had lower CHL likelihood compared to the general population. ConclusionWhile Black patients had a higher likelihood of being diagnosed with CHL than the general population, socioeconomic factors such as income greatly influenced the likelihood of CHL diagnosis. Other significant factors included income, region of the country, sex, and age. Further research is needed to better understand and address healthcare disparities related to pediatric hearing loss.

Losartan May Not Prevent Vestibular Schwannoma Growth or Related Hearing Loss During Observation.

To evaluate the impact of losartan on vestibular schwannoma (VS) growth and related hearing loss during observation. Retrospective cohort study. Tertiary referral center. Sporadic VS patients undergoing initial observation with at least two magnetic resonance imaging and audiologic examinations. Losartan. Endpoints included VS growth, quantitative audiologic changes, survival free of tumor growth, and survival free of nonserviceable hearing. Patient characteristics and endpoints were compared by losartan use. Seventy-nine patients were included, of which 33% were taking losartan. Tumor growth was observed in 50% of patients in the losartan group and 36% in the non-losartan group (p = 0.329). Survival analysis failed to show a significant difference in the hazard rate of VS growth between groups (hazard ratio, 1.38; 95% confidence interval, 0.70-2.70; p = 0.346). Throughout observation, mean decreases in normalized pure-tone average were 5.5 and 9.3 dB in the losartan and non-losartan groups, respectively (p = 0.908). Mean decreases in normalized word recognition score were 11.0 and 16.6% in the losartan and non-losartan groups, respectively (p = 0.757). Nonserviceable hearing developed in 19% of patients in the losartan group and 28% in the non-losartan group (p = 0.734). Survival analysis did not demonstrate a significant difference in the hazard rate of developing nonserviceable hearing between groups (hazard ratio, 1.71; 95% confidence interval, 0.56-5.21; p = 0.337). Losartan use may not reduce the risk of VS growth or hearing loss during observation. A randomized trial would be ideal to further identify the true effect on growth and hearing.

Hearing loss in Australian First Nations children at 6-monthly assessments from age 12 to 36 months: Secondary outcomes from randomised controlled trials of novel pneumococcal conjugate vaccine schedules.

In Australian remote communities, First Nations children with otitis media (OM)-related hearing loss are disproportionately at risk of developmental delay and poor school performance, compared to those with normal hearing. Our objective was to compare OM-related hearing loss in children randomised to one of 2 pneumococcal conjugate vaccine (PCV) formulations. In 2 sequential parallel, open-label, randomised controlled trials (the PREVIX trials), eligible infants were first allocated 1:1:1 at age 28 to 38 days to standard or mixed PCV schedules, then at age 12 months to PCV13 (13-valent pneumococcal conjugate vaccine, +P) or PHiD-CV10 (10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine, +S) (1:1). Here, we report prevalence and level of hearing loss outcomes in the +P and +S groups at 6-monthly scheduled assessments from age 12 to 36 months. From March 2013 to September 2018, 261 infants were enrolled and 461 hearing assessments were performed. Prevalence of hearing loss was 78% (25/32) in the +P group and 71% (20/28) in the +S group at baseline, declining to 52% (28/54) in the +P groups and 56% (33/59) in the +S group at age 36 months. At primary endpoint age 18 months, prevalence of moderate (disabling) hearing loss was 21% (9/42) in the +P group and 41% (20/49) in the +S group (difference -19%; (95% confidence interval (CI) [-38, -1], p = 0.07) and prevalence of no hearing loss was 36% (15/42) in the +P group and 16% (8/49) in the +S group (difference 19%; (95% CI [2, 37], p = 0.05). At subsequent time points, prevalence of moderate hearing loss remained lower in the +P group: differences -3%; (95% CI [-23, 18], p = 1.00 at age 24 months), -12%; (95% CI [-30, 6], p = 0.29 at age 30 months), and -9%; (95% CI [-23, 5], p = 0.25 at age 36 months). A major limitation was the small sample size, hence low power to reach statistical significance, thereby reducing confidence in the effect size. In this study, we observed a high prevalence and persistence of moderate (disabling) hearing loss throughout early childhood. We found a lower prevalence of moderate hearing loss and correspondingly higher prevalence of no hearing loss in the +P group, which may have substantial benefits for high-risk children, their families, and society, but warrant further investigation. ClinicalTrials.gov NCT01735084 and NCT01174849.

The Association between Untreated and Treated Hearing Loss and Cognitive Performance in Men and Women Aged 60-96 Years: Data from the Swedish "Good Aging in Skåne" Population Study.

Background/Objectives: Recent decades have witnessed a sharp increase in research investigating the association between hearing loss and cognitive impairment. Few previous studies have stratified for sex when investigating this issue, where results were inconsistent and require further clarification. Thus, the objective was to investigate the association between self-reported hearing loss and levels of cognitive impairment, stratified for sex. Methods: In this cross-sectional study, data were collected from 2001 to 2016. The study sample consisted of 5075 individuals, 2325 (45.8%) men, mean age 68.3 years, and 2750 (54.2%) women, mean age 70.0 years. Multiple variate ordinal regression models were constructed and adjusted for age, marital status, education, physical activity, depressive mood, hypertension, stroke, diabetes, and use of sedatives to investigate associations between groups of self-reported untreated and treated hearing loss and those reporting no hearing loss in relation to levels of cognitive impairment assessed by the Mini-Mental State Examination scale. Results: In men, treated hearing loss was associated with levels of cognitive impairment, odds ratio (OR) = 1.64, 95% confidence interval (CI) = 1.14-2.36. In women, both untreated hearing loss, (OR = 1.45, CI 1.07-1.98) and treated hearing loss (OR= 1.46, CI 1.06-2.04) were associated with levels of cognitive impairment. Conclusions: Hearing loss was found to be associated with cognitive impairment despite hearing aid use as well as awareness amongst physicians. The introduction of screening programs for hearing loss in older adults could be a crucial step for earlier identification of individuals at higher risk of developing cognitive impairment and dementia.

Analysis of a mathematical model with hybrid fractional derivatives under different kernel for hearing loss due to mumps virus

ABSTRACT Genetics, birth defects, some viral diseases, persistent ear infections, medications, loud noises, and age can all cause hearing loss, a global health issue. The mumps are typically the cause of unilaterally acquired sensorineural hearing loss in children. A hybrid fractional operator model employing Constant Proportional Caputo (CPC), Constant Proportional Caputo Fabrizio (CPCF), and Constant Proportional Atangana-Baleanu Caputo (CPABC) in the Caputo sense is developed to investigate mumps induced hearing loss in children. We focused on the region that is positively invariant and well-posed in the suggested model. We assessed the endemic and disease free equilibrium, reproductive number, strength number, and parameter sensitivity, and examined the global stability of the proposed system. The existence, uniqueness, and Hilfer generalized proportional operators for the constant of proportionality of the system’s solutions are demonstrated using fixed-point theorems. We simulated a system of fractional differential equations analytically using the Laplace Adomian Decomposition Method (LADM). This study is important since it is the first to model mumps related hearing loss using a fractional order model based on hybrid fractional operators without a singular kernel. The fractional-order derivative retains the system memory effect, is nonlocal, and outperforms the integer-order derivative in this regard. This sort of study aids medical professionals in diagnosis, treatment planning, and decision-making for mumps induced hearing loss.

Identification of common stria vascularis cellular alteration in sensorineural hearing loss based on ScRNA-seq.

The stria vascularis (SV), located in the lateral wall of the cochlea, maintains cochlear fluid homeostasis and mechanoelectrical transduction (MET) activity required for sound wave conduction. The pathogenesis of a number of human inheritable deafness syndromes, age related hearing loss, drug-induced ototoxicity and noise-induced hearing loss results from the morphological changes and functional impairments in the development of the SV. In this study, we investigate the implications of intercellular communication within the SV in the pathogenesis of sensorineural hearing loss (SNHL). We aim to identify commonly regulated signaling pathways using publicly available single-cell transcriptomic sequencing (scRNA-seq) datasets. We analyzed scRNA-seq data, which was derived from studying the cochlear SV in mice with SNHL compared to normal adult mice. After quality control and filtering, we obtained the major cellular components of the mouse cochlear SV and integrated the data. Using Seurat's FindAllMarkers and FindMarkers packages, we searched for novel conservative genes and differential genes. We employed KEGG and GSEA to identify molecular pathways that are commonly altered among different types of SNHL. We utilized pySCENIC to discover new specific regulatory factors in SV subpopulation cells. With the help of CellChat, we identified changes in subpopulation cells showing similar trends across different SNHL types and their alterations in intercellular communication pathways. Through the analysis of the integrated data, we discovered new conserved genes to SV specific cells and identified common downregulated pathways in three types of SNHL. The enriched genes for these pathways showing similar trends are primarily associated with the Electron Transport Chain, related to mitochondrial energy metabolism. Using the CellChat package, we further found that there are shared pathways in the incoming signaling of specific intermediate cells in SNHL, and these pathways have common upstream regulatory transcription factor of Nfe2l2. Combining the results from pySCENIC and CellChat, we predicted the transcription factor Nfe2l2 as an upstream regulatory factor for multiple shared cellular pathways in IC. Additionally, it serves as an upstream factor for several genes within the Electron Transport Chain. Our bioinformatics analysis has revealed that downregulation of the mitochondrial electron transport chain have been observed in various conditions of SNHL. E2f1, Esrrb, Runx1, Yy1, and Gata2 could serve as novel important common TFs regulating the electron transport chain. Adm has emerged as a potential new marker gene for intermediate cells, while Itgb5 and Tesc show promise as potential new marker genes for marginal cells in the SV. These findings offer a new perspective on SV lesions in SNHL and provide additional theoretical evidence for the same drug treatment and prevention of different pathologies of SNHL.

Self-reporting of hearing loss and tinnitus in the diagnosis of ototoxicity by meglumine antimoniate in patients treated for American tegumentary Leishmaniasis.

American Tegumentary Leishmaniasis (ATL) treatment is based on pentavalent antimonials (Sb5+), but these drugs have been associated to several adverse effects. Hearing loss and tinnitus during treatment with meglumine antimoniate (MA) have already been reported. This study aimed to describe the usefulness of self-reporting of hearing loss and tinnitus in diagnosing MA-induced ototoxicity. A prospective longitudinal study was conducted with 102 patients with parasitological diagnosis of ATL, treated with different MA schemes. The presence of clinical auditory toxicity was defined as the emergence or worsening of self-reporting hearing loss and/or tinnitus during monitoring. Measures of sensitivity, specificity, and the positive and negative predictive value of the patient's self-reporting of hearing loss and tinnitus in relation to the result of the audiometric test (considered the gold standard) were calculated. The age of the evaluated patients ranged from 15 to 81 years, with a median of 41 years, and most were male (73.5%). Seventy-five patients (73.5%) had cutaneous leishmaniasis and 27 (26.5%) mucosal leishmaniasis. Eighty-six patients (84.3%) received intramuscular (IM) treatment and 16 (15.7%) were treated with intralesional MA. During treatment, 18 (17,6%) had tinnitus and 7 (6,9%) had complaint of hearing loss. 53 (52%) patients had cochlear toxicity confirmed by tone threshold audiometry and high frequency audiometry, from which 60% received a dose of 20 mg Sb5+/kg/day (p = 0.015) and 96.2% were treated with IM MA (p = 0.001). Tinnitus has greater specificity and positive predictive value than hearing loss, with a low number of false positives, but with a high false negative value. Although the large number of false negatives suggests that self-report of hearing loss or tinnitus cannot be considered a good screening test for referring the patient to an audiometry, the low number of false positives suggests the need to value the patient's complaint for referral. Otherwise, this study reinforces the importance of audiological monitoring during treatment with MA, especially in those patients with self-reporting of hearing loss or tinnitus when treated with 20 mg Sb5+/kg/day via IM.

Genetic Relationship Between Chronic Otitis Media Infection And TLR4 Gene In AL-Qadisyah province, Iraq .

Background :otitis media is considered the more diseases common spread related hearing loss ,This study is designed to focus on TLR4 expression that stimulating result presence LPS in otitis media
 Objective :detect the genotype more infection in otitis media on blood patients sample expression in PCR Technical.
 Methods :The current study blood specimens we get of 50 patient and chronic Otitis media and 50 blood samples from healthy people to Extracting and dissection of the DNA blood gram negative bacteria and evaluate the mechanical and work of LPS and its effect on Toll like receptor4.
 Results :The results show most patients with P. arogenosia isolates have GG genotype 9 in comparison with other genotype AG, 15 and AA 26 and control group show GG genotype 4 in comparison with other genotype AG 11, and AA 36 .
 Conclusions: The study is showed a high rate of chronic otitis media in patients with the GG genotype, suggesting that this genotype may be a risk factor compared to the control group. On the other hand, the AA genotype was found to be ӏow in patients but high in the control group, indicating a possible is protected factor.

Natural History of KCNQ4 p.G285S Related Hearing Loss, Construction of iPSC and Mouse Model.

KCNQ4 is one of the most common disease-causing genes involved in autosomal dominant non-syndromic hearing loss. We previously found that patients with KCNQ4 p.G285S exhibited a much more rapid deterioration in hearing loss than those with other KCNQ4 variants. To determine the rate of hearing loss and assess the disease for further analysis, we performed a long-term follow-up of these patients and generated patient-derived induced pluripotent stem cells (iPSCs), and a mouse model. Patients with KCNQ4 p.G285S from a five-generation family with hearing loss were followed up from 2005 to 2022. iPSCs were generated by stimulating peripheral blood mononuclear cells from the proband, and their pluripotency was determined. The Kcnq4 p.G286S mouse model was generated using CRISPR/Cas9, and its genotype and phenotype were identified. (1) The annual rates of hearing loss at the frequencies of speech were 0.96 dB for the proband and 0.87 dB for his father during the follow-up period, which were faster than patients with other KCNQ4 variants. (2) The patient-derived iPSC line carrying KCNQ4 p.G285S, possessed the capacity of differentiation and pluripotency capacities. (3) Mutant mice with Kcnq4 p.G286S exhibited hearing loss and outer hair cell loss at 1 month of age. Patients with KCNQ4 p.G285S variant exhibited significantly accelerated progression of hearing loss compared to those with other reported variants. Awareness of the natural history of hearing loss associated with KCNQ4 p.G285S is beneficial for genetic counseling and prognosis. The generation of the iPSCs and mouse model can provide a valuable foundation for further in-depth analyses. 4 Laryngoscope, 134:2356-2363, 2024.

Hearing Aid in Vestibular-Schwannoma-Related Hearing Loss: A Review.

(1) Background: Several types of hearing aids are available for the rehabilitation of vestibular-schwannoma (VS)-related hearing loss. There is a lack of recently published papers regarding this theme. The aim of the present work is to organize current knowledge. (2) Methods: A review of the literature regarding the topics "vestibular schwannoma", "hearing loss", and "hearing aid" was performed. Nineteen studies were thus considered. (3) Results: Conventional hearing aids, contralateral routing of signal (CROS) aids, bone anchored hearing aids (BAHA), and others are available options for hearing rehabilitation in VS patients. The speech discrimination score (SDS) is considered the best measure to assess candidacy for rehabilitation with hearing aids. The best hearing rehabilitative conditions in VS patients when using conventional hearing aid devices are a mild-moderate hearing loss degree with good word recognition (more than 50% SDS). CROS-Aid and BAHA are reported to be beneficial. CROS-Aid expands on the area of receiving hearing. BAHA aids use direct bone-conduction stimulation. Unfortunately, there are no available studies focused specifically on VS patients that compare CROS and BAHA technologies. (4) Conclusions: Hearing aids, CROS, and BAHA are viable options for rehabilitating hearing impairment in VS, but require an accurate case-by-case audiological evaluation for rehabilitating hearing impairment in VS. Further studies are needed to prove if what is currently known about similar hearing illnesses can be confirmed, particularly in the case of VS.

Hearing Loss and Blood Coagulation Disorders: A Review.

A relationship between microvascular disorders and sensorineural hearing loss (SNHL) has been widely proposed. The vascular hypothesis, theorized for the onset of sudden SNHL (SSNHL), is among the most acknowledged: a localized acute cochlear damage, of ischemic or haemorrhagic nature, could be considered a causative factor of SSNHL. The aim of this review is to assess (i) the effect on hearing in patients affected by blood coagulation disorders (prothrombotic or haemorrhagic) and (ii) the possible etiopathogenetic mechanisms of the related hearing loss. A PRISMA-compliant review was performed. Medline, Embase, and Cinahl databases were searched from inception to 31 January 2023, and a total of 14 studies have been included in the review. The available data suggest that it is possible to consider clotting disorders as a potential condition at risk for sensorineural hearing loss; in particular, coagulation tests and eventually the assessment of genetic and acquired prothrombotic factors should be recommended in patients with SSNHL. Also, an audiological evaluation should be recommended for patients with blood coagulation disorders presenting cochlear symptoms, especially in those suffering from clotting diseases.

Assessment of middle ear structure and function with optical coherence tomography

Background Current clinical tests for middle ear (ME) injuries and related conductive hearing loss (CHL) are lengthy and costly, lacking the ability to noninvasively evaluate both structure and function in real time. Optical coherence tomography (OCT) provides both, but its application to the audiological clinic is currently limited. Objective Adapt and use a commercial Spectral-Domain OCT (SD-OCT) to evaluate anatomy and sound-evoked vibrations of the tympanic membrane (TM) and ossicles in the human ME. Materials and Methods SD-OCT was used to capture high-resolution three-dimensional (3D) ME images and measure sound-induced vibrations of the TM and ossicles in fresh human temporal bones. Results The 3D images provided thickness maps of the TM. The system was, with some software adaptations, also capable of phase-sensitive vibrometry. Measurements revealed several modes of TM vibration that became more complex with frequency. Vibrations were also measured from the incus, through the TM. This quantified ME sound transmission, which is the essential measure to assess CHL. Conclusion and Significance We adapted a commercial SD-OCT to visualize the anatomy and function of the human ME. OCT has the potential to revolutionize point-of-care assessment of ME disruptions that lead to CHL which are otherwise indistinguishable via otoscopy.

Hearing loss and its link to cognitive impairment and dementia.

Hearing loss is an important risk factor for the development of dementia, particularly Alzheimer's disease (AD). Mid-life hearing loss increases the risk of developing dementia by double any other single factor. However, given this strong connection between hearing loss and AD, the mechanisms responsible for this link are still unknown. Data from observational studies relating hearing loss and cognitive impairment, measured with standardized questionnaires, has shown a strong relationship between them. Similar findings have emerged from animal studies, showing that the induction of hearing loss via prolonged loud sound exposure or ear canal blocking, can impair cognitive abilities. Interestingly, patients with age-related hearing impairment exhibit increased phosphorylated tau in the cerebrospinal fluid, but no such relationship has been identified for amyloid-β. In addition, hearing loss predisposes to social isolation precipitating the development of dementia through a supposed reduction in cognitive load and processing requirements. Given this link between hearing loss and dementia, the question arises whether the restoration of hearing might mitigate against the onset or progress of AD. Indeed, there is a growing body of research that suggests that those who wear hearing aids for age-related hearing problems maintain better cognitive function over time than those who do not. These are compelling findings, as they suggest the use of hearing aids has the potential to be a cost-effective treatment for those with hearing loss both prior (for those at high risk for AD) and after the development of symptoms. This review aims to summarize the current theories that relate hearing loss and cognitive decline, present the key findings of animal studies, observational studies and summarize the gaps and limitations that need to be addressed in this topic. Through this, we suggest directions for future studies to tackle the lack of adequately randomized control trials in the field. This omission is responsible for the inability to provide a conclusive verdict on whether to use hearing interventions to target hearing-loss related cognitive decline.

Mechanisms linking hearing loss with risk for dementia depends on age

AbstractBackgroundAge related hearing loss has been associated with increased prevalence and incidence of dementia. Underlying mechanisms that connect hearing loss with dementia remain largely unclear.MethodsWe studied the association of hearing loss and other risk markers for dementia in two cohorts with normal cognition and different age: 65 participants from the EMIF‐AD 90+ study (mean age 92.7 years, 56.9% female) and 60 participants from the EMIF‐AD PreclinAD study (mean age 74.4, 43.3% female). Individuals were selected when they had hearing function (‘digits‐in‐noise test’) and neuropsychological testing available. Amyloid binding potential (BPND) was derived from dynamic PET scans. We used linear regression analysis and generalized estimating equations to test the association of hearing loss and BPND. We used linear mixed models to test the association of hearing function and cognition over time. In the oldest‐to‐old individuals, magnetic resonance imaging was available at the time of hearing function testing, and we performed mediation analyses to study whether cognitive decline is mediated through regional brain regions. All models included age, sex, and amyloid status as covariates, and longitudinal analyses were corrected for education years.ResultsOldest‐to‐old individuals showed worse hearing functioning than the younger cohort (p< .001). In oldest‐to‐old hearing loss was not associated with BPND (p = .70), whereas younger individuals showed an association of hearing loss with higher BPND (p = .003, figure 1). Oldest‐to‐old individuals showed associations of worse hearing with a steeper decline in memory (β ± SE = ‐0.018 ± 0.007), global cognition (β ± SE = ‐0.017 ± 0.007) and language (β ± SE = ‐0.014 ± 0.007), while in the younger cohort worse hearing was associated with steeper decline in language only (β ± SE = ‐0.086 ± 0.02, figure 2). Mediation analyses demonstrated that the hippocampus and nucleus accumbens fully mediate the effects of hearing loss on memory and global cognition in the older individuals (figure 3‐4).ConclusionsHearing loss was associated with amyloid burden in younger individuals only, and with cognitive decline in both age groups. These results suggest that mechanisms linking hearing loss with risk for dementia depends on age.

An Assessment of Hearing Health Care Needs in Rural West Central and South Alabama.

Hearing loss has become a significant public health concern because of its association with physical health, cognition, and emotional well-being. Age-related hearing loss is the third leading cause of global years lived with disability after lower back pain and migraine. Among other sensory disorders, hearing loss is ranked first. To help mitigate these health concerns, access to affordable hearing health care across rural and urban communities will be necessary. For this study, the needs of rural communities and their residents with hearing loss were explored. Individual interviews and focus group discussions with 26 adults with hearing loss, 14 friends and family of those with hearing loss, and 25 community members who worked and lived in rural communities were conducted. Collectively, four themes emerged from qualitative analysis of the comments from all three groups, including Communication and Other Related Hearing Loss Issues, Social and Emotional Issues, Dealing with Hearing Loss, and Addressing Hearing Loss in the Community. Factors associated with the themes were mapped onto the Meikirch Model of Health to determine potential areas of intervention within the individual, society, and environment components of the model. Future care mitigating health concerns for adults with hearing loss living in rural communities will involve interprofessional collaboration and increased access to hearing health care.