Increasing Hearing Loss Research Articles

Sensorineural hearing loss among hypertensive patients attending cardiac institute in Tanzania: A cross-sectional study

INTRODUCTION Hypertension is among non-communicable diseases worldwide and it has been associated with sensorineural hearing loss. Almost 1.39 billion people (1 out of 4 adults) have hypertension and this figure is expected to increase. In Sub-Saharan Africa, hypertension is the leading cause of death and disability. Hypertension is associated with sensorineural hearing loss by compromising the blood supply in the cochlea. MATERIALS AND METHODS An assessment of the proportion and patterns of sensorineural hearing loss among hypertensive patients was conducted. 191 patients aged 18 years and above were recruited. History and physical examination including blood pressure, and otoscopy were done. Pure tone audiometry (PTA) was conducted. RESULTS Patients aged from 36 to 88 years with a mean age of 60 years and a standard deviation of 10. The patients aged between 61–76 years accounted for 85 (44.5%), whereas 29–44 and > 76 years accounted for 12 (6.3%) each. The female-to-male ratio was 1:1. Sensorineural hearing loss was detected in 144 (75.4%), commonly above 76 years of age which was 11 (91.7%. Mild sensorineural hearing loss was the most common degree revealed. There was no relationship between the degree of sensorineural hearing loss and the grades of hypertension (p-value of 0.113). No relationship between the duration of hypertension with the severity of hearing loss, p-value =0.369. CONCLUSION The prevalence of sensorineural hearing loss among hypertensive patients was 75.4%. The bilateral and mild degree was the commonest presentation. Increasing age was found to be associated with increased hearing loss. The duration and grade of hypertension were not related to the severity of hearing loss.

Comparison of horizontal plane auditory spatial discrimination abilities and testing methods in patients with symmetrical sensorineural hearing loss

Objective: To evaluate auditory spatial discrimination capabilities in patients with mild to moderately severe symmetrical sensorineural hearing loss (SNHL) and to compare the impact of different psychophysical testing methods on Minimum Audible Angle (MAA) and test duration. Methods: A total of 105 symmetrical SNHL patients aged from 18 to 60 years old were enrolled from April to July 2023, including 56 males and 49 females. They were divided into three groups based on PTA: mild, moderate, and moderately severe hearing loss, with 35 individuals in each group. Additionally, a control group of 35 individuals with normal hearing was tested, including 18 males and 17 females. Participants underwent four distinct psychophysical discrimination tests: the block up-down, 1-up/1-down, 1-up/2-down, and 1-up/3-down procedures. We recorded the MAA and test duration for each. We employed repeated measures of ANOVA to compare the MAA and test duration across different methods and groups, and Pearson's correlation to assess the relationship between MAA and degree of hearing loss. Results: MAA of sound localization in patients with symmetrical SNHL was significantly positively correlated with the degree of hearing loss (r=0.59, P<0.01). Significant deterioration in MAA was observed as hearing loss progressed to the moderate level (PTA≥35 dBHL, P<0.01). The testing methods significantly influenced MAA and testing duration (F=24.02, P<0.01; F=75.56, P<0.01) and the 1-up/1-down method was the quickest, averaging only (0.69±0.32) mins. Conclusions: The horizontal plane auditory spatial discrimination abilities in patients with symmetrical SNHL is impaired progressively with increasing hearing loss, notably beyond moderate hearing loss levels. Different psychophysical methods influence both MAA and test duration, the quicker 1-up/1-down method is recommended for assessing MAA in symmetrical SNHL patients.

The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss?

Hearing loss is prevalent and consequential but under-diagnosed and managed. The Medicare Annual Wellness Visit (AWV) health risk assessment elicits patient-reported hearing concerns but whether such information affects documentation, diagnosis, or referral is unknown. We use 5 years of electronic medical record (EMR) data (2017-2022) for a sample of 13,776 older primary care patients. We identify the first (index) AWV indication of hearing concerns and existing and subsequent hearing loss EMR diagnoses (visit diagnoses or problem list diagnoses) and audiology referrals. For a 20% random sample of AWV notes (n = 474) we compared hearing loss EMR diagnoses to documentation of (1) hearing concerns, (2) hearing loss/aid use, and (3) referrals for hearing care. Of 3845 (27.9%) older adults who identified hearing concerns (mean age 79.1 years, 57% female, 75% white) 24% had an existing hearing diagnosis recorded. Among 474 patients with AWV clinical notes reviewed, 90 (19%) had an existing hearing loss diagnosis. Clinicians were more likely to document hearing concerns or hearing loss/aid use for those with (vs. without) an existing EMR diagnosis (50.6% vs. 35.9%, p = 0.01; 68.9% vs. 37.5%, p < 0.001, respectively). EMR diagnoses of hearing loss were recorded for no more than 40% of those with indicated hearing concerns. Among those without prior diagnosis 38 (9.9%) received a hearing care referral within 1 month. Subgroup analysis suggest greater likelihood of documenting hearing concerns for patients age 80+ (OR:1.51, 95% confidence interval [CI]: 1.03, 2.19) and decreased likelihood of documenting known hearing loss among patients with more chronic conditions (OR: 0.49, 95% CI: 0.27, 0.9), with no differences observed by race. Documentation of hearing loss in EMR and AWV clinical notes is limited among older adults with subjective hearing concerns. Systematic support and incorporation of hearing into EMR and clinical notes may increase hearing loss visibility by care teams.

Hearing acuity in nonagenarians aged 90 and 95 assessed in a home setting using standardized pure-tone audiometry

Objective Knowledge regarding hearing acuity in the nonagenarian age group is sparse. In this study we aimed to advance our understanding of hearing loss in the 10th decade of life. Design A cross-sectional study in which standardised hearing measurements were performed during home visits, which included care home facilities and nursing homes to maximise participation. Study sample Two unselected groups of individuals aged 90 (n = 42) and 95 (n = 49), sampled from the population-based Gothenburg H70 Birth Cohort Studies. Results 98% of the participants (95% CI [95, 100]) had some degree of hearing loss in their better ear, with 83% (95% CI [73, 89]) having a potentially disabling hearing loss of moderate degree or worse, according to WHO criteria. Furthermore, differences between the two age groups (five years apart) indicate an increasing hearing loss, primarily at frequencies ≥ 2 kHz. Conclusion Hearing loss was present in almost all of the participants in the nonagenarian age group and among a majority of them potentially to a degree that would warrant rehabilitation. Carrying out standardised hearing measurements in a home setting was feasible in this age group and enhanced the representativeness of the study population.

Listening effort mitigates rollover effects on speech-in-noise perception

Increasing the sound intensity may lead to worse speech understanding, especially in noise. This is known as the “Rollover” phenomenon. There is mounting evidence that listening effort plays an important role in challenging listening conditions and can be directly quantified with objective measures such as pupil dilation. However, there is limited understanding of how listening effort relates to rollover in speech understanding. We hypothesized that listening effort plays an essential role in mitigating rollover effects to differential extents across age and hearing status. We recruited across the adult lifespan (N = 50, 20–83 years) with different hearing statuses in acoustic listeners and cochlear implant users to perform a speech discrimination task. Minimal word pairs were presented both in quiet and in 0 dB SNR babble noise, ranging from 35–85 dB SPL. Pupil area was tracked simultaneously with behavioral responses during the task. We found that normal-hearing listeners are fully able to utilize effort contributions to minimize rollover effects between in quiet and in noise conditions, with diminishing benefit as a function of age and increased hearing loss. The results of this project could broadly influence how to design future hearing devices and interventions that maximize hearing abilities for those affected by hearing loss.

A Large-Scale Study of the Relationship Between Degree and Type of Hearing Loss and Recognition of Speech in Quiet and Noise.

Understanding speech in noise (SIN) is the dominant complaint of individuals with hearing loss. For decades, the default test of speech perception in routine audiologic assessment has been monosyllabic word recognition in quiet (WRQ), which does not directly address patient concerns, leading some to advocate that measures of SIN should be integrated into routine practice. However, very little is known with regard to how SIN abilities are affected by different types of hearing loss. Here, we examine performance on clinical measures of WRQ and SIN in a large patient base consisting of a variety of hearing loss types, including conductive (CHL), mixed (MHL), and sensorineural (SNHL) losses. In a retrospective study, we examined data from 5593 patients (51% female) who underwent audiometric assessment at the Stanford Ear Institute. All individuals completed pure-tone audiometry, and speech perception testing of monaural WRQ, and monaural QuickSIN. Patient ages ranged from 18 to 104 years (average = 57). The average age in years for the different classifications of hearing loss was 51.1 (NH), 48.5 (CHL), 64.2 (MHL), and 68.5 (SNHL), respectively. Generalized linear mixed-effect models and quartile regression were used to determine the relationship between hearing loss type and severity for the different speech-recognition outcome measures. Patients with CHL had similar performance to patients with normal hearing on both WRQ and QuickSIN, regardless of the hearing loss severity. In patients with MHL or SNHL, WRQ scores remained largely excellent with increasing hearing loss until the loss was moderately severe or worse. In contrast, QuickSIN signal to noise ratio (SNR) losses showed an orderly systematic decrease as the degree of hearing loss became more severe. This effect scaled with the data, with threshold-QuickSIN relationships absent for CHL, and becoming increasingly stronger for MHL and strongest in patients with SNHL. However, the variability in these data suggests that only 57% of the variance in WRQ scores, and 50% of the variance in QuickSIN SNR losses, could be accounted for by the audiometric thresholds. Patients who would not be differentiated by WRQ scores are shown to be potentially differentiable by SIN scores. In this data set, conductive hearing loss had little effect on WRQ scores or QuickSIN SNR losses. However, for patients with MHL or SNHL, speech perception abilities decreased as the severity of the hearing loss increased. In these data, QuickSIN SNR losses showed deficits in performance with degrees of hearing loss that yielded largely excellent WRQ scores. However, the considerable variability in the data suggests that even after classifying patients according to their type of hearing loss, hearing thresholds only account for a portion of the variance in speech perception abilities, particularly in noise. These results are consistent with the idea that variables such as cochlear health and aging add explanatory power over audibility alone.

Feasibility of an Adaptive Version of the Everyday Conversational Sentences in Noise Test.

To investigate potential reasons for the mismatch between laboratory/clinic-based sentence-in-noise performance and real-world listening abilities, we recently developed a corpus of natural, spontaneously spoken speech with three vocal effort levels (Everyday Conversational Sentences in Noise [ECO-SiN]). Here, we examined the feasibility of using the ECO-SiN corpus for adaptive speech-in-noise testing, which might be a desirable format in certain situations (e.g., during a clinical visit). Ten young, normal-hearing adults, along with 20 older adults with hearing loss participated in the study. Speech reception thresholds (SRTs) were obtained using ECO-SiN sentences, which were systematically compared to the SRTs obtained using traditional Bamford-Kowal-Bench-like sentences. Results demonstrated the properties of the test compared favorably with those of a standard test based on scripted and clearly spoken sentences. Moreover, whereas normal-hearing listeners received a benefit from an increase in vocal effort, the participants with hearing loss showed a disbenefit that increased with increasing hearing loss. The adaptive version of the ECO-SiN test is feasible for research and clinical testing. https://doi.org/10.23641/asha.25146338.

Hearing loss in Takayasu's arteritis.

Neurosensory hearing loss is well-documented in chronic autoimmune conditions such as systemic lupus erythematosus (SLE). However, the literature lacks data on the prevalence and characteristics of hearing impairment in Takayasu's arteritis (TAK). In this cross-sectional study, our principal objective was to systematically assess the auditory function of individuals diagnosed with TAK, against SLE patients and healthy controls (HC). Age and gender matched TAK and SLE patients followed up in a tertiary centre along with healthy controls were included in a two-phase study. In the first phase, a questionnaire on ENT symptoms was administered to the patient (TAK: n=104 and SLE: n= 151) and HC (n=174) groups. In the second phase, patients (TAK: n=53 and SLE: n=33) and HC (n=45) underwent audiometric tests. The questionnaire survey revealed that both TAK and SLE patients reported hearing loss (27.9%, 25.8%, 7.4%, p<0.001), tinnitus (49%, 35.8%, 13.8%, p<0.001) and vertigo (46.2%, 33.8%, 16.7%, p<0.001) at significantly higher rates than HC. Audiometry results indicated that both TAK (30.2%) and SLE patients (18.2%) had increased hearing loss compared to HC (8.9%), however, only TAK patients were found to have significantly increased risk in age adjusted logistic regression analysis (OR= 3.915, 95%CI: 1.179-12.998, p=0.026). Hearing loss was mainly neurosensory in all groups. TAK patients were affected at both low (<6000 Hz) and high (>6000 Hz) frequencies, whereas SLE patients were affected only at high frequencies. Hearing loss was significantly associated only with older age. No association was observed with the anatomical location of vascular involvement or history of stroke. Our study reveals an increased prevalence of hearing loss in TAK. Further research is crucial to uncover the underlying causes.

Effect of changes in the hearing aid subsidy on the prevalence of hearing loss in South Korea.

South Korea's National Health Insurance has provided hearing aids to registered individuals with hearing disabilities since 1989. In 2015, hearing aid subsidies increased to approximately US$1,000. This study aimed to understand hearing loss categories in Korea by analyzing patients between 2010 and 2020 and the effect of the 2015 hearing aid policy change on the prevalence of hearing loss. The participants were patients registered on the National Health Insurance Service database from 2010 to 2020 with hearing loss. A total of 5,784,429 patients were included in this study. Hearing loss was classified into conductive, sensorineural, and other categories. Patients with hearing loss were classified according to the International Classification of Diseases diagnostic code. Disability diagnosis and hearing aid prescription were defined using the National Health Insurance Disability and Hearing Aid Code. The increase in hearing aid prescriptions and hearing disability registrations following the subsidy increase impacts hearing loss prevalence. Hearing aid prescription and hearing disability were found to have an effect on increasing hearing loss prevalence in univariate and multivariate analyses. The r-value of each analysis exceeded 0.95. Other hearing losses increased rapidly after the increased subsidy. A hearing-impaired individual must be diagnosed with a hearing disability and prescribed a hearing aid to receive the subsidy. The prevalence of hearing loss was affected by increased hearing disabilities following changes in the hearing aid subsidy and the number of people prescribed hearing aids. Therefore, caution should be exercised when studying hearing loss prevalence over mid-long-term periods.

Speech perception in modulated noise assessed in bimodal CI users.

Although good speech perception in quiet is achievable with cochlear implants (CIs), speech perception in noise is severely impaired compared to normal hearing (NH). In the case of abimodal CI fitting with ahearing aid (HA) in the opposite ear, the amount of residual acoustic hearing influences speech perception in noise. The aim of this work was to investigate speech perception in noise in agroup of bimodal CI users and compare the results to age-matched HA users and people without subjective hearing loss, as well as with ayoung NH group. Study participants comprised 19bimodal CI users, 39HA users, and 40subjectively NH subjects in the age group 60-90years and 14young NH subjects. Speech reception thresholds (SRTs) in noise were adaptively measured using the Oldenburg Sentence Test for the two spatial test conditions S0N0 (speech and noise from the front) and multisource-noise field (MSNF; speech from the front, four spatially distributed noise sources) in continuous noise of the Oldenburg Sentence Test (Ol-noise) and amplitude-modulated Fastl noise (Fastl-noise). With increasing hearing loss, the median SRT worsened significantly in all conditions. In test condition S0N0, the SRT of the CI group was 5.6 dB worse in Ol-noise than in the young NH group (mean age 26.4years) and 22.5 dB worse in Fastl-noise; in MSNF, the differences were 6.6 dB (Ol-noise) and 17.3 dB (Fastl-noise), respectively. In the young NH group, median SRT in condition S0N0 improved by 11 dB due to gap listening; in the older NH group, SRTs improved by only 3.1 dB. In the HA and bimodal CI groups there was no gap listening effect and SRTs in Fastl-noise were even worse than in Ol-noise. With increasing hearing loss, speech perception in modulated noise is even more impaired than in continuous noise.

The development and evaluation of an online hearing loss prevention program

Recent studies underline the need for research on approaches to encouraging healthy listening habits. This study aims to develop and evaluate an online hearing loss prevention program; and examine its influence on the participants’ use of hearing protection, hearing loss prevention knowledge, attitude towards noise, and program useability and adherence.The study was conducted in the county of Västra Götaland, Sweden, from March through October 2021. The program included four modules focused on hearing and hearing loss prevention and was accessible to the participants for four weeks. In total, 75 participants completed the program which was evaluated using the Youth Attitude to Noise Scale and four additional self-designed questionnaires. The questionnaires were deployed before and immediately after program completion.The findings indicate that the program may influence the participants’ attitudes toward noise and the use of hearing protection. The participants who completed the program perceived high useability and increased hearing loss prevention knowledge. This program is most needed to promote healthy hearing. Future studies should target specific groups with this program and evaluate its long-term effects.

The Influence of Knowledge and Behavior of Student's Personal Listening Devices Usage On The Speech Frequency Hearing Threshold In Online Learning During The Pandemic Period

In the era of the COVID-19 pandemic, activities have changed to be online, which increased the use of technology, one of which was audiovisual. Most users use personal listening devices (PLDs) such as earphones, headphones, and so on to make it easier to listen to conversations, study, entertainment, and many more. Although there are many benefits to using PLDs, these devices also indirectly hurt hearing. WHO estimates there will be a certain degree of increased hearing loss due to exposure to loud noises. This study aims to determine the effect of students' knowledge, and behavior in PLDs usage on the speech frequency hearing threshold. It was observational-analytic research by filling out online questionnaires for students of the Faculty of Medicine, University of Brawijaya. We selected the samples by consecutive sampling and selected according to inclusion and exclusion criteria, and then bivariate analysis was carried out with the chi-square test. The variables measured were the level of knowledge, the level of behavior in PLDs usage, and the speech frequency hearing threshold level. The results showed no relationship between knowledge and behavior to the speech frequency hearing threshold (p-value&gt;0.05). The conclusion was that increased PLDs usage during the pandemic could increase hearing loss risk. Routine hearing screening is needed to prevent hearing loss among students.

Hearing-related quality of life in children and adolescents in rural Alaska.

This study evaluated the Hearing Environments and Reflection on Quality of Life (HEAR-QL) questionnaire in rural Alaska, including an addendum crafted through community feedback to reflect the local context. The objectives were to assess whether HEAR-QL score was inversely correlated with hearing loss and middle ear disease in an Alaska Native population. The HEAR-QL questionnaires for children and adolescents were administered as part of a cluster randomized trial in rural Alaska from 2017 to 2019. Enrolled students completed an audiometric evaluation and HEAR-QL questionnaire on the same day. A cross-sectional evaluation of questionnaire data was utilized. A total of 733 children (ages 7-12 years) and 440 adolescents (ages ≥13 years) completed the questionnaire. Median HEAR-QL scores were similar among children with and without hearing loss (Kruskal-Wallis, p= .39); however, adolescent HEAR-QL scores significantly decreased with increasing hearing loss (p< .001). Median HEAR-QL scores were significantly lower in both children (p= .02) and adolescents (p< .001) with middle ear disease compared with those without. In both children and adolescents, the addendum scores were strongly correlated with total HEAR-QL score (ρSpearman= 0.72 and 0.69, respectively). The expected negative association between hearing loss and HEAR-QL score was observed in adolescents. However, there was significant variability that could not be explained by hearing loss, and further investigation is warranted. The expected negative association was not observed in children. HEAR-QL scores were associated with middle ear disease in both children and adolescents, making it potentially valuable in populations where the prevalence of ear infections is high. Level 2 Clinicaltrials.gov registration numbers: NCT03309553.

A Missense Variant in COMT Associated with Hearing Loss among Young Adults: The National Longitudinal Study of Adolescent to Adult Health (Add Health).

Hearing loss is a major public problem with a heritability of up to 70%. Catechol-O-methyltransferase (COMT) encodes an enzyme that is highly expressed in sensory hair cells of the inner ear. The association between COMT and hearing loss has not been reported previously in nationally representative population-based studies. A regression linear model was used to estimate associations between the allele/genotype of COMT and self-reported hearing loss based on 13,403 individuals from Wave IV of the Add Health study, a nationally representative sample of multiethnic U.S. young adults. The inverse variance-weighted effect magnitude was estimated using a genetic meta-analysis model. The "A" allele frequency of rs6480 (a missense variant in COMT) was 0.44. The prevalence of hearing loss was 7.9% for individuals with the "A" allele and 6.5% for those with the "G" allele. The "A" allele was significantly associated with increased hearing loss (p = 0.01). The prevalence of hearing loss was 6.0%, 7.2%, and 8.7% for individuals with GG, AG, and AA genotypes, respectively, which was consistent with a genetic additive model. The genotypic association model showed that rs4680 was significantly associated with increased hearing loss (p = 0.006). A missense variant of rs4680 in COMT was significantly associated with increased hearing loss among young adults in a multi-racial/ethnic U.S. population-based cohort.

Cell division cycle 42 positively correlates with T helper 2 cytokine, effusion viscosity, and hearing loss degree in otitis media with effusion patients.

Cell division cycle 42 (CDC42) participates in the pathogenesis of some T-cell-mediated inflammatory diseases via regulating CD4+ T-cell differentiation and inflammation response. This study aimed to evaluate the correlation of CDC42 and T helper (Th)1/Th2 cytokines with disease risk, effusion viscosity, and hearing loss degree of otitis media with effusion (OME). CDC42, interleukin (IL)-4, and interferon-gamma (IFN-γ) in effusion and serum of 78 OME patients were determined by enzyme-linked immunosorbent assay. Besides, the effusion (irrigating fluid) and serum samples of 30 controls (adenoid hypertrophy patients without OME) were also obtained for CDC42, IL-4, and IFN-γ determination. Effusion CDC42 and IL-4 were elevated in OME patients compared with controls (both p < 0.001). Effusion CDC42 was positively correlated with effusion IL-4 in OME patients (p=0.004) and controls (p=0.012) but was not related to effusion IFN-γ (both p > 0.050). Additionally, effusion CDC42 (p=0.025) and IL-4 (p=0.023) were increased in OME patients with mucoid effusion compared to patients with serous effusion, while effusion IFN-γ was of no difference between those patients (p=0.215). Meanwhile, elevated effusion CDC42 (p=0.012) and IL-4 (p=0.033) were linked with increased hearing loss degrees, whereas effusion IFN-γ was not related to hearing loss degrees (p=0.057). Moreover, the findings of serum CDC42, IL-4, and IFN-γ showed similar trends as effusion ones; nonetheless, their correlation with disease features was generally weaker. OME patients present with elevated CDC42 and IL-4 levels; the latter factors are intercorrelated and positively associate with effusion viscosity and hearing loss degree.

Association of hypertension and age-related sensorineural hearing loss among elderly: A cross-sectional study

Background: Hearing loss (HL) has negative impact on quality of life. The prevalence of HL increases with age. Aims and Objectives: The present study was planned to explore the possible association of hypertension with age-related sensorineural HL (SNHL) in the elderly. Materials and Methods: This was a cross-sectional study done in the ENT Department of Great Eastern Medical School and Hospital, Srikakulam. Consecutive sampling method used. Sample size was considered using the formula – 4pq/l2 and 137 subjects from age group 60–75 years were included in the study. Hypertension was verified through a mercury sphygmomanometer and by a systematized questionnaire about hypertension and the use of medication for blood pressure. The hearing was assessed through threshold audiometric and audiological assessment. The study period: 4 months. All patients from the ENT department in the age group 60–75 years and who gave written informed consent were involved in the study. Participants with a history of ear surgery performed in the past, exposure to loud sounds, recently use of ototoxic drugs, patients with hearing aids, and ear diseases were excluded from the study. Results: Out of 137 subjects 52% had hypertension and 48% had no hypertension. Grade 1 hypertensives suffered from mild HL (7.9%), moderate HL (73%), severe HL (11%), and profound HL (7.9%). In Grade 2, hypertensives suffered from moderate HL (11%), severe HL (33.3%), and profound HL (55.5%). The P-value calculated by the Chi-square method was found to be &lt;0.05 and an odds ratio of more than 1, showing a significant association between hypertension and an increase in HL. Moreover, also a statistically positive correlation of MAP and duration of hypertension with age-related SNHL in both ears. Conclusion: HL in the population under study suggested that hypertension is an accelerating factor of degeneration of the hearing apparatus along with age-related SNHL. Hypertension and ageing were significantly associated with the risk of HL. Patients with hypertension have a greater increase in hearing threshold as compared to those without hypertension.

Adapting practice through a pandemic and increasing hearing loss (when you!re not Beethoven!)

The journey through 2 years of a pandemic has not been easy for anyone. Everyone has had their own experiences and path through this and for this paper I am tracing one path, my own one, as a composer/performer adapting to increasing hearing loss and to working online. I trace my journey through the past 2 years through the musical works I have been commissioned to write and the projects I have been involved with in a creative capacity. I end the paper in Spring 2022, back to working in person and detail the surprising

Relationship between hearing loss and depression symptoms among older adults in China: The mediating role of social isolation and loneliness.

To evaluate whether social isolation and loneliness mediates the relationship between hearing loss and depression symptoms in older adults in China. A cross-sectional analysis was conducted of 3769 participants (aged≥60years) in Shandong province of China. Hearing loss was assessed using Pure-Tone Audiometry test, depression symptoms using 15-item Geriatric Depression Scale, loneliness through UCLA Loneliness Scale and social isolation using Lubben Social Network Scale. Regression and bootstrap analyses were performed to test both direct associations of hearing loss and depression symptoms, and whether the mediating role of social isolation and loneliness. Overall, 44% of older adults had hearing loss, which was generally mild (30%) rather than moderate (10%), severe (3%) or profound (0.6%). Increasing levels of hearing loss was associated with increasing levels of social isolation and depressions. Hearing loss was also associated with loneliness, but here a threshold effect was apparent and no trend for increasing loneliness with increasing hearing loss. Models that included social isolation and loneliness showed an amelioration in the association of hearing loss and depression, although it remained significant at all levels of hearing loss. Overall, 8% of the total effect of hearing loss on depression symptoms was explained by the mediated effect through social isolation and 42% by loneliness. Psychosocial factors such as social isolation and loneliness might explain the association between hearing loss and depression. Interventions that address older adults' social isolation and loneliness may ameliorate depression in older adults with hearing loss.

Hearing impairment among workers and satisfaction with the use of hearing aids.

Hearing problems can have adverse effects on an individual's job performance, as well as on unemployment or underemployment and increased risk of stress-related sick leave. To investigate hearing impairment among workers and satisfaction with the use of hearing aids. Cross-sectional study with workers who are hearing aid users. Subjects underwent pure tone audiometry and answered the Hearing Handicap Inventory for Adults and the Satisfaction with Amplification in Daily Life questionnaires. Participants were 36 workers between 36 and 75 years old, with an average age of 53.47 years, 52.7% male and 47.3% female. There was a mild to moderate hearing handicap perception, with worse results for women in the emotional domain. As hearing loss increased, workers' frustration increased when talking to coworkers. Everyone was satisfied with the use of their hearing aids. Satisfaction increased with increasing age and decreased with increasing hearing loss. The greater the frustration when talking to co-workers, the lower the overall satisfaction with hearing aid use; the lower the satisfaction with the competence of the professional who assisted in adapting the hearing aid; the lower the satisfaction in environments with background noise and overall worse personal image. The worse the attitudes and emotional responses of workers regarding their hearing impairment, the lower the overall satisfaction with the hearing aid. Despite the use of hearing aids, workers perceive having a hearing impairment, especially women. As hearing loss and frustration in talking with co-workers increased, satisfaction decreased.

Communication with face masks during the COVID-19 pandemic for adults with hearing loss

Face masks have become common protective measures in community and workplace environments to help reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Face masks can make it difficult to hear and understand speech, particularly for people with hearing loss. An aim of our cross-sectional survey was to investigate the extent that face masks as a health and safety protective measure against SARS-CoV-2 have affected understanding speech in the day-to-day lives of adults with deafness or hearing loss, and identify possible strategies to improve communication accessibility. We analyzed closed- and open-ended survey responses of 656 adults who self-identified as D/deaf or hard of hearing. Over 80% of respondents reported difficulty with understanding others who wore face masks. The proportion of those experiencing difficulty increased with increasing hearing loss severity. Recommended practical supports to facilitate communication and social interaction included more widespread use of clear face masks to aid lip-reading; improved clarity in policy guidance on face masks; and greater public awareness and understanding about ways to more clearly communicate with adults with hearing loss while wearing face masks.