Loss In Older Adults Research Articles

Measures of hearing threshold and temporal processing across the adult lifespan

Psychophysical data on hearing sensitivity and various measures of supra-threshold auditory temporal processing are presented for large groups of young (18–35 y), middle-aged (40–55 y) and older (60–89 y) adults. Hearing thresholds were measured at 500, 1414 and 4000 Hz. Measures of temporal processing included gap-detection thresholds for bands of noise centered at 1000 and 3500 Hz, stimulus onset asynchronies for monaural and dichotic temporal-order identification for brief vowels, and stimulus onset/offset asynchronies for the monaural temporal masking of vowel identification. For all temporal-processing measures, the impact of high-frequency hearing loss in older adults was minimized by a combination of low-pass filtering the stimuli and use of high presentation levels. The performance of the older adults was worse than that of the young adults on all measures except gap-detection threshold at 1000 Hz. Middle-aged adults performed significantly worse than the young adults on measures of threshold sensitivity and three of the four measures of temporal-order identification, but not for any of the measures of temporal masking. Individual differences are also examined among a group of 124 older adults. Cognition and age were found to be significant predictors, although only 10–27% of the variance could be accounted for by these predictors.

Audiologic Management of the Older Patient

Audiologic Management of the Older Patient

Severe tooth loss in older adults as a key indicator of compromised dietary quality

Poor oral health influences the dietary quality of older individuals. The objective of the present study was to relate the number of teeth to adherence to the 2005 Dietary Guidelines for Americans among an ethnically diverse sample of older adults. A block cluster design was used to obtain a sample of older adults. Data were weighted to census data for ethnicity and gender. Dietary intakes were assessed using an FFQ and converted into Healthy Eating Index-2005 (HEI-2005) scores. Two counties in North Carolina, USA, with large African-American and American Indian populations. Community-dwelling older adults (N 635). Three hundred and twenty-six participants had severe tooth loss (0-10 teeth remaining), compared with 305 participants with 11+ teeth. After controlling for socio-economic factors, those with 0-10 teeth had lower total HEI-2005 scores and consumed less Total Fruit, Meat and Beans, and Oils, and more energy from Solid Fat, Alcohol and Added Sugar, compared with those with 11+ teeth. Less than 1 % of those with 0-10 teeth and 4 % of those with 11+ teeth met overall HEI-2005 recommendations. Those with 0-10 teeth were less likely to eat recommended amounts of Total Vegetables, Dark Green and Orange Vegetables, and energy from Solid Fat, Alcohol and Added Sugar. Older adults with severe tooth loss are less likely than those with moderate to low tooth loss to meet current dietary recommendations. Nutrition interventions for older adults should take oral health status into consideration and include strategies that specifically address this as a barrier to healthful eating.

New Possibilities in Cognition Enhancement for Schizophrenia

Cognitive remediation for schizophrenia and other mental disorders can be divided into two distinctly different approaches. Cognition-enhancing approaches train subjects with laboratory tasks designed to improve specific abilities in various cognitive domains, such as perception, learning, or memory. In contrast, compensatory approaches attempt to bypass cognitive deficits and teach strategies to compensate for them by relying on aids or other processes (1, 2). The article by Fisher et al. (3) in this issue of the Journal represents a new development in the cognition-enhancing approach. They applied to schizophrenia a cognitive training program that was well grounded in a neuroscientific rationale. This and similar training studies will set higher expectations for results in functional benefits for patients. To put this study in perspective, it is useful to review the key findings, establish what new terrain was covered by it, and then focus on critical missing pieces of the cognitive training puzzle.

Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: The Tasmanian older adult cohort study

To determine the associations between serum levels of vitamin D, sunlight exposure, and knee cartilage loss cross-sectionally and longitudinally in older adults. A total of 880 randomly selected subjects (mean age 61 years [range 51-79 years], 50% women) were studied at baseline, and 353 of these subjects were studied 2.9 years later. Serum levels of 25-hydroxyvitamin D (25[OH]D) were assessed by radioimmunoassay, and sunlight exposure was assessed by questionnaire. T1-weighted fat-suppressed magnetic resonance imaging (MRI) of the right knee was performed to determine knee cartilage volume and defects. Knee radiographic osteoarthritis (OA) and knee pain were also assessed. The mean 25(OH)D serum level was 52.8 nmoles/liter at baseline (range 13-119 nmoles/liter). Winter sunlight exposure and serum 25(OH)D level were both positively associated with medial and lateral tibial cartilage volume, and a serum 25(OH)D level<50 nmoles/liter was associated with increased medial tibiofemoral joint space narrowing (all P<0.05). Longitudinally, baseline serum 25(OH)D level predicted change in both medial and lateral tibial cartilage volume (beta=+0.04% per annum per nmole/liter for both; P<0.05), and change in serum 25(OH)D level was positively associated with change in medial tibial cartilage volume. These associations were consistent in subjects with radiographic OA and knee pain and/or in women, but not in men or in subjects without radiographic OA or knee pain. Sunlight exposure and serum 25(OH)D levels are both associated with decreased knee cartilage loss (assessed by radiograph or MRI). This is best observed using the whole range of 25(OH)D levels rather than predefined cut points and implies that achieving vitamin D sufficiency may prevent and/or retard cartilage loss in knee OA.

Prevalence of Age-Related Hearing Loss in Older Adults: Blue Mountains Study

Prevalence of Age-Related Hearing Loss in Older Adults: Blue Mountains Study

Advances in Hearing Conservation Practices: An Interview With Mark Stephenson

Abstract It is estimated that 30 million Americans are exposed to hazardous noise levels at work (Stephenson et al., 2003). The Occupational Safety and Health Act of 1970 created two separate agencies dedicated to promoting worker health and safety: the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH). Research at NIOSH informs OSHA regulations. This report comprises an interview with Mark Stephenson, PhD, Scientific Research Coordinator for the NIOSH noise and hearing loss research program. He provides insights into the latest advances in hearing conservation practices, what works and why. Current hearing conservation practices developed at NIOSH and not yet mandated by OSHA use methods borrowed from evidence-based health communication theories to change the ways individuals view the problem of noise exposure, eliminate barriers that prevent effective hearing protector use, and create a culture of self-efficacy with respect to hear...

The Cdx-2 polymorphism of the vitamin D receptor gene and bone loss in older adults in China

The Cdx-2 polymorphism of the vitamin D receptor gene and bone loss in older adults in China

Hearing loss in older adults: Perspectives for rehabilitation with customised hearing aids and a follow-up fitting procedure

Hearing loss in older adults: Perspectives for rehabilitation with customised hearing aids and a follow-up fitting procedure

Chronic Pain Is Associated with Brain Volume Loss in Older Adults: Preliminary Evidence

The primary aim of this pilot investigation was to identify structural brain differences in older adults with chronic low back pain (CLBP) as compared with pain-free individuals. Cross-sectional, case-control. Sixteen cognitively intact older adults, eight with CLBP and eight pain-free; excluded if with psychiatric or neurological disorders, substance abuse, opioid use, diabetes mellitus, and/or hypertension. Brain magnetic resonance imaging (MRI) and tests of neuropsychological performance (digit span, digit symbol substitution, letter-number sequencing, trail making) were administered to all participants. Gray matter (GM), white matter (WM), cerebrospinal fluid, and corpus callosum (CC) volumes were measured as a percentage of total supratentorial intracranial volume. Voxel-based morphometry analysis of GM and WM assessed regional differences. Between-groups analysis revealed a non-significant trend toward decreased middle CC volume in the CLBP group (1.43E-03 +/- 2.67E-04, 1.63E-03 +/- 2.00E-04: P = 0.09). Regional analysis in the CLBP group demonstrated significantly decreased GM volume (P < 0.001) in the posterior parietal cortex and middle cingulate WM volume (P < 0.001) of the left hemisphere. CLBP participants performed significantly worse on digit span forward (P = 0.03). Older adults with CLBP have structural brain changes in the middle CC, middle cingulate WM, and the GM of the posterior parietal cortex as well as impaired attention and mental flexibility. Additional investigation is needed to corroborate and extend these findings and more clearly elucidate their relationship to physical function and the risk of disability.

Introduction to dual sensory loss issue.

Introduction to dual sensory loss issue.

Vulnerability of the Orbitofrontal Cortex to Age‐Associated Structural and Functional Brain Changes

Cross-sectional and longitudinal findings from the Baltimore Longitudinal Study of Aging (BLSA) neuroimaging study indicate that the orbitofrontal cortex (OFC) is among those regions vulnerable to age-associated tissue loss in older adults without dementia. Neuropathologic and recent in vivo amyloid imaging studies indicate that the OFC is also among the earliest neocortical regions to show deposition of amyloid plaques in aging and Alzheimer's disease. We performed behavioral and imaging studies to investigate age effects on specific aspects of OFC function. We compared performance in young (age 20-40) and old (age 60 and older) adults on cognitive tasks selected for differential sensitivity to OFC versus dorsolateral prefrontal cortex (DLPFC). Overall, greater age differences were seen in the OFC tasks compared to DLPFC tasks, with Delayed Match and Non-Match to Sample tasks showing the greatest effect size among OFC tasks and Self-Ordered Pointing Task showing the greatest effect size among DLPFC tasks. A functional magnetic resonance imaging study was conducted in parallel to probe the neural underpinnings of age differences in OFC function using the Delayed Match and Non-Match to Sample paradigm. Young but not old adults showed the expected OFC activation. Older compared with young adults showed greater activation in association with successful performance for several posterior regions, perhaps indicating compensation in the face of OFC deficits. Together, these findings indicate a vulnerability of the OFC to age-related decline in brain structure and function. Future studies using new in vivo imaging probes will help determine whether neuropathologic changes underlie the structural and functional changes.

Dental pathology and diet at Apollonia, a Greek colony on the Black Sea

AbstractDental pathology has the potential to provide insight into the composition of the diet and to reveal dietary differences based on age, sex and social status. Human skeletal remains from the Greek colonial site of Apollonia (5th to 2nd centuries BC) on the Black Sea coast of Bulgaria were analysed for various forms of dental pathology in order to: assess the prevalence of dental disease in the population; compare the dental pathology data from Apollonia with dietary data derived from ancient literary texts and from previous stable isotopic analysis of the colonists' remains; explore variations in dental disease with respect to age and sex; and compare the prevalence of dental pathology in the Apollonians with that of other Greek populations. The composition of the diet, as indicated by the dental pathology data, is consistent with the stable isotopic evidence from Apollonia and with the ancient literary texts, both of which indicate the consumption of a relatively soft, high carbohydrate diet. The higher frequency of dental caries, abscesses, calculus, and antemortem tooth loss in older adults compared with younger ones reflects the age‐progressive nature of these conditions. The lack of significant sex differences in caries, abscesses, calculus and tooth loss corresponds with the stable carbon and nitrogen isotopic data derived from bone collagen, which indicate no significant sex differences in the consumption of dietary protein. In contrast, these findings conflict with the ancient literary texts, which refer to distinct dietary differences between males and females, and with the stable carbon isotopic values derived from bone carbonate, which indicate sex differences with respect to the overall diet. Despite the lack of marked sex differences in dental pathology, overall trends point to subtle dietary differences between males and females. A greater degree of tooth wear in males also hints at possible sex differences in the use of the teeth as tools. Copyright © 2007 John Wiley &amp; Sons, Ltd.

Anticipation of monetary gain but not loss in healthy older adults

Although global declines in structure have been documented in the aging human brain, little is known about the functional integrity of the striatum and prefrontal cortex in older adults during incentive processing. We used event-related functional magnetic resonance imaging to determine whether younger and older adults differed in both self-reported and neural responsiveness to anticipated monetary gains and losses. The present study provides evidence for intact striatal and insular activation during gain anticipation with age, but shows a relative reduction in activation during loss anticipation. These findings suggest that there is an asymmetry in the processing of gains and losses in older adults that may have implications for decision-making.

A Model for Assessing Hearing Loss in Older Adults with Neurogenic Communication Disorders

A Model for Assessing Hearing Loss in Older Adults with Neurogenic Communication Disorders

Current Randomized Controlled Trials of Physical Activity Counseling and Weight Loss in Older Adults - The Wake Forest Pepper Center

Current Randomized Controlled Trials of Physical Activity Counseling and Weight Loss in Older Adults - The Wake Forest Pepper Center

Age-Related Hearing Loss, Methylmalonic Acid, and Vitamin B12 Status in Older Adults

Hearing loss has been associated with poor vitamin B12 status in some, but not all studies. This study examined a possible relationship between age-related hearing loss and poor B12 status in 93 older adults using different indices of B status. Hearing loss was defined as pure-tone average threshold > 25 decibel hearing level. Participants with methylmalonic acid (MMA) > 271 nmol/L at baseline received 1,000 μg/d, and those with MMA <271 nmol/L were randomly assigned to receive 0,25, or 100 Ltg/d of B12. In a series of logistic regression analyses, compared with participants with normal hearing, those with impaired hearing had a significantly higher serum mean MMA concentrations in the best and the worst ears and a higher prevalence of elevated MMA (> 271 nmol/L) in the worst ear only. Thus, elevated MMA concentration may be associated with hearing loss in older adults. However, short-term B12 supplementation was unrelated to improvements in hearing status in B12-deficient individuals.

Hearing sensitivity and bone mineral density in older adults: the Health, Aging and Body Composition Study

Bone mineral density (BMD) may be associated with hearing loss in older adults. Demineralization of the cochlear capsule has been associated with hearing loss in those with Paget's disease of the bone and otosclerosis. Osteoporosis may also result in cochlear capsule demineralization. We hypothesized that lower hip BMD and lower heel ultrasound measurements would be associated with hearing loss in a population-based sample of 2,089 older black and white men and women. Bone parameters and hearing function were measured at the fourth clinical follow-up visit. Audiometric threshold testing was used to measure air- and bone-conduction hearing sensitivity. BMD of the hip and its subregions was measured using dual-energy X-ray absorptiometry. Calcaneal bone measurements [broadband ultrasound attenuation (BUA), speed of sound (SOS) and the quantitative ultrasound index (QUI)] were obtained using heel ultrasound. After adjusting for known hearing loss risk factors, no association was found between hearing and any of the bone measurements in whites and black women. In black men, however, lower hip BMD was associated with higher odds of hearing loss; for each standard deviation decrease in total hip BMD, the odds of hearing loss were 1.41 (95% confidence interval 1.08, 1.83), 1.39 (95% CI 1.07, 1.82) for femoral neck BMD and 1.65 (95% CI 1.26, 2.16) for trochanter BMD. Conductive hearing loss was associated with lower heel ultrasound measurements, though only among white men. The results of this study are mixed and inconclusive. Lower BMD of the hip and its subregions was associated with hearing loss among black men, but not among whites or black women. Lower measurements on heel ultrasound were associated with conductive hearing loss, though only among white men. These results suggest that axial and appendicular bone parameters may be modestly associated with hearing loss in older men, but not in women.

Weight Loss in Older Adults

Weight Loss in Older Adults

An approach to the management of unintentional weight loss in elderly people

Unintentional weight loss, or the involuntary decline in total body weight over time, is common among elderly people who live at home. Weight loss in elderly people can have a deleterious effect on the ability to function and on quality of life and is associated with an increase in mortality over a 12-month period. A variety of physical, psychological and social conditions, along with age-related changes, can lead to weight loss, but there may be no identifiable cause in up to one-quarter of patients. We review the incidence and prevalence of weight loss in elderly patients, its impact on morbidity and mortality, the common causes of unintentional weight loss and a clinical approach to diagnosis. Screening tools to detect malnutrition are highlighted, and nonpharmacologic and pharmacologic strategies to minimize or reverse weight loss in older adults are discussed.