Objective Measures Of Hearing Research Articles

Personality traits and the risk of sensory impairment: Evidence from the National Health and Aging Trends Study

ObjectiveSensory impairment has pervasive effects on older individuals' quality of life and health. Although recent research found an association between personality traits and the risk of hearing and vision impairment, data on older adults is limited, and no study has examined dual-sensory impairment. Therefore, the present study examined the prospective relationship between personality traits and risk of hearing, vision, and dual sensory impairment among older adults. MethodParticipants were older adults aged 67 to 94 years (N = 829) from the National Health and Aging Trends Study (NHATS). Personality traits, demographic, clinical (body mass index, diabetes, and high blood pressure), and behavioral (smoking and physical activity) factors were assessed in 2013/2014. Objective measures of hearing and vision were obtained in 2021. ResultsControlling for demographic factors, higher conscientiousness was associated with a lower risk of hearing (OR: 0.81; 95%CI: 0.67–0.97, p = .022), vision (OR: 0.83, 95%CI: 0.71–0.97, p = .022) and dual sensory impairment (OR: 0.70, 95%CI: 0.56–0.86, p < .001). Higher openness (OR: 0.81, 95%CI: 0.68–0.97, p = .023) and neuroticism (OR: 0.74, 95%CI: 0.62–0.88, p < .001) were associated with a lower risk of hearing impairment. Clinical and behavioral covariates partially accounted for these associations. ConclusionConsistent with other age-related health and cognitive outcomes, conscientiousness may be protective against sensory impairment. Surprisingly, neuroticism had a protective effect for hearing, but not vision. The findings provide novel evidence for an association between personality and sensory impairment among older adults.

Hearing impairment and frailty in later life: The Health in Men Study (HIMS)

ObjectiveTo determine if hearing loss is associated with increased risk of frailty in later life. Study designCross-sectional study of a community sample of 4,004 men aged 70 years and above living in the metropolitan region of Perth, Western Australia. Data were retrieved from the Health in Men Study (HIMS) and the Western Australian Data Linkage System (WADLS). Frailty was assessed using the FRAIL scale and the Frailty Index. Hearing loss was defined by self-report or by diagnosis recorded in the WADLS. We also collected demographic, lifestyle and social support information. Main outcome measuresFrailty was assessed using the FRAIL scale and the Frailty Index. ResultsThe prevalence of frailty in the sample population was 16.1% and 25.4% when assessed using the FRAIL scale and the Frailty Index respectively. After adjusting for participant demographic, lifestyle and social factors, hearing loss was significantly associated with the prevalence of frailty when diagnosed by either measure (FRAIL scale: odds ratio [OR] 1.59, 95 CI% 1.32 to 1.91; Frailty Index: OR 1.76, 95 CI% 1.50 to 2.05). The proportion of men with hearing loss increased with increasing severity of frailty. ConclusionHearing loss is associated with increased prevalence of frailty in older men when assessed using the FRAIL scale and the Frailty Index. Future longitudinal studies using objective measures of hearing will be helpful in determining if this association is likely to be causal.

A Review of Adult-Onset Hearing Loss: A Primer for Neurologists.

The goal of this review is to highlight current approaches to diagnosis and treatment for adult-onset hearing loss in patients likely to present to a neurologist's office. The review will discuss primary and secondary causes of acute and chronic hearing loss, and will discuss common situations that can be managed by a neurologist as well as situations that require immediate care and referral for further management by an otolaryngologist-head and neck surgeon. Hearing screening assessments using mobile applications and tablet devices are now available and can be integrated into many clinical practice settings, including in the evaluation of hearing concerns related to various neurological pathologies. For patients presenting with a sudden worsening in hearing, bedside evaluation, including with objective measures of hearing, can inform neurologists about diagnosis and subsequent management. For patients who present with gradual worsening in hearing, particularly those related to neurologic disorders, hearing care can be an important adjunct to ongoing neurologic care. More commonly encountered, age-related hearing loss is highly prevalent among older adults and may affect overall neurological assessment, including neurocognitive testing, as well as patient-provider communication, patient satisfaction, and care outcomes. Hearing loss is increasingly recognized as a potentially modifiable risk factor for dementia. Neurologists can support the hearing health of their patients through the routine use of communication strategies and by integrating simple, low-cost technology with their current clinical practices. Both acute and chronic hearing loss can be a symptom of many conditions managed by neurologists. Few conditions are emergent, requiring immediate referral to and treatment by an otolaryngologist-head and neck surgeon. Despite the range of hearing interventions available, including hearing aids, over-the-counter devices, and aural rehabilitation, hearing loss is a common and under-treated chronic health condition. By promptly addressing a patient's hearing concerns, neurologists can improve patients' awareness of the deficit and support the overall importance of maintaining sensory health across the life course.

Adults who report difficulty hearing speech in noise: an exploration of experiences, impacts and coping strategies

Objective: Listening difficulties in noise are common, even in those with clinically normal hearing. There is a suggestion that subjective assessment of hearing difficulties may be more closely associated with listening effort and fatigue rather than objective measures of hearing and/or speech perception. The aim of this study was to better understand these perceptual deficits and experiences of this population.Design: An exploratory survey was distributed to participants with self-reported listening-in-noise difficulties. The primary aim of the survey was to gather information about challenging listening environments, its impact, and preferred rehabilitation strategies. Secondly, responses were compared to their performance on behavioural tasks.Study sample: Fifty adults aged 33–55 (22 females, with normal or near-normal hearing thresholds), completed the survey, and 45 of these performed behavioural tasks.Results: Background noise with conversational content was the most common source of hearing difficulties. Participants expended higher concentration and attention when communicating in noise, and correlations with previously published behavioural data was reported. Social impacts varied, few had sought treatment, and respondents preferred training over devices.Conclusions: Insights gained may provide clinicians and researchers with an understanding of the situations, impacts and non-auditory factors associated with listening-in-noise difficulties, and preferred rehabilitation for these clients.

Health-related Quality of Life of Individuals With Neurofibromatosis Type 2: Results From the NF2 Natural History Study.

To explore health-related quality of life (HRQoL) reported by individuals with neurofibromatosis type 2 (NF2) and to assess for correlations between HRQoL and objective measures of disease manifestations. Prospective observational study. Seven international NF2 centers. Eighty-one individuals with NF2, 73 adults (>18 years) and 8 children/adolescents (10-17 years). Quality of life was measured by Short Form-36 (SF-36) norm-based scores. Objective clinical measures were hearing (categorized by word-recognition scores), facial function (categorized by the House-Brackmann scale) and the volume of subjects' larger vestibular schwannoma (VS). At baseline, adults showed significant deficits in all but two subscales of the SF-36 compared with age- and gender-adjusted United States population norms. In linear regression models including age, gender, inheritance status, hearing, facial weakness and VS volume, demographic and functional measures showed no relationship to any SF-36 subscale. Larger baseline VS volume was significantly related to reduced physical role performance, reduced mental health, and increased pain (p < 0.05). In bivariate analysis, previous VS surgery was not significantly associated with baseline HRQoL; receipt of VS surgery or tumor growth during the observation period was not significantly associated with changes in HRQoL. NF2 patients report reduced HRQoL in physical, social, and mental domains, but this was not significantly related to objective measures of hearing or facial functioning. Larger baseline VS volume negatively impacted patient-reported HRQoL whereas VS surgery or tumor growth did not. Future studies should explore the relationship between tumor volume and HRQoL and psychosocial factors that may moderate this relationship.

Age Affects Responses on the Speech, Spatial, and Qualities of Hearing Scale (SSQ) by Adults with Minimal Audiometric Loss

Age-related declines in auditory and cognitive processing may contribute to the difficulties with listening in noise that are often reported by older adults. Such difficulties are reported even by those who have relatively good audiograms that could be considered "normal" for their age (ISO 7029-2000 [ISO, 2000]). The Speech, Spatial, and Qualities of Hearing Scale (SSQ; Gatehouse and Noble, 2004) is a questionnaire developed to measure a listener's self-reported ability to hear in a variety of everyday situations, such as those that are challenging for older adults, and it can provide insights into the possible contributions of auditory and cognitive factors to their listening difficulties. The SSQ has been shown to be a sensitive and reliable questionnaire to detect benefits associated with the use of different hearing technologies and potentially other forms of intervention. Establishing how age-matched listeners with audiograms "normal" for their age rate the items on the SSQ could enable an extension of its use in audiological assessment and in setting rehabilitative goals. The main purpose of this study was to investigate how younger and older adults who passed audiometric screening and who had thresholds considered to be "normal" for their age responded on the SSQ. It was also of interest to compare these results to those reported previously for older listeners with hearing loss in an attempt to tease out the relative effects of age and hearing loss. The SSQ was administered to 48 younger (mean age = 19 yr; SD = 1.0) and 48 older (mean age = 70 yr, SD = 4.1) adults with clinically normal audiometric thresholds below 4 kHz. The younger adults were recruited through an introductory psychology course, and the older adults were volunteers from the local community. Both age groups completed the SSQ. The differences between the groups were analyzed. Correlations were used to compare the pattern of results across items for the two age groups in the present study and to assess the relationship between SSQ scores and objective measures of hearing. Comparisons were also made to published results for older adults with hearing loss. The pattern of reported difficulty across items was similar for both age groups, but younger adults had significantly higher scores than older adults on 42 of the 46 items. On average, younger adults scored 8.8 (SD = 0.6) out of 10 and older adults scored 7.7 (SD = 1.2) out of 10. By comparison, scores of 5.5 (SD = 1.9) have been reported for older adults (mean age = 71 yr, SD = 8.1) with moderate hearing loss (Gatehouse and Noble, 2004). By establishing the best scores that could reasonably be expected from younger and older adults with "normal" hearing thresholds, these results provide clinicians with information that should assist them in setting realistic targets for interventions for adults of different ages.

Distortion Product Emissions in Humans

The realization that otoacoustic emissions are sensitive to cochlear disorders has resulted in the speculation that they may have considerable clinical potential as objective measures of hearing. To assess the clinical utility of one type of emission, the distortion product emission (DPE), a study was undertaken in individuals with hearing impairments representing a number of common otologic disorders. The results of this investigation provided evidence that tests of DPEs promise to satisfy a number of requirements important to clinical testing, including objectivity of measurement procedures, test-retest reliability, simple subject preparation, readily available instrumentation, and relatively brief examination periods. The fine resolution of DPEs within the stimulus frequency and level domains also permits an accurate confirmation of the pattern of hearing loss. For example, tests of DPEs detected a 20-dB hearing level impairment at a single frequency in an ear exhibiting early signs of noise-induced hearing loss, and a 10-dB improvement in sensitivity following ingestion of the hyperosmotic agent glycerol in an ear displaying a mild to moderate hearing loss due to Meniere's disease. Finally, the application of DPEs to the objective testing of otologic disorders suggests that the ability of these responses to assess the sensory component of a sensorineural disorder may contribute to the eventual understanding of the complicated pathogenesis of many cochlear diseases. When all the positive features of DPE testing are realized, the potential contribution that these measures can make in a clinical setting becomes apparent.