Presence Of Hearing Impairment Research Articles

Dependency and associated factors among elderly in central Kerala

Background: Globally the proportion of elderly has been increasing and physical dependency is one of major problem faced by elderly. Physical dependency will affect the quality of life. Despite this, very limited number of studies were done to assess the dependency among elderly. Aim was to estimate the prevalence of dependency and to determine the association between selected factors and dependency among elderly >60 years. Methods: A cross-sectional study was conducted among 352 elderly in Athirampuzha Panchayat using simple random sampling. A semi-structured interview schedule using basic activities of daily living scale-BADL (Katz scale) was used. Data was coded and entered in Microsoft Excel and analysed using IBM SPSS software version 22. Results: The mean age of participants was 71.68 years with a standard deviation of 8.457 years and the prevalence of dependency was found to be 30.7%. Univariate analysis results revealed that age (>85 years), occupation, living arrangement, presence of aphasia, hearing impairment, visual disturbances, locomotor disability, presence of comorbidity, onset of comorbidity and comorbid conditions like diabetes mellitus, coronary artery disease and chronic arthritis were found to have significant association with dependency. Binary logistic regression results revealed that factors like age group (>85 years), presence of hearing impairment, loco motor disability, onset of comorbidity, presence of diabetes mellitus and coronary artery disease were found to be independent predictors of dependency. Conclusions: Since dependency increases with age physical dependency is to be assessed periodically to achieve healthy ageing.

Association of Hearing Status and Cognition With Fall Among the Oldest-Old Chinese: A Nationally Representative Cohort Study.

The oldest-old (aged ≥80 years) are the most rapidly growing population and age is related to hearing impairment (HI) and cognitive decline. We aimed to estimate the association between HI and fall, and the effect of different cognitive states on this association among the oldest-old Chinese population. A total of 6931 Chinese oldest-old were included in the 2018 cross-cohort from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The presence of HI was identified by using a dichotomized metric of self-reported hearing status. Cognitive function was evaluated by using the modified Mini-Mental State Examination (MMSE). Cognitive impairment was defined as the MMSE score below 24 points. Data on fall history were collected by questionnaires survey from the participants or their relatives. We studied the association of hearing status and cognitive function with fall by using multivariable logistic regressions, upon adjustment of sociodemographic characteristics, lifestyles, and health conditions. Our participants were aged 92 (range 80 to 117) on average, with 60.1% being women. In total, 39.1% of the participants had reported HI, 50.1% had cognitive impairment, and 26.2% had a history of falling. Participants with HI had a higher incidence of cognitive impairment (79.4%), as compared with their counterparts without HI (31.3%). Compared with those without HI, HI patients had a higher risk of falling after full adjustment for potential confounders (OR = 1.16 [95% confidence interval, CI, 1.01, 1.32], p = 0.031). In comparison with HI participants without cognitive impairment, HI patients with cognitive impairment had a higher fall risk (OR = 1.45 [95% CI = 1.23, 1.72], p < 0.001). Association of hearing status and cognition with fall was, for the first time, examined on the basis of a nationally-representative oldest-old Chinese population. Poor cognitive performance was common in individuals with HI, and those with HI and cognitive impairment further increased the risk of falling.

Is Auditory Steady-State Response Testing the Key for Diagnosing Non-Organic Hearing Disorders? Implications for Current Audiological Practice.

Background and ObjectivesTo describe all possible facets of non-organic hearing disorders (NOHD) and emphasize the superiority of auditory steady-state response (ASSR) over previously employed hearing assessment tools.Subjects and MethodsA series of seven patients consisting of three males and four females with NOHD were assessed at Attikon University Hospital (age range: 17-59 years). Three patients had Munchausen syndrome, three intentionally feigned hearing loss, and one intentionally feigned normal hearing. The audiological evaluation consisted of tympanometry, pure-tone audiometry, and ASSR testing.ResultsThe hearing of all patients was accurately determined using ASSR. The results were confirmed by auditory brainstem responses (ABR) and otoacoustic emissions.ConclusionsNOHD is a multi-faceted condition encompassing various etiologies. ASSR testing represents an objective and reliable method of hearing assessment, which can serve as a gold standard method for distinguishing NOHD from actual hearing loss. It can reliably indicate the hearing levels at the four main frequencies (500, 1,000, 2,000, and 4,000 Hz) by obtaining a valid estimated audiogram through statistical measures. Compared to ABR testing, ASSR thresholds are closer to the actual audiometric thresholds in the presence of hearing impairment and are superior when the corresponding pure-tone audiogram is widely ranging between the adjacent frequencies or when the obtained ABR curves are not easily distinguished. A non-confrontational approach should be adopted by ENT doctors towards cases of suspected NOHD as the use of ASSR could reliably assess hearing even when medical or medico-legal implications are involved.

Early Retirement and Sensory Impairments: The Modifying Effect of Total Assets

Sensory impairments are common among older adults. Little is known on the association between sensory impairments, which impact labor productivity, and the effect modification of wealth. We used the 2006-2018 rounds of the Health and Retirement Study. Hearing (HI) and vision (VI) impairments (self-report) at baseline, and working status throughout the study period was observed. Logistic regression models, adjusted for demographic, socioeconomic, and health characteristics, were used to characterize the association of sensory impairment and early retirement (i.e., before age 65). Secondary analysis stratified by assets. Among 1,688 adults ages 53-64, 1,350 had no impairment, 140 had HI only, 141 VI only, and 57 had dual sensory impairment (DSI). Only adults with HI had higher odds of early retirement (Odds Ratio [OR]: 1.6; 95% Confidence Interval [CI]: 1.0,2.5) relative to those without sensory impairment. Among those with large assets, those with HI had higher odds (OR:2.6, 95% CI: 1.4,5.2) and those with VI had lower odds (OR. 0.37; 95% CI: 0.2,0.8) of early retirement. Among the low asset group, we found no differences across impairment groups for the odds of retirement. In sample of older adults, we provide evidence that the presence of hearing impairment is associated early retirement. Secondary analyses suggest wealth may modify this association which highlights the wealth disparities faced by people with sensory impairments.

Association between Hearing Impairment and Cognitive Decline: The Protective Role of Hearing Aids

Relationships between hearing impairment (HI) and dementia have been reported in elderly adults, and there is growing evidence that HI is an independent modifiable risk factor for dementia. However, there is insufficient evidence to recommend the use of hearing aids to reduce the risk of cognitive decline. To address these issues, we are currently conducting an observational study in cooperation with neurologists, gerontologists, and otorhinologists to investigate the association between cognitive function and HI in elderly adults. As part of this study, we also investigated this association using data from healthcare check-up programs for community dwellers. We analyzed the data of 1602 eligible community-dwellers. Hearing aid users were older and less likely to exhibit cognitive impairment than non-hearing aid users. Multivariate logistic regression analysis showed that HI was independently associated with an inability to draw a clock correctly (odds ratio 1.60, 95% confidence interval 1.12-2.26). Compared with those in Western countries, the usage rate of hearing aids in Japan is lower, although the rate of elderly adults presenting with HI is similar to those in Western countries. Both otorhinologists and geriatricians should be aware of the potential presence of HI in elderly adults.

Cortical and subcortical gray matter changes in patients with chronic tinnitus sustaining after vestibular schwannoma surgery

Tinnitus is attributed to partial sensory deafferentation resulting in a central maladaptive neuroplasticity. Unfortunately, the agent of deafferentation is usually unknown or irreversible. In patients with unilateral vestibular schwannoma (VS), however, the auditory nerve is affected by a benign tumor. Hence, removal of the tumor can cease the tinnitus. In turn, sustaining complaints after surgery indicate cortical neuroplasticity. The present study is a cross sectional study which aims to track cortical structural changes by surface-based morphometry in 46 VS patients with sustained (i.e. centralized) or ceased (i.e. peripheral) tinnitus after surgery. A volumetric analysis of cortical and subcortical gray matter (GM) anatomy was performed on preoperative high-resolution MRI and related to the presence of hearing impairment, pre- and/or postoperative tinnitus. Patients with sustained (i.e. chronic) tinnitus showed an increased GM volume of the bilateral caudate nucleus, the contralateral superior colliculus, the middle frontal and middle temporal gyrus, the fusiform gyrus as well as the ipsilateral pars orbitalis when compared to those patients in whom tinnitus ceased postoperatively. Chronic tinnitus in VS patients is associated with characteristic structural changes in frontal, temporal and subcortical areas. Notably, a significant GM change of the caudate nucleus was detected providing further support for the striatal gaiting model of tinnitus.

A Study on the Relationship between Cognitive Performance, Hearing Impairment, and Frailty in Older Adults

Introduction: As the human lifespan rises, older people are increasingly affected by multimorbidity, including hearing impairment (HI), frailty, and cognitive decline. Objective: We studied the effect of HI on the cognitive performance of older patients with mild cognitive impairment and mild dementia and how this effect is altered when HI and frailty coexist. Methods: The sample comprised 172 outpatients (age ≥65 years) with a Clinical Dementia Rating of 0.5–1 and a Mini-Mental State Examination score ≥20. Cognitive, neuropsychological, physical function tests, and body measurements were performed. The participants’ comorbidity indices were calculated, and they were asked to report their hearing condition. Finally, the participants were divided into 4 groups based on the presence of frailty, HI, both conditions, or neither. Results: The presence of HI was significantly associated with a lower Digit Symbol Substitution Test (DSST) score (unadjusted model: p = 0.003; adjusted: p = 0.012). Moreover, people with both HI and frailty were more likely to have a low DSST score than those in the other groups (unadjusted model: OR: 3.741, 95% CI: 1.374–10.183, p = 0.010; adjusted model: OR: 4.192, 95% CI: 1.026–17.136, p = 0.046). Conclusions: This study highlights the negative relationship between cognitive performance scored on the DSST and the presence of HI. Furthermore, the presence of both frailty and HI is associated with a worse cognitive score than HI alone.

RELATIONSHIP BETWEEN SOMATOTYPE AND LONGITUDINAL BODY SIZES IN THE PRACTICALLY HEALTHY CHILDREN OF 6-8 YEARS OLD AND THEIR YEARLING WITH HEARING IMPAIRMENT

Introduction. Somatotype is a form of manifestation the natural biological diversity, which is discrete and determines natural composition different variants of the constitution typology. Somatotype reflects main features in the dynamics of ontogenesis, metabolism, reactivity of the organism. These properties form individual features of the structure and, consequently, functions of the organism, determine its response to ever-changing environmental factors. Aim is to study relationship between somatotype in the children of 6-8 years and longitudinal dimensions of their bodies. Material and methods: analysis and generalization of scientific and methodological literature, anthropometric measurements included determining length and weight of the body, chest, shoulder, waist and thighs, measuring thickness of the skin and fat folds of the biceps, triceps, forearms, shoulder blades, abdomen, legs and thighs. Determination of somatotype was carried out by W.H. Sheldon: digestive, muscular, thoracic, asthenoid. Attention was focused on the development and ratio of such features as shape of the back, chest, abdomen, legs, state of development the bone, muscle and adipose tissue, statistical analysis. Results. There are measured and analyzed differences between the longitudinal body sizes in a practically healthy children and children of 6-8 years with hearing impairment depending on their somatotypes. Correlation analysis of a longitudinal body size allowed to determine common for all groups of children tendency to a direct dependence length of the body and torso on the somatotype in the examined children. At the same time, it is shown inverse relationship between somatotype of children with length of the upper and lower extremities, forearms, hands and legs. Conclusions. Cluster analysis confirmed that formation four subgroups of somatotypes in the children of 6-8 years determined by a longitudinal size of their body. Unlike practically healthy, at the children with disturbance of hearing with asthenoid and thoracic somatotypes, there are no differences between length of the body and length of the forearm, and in the children with thoracic and digestive somatotypes – between lengths of the hand. There is a different relationship between type of somatotype in the children of 6-8 years with a longitudinal size of their body, which did not depend on the gender and presence of hearing impairment. It is confirmed, that children with higher body and body characteristics belong to the muscular or digestive, and with higher extremities – to the asthenoid and thoracic somatotypes

Examining the independent and joint effects of molecular genetic liability and environmental exposures in schizophrenia: results from the EUGEI study.

Schizophrenia is a heritable complex phenotype associated with a background risk involving multiple common genetic variants of small effect and a multitude of environmental exposures. Early twin and family studies using proxy-genetic liability measures suggest gene-environment interaction in the etiology of schizophrenia spectrum disorders, but the molecular evidence is scarce. Here, by analyzing the main and joint associations of polygenic risk score for schizophrenia (PRS-SCZ) and environmental exposures in 1,699 patients with a diagnosis of schizophrenia spectrum disorders and 1,542 unrelated controls with no lifetime history of a diagnosis of those disorders, we provide further evidence for gene-environment interaction in schizophrenia. Evidence was found for additive interaction of molecular genetic risk state for schizophrenia (binary mode of PRS-SCZ above 75% of the control distribution) with the presence of lifetime regular cannabis use and exposure to early-life adversities (sexual abuse, emotional abuse, emotional neglect, and bullying), but not with the presence of hearing impairment, season of birth (winter birth), and exposure to physical abuse or physical neglect in childhood. The sensitivity analyses replacing the a priori PRS-SCZ at 75% with alternative cut-points (50% and 25%) confirmed the additive interaction. Our results suggest that the etiopathogenesis of schizophrenia involves genetic underpinnings that act by making individuals more sensitive to the effects of some environmental exposures.

Validity of the modified Berg Balance Scale in adults with intellectual and visual disabilities

BackgroundA modified version of the Berg Balance Scale (mBBS) was developed for individuals with intellectual and visual disabilities (IVD). However, the concurrent and predictive validity has not yet been determined. AimThe purpose of the current study was to evaluate the concurrent and predictive validity of the mBBS for individuals with IVD. MethodFifty-four individuals with IVD and Gross Motor Functioning Classification System (GMFCS) Levels I and II participated in this study. The mBBS, the Centre of Gravity (COG), the Comfortable Walking Speed (CWS), and the Barthel Index (BI) were assessed during one session in order to determine the concurrent validity. The percentage of explained variance was determined by analyzing the squared multiple correlation between the mBBS and the BI, COG, CWS, GMFCS, and age, gender, level of intellectual disability, presence of epilepsy, level of visual impairment, and presence of hearing impairment. Furthermore, an overview of the degree of dependence between the mBBS, BI, CWS, and COG was obtained by graphic modelling. Predictive validity of mBBS was determined with respect to the number of falling incidents during 26 weeks and evaluated with Zero-inflated regression models using the explanatory variables of mBBS, BI, COG, CWS, and GMFCS. ResultsThe results demonstrated that two significant explanatory variables, the GMFCS Level and the BI, and one non-significant variable, the CWS, explained approximately 60% of the mBBS variance. Graphical modelling revealed that BI was the most important explanatory variable for mBBS moreso than COG and CWS. Zero-inflated regression on the frequency of falling incidents demonstrated that the mBBS was not predictive, however, COG and CWS were. ConclusionsThe results indicated that the concurrent validity as well as the predictive validity of mBBS were low for persons with IVD.

Effect of palatoplasty on hearing ability of nonsyndromic cleft palate patients: A prospective clinical study

Introduction: Cleft palate patients suffer from many comorbidities, otitis media with effusion being one of them. There is a universal consensus regarding the presence of hearing impairment in such patients. However, there are different schools of thought regarding the effect of palatal repair on hearing ability. Hence, this study was conducted to find out the effect of palatoplasty on hearing ability of children with cleft palate. Patients and Methods: Seventy-five patients with cleft palate underwent palatoplasty and were subjected to otoscopy and brainstem evoked response audiometry, preoperatively, 1 month postoperatively and 6 months postoperatively. The otoscopy and audiometry findings were statistically analyzed using Chi-square test and students unpaired t-test. Results: Ninety-two percent of patients had hearing impairment with majority of them belonging to age group

OP02.02: 3D‐virtual reality CRL and embryonic volume measurements in aneuploid fetuses

centile) 2) Control group (n = 88) included patients whose infants were appropriate for gestational age (birth weight >10th centile). Poor neurodevelopmental outcome was defined as the presence of hearing impairment or severe developmental delay and was compared between the two groups. Results: Primary CMV infection occurred during the first trimester in 5 (33%) of the IUGR cases and 26 (29%) of the control cases (P = 0.8). The mean birth weight in the study group was 2460 gr compared to 3180 gr among the control patients (P < 0.01). The median age of children at follow-up was 2 years (range 3 months–8 years). The rate of poor neurodevelopmental outcome was similar among the two groups: Two (13%) infants in the study group had hearing impairment whereas 8 (9%) of the infants in the control group were diagnosed with hearing impairment (7) or developmental delay (1) on post-natal follow-up (P = 0.6). Conclusions: The outcome of congenital CMV infection does not seem to be affected by the presence of isolated IUGR. Therefore, the prognostic value of IUGR as a sole finding in fetuses infected by CMV is limited.

OP02.01: Early first trimester 3D‐US trophoblast volume measurements using VOCAL technique

centile) 2) Control group (n = 88) included patients whose infants were appropriate for gestational age (birth weight >10th centile). Poor neurodevelopmental outcome was defined as the presence of hearing impairment or severe developmental delay and was compared between the two groups. Results: Primary CMV infection occurred during the first trimester in 5 (33%) of the IUGR cases and 26 (29%) of the control cases (P = 0.8). The mean birth weight in the study group was 2460 gr compared to 3180 gr among the control patients (P < 0.01). The median age of children at follow-up was 2 years (range 3 months–8 years). The rate of poor neurodevelopmental outcome was similar among the two groups: Two (13%) infants in the study group had hearing impairment whereas 8 (9%) of the infants in the control group were diagnosed with hearing impairment (7) or developmental delay (1) on post-natal follow-up (P = 0.6). Conclusions: The outcome of congenital CMV infection does not seem to be affected by the presence of isolated IUGR. Therefore, the prognostic value of IUGR as a sole finding in fetuses infected by CMV is limited.

Clinical Presentation and the Presence of Hearing Impairment in Branchio-Oculo-Facial Syndrome: A New Mutation in the TFAP2A Gene

We report on the clinical presentation of branchio-oculo-facial (BOF) syndrome in 2 patients with mutations in the TFAP2A gene (OMIM 107580). This TFAP2A gene was recently shown to be involved in the causation of BOF syndrome. An overview of the literature on BOF syndrome is given based on clinical reports written in the period during which mutation analysis was not yet available for BOF syndrome. We also give descriptions of the mutations in the TFAP2A gene in our 2 new patients with BOF syndrome. Congenital conductive hearing impairments are described, including hearing rehabilitation and the results of ear surgery.

Perda auditiva leve: desempenho no Teste da Habilidade de Atenção Auditiva Sustentada

hearing loss during childhood is considered a risk factor for developmental delay. to verify the performance of children diagnosed with mild hearing loss, conductive and sensorineural, in the Sustained Auditory Attention Ability Test (SAAAT). The purpose of the study was to verify if the test is influenced by the presence of hearing impairment. a clinical study of the SAAAT considering three groups: Group 1 (G1) control group composed by children with normal hearing, Group 2 (G2) composed by children with mild bilateral sensorineural hearing loss and Group 3 (G3), composed by children with mild bilateral conductive hearing loss. Participants were children with ages between 7 and 11 years; 30 children in each group. A prospective study. Pure Tone Audiometry, Acoustic Imittance Measures and SAAAT. children with sensorineural and conductive hearing loss presented a lower performance in all of the SAAT results when compared to the control group. the SAAAT was influenced by the presence of mild hearing impairment, considering that the greatest influence was observed in the presence of sensorineural hearing loss.

A test battery to assess localization ability in simulated complex acoustic environments.

In complex acoustic environments, following a target sound is made difficult by the presence of noise and reverberation and especially hearing impaired people struggle understanding speech in such settings. Localizing the speaker is important in such situations to follow discussions and to gain additional benefit from visual cues. A test battery is proposed to quantify localization performance in different realistic environments and with laboratory tests when noise and reverberation are present. The aim is to relate real‐life performance to that in simplified tests. In the localization tests, participants indicate the sound location with a visual pointer. Sounds are played in an anechoic chamber from loudspeakers across the frontal hemi‐field. Localization performance is measured in quiet, in diffuse background noise, and with reverberation of simulated rooms. The ability to cope with a single reflection is assessed in a precedence effect paradigm where participants localize a sound and its delayed copy for various delays and levels. The test battery is completed by questionnaires (e.g., SSQ), a speech, and a cognitive test. By cross‐comparing results from the tests, we attempt to predict the performance in real‐world environments from outcomes of simplified tests particularly in the presence of hearing impairment.

Non-invasive measurements of intralabyrinthine pressure changes by electrocochleography and otoacoustic emissions

By varying the mechanical load on the stapes footplate, intralabyrinthine pressure (ILP) influences the stiffness of the middle ear and modifies its transfer function. This results in a characteristic phase shift of the otoacoustic emissions (OAEs) around 1 kHz [Buki, B., Avan, P., Lemaire, J.J., Dordain, M., Chazal, J., Ribari, O., 1996. Otoacoustic emissions: a new tool for monitoring intracranial pressure changes through stapes displacements. Hear. Res. 94, 125–139]. This finding provides non-invasive means of monitoring changes of ILP and indirectly of intracranial pressure. Yet the vulnerability of OAEs to sensorineural hearing loss excludes many patients from being monitored in this manner. Being dependent on the middle-ear transfer function, the phase of the cochlear microphonic potential (CM) around 1 kHz should also respond to ILP changes while being less affected by impaired hearing than OAEs. Here, normal volunteers were subjected to body tilt resulting in stepwise changes in their intracranial pressure and ILP. Their CM around 1 kHz was recorded by extratympanic electrocochleography and its dependence on body position was compared to that of distortion-product OAEs. The posture-induced CM changes were also monitored in ears with sensorineural deafness and impaired OAEs to assess the usefulness of CM in the presence of hearing impairment. Last, OAEs and CM were simultaneously monitored in gerbils during intracranial pressure changes brought about via an intracranial catheter. The phase and level shifts induced by body tilt in man and intracranial pressure changes in gerbils showed up both in distortion-product OAEs and CM with similar time courses. In normally-hearing subjects, the mean phase shifts reached 16.3° for CM and 41.6° for OAEs, and CM remained large enough in hearing-impaired subjects for ILP to be monitored. The ratio of about two of OAEs to CM phase shifts matched the prediction of middle-ear models allowing for the fact that CM does not travel back through the middle ear while OAEs do. It follows that CM phase around 1 kHz provides non-invasive access to ILP changes even if OAEs cannot be measured due to sensorineural hearing loss.

Muscle Phenotype and Mutation Load in 51 Persons With the 3243A&gt;G Mitochondrial DNA Mutation

Mitochondrial disorders are generally not associated with a clear phenotype-genotype relationship, which complicates the understanding of the disease and genetic counseling. To investigate the relationship between the muscle and blood mitochondrial DNA mutation load and phenotype. Survey. The Neuromuscular Research Unit, Rigshospitalet, Copenhagen, Denmark. Fifty-one persons with the 3243A>G point mutation of mitochondrial DNA, and 20 healthy control subjects. We recorded the maximal oxygen uptake (Vo(2)max), maximal workload, resting and peak-exercise plasma lactate levels, muscle and blood mutation load, muscle morphology, and presence of diabetes mellitus and hearing impairment in all subjects. Muscle mutation load (mean +/- SE, 50% +/- 5%; range, 2%-95%) correlated with Vo(2)max and resting plasma lactate level (P<.001; R>/=0.64). All persons except 5 with a muscle mutation load above 50% had abnormal Vo(2)max and morphology on muscle biopsy findings. Persons with hearing impairment and diabetes mellitus had a muscle mutation load above 65%. The mutation load in blood (mean +/- SE, 18% +/- 3%; range, 0%-61%) did not correlate with Vo(2)max, resting plasma lactate levels, or presence of hearing impairment or diabetes mellitus. This study demonstrates a close relationship between the muscle mutation load and phenotype in persons carrying the 3243A>G mutation. The lack of correlation between the mutation load in blood and symptoms from other tissues emphasizes the importance of assessing phenotype-genotype correlations in the same tissue in mitochondrial disease. The results indicate that the threshold of muscle mutation load at which oxidative impairment occurs can be as low as 50%, which is as much as 40% lower than that suggested by in vitro studies.

Hearing impairment and psychosis: A replication in a cohort of young adults

Previous work has demonstrated an association between hearing impairment and psychosis. In the current study, this association was studied in a cohort of young people. In addition, it was studied to what degree duration of hearing problems (i.e. onset earlier in life) impacted on risk. Data were derived from the Greek National Perinatal Survey, a prospective birth cohort study of 11,048 neonates at baseline, 6594 seven-year olds at T1 and 3500 nineteen-year olds at T2. A significant association was found at age 19 years between the presence of hearing impairment and the presence of self-reported positive psychotic-like experiences ( β = 0.18, S.E. = 0.02, p < 0.000). In addition, this association was conditional on the duration of hearing problems, in that the association at age 19 years was stronger if hearing impairment had already been reported at age 7 years (test for interaction: p = 0.022). These results replicate previous findings of an association between hearing impairment and psychosis, extend it to the age range of late adolescence, and suggest that longer duration is associated with stronger risk.

Academic and behavioral limitations and health-related quality of life in school-age survivors of bacterial meningitis

The objectives of this study were to describe health-related quality of life of postmeningitic children and to examine the association between academic and/or behavioral limitations and health-related quality of life. One hundred and eighty-two children (mean age 9.7 years; range 5.3-14.2) were selected randomly from a cohort of 674 school-age children who recovered from non-Haemophilus influenzae type B bacterial meningitis. These children had neither meningitis with 'complex onset', nor prior cognitive or behavioral problems, nor severe disease sequelae. On average 7.4 years after meningitis, they were evaluated using an 'Academic Achievement Test' and their parents filled in the Child Behavior Checklist, the Child Health Questionnaire, and the Health Utilities Index. The long-term incidence of academic and/or behavioral limitations was 32%. Overall health-related quality of life of the postmeningitic children was decreased in comparison with that of a reference population of schoolchildren. The group of postmeningitic children with academic and/or behavioral limitations showed the most marked decrease in quality of life, especially concerning psychosocial health, cognition and family life. The negative effects on quality of life were not significantly influenced by age, gender, causative pathogen, presence of minor neurological impairment, or presence of hearing impairment. In conclusion, health-related quality of life of postmeningitic children is decreased, particularly of those with academic and/or behavioral limitations.