Query: hearing loss older

title: Hearing Loss and Depression in Older Adults: A Systematic Review and Meta analysis.
abstract: Studies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta analysis of the evidence.  A search of academic databases (e.g. MEDLINE) and gray literature (e.g. OpenGrey) identified relevant articles published up to July 17, 2018. Cross sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random effects meta analysis ( A total of 147,148 participants from 35 studies met inclusion criteria. Twenty four studies were cross sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR 1.47, 95% confidence interval [CI] 1.31 1.65) When studies were stratified by design, hearing loss was associated with greater odds of depression in cross sectional studies (OR 1.54, 95% CI 1.31 1.80) and cohort studies (OR 1.39, 95% CI 1.16 1.67) and there was no difference between cross sectional or cohort effect estimates (Q 0.64, p .42) There was no effect of moderator variables (i.e. hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as "low."  Older adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.

title: Characteristics of Real World Signal to Noise Ratios and Speech Listening Situations of Older Adults With Mild to Moderate Hearing Loss
abstract: The first objective was to determine the relationship between speech level, noise level, and signal to noise ratio (SNR) as well as the distribution of SNR, in real world situations wherein older adults with hearing loss are listening to speech. The second objective was to develop a set of prototype listening situations (PLSs) that describe the speech level, noise level, SNR, availability of visual cues, and locations of speech and noise sources of typical speech listening situations experienced by these individuals.  Twenty older adults with mild to moderate hearing loss carried digital recorders for 5 to 6 weeks to record sounds for 10 hours per day. They also repeatedly completed in situ surveys on smartphones several times per day to report the characteristics of their current environments, including the locations of the primary talker (if they were listening to speech) and noise source (if it was noisy) and the availability of visual cues. For surveys where speech listening was indicated, the corresponding audio recording was examined. Speech plus noise and noise only segments were extracted, and the SNR was estimated using a power subtraction technique. SNRs and the associated survey data were subjected to cluster analysis to develop PLSs.  The speech level, noise level, and SNR of 894 listening situations were analyzed to address the first objective. Results suggested that as noise levels increased from 40 to 74 dBA, speech levels systematically increased from 60 to 74 dBA, and SNR decreased from 20 to 0 dB. Most SNRs (62.9% of the collected recordings were between 2 and 14 dB. Very noisy situations that had SNRs below 0 dB comprised 7.5% of the listening situations. To address the second objective, recordings and survey data from 718 observations were analyzed. Cluster analysis suggested that the participants' daily listening situations could be grouped into 12 clusters (i.e. 12 PLSs) The most frequently occurring PLSs were characterized as having the talker in front of the listener with visual cues available, either in quiet or in diffuse noise. The mean speech level of the PLSs that described quiet situations was 62.8 dBA, and the mean SNR of the PLSs that represented noisy environments was 7.4 dB (speech 67.9 dBA) A subset of observations (n 280) which was obtained by excluding the data collected from quiet environments, was further used to develop PLSs that represent noisier situations. From this subset, two PLSs were identified. These two PLSs had lower SNRs (mean 4.2 dB) but the most frequent situations still involved speech from in front of the listener in diffuse noise with visual cues available.  The present study indicated that visual cues and diffuse noise were exceedingly common in real world speech listening situations, while environments with negative SNRs were relatively rare. The characteristics of speech level, noise level, and SNR, together with the PLS information reported by the present study, can be useful for researchers aiming to design ecologically valid assessment procedures to estimate real world speech communicative functions for older adults with hearing loss.

title: A novel study on association between untreated hearing loss and cognitive functions of older adults: Baseline non verbal cognitive assessment results
abstract: Age related hearing loss (ARHL) is highly prevalent in older adults, and more than two thirds above age of 70 years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment; however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in overestimation of cognitive impairment in such individuals. This baseline cross sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined.

title: Hearing loss and associated medical conditions among individuals 65 years and older.
abstract: Hearing loss is prevalent, but few studies have investigated its associations with common medical conditions.  The objective was to assess the prevalence of medical conditions among individuals with hearing loss, compared to those without hearing loss, in people aged 65 years and older.  The National Health Interview Survey (NHIS) collects data on a variety of health related topics, including disability. Three years of NHIS data (2011 2013; unweighted n 53,111) were pooled to examine subpopulations of individuals with hearing loss. Comparisons were made between adults aged 65 and older with, and without, self reported hearing loss. Statistical analysis included descriptive frequencies, Chi square tests, and multiple logistic regressions. The outcomes of interest included self reported diagnosis of arthritis, cardiovascular disease, diabetes, high blood pressure, emphysema, stroke, cancer, asthma, multiple chronic conditions, health status, and obesity.  Hearing loss prevalence was nearly 37% After adjusting for sociodemographics, smoking status, and disability, hearing loss was independently associated with the following conditions: arthritis (OR 1.41; 1.27 1.57) cancer (OR 1.35; 1.21 1.5) cardiovascular disease (OR 1.48; 1.33 1.66) diabetes (OR 1.16; 1.03 1.31) emphysema (OR 1.41; 1.14 1.74) high blood pressure (OR 1.29; 1.17 1.43) and stroke (OR 1.39; 1.12 1.66) There was an association with worse health status over the past year (OR 1.5 (1.3 1.73)  Hearing loss among older individuals is independently associated with increased disease burden and poorer self reported health. Future studies are needed to investigate the mechanistic nature of these associations, and whether improved access to hearing healthcare surveillance can reduce the overall health burden among these individuals.

title: Association between speech and high frequency hearing loss and depression, anxiety and stress in older adults.
abstract: Age related hearing loss (ARHL) and depression are considered leading causes of disability in older adults. This cross sectional study investigated the association between the severity of speech and high frequency ARHL and depression, anxiety and stress in older adults.   A hearing assessment was completed by 151 participants (73 males and 78 females; M 64.44 10.77 years) Based on their better ear speech (0.5, 1, 2, 4 kHz) and high frequency (6 8 kHz) hearing thresholds, they were divided three groups: those with normal hearing; those with mild to moderate hearing loss; and those with moderately severe to profound hearing loss. All participants also completed the Depression, Anxiety and Stress Scale (DASS 21)  A binomial logistic regression analysis revealed that the respective odds ratios (ORs) (95% confidence interval) of clinically significant depression, anxiety and stress for participants with a moderately severe to profound hearing loss across the speech frequency range were: 27.51 (3.25, 232.95) 5.89 (1.95, 17.73) and 5.64 (1.55, 20.48) Similarly, the respective ORs of clinically significant depression, anxiety and stress were 6.54 (0.75, 57.02) 6.21 (1.52, 25.33) and 5.32 (1.02, 27.75) for participants with moderately severe to profound hearing loss across high frequencies. The non parametric Cuzik test revealed a statistically significant positive (p .05) trend of association between both better ear speech and high frequency hearing loss and DASS scores.  The observed graded associations suggest that hearing loss is a causative factor for clinically significant depression, anxiety and stress symptoms.

title: Hearing loss prevalence and risk factors among older adults in China
abstract: This study aims to investigate the prevalence of hearing loss, and to analyse the major demographics and risk factors that influence the prevalence in older adults of China.   Probability proportionate to size sampling (PPS) was adopted for this survey. Among 45,052 individuals, 6984 older adults =60 years) were selected as subjects for this study.  The prevalence of hearing loss defined as a speech frequency pure tone average of more than 25 dB HL in the better ear was 58.85% Age and gender were the factors most strongly associated with hearing loss after multivariate adjustment. Ear disease, diabetes, hypertension, atherosclerosis, noise exposure, and ototoxic drugs were significantly correlated with hearing loss. The largest effects were found for ear disease and noise exposure (OR 2.83 [95% CI: 2.43 3.29] OR 2.59 [95% CI: 1.80 3.72]  Hearing loss is prevalent in nearly two thirds of adults aged 60 years and older in China population. Chronic diseases, ear disease, and noise are important factors in adults aged 60 years and older.

title: Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review.
abstract: The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population.  A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech Language Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools.  Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia related behavior problems.  Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

title: Association of Cardiovascular Comorbidities With Hearing Loss in the Older Old
abstract: In the United States, the population of individuals older than 80 years is expected to double in the next 40 years. Cardiovascular comorbidities are prevalent in this older old population, and their relationship with hearing loss has not been well characterized.  To investigate the association of cardiovascular disease (CVD) related risk factors with auditory function among the older old >80 years) Design, Setting, and Participants Audiological data and medical records from 2001 through 2014 of 433 patients aged 80 to 106 years at an academic medical center were analyzed in 2017.  The degree of low and high frequency hearing loss of participants with coronary artery disease, diabetes, hypertension, history of cerebrovascular accident, and smoking status was compared with that of disease free individuals. Rate of hearing loss was also determined.  Among the 433 patients (67% female; mean [SD] age, 89 [5.8] years) the presence of at least 1 cardiovascular morbidity was associated with elevated mean (SD) low frequency pure tone average (LFPTA) of 42.4 (1.6) vs 36.9 (3.5) decibels hearing loss (dB HL) a difference of 5.47 (95% CI, 4.15 9.49) dB HL. Among the 96 patients with 2 audiograms performed at age 80 years or older from which the rate of hearing loss could be calculated, 32 patients had CVD or related risk factors and 64 were healthy controls. Those with at least 1 disease had accelerated hearing loss. Patients with cardiovascular morbidity experienced a faster mean (SD) decline in LFPTA of 1.90 (0.27) vs 1.18 (0.42) dB HL/y, a difference of 0.72 (95% CI, 0.08 1.36) dB HL/y. Of the conditions studied, coronary artery disease had the highest association with audiometric thresholds and was associated with hearing loss at all frequencies tested and with poor word recognition score. Hearing loss was more strongly associated with CVD risk factors in men than in women.  In this study of the older old, cardiovascular risk factors and disease were associated with worse hearing and a greater rate of hearing deterioration. Hearing loss in women was less associated with the presence of CVD, possibly owing to the cardioprotective effects of estrogen. The association of hearing with CVD severity and management remains to be determined.

title: Hearing loss in older adults From epidemiological insights to national initiatives
abstract: The broader implications of hearing loss for the health and functioning of older adults have begun to be demonstrated in epidemiologic studies. These research findings on the association between hearing loss and poorer health outcomes have formed the foundation for national initiatives on hearing loss and public health. These national initiatives range from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) clinical trial to the recent passage of the bipartisan Over The Counter Hearing Aid Act. Utilizing population health research methodologies to study hearing loss can provide the foundation for initiating top down approaches to increase the adoption and accessibility of hearing care for older Americans with hearing loss. HighlightsEpidemiologic studies have informed national initiatives to address hearing care.National initiatives are transforming how hearing loss is addressed.Policy changes could enhance adoption of hearing aids and improve hearing care access.

title: Prevalence of age related hearing loss, including sex differences, in older adults in a large cohort study
abstract: To obtain actual status of age related hearing loss in a general unscreened population of older Dutch adults and to investigate whether the prevalence or degree has changed over time.