ORCID Profile
0000-0003-3180-9884
Current Organisations
University of Queensland
,
University of Manchester
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Publisher: Wiley
Date: 09-03-2021
DOI: 10.1111/AJAG.12928
Abstract: This study assessed the long‐term symptom relapse rates among older adults previously treated with cognitive behaviour therapy (CBT) for anxiety and/or depression during COVID‐19. Participants were 37 older adults ( M = 75 years, SD = 5 65% female) previously treated with CBT for anxiety and/or unipolar depression who were re‐assessed an average of 5.6 years later, during the first Australian COVID‐19 lockdown. On average, there was no significant group‐level change in anxiety, depression or quality of life. When assessing change in symptoms based on clinical cut‐off points on self‐report measures, results suggest only 17%‐22% showed a relapse of symptoms by the COVID‐19 pandemic. Findings suggest that CBT may be protective in coping with life stressors many years after treatment ends. However, results warrant replication to attribute continued symptom improvement to CBT given the lack of control group.
Publisher: INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols
Date: 20-10-2020
Publisher: Wiley
Date: 22-08-2014
DOI: 10.1002/LARY.24898
Publisher: Wiley
Date: 03-2021
DOI: 10.1111/AJAG.12924
Publisher: American Speech Language Hearing Association
Date: 08-2008
DOI: 10.1044/1092-4388(2008/073)
Abstract: To examine development of sensitivity to auditory and visual temporal processes in children and the association with standardized measures of auditory processing and communication. Normative data on tests of visual and auditory processing were collected on 18 adults and 98 children aged 6–10 years of age. Auditory processes included detection of pitch from temporal cues using iterated rippled noise and frequency modulation detection at 2 Hz, 40 Hz, and 240 Hz. Visual processes were coherent form and coherent motion detection. Test–retest data were gathered on 21 children. Performance on perceptual tasks improved with age, except for fine temporal processing (iterated rippled noise) and coherent form perception, both of which were relatively stable over the age range. Within-subject variability (as assessed by track width) did not account for age-related change. There was no evidence for a common temporal processing factor, and there were no significant associations between perceptual task performance and communication level (Children’s Communication Checklist, 2nd ed. D. V. M. Bishop, 2003) or speech-based auditory processing (SCAN-C R. W. Keith, 2000). The auditory tasks had different developmental trajectories despite a common procedure, indicating that age-related change was not solely due to responsiveness to task demands. The 2-Hz frequency modulation detection task, previously used in dyslexia research, and the visual tasks had low reliability compared to other measures.
Publisher: Public Library of Science (PLoS)
Date: 11-10-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-01-2022
DOI: 10.1097/AUD.0000000000001195
Abstract: Provision of information is already part of standard care and may not be sufficient to promote hearing aid use. The I-PLAN is a behavior change intervention that is designed to promote hearing aid use in adults. It consists of a prompt, an action plan and provision of information. The objective was to test the effectiveness of the I-PLAN prompt and plan components in promoting hearing aid use and benefit. Hypotheses were: there would be greater hearing aid use, benefit, self-regulation, and hearing aid use habit among participants who received the prompt or plan component, compared with no prompt or no plan component, and the effect would be the greatest in participants who received both prompt and plan and self-regulation and habit would mediate the effect of prompt and/or plan components on hearing aid use and benefit. A 2 x 2 factorial randomized controlled trial design. Two hundred forty new adult patients (60 in each group) were randomized to: information (info) only info + prompt info + plan or info + prompt + plan. All participants received treatment as usual in addition to I-PLAN components, which were provided in a sealed envelope at the end of the hearing aid fitting consultation. Participants in the prompt group were instructed to use their hearing aid box as a physical prompt to remind them to use the device. Participants in the plan group were instructed to write an action plan to encourage them to turn their intentions into action. Participants, audiologists, and researchers were blinded to group allocation. The primary outcome was self-reported proportion of time hearing aids were used in situations where they had listening difficulties. Secondary outcomes were hearing aid use derived from data logging, self-reported hearing aid benefit, self-reported self-regulation, and habit. Outcomes were measured at 6-week post-fitting. Contrary to predictions, participants who received the prompt component reported using their hearing aid less than participants without the prompt ( p = 0.03 d = 0.24). The mean proportion of time hearing aid were used was 73.4% of the time in the prompt group compared with 79.9% of the time in the no prompt group. Participants who received the plan component reported using their hearing aids more frequently than those who did not receive the plan ( Mean plan = 81.0% vs Mean noplan = 71.8% of the time p = 0.01 d = 0.34). Receiving both prompt and plan components did not change self-reported proportion of time hearing aids were used but data-logging use was significantly reduced. The prompt reduced self-regulation of hearing aid use compared with the no prompt ( p = 0.04 d = 0.28), while the plan promoted stronger hearing aid use habits than the no plan group ( p = 0.02 d = 0.30). Audiologists should consider using action plans to promote hearing aid use. Despite the decrease in hearing aid use when using the hearing aid box as a physical prompt, hearing aid use was still high (≈70% of the time). The hearing aid box may have slightly reduced hearing aid use by undermining self-regulation. Participants may have delegated responsibility for hearing aid use to the prompt. Subsequent studies should evaluate different prompts and test the long-term benefit of the plan on hearing aid use via habit formation.
Publisher: SAGE Publications
Date: 2019
Abstract: Direct-to-consumer (DTC) hearing devices can be purchased without consulting a hearing health professional. This project aims to compare 28 DTC devices with the most popular hearing aid supplied by the U.K. National Health Service (NHS). The comparison was based on technical performance, cosmetic acceptability, and the ability to match commonly used gain and slope targets. Electroacoustic performance was evaluated in a 2-cc coupler. Match to prescription target for both gain and slope was measured on a Knowles Electronic Manikin for Acoustic Research using a mild and also a moderate sloping hearing loss. Using an online blinded paired comparison of each DTC and the NHS reference device, 126 participants (50 were hearing aid users and 76 were nonhearing aid users) assessed the cosmetic appearance and rated their willingness-to-wear the DTC devices. The results revealed that higher purchase prices were generally associated with a better match to prescribed gain–frequency response shapes, lower distortion, wider bandwidth, better cosmetic acceptability, and higher willingness-to-wear. On every parameter measured, there were devices that performed worse than the NHS device. Most of the devices were rated lower in terms of aesthetic design than the NHS device and provided gain–frequency responses and maximum output levels that were markedly different from those prescribed for commonly encountered audiograms. Because of the absence or inflexibility of most of the devices, they have the potential to deliver poor sound quality and uncomfortably loud sounds. The challenge for manufacturers is to develop low-cost products with cosmetic appeal and appropriate electroacoustic characteristics.
Publisher: JMIR Publications Inc.
Date: 17-01-2020
DOI: 10.2196/14551
Abstract: Tools for app- and Web-based self-testing for identification of cognitive impairment are widely available but are of uncertain quality. The objective of this study was to undertake a scoping review of app- and Web-based self-tests for cognitive impairment and determine the validity of these tests. We conducted systematic searches in electronic databases, including Google search, Google Play Store, and iPhone Operating System App Store, using the search terms “Online OR Internet-based AND Memory OR Brain OR Dementia OR mild cognitive impairment OR MCI AND Test OR Screen OR Check.” We identified 3057 tools, of which 25 were included in the review. Most tools meeting the inclusion criteria assessed multiple cognitive domains. The most frequently assessed domains were memory, attention, and executive function. We then conducted an electronic survey with the developers of the tools to identify data relating to development and validation of each tool. If no response to the survey was received, Google (to identify gray literature), Google Scholar, and Medical Literature Analysis and Retrieval System Online were searched using key terms “(name of developer, if available)” AND “(the name of the tool)” to identify any additional data. Only 7 tools had any information concerning psychometric quality, and only 1 tool reported data on performance norms, reliability, validity, sensitivity, and specificity for the detection of cognitive impairment. The number of cognitive self-assessment electronic health tools for cognitive impairment is increasing, but most are of uncertain quality. There is a need for well-validated tools and guidance for users concerning which tools provide reliable information about possible cognitive impairment that could warrant further investigation.
Publisher: SAGE Publications
Date: 21-12-2017
Abstract: A population health approach to mental health service planning requires estimates that align interventions with the needs of people with mental illness. The primary objective was to estimate the number of people in Australia living with severe and persistent mental illness who have complex, multi-agency needs. The secondary objective was to describe the possible service needs of in iduals with severe mental illness. We disaggregated the estimated 12-month prevalence of adults with severe mental illness into needs-based sub-groups, using multiple data sources. Possible service needs of 1825 adults with psychotic disorders and 334 adults with severe past-year affective and/or anxiety disorders were described using data from the 2010 Survey of High Impact Psychosis and 2007 National Survey of Mental Health and Wellbeing, respectively. Using best available data, we estimated that 3.3% of adults experience a severe mental illness each year, of whom one-third (1.1% of adults) experience a persistent mental illness that requires ongoing services to address residual disability. Among those with severe and persistent mental illness, one-third of adults (0.4% or 59,000 adults in 2015) have complex needs requiring multi-agency support to maximise their health, housing, social participation and personal functioning. Survey of High Impact Psychosis data indicated that among adults with psychotic disorders, use of accommodation (40%), non-government (30%) services and receipt of income support (85%) services were common, as were possible needs for support with socialising, personal care and employment. National Survey of Mental Health and Wellbeing data indicated that among in iduals with severe affective and anxiety disorders, receipt of income support (37%) was common (information on accommodation and non-government support services was not available), as were possible needs for financial management and employment support. Agreed indicators of complex, multi-agency needs are required to refine these estimates. Closer alignment of information collected about possible service needs across epidemiological surveys is needed.
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-039321
Abstract: We aimed to evaluate the impact of patient and public involvement (PPI) at each stage of the research cycle in a dementia research programme. We used monitoring forms to record the impact of the research programme’s PPI at different stages of research and qualitative interviews with all participants to evaluate the impact of PPI. We evaluated Research User Groups (RUGs—older people with dementia and care partners) which were established to provide PPI support for the research programme in multiple European sites. We purposively s led RUG members (n=34) and researchers (n=13) who had participated in PPI activities. Inclusion criteria for the study were: (a) RUG members who had participated in the research awareness training and in PPI activities and had the capacity to consent (b) researchers who involved RUGs in their work. Impact on the research: changes to the study conduct were made as a result of the feedback from RUGs. These included prioritisation of clinical recommendations, the wording of study information and recruitment materials, the content and layout of the user interface for a computerised memory test, interpretation of intervention results and advice on dissemination avenues. Impact on RUG members : they reported that involvement had given them a sense of purpose and satisfaction. Their perception of health research changed from being an exclusive activity to one, which lay people, could have meaningful involvement. Impact on researchers : PPI was a new way of working and interacting with PPI members had given them insight into the impact of their work on people living with dementia. PPI can have a substantial impact on dementia research and the people involved in the research. To justify the time and expense of PPI, the advantageous practical impacts of PPI should be systematically recorded and consistently reported.
Publisher: Informa UK Limited
Date: 03-07-2015
Publisher: Informa UK Limited
Date: 24-02-2021
DOI: 10.1080/07317115.2021.1884158
Abstract: This study examined the impacts of COVID-19 lockdown on health and lifestyle factors for older adults in Sydney, Australia. The study examined demographic differences, social engagement, loneliness, physical activity, emotion regulation, technology use, and grandparenting experiences and their contribution to emotional health and quality of life during lockdown. Participants were 201 community-dwelling older adults (60-87 years, One-third of older adults experienced depression, and 1 in 5 experienced elevated anxiety and/or psychological distress during lockdown. Specific emotion regulation strategies, better social and family engagement, and new technology use were associated with better emotional health and quality of life 63% of older adults used new technologies to connect with others. Older adults were adaptable and resilient during lockdown, demonstrating high uptake of new technologies to remain connected to others, while negative emotional health outcomes were linked to loneliness and unhelpful emotion regulation. Further ersifying use of video technologies may facilitate improved physical and emotional health outcomes.
Publisher: Wiley
Date: 29-04-2019
DOI: 10.1111/JGS.15936
Abstract: People with dementia (PwD) frequently experience hearing and vision impairment that is underrecognized and undertreated, resulting in reduced quality of life. Managing these impairments may be an important strategy to improve outcomes in PwD. Our objective was to field-trial a multifaceted sensory intervention (SI) to enhance hearing and vision in PwD. An international single-arm open-label feasibility, acceptability, and tolerability study. Home-based setting in the United Kingdom, France, and Cyprus. Adults aged 60 years and older with mild-to-moderate dementia and uncorrected or suboptimally corrected hearing and/or vision impairment, and their study partners (n = 19 dyads). A sensory intervention (SI), comprising assessment of hearing and vision, fitting of corrective devices (glasses, hearing aids), and home-based support from a sensory support therapist for device adherence and maintenance, communication training, referral to support services, environmental sensory modification, and optimization of social inclusion. Ratings of study procedure feasibility, and intervention acceptability/tolerability, ascertained through questionnaires, participant diaries, therapist logbooks, and semistructured interviews. We successfully delivered all intervention components, and these were received and enacted as intended in all those who completed the intervention. No serious adverse events were reported. Acceptability (ie, understanding, motivation, sense of achievement) and tolerability (ie, effort, fatigue) ratings of the intervention were within a priori target ranges. We met recruitment and retention (93.8%) targets in two of the three sites. Participants completed more than 95% of diary entries, representing minimal missing data. Delays in the logistics circuit for the assessment and delivery of hearing aids and glasses were identified, requiring modification. The need for minor modifications to some outcome measures and the inclusion criteria were identified. This is the first study combining home-based hearing and vision remediation in PwD. The positive feasibility, acceptability, and tolerability findings suggest that a full-scale efficacy trial, with certain modifications, is achievable.
Publisher: Informa UK Limited
Date: 29-09-2014
DOI: 10.3109/14992027.2014.938782
Abstract: To describe getting used to hearing aids from the perspective of adult hearing-aid users. Three focus group discussions were carried out. A topic guide and discussion exercises were used to elicit views on getting used to hearing aids. Discussion was audio recorded, transcribed verbatim, and subjected to qualitative content analysis. Adult hearing aid users (n = 16). Participants described getting used to hearing aids as a multi-factorial process which included adjusting to altered sensory input, practical matters such as cleaning and maintenance, and managing the psychosocial impact of hearing-aid use, such as on self-image. Users reported a process of discovering benefits and limitations of hearing aids leading to in idual patterns of use that was relatively independent of input from audiologists. Getting used to hearing aids is a challenging multi-factorial process with both psychosocial and practical difficulties besides demands of adjusting to hearing-aid input.
Publisher: BMJ
Date: 25-05-2010
Publisher: Informa UK Limited
Date: 18-08-2021
DOI: 10.1080/14992027.2021.1951852
Abstract: The current study aimed to: i) determine the patterns of hearing protection device (HPD) use in early-career musicians, ii) identify barriers to and facilitators of HPD use, and iii) use the Behaviour Change Wheel (BCW) to develop an intervention to increase uptake and sustained use of HPDs. A mixed-methods approach using questionnaires and semi-structured interviews. Eighty early-career musicians (age range = 18-26 years women 42.5% percent of participants reported using HPDs at least once a week, 35% less than once a week, and 22.5% reported never using HPDs for music-related activities. Six barriers and four facilitators of HPD use were identified. Barriers include the impact of HPDs on listening to music and performing, and a lack of concern about noise exposure. Barriers/facilitators were mapped onto the Theoretical Domains Framework. Following the systematic process of the BCW, our proposed intervention strategies are based on 'Environmental Restructuring', such as providing prompts to increase awareness of noisy settings, and 'Persuasion/Modelling', such as providing credible role models. For the first time, the present study demonstrates the use of the BCW for designing interventions in the context of hearing conservation.
Publisher: Informa UK Limited
Date: 09-06-2022
DOI: 10.1080/14992027.2022.2075798
Abstract: Remote hearing screening and assessment may improve access to, and uptake of, hearing care. This review, the most comprehensive to date, aimed to (i) identify and assess functionality of remote hearing assessment tools on smartphones and online platforms, (ii) determine if assessed tools were also evaluated in peer-reviewed publications and (iii) report accuracy of existing validation data. Protocol was registered in INPLASY and reported according to PRISMA-Extension for Scoping Reviews. In total, 187 remote hearing assessment tools (using tones, speech, self-report or a combination) and 101 validation studies met the inclusion criteria. Quality, functionality, bias and applicability of each app were assessed by at least two authors. Assessed tools showed considerable variability in functionality. Twenty-two (12%) tools were peer-reviewed and 14 had acceptable functionality. The validation results and their quality varied greatly, largely depending on the category of the tool. The accuracy and reliability of most tools are unknown. Tone-producing tools provide approximate hearing thresholds but have calibration and background noise issues. Speech and self-report tools are less affected by these issues but mostly do not provide an estimated pure tone audiogram. Predicting audiograms using filtered language-independent materials could be a universal solution.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.JAMDA.2021.11.011
Abstract: To report the effectiveness of, and barriers and facilitators to, hearing rehabilitation for care home residents with dementia. Systematic review. Care home residents with dementia and hearing loss. No restrictions on publication date or language were set and gray literature was considered. Eligible studies were critically appraised and presented via a narrative review. Sixteen studies, most of low to moderate quality, were identified. Hearing rehabilitation, including hearing devices, communication techniques, and visual aids (eg, flashcards), was reported to improve residents' communication and quality of life and reduce agitation, with improvements in staff knowledge of hearing loss and job satisfaction. Residents' symptoms of dementia presented barriers, for ex le, losing or not tolerating hearing aids. Low staff prioritization of hearing loss due to time pressures and lack of hearing-related training for staff were further barriers, particularly for residents who required assistance with hearing devices. Adopting a person-centered approach based on residents' capabilities and preferences and involving family members facilitated hearing device use. Residents with dementia can benefit from hearing rehabilitation. Identifying and implementing efficient, in idualized hearing rehabilitation is necessary for those with complex cognitive needs. Increased funding and support for the social care sector is required to address systemic issues that pose barriers to hearing rehabilitation, including time pressures, lack of training for staff and access to audiology services for residents.
Publisher: Oxford University Press (OUP)
Date: 12-04-2019
Abstract: We aimed to determine whether self-assessed single (hearing or visual) and dual sensory (hearing and visual) impairments are associated with cognitive decline and incident possible cognitive impairment, no dementia (CIND) and probable dementia. Data were drawn from the 1996–2014 surveys of the Health and Retirement Study (HRS), involving 19,618 respondents who had no probable dementia and who were aged 50 years or older at the baseline. We used linear mixed models to test the association between self-assessed sensory impairment and cognitive decline followed by a Cox proportional hazard model to estimate the relative risk of incident possible CIND and probable dementia associated with the presence of sensory impairment. Respondents with self-assessed single and dual sensory impairment performed worse in cognitive tests than those without sensory impairment. The fully adjusted incidence of developing possible CIND was 17% higher for respondents with hearing impairment than those without hearing impairment. Respondents with visual impairment had 35% and 25% higher risk for developing possible CIND and probable dementia, respectively, than those without visual impairment. Respondents with dual sensory impairment at baseline were 38% and 26% more likely to develop possible CIND and probable dementia, respectively, than those with no sensory impairment. Self-assessed sensory impairment is independently associated with cognitive decline and incident possible CIND and probable dementia. Further studies are needed to identify the mechanism underlying this association and to determine whether treatment of sensory impairment could ameliorate cognitive decline and delay the onset of dementia among older adults.
Publisher: Elsevier BV
Date: 09-2020
Publisher: BMJ
Date: 03-2019
DOI: 10.1136/BMJOPEN-2018-026246
Abstract: Hearing and vision impairments are highly prevalent among older adults and impact commonly used cognitive assessment tools for the identification of dementia. Adaptations of such tests for people with hearing or vision impairment have not been adequately validated among populations with such sensory impairment. We will develop two versions of the Montreal Cognitive Assessment (MoCA) for people with acquired hearing impairment (MoCA-H) or vision impairment (MoCA-V). The MoCA-H and MoCA-V will exclude the existing MoCA items that are presented in spoken or visual format, respectively, and include new suitably adapted items. Participants (n=792) with combinations of hearing, vision and cognitive impairment will complete standard or adapted versions of the MoCA across three language sites (English, French and Greek). Development of the MoCA-H and the MoCA-V will be based on analysis of adapted and standard MoCA items following model-based development to select the combination of items for the MoCA-H and MoCA-V that provide optimal sensitivity and specificity for detection of dementia. The study has received ethical approval from respective centres in the UK, France, Greece and Cyprus. The results of the study will be disseminated through peer-reviewed publication, conference presentations, the study website ( www.sense-cog.eu/ ), the SENSE-Cog Twitter account (@sense_cog) and the MoCA test website ( www.mocatest.org/ ). The main outputs of the study will be versions of the MoCA that are appropriate for use with adults with acquired hearing or vision impairment and will contribute significantly to the clinical care of older people.
Publisher: American Society for Clinical Investigation
Date: 06-09-2016
DOI: 10.1172/JCI85774
Publisher: Acoustical Society of America (ASA)
Date: 07-2013
DOI: 10.1121/1.4807783
Abstract: Spatial release from masking (SRM) was tested within the first week of fitting and after 12 weeks hearing aid use for unilateral and bilateral adult hearing aid users. A control group of experienced hearing aid users completed testing over a similar time frame. The main research aims were (1) to examine auditory acclimatization effects on SRM performance for unilateral and bilateral hearing aid users, (2) to examine whether hearing aid use, level of hearing loss, age or cognitive ability mediate acclimatization, and (3) to compare and contrast the outcome of unilateral versus bilateral aiding on SRM. Hearing aid users were tested with and without hearing aids, with SRM calculated as the 50% speech recognition threshold advantage when maskers and target are spatially separated at ±90° azimuth to the listener compared to a co-located condition. The conclusions were (1) on average there was no improvement over time in familiar aided listening conditions, (2) there was large test-retest variability which may overshadow small average acclimatization effects greater improvement was associated with better cognitive ability and younger age, but not associated with hearing aid use, and (3) overall, bilateral aids facilitated better SRM performance than unilateral aids.
Publisher: Elsevier BV
Date: 09-2023
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-042571
Abstract: Research using the UK Biobank data has shown ethnic inequalities in hearing health however, the hearing test used may exhibit a disadvantage for non-native language speakers. To validate the results of the UK Biobank hearing test (Digit Triplet Test, DTT) against self-reported measures of hearing in the dataset and create classifications of hearing health. To observe if language proficiency and migration age have the same effect on hearing health classification as on the DTT in isolation. Our hypothesis is that language proficiency acts differently on the DTT, demonstrating that the DTT is biased for non-native speakers of English. Latent classes representing profiles of hearing health were identified from the available hearing measures. Factors associated with class membership were tested using multinomial logistic regression models. Ethnicity was defined as (1) White, native English-speaking, (2) ethnic minority, arrived in the UK aged or (3) ethnic minority, arrived aged . The UK Biobank participants with valid hearing test results and associated covariates (N=151 268). DTT score, self-reported hearing difficulty, self-reported hearing difficulty in noise and hearing aid use. Three classes of hearing health were found: ‘normal’, ‘generally poor’ and ‘only subjectively poor’. In a model adjusting for known confounders of hearing loss, a poor or insufficient hearing test result was less likely for those with better language (OR 0.69, 95% CI 0.65 to 0.74) or numerical ability (OR 0.71, 95% CI 0.67 to 0.75) but more likely for those having migrated aged (OR 3.85, 95% CI 3.64 to 4.07). The DTT showed evidence of bias, having greater dependence on language ability and migration age than other hearing indicators. Designers of future surveys and hearing screening applications may wish to consider the limitations of speech-in-noise tests in evaluating hearing acuity for populations that include non-native speakers.
Publisher: Informa UK Limited
Date: 29-06-2023
Publisher: Wiley
Date: 29-05-2014
DOI: 10.1111/OPO.12138
Publisher: Oxford University Press (OUP)
Date: 25-04-2018
Abstract: highly prevalagent hearing and vision sensory impairments among older people may contribute to the risk of cognitive decline and pathological impairments including dementia.This study aims to determine whether single and dual sensory impairment (hearing and/or vision) are independently associated with cognitive decline among older adults and to describe cognitive trajectories according to their impairment pattern. we used data from totals of 13,123, 11,417 and 21,265 respondents aged 50+ at baseline from the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA) and the Survey of Health, Ageing and Retirement in Europe (SHARE), respectively. We performed growth curve analysis to identify cognitive trajectories, and a joint model was used to deal with attrition problems in longitudinal ageing surveys. respondents with a single sensory impairment had lower episodic memory score than those without sensory impairment in HRS (β = -0.15, P < 0.001), ELSA (β = -0.14, P < 0.001) and SHARE (β = -0.26, P < 0.001). The analysis further shows that older adults with dual sensory impairment in HRS (β = -0.25, P < 0.001), ELSA (β = -0.35, P < 0.001) and SHARE (β = -0.68, P < 0.001) remembered fewer words compared with those with no sensory impairment. The stronger associations between sensory impairment and lower episodic memory levels were found in the joint model which accounted for attrition. hearing and/or vision impairments are a marker for the risk of cognitive decline that could inform preventative interventions to maximise cognitive health and longevity. Further studies are needed to investigate how sensory markers could inform strategies to improve cognitive ageing.
Publisher: Oxford University Press (OUP)
Date: 03-05-2018
Abstract: the aim of this study was to examine the bidirectional association of vision loss (VL) and hearing loss (HL) with anxiety over a 12-year period. this was a prospective population-based study. community-dwelling French adults. the study included 3,928 adults aged 65 and above from the Three-City study. the relationships of VL, as assessed by near visual acuity and self-reported HL to a diagnosis of generalised anxiety disorder (GAD) were assessed over 12 years. A further objective was to explore whether sensory loss has a differential relationship with GAD than with anxiety symptoms, assessed by the Spielberger's State-Trait Anxiety Inventory. at baseline, HL [odds ratio (OR) = 1.41, 95% confidence interval (CI) 1.02-1.96, P = 0.04], but not mild or moderate to severe VL, was associated with self-reported anxiety symptoms (OR = 1.07 95% CI 0.63-1.83, P = 0.80 OR = 0.66 95% CI 0.12-2.22, P = 0.50, respectively). Neither vision nor HL was significantly associated with incident GAD. Baseline GAD was related to increased risk of incident HL (OR = 1.17, 95% CI 1.07-1.28, P < 0.001), but not mild or moderate to severe vision loss (OR = 1.01, 95% CI 0.96-1.06, P = 0.81 OR = 0.97, 95% CI 0.89-1.05, P = 0.45, respectively). increased anxiety symptoms were observed in older adults with HL, whereas we found no evidence for an association between VL and anxiety. Anxiety was prospectively associated with increased risk of reporting HL. Improved detection of anxiety in older adults with HL may improve quality of life.
Publisher: Oxford University Press (OUP)
Date: 04-01-2019
Publisher: Elsevier BV
Date: 07-2021
Publisher: Frontiers Media SA
Date: 13-12-2022
Publisher: S. Karger AG
Date: 2016
DOI: 10.1159/000444565
Publisher: Springer Science and Business Media LLC
Date: 26-11-2019
DOI: 10.1038/S41746-019-0195-9
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Publisher: Wiley
Date: 03-12-2019
DOI: 10.1002/GPS.5231
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 22-11-2018
Publisher: Informa UK Limited
Date: 26-12-2022
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-01-2020
DOI: 10.1097/AUD.0000000000000839
Abstract: Approximately 10 to 35% of people with a hearing impairment own a hearing aid. The present study aims to identify barriers to obtaining a hearing aid and inform future interventions by examining the biopsychosocial characteristics of adults aged 50+ according to 7 categories: (i) Did not report hearing difficulties, (ii) Reported hearing difficulties, (iii) Told a healthcare professional about experiencing hearing difficulties, (iv) Referred for a hearing assessment, (v) Offered a hearing aid, (vi) Accepted a hearing aid, and (vii) Reported using a hearing aid regularly. The research was conducted using the English Longitudinal Study of Aging wave 7 with data obtained from 9666 adults living in England from June 2014 to May 2015. Cross-sectional data were obtained from a subset of 2845 participants aged 50 to 89 years of age with a probable hearing impairment measured by hearing screening (indicating a hearing threshold of dB HL at 1 kHz or dB HL at 3 kHz in the better ear). Classification according to hearing health-seeking category was via participants’ self-report. Participants in each category were compared with people in all subsequent categories to examine the associations between each category and biopsychosocial correlates (sex, age, ethnicity, educational level, wealth, audiometric hearing level, self-reported health status, cognitive performance, attitudes to aging, living alone, and engagement in social activities) using multiple logistic regression. The proportions of in iduals (N = 2845) in categories i to vii were 40.0% (n = 1139), 14.0% (n = 396), 4.5% (n = 129), 4.0% (n = 114), 1.2% (n = 34), 7.7% (n = 220), and 28.6% (n = 813), respectively. Severity of hearing impairment was the only factor predictive of all the categories of hearing health-seeking that could be modeled. Other correlates predictive of at least one category of hearing health-seeking included sex, age, self-reported heath, participation in social activities, and cognitive function. For the first time, it was shown that 40.0% of people with an audiometrically identified probable hearing impairment did not report hearing difficulties. Each of the five categories of hearing health-seeking that could be modeled had different drivers and consequently, interventions likely should vary depending on the category of hearing health-seeking.
Publisher: Oxford University Press (OUP)
Date: 02-2023
Abstract: This study aimed to investigate the relationships between trajectories of change in self-reported hearing over eight years with subsequent effects on cognition, measured using episodic memory. Data were drawn from 5 waves (2008–2016) of the English Longitudinal Study of England (ELSA) and the Health and Retirement Study (HRS), involving 4,875 in iduals aged 50+ at the baseline in ELSA and 6,365 in HRS. The latent growth curve modelling was used to identify trajectories of hearing over eight years, and linear regression models were performed to investigate the relationship between hearing trajectory memberships and episodic memory scores, controlling for confounding factors. Five trajectories of hearing (stable very good, stable fair, poor to fair/good, good to fair, and very good to good) were retained in each study. In iduals whose hearing remains suboptimal and those whose hearing deteriorates within suboptimal levels throughout eight years have significantly poorer episodic memory scores at follow-up than those with stable very good hearing. Conversely, in iduals whose hearing declines but is within an optimal category at baseline do not see significantly poorer episodic memory scores than those with consistently optimal hearing. There was no significant relationship between in iduals whose hearing improved from suboptimal baseline levels to optimal by follow-up and memory in ELSA. However, analysis using HRS data shows a significant improvement for this trajectory group (−1.260, P & 0.001). Either stable fair or deterioration in hearing is associated with worse cognitive function, both stable good or improving hearing is associated with better cognitive function specifically episodic memory.
Publisher: Public Library of Science (PLoS)
Date: 04-2015
Publisher: Springer Science and Business Media LLC
Date: 26-01-2017
Publisher: Informa UK Limited
Date: 23-05-2021
DOI: 10.1080/09638288.2021.1923071
Abstract: Aging-related sensory impairments are among the most common and disabling comorbidities in people with dementia (PwD). This study explored the unmet support care needs (SCNs) from the perspectives of people with hearing and/or vision impairment in dementia (PwD), and their care partners in Europe. This was a two-phase mixed methods study. We administered standardized questionnaires of SCNs and quality of life (QoL) to PwD with hearing and/or vision impairment ( Over 94% of the participants reported unmet SCNs (median, 13 (range 5-23)). Nearly three-quarters reported SCNs in the moderate to high range, with the most prevalent unmet SCNs for PwD being in the psychological (>60%) and physical domains (>56%), followed by the need for health information (>46%). Emergent qualitative themes were: (1) the need for tailored support care interventions (2) care burden, social isolation, and loneliness arising from the combined problems (3) the need for adequate support from professionals from the different fields, including education around the use of sensory aids. Both study phases revealed that SCNs were highly in idualized. This cross-national study revealed that PwD with sensory impairment and their care partners experience a wide range of unmet SCNs, the interactions between sensory impairments, SCNs and QoL are also complex. A tailored intervention could address these unmet SCNs, including additional support with sensory aids, psychological support, more information about concurrent impairments, and joined up health systems providing care.Implications for rehabilitationA majority of participants with combined age-related hearing, vision, and cognitive impairment had unmet SCNs.The needs of care partners including the risk of loneliness and social isolation, need to be considered.In idually tailored, specific interventions for hearing, vision, and cognitive impairment should incorporate physical and psychological support, as well as education.
Publisher: Springer Science and Business Media LLC
Date: 25-01-2019
Publisher: Informa UK Limited
Date: 13-03-2015
Publisher: Wiley
Date: 02-2023
DOI: 10.1111/JGS.18241
Abstract: Hearing impairment is common among older adults and affects cognitive assessments for identification of dementia which rely on good hearing function. We developed and validated a version of the Montreal Cognitive Assessment (MoCA) for people with hearing impairment. We adapted existing MoCA 8.1 items for people with hearing impairment by presenting instructions and stimuli in written rather than spoken format. One Attention domain and two Language domain items required substitution by alternative items. Three and four candidate items respectively were constructed and field‐tested along with the items adapted to written form. We used a combination of in idual item analysis and item substitution to select the set of alternative items to be included in the final form of the MoCA‐H in place of the excluded original items. We then evaluated the performance and reliability of the final tool, including making any required adjustments for demographic factors. One hundred and fifty‐nine hearing‐impaired participants, including 76 with normal cognition and 83 with dementia, completed the adapted version of the MoCA. A further 97 participants with normal hearing completed the standard MoCA as well as the novel items developed for the MoCA‐H to assess score equivalence between the existing and alternative MoCA items and for independence from hearing impairment. Twenty‐eight participants were retested between 2–4 weeks after initial testing. After the selection of optimal item set, the final MoCA‐H had an area under the curve of 0.973 (95% CI 0.952–0.994). At a cut‐point of 24 points or less sensitivity and specificity for dementia was 92.8% and 90.8%, respectively. The intraclass correlation for test–retest reliability was 0.92 (95%CI 0.78–0.97). The MoCA‐H is a sensitive and reliable means of identifying dementia among adults with acquired hearing impairment.
Publisher: Informa UK Limited
Date: 15-12-2020
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.IJPORL.2007.12.007
Abstract: Auditory processing disorder (APD) is characterised by listening difficulties despite a normal audiogram. APD is becoming ever more widely diagnosed in children, though there is a controversy over definition, diagnosis and aetiology. This study sought to describe presenting features and investigate aetiological factors for children diagnosed with APD compared to those for whom APD was excluded. Medical notes for children referred to a specialist hospital-based APD clinic were reviewed in relation to presenting features and potential aetiological factors. 32 children diagnosed with APD and 57 non-APD children were compared. They reported similar symptoms and similarly had high rates of co-morbid learning problems. No aetiological factor (including history of otitis media, adverse obstetric history or familial history of listening problems) predicted APD group membership. Children identified with APD on the basis of commonly used APD tests cannot be distinguished on the basis of presenting features or the aetiological factors examined here. One explanation is that learning problems exist independently of auditory processing difficulties and the aetiological factors do not have a strong causal role in APD. However, no gold standard for APD testing exists and an alternative explanation is that the commonly used APD tests used as selection criteria in this study may be unreliable.
Publisher: Informa UK Limited
Date: 27-03-2014
DOI: 10.3109/14992027.2014.890296
Abstract: There is growing interest in the concepts of listening effort and fatigue associated with hearing loss. However, the theoretical underpinnings and clinical meaning of these concepts are unclear. This lack of clarity reflects both the relative immaturity of the field and the fact that research studies investigating listening effort and fatigue have used a variety of methodologies including self-report, behavioural, and physiological measures. This discussion paper provides working definitions for listening effort and listening-related fatigue. Using these definitions as a framework, methodologies to assess these constructs are reviewed. Although each technique attempts to characterize the same construct (i.e. the clinical presentation of listening effort and fatigue), different assumptions are often made about the nature of these phenomena and their behavioural and physiological manifestations. We suggest that researchers consider these assumptions when interpreting their data and, where possible, make predictions based on current theoretical knowledge to add to our understanding of the underlying mechanisms of listening effort and listening-related fatigue. Following recent interest in the cognitive involvement in hearing, the British Society of Audiology (BSA) established a Special Interest Group on Cognition in Hearing in May 2013. In an exploratory group meeting, the ambiguity surrounding listening effort and fatigue was discussed. To address this problem, the group decided to develop a 'white paper' on listening effort and fatigue. This is a discussion document followed by an international set of commentaries from leading researchers in the field. An approach was made to the editor of the International Journal of Audiology who agreed to this suggestion. This paper, and the associated commentaries that follow, are the result.
Publisher: SAGE Publications
Date: 2021
Abstract: Suboptimal hearing aid use negatively impacts health and well-being. The aim of this study was to conduct a controlled trial of a behavior change intervention to promote hearing aid use. This study was a quasi-randomized controlled trial with two arms. A total of 160 first-time hearing aid users were recruited at their hearing aid fitting appointments. The control arm received standard care. In addition to standard care, the intervention arm received I-PLAN, which comprised (a) information about the consequences of hearing aid use/nonuse, (b) reminder prompt to use the hearing aids, and (c) an action plan. The primary outcome, measured at 6 weeks, was self-reported proportion of time the hearing aid was used in situations that caused hearing difficulty. Secondary outcomes were data-logged hearing aid use, self-reported hearing aid benefit, self-regulation, and habit formation. The results showed that the proportion of time the hearing aids were used in situations that caused hearing difficulty was similar in both groups. There were no statistically significant differences between groups in any outcome measure including data-logged hearing aid use. The relatively high levels of hearing aid use across research participants may have limited the potential for the intervention to impact on hearing aid use. Although the intervention materials proved acceptable and deliverable, future intervention trials should target suboptimal hearing aid users.
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S12877-019-1336-3
Abstract: Hearing and vision (sensory) impairments are highly prevalent in people with dementia (PwD) and exacerbate the impact of living with dementia. Assessment of sensory or cognitive function may be difficult if people have concurrent dual or triple impairments. Most standard cognitive assessment tests are heavily dependent on having intact hearing and vision, and impairments in these domains may render the assessments unreliable or even invalid. Likewise, dementia may impede on the accurate reporting of symptoms that is required for most hearing and vision assessments. Thus, there is an urgent need for hearing, vision and cognitive assessment strategies to be adapted to ensure that appropriate management and support can be provided. To explore the perspectives of PwD and the care partners regarding the need for accurate hearing, vision and cognitive assessments. We conducted focus groups and semi-structured interviews regarding the clinical assessment for cognitive, hearing and visual impairment. Participants ( n = 18) were older adults with mild to moderate dementia and a sensory impairment as well as their care partners (e.g. a family member) ( n = 15) at three European sites. The qualitative material was analysed according to Mayring’s summative content analysis approach. Participants reported that hearing, vision and cognitive assessments were not appropriate to the complex needs of PwD and sensory comorbidity and that challenges in communication with professionals and conveying unmet needs and concerns by PwD were common in all three types of clinical assessments. They felt that information about and guidance regarding support for the condition was not adequate in the assessments and that information sharing among the professionals regarding the concurrent problems was limited. Professionals were reported as being concerned only with problems related to their own discipline and had limited regard for problems in other domains which might impact on their own assessments. The optimal assessment and support for PwD with multiple impairments, more comprehensive, yet easy to understand, information regarding these linked to conditions and corrective device use is needed. Communication among health care professionals relevant to hearing, vision and cognition needs to be improved.
Publisher: Oxford University Press (OUP)
Date: 12-05-2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 17-04-2013
Publisher: Wiley
Date: 10-08-2018
DOI: 10.1002/GPS.4771
Abstract: Knowledge is limited about the standardised instruments used to collect resource use and quality of life data alongside trials of dementia interventions. This review aimed to identify the trials using such instruments in order to guide the design of future trial-based cost-effectiveness studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research in major databases and general searches published until June 2017, including randomised clinical trials, pilot studies, or feasibility studies about interventions for older adults with dementia or cognitive impairment. Forty-one studies were identified. Only 8 collected the resource use data using adapted Client Service Receipt Inventory (CSRI), Resource Use Inventory (RUI), cost diary, or study-specific questionnaire. Quality of life was assessed using a wide range of instruments. The most frequently used dementia-specific instrument was Quality of Life in Alzheimer's Disease (QOL-AD) and Dementia Quality of Life questionnaire (DEMQOL). Among the generic measures, EuroQol 5-dimentison (EQ-5D) was mostly used to collect health utility data, and Short Form surveys (SF-36 or SF-12) were widely to measure general health. Several useful resource use and quality of life measurement instruments have been identified by this review. For resource use, CSRI was mostly used, but no studies have used Resource Utilisation in Dementia (RUD) for quality of life, we recommend the inclusion of dementia-specific DEMQOL, generic SF-12, and health utility EQ-5D-5L, based on both self-report and proxy-report.
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1002/GPS.5563
Abstract: Up to 90% of people with dementia in long term care (LTC) have hearing and/or vision impairment. Hearing/vision difficulties are frequently under‐recognised or incompletely managed. The impacts of hearing/vision impairment include more rapid cognitive decline, behavioural disturbances, reduced quality of life, and greater care burden. This research investigated LTC staff knowledge, attitudes and practice regarding hearing/vision care needs for residents with dementia. A survey of staff in LTC facilities in England, South Korea, India, Greece, Indonesia and Australia. Respondents used a five‐point scale to indicate agreement or YES/NO response to questions regarding sensory‐cognitive care knowledge (what is known) attitudes (what is thought) practice (what is done). Respondents reported high awareness of hearing/vision care needs, although awareness of how to identify hearing/vison difficulties or refer for assessment was low. Most felt that residents were not able to use hearing/vision devices effectively due to poor fit, being poorly tolerated or lost or broken devices. A substantial minority of respondents reported low confidence in supporting use of assistive hearing/vision devices, with lack of training the main reason. Most staff did not undertake routine checking of hearing/vision devices, and it was rare for facilities to have designated staff responsible for sensory needs. Variation among countries was not significant after accounting for staff experience and having received dementia training. There is a need to improve sensory support for people with dementia in LTC facilities internationally. Practice guidelines and training to enhance sensory‐cognitive knowledge, attitudes and practice in professional care teams is called for.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-12-2020
DOI: 10.1097/AUD.0000000000000969
Abstract: To determine population-based risks of adverse effects on hearing and well-being outcomes associated with unilateral hearing impairment. A group of 40- to 69-year-old adults (n = 861) who reported being able to hear only in one ear and having speech reception thresholds (SRTs) in noise indicating normal hearing in that ear (SRT N/− ) was selected from the UK Biobank cohort. The UK Biobank participants with SRTs indicating either normal (SRT N/N , n = 95,514) or symmetrically impaired hearing in both ears (SRT I/I , n = 17,429) were selected as comparison groups. Self-reported difficulty following conversations in noise, tinnitus presence, feeling depressed, lonely, unhappy, and being in poor health or dissatisfied with health were selected as hearing and well-being outcomes. Logistic regression models were used to evaluate the risks of reporting adverse outcomes associated with SRT N/− compared with SRT N/N and SRT I/I while controlling for numerous factors linked to hearing and general health. People with SRT N/− were significantly more likely to report difficulties following conversations in noise (odds ratio, 10.61 95% confidence interval, 8.83 to 12.75), tinnitus (4.04 3.51 to 4.66), poor health (1.35 1.15 to 1.58), health dissatisfaction (1.22 1.00 to 1.47), and loneliness (1.28 1.08 to 1.51) compared with people with SRT N/N . Well-being outcomes were similar in the SRT N/− and SRT I/I groups. However, difficulties following conversations in noise (5.35 4.44 to 6.44) and tinnitus presence (2.66 2.31 to 3.08) were significantly more likely with SRT N/− than with SRT I/I . The SRT N/− was associated with increased risk of self-reported poor health by 18% (relative risk, 1.18 95% confidence interval, 1.06 to 1.32) and loneliness by 24% (1.24 1.07 to 1.43) compared with SRT N/N . The risk of reporting difficulties following conversations in noise increased by 64% (1.64 1.58 to 1.71) and tinnitus presence by 84% (1.84 1.69 to 2.01) compared with SRT I/I . The effect of SRT N/− on reporting poor health was similar to that from having other health problems such as hypertension or high cholesterol. The large increases in the risks of reporting adverse hearing-related outcomes associated with unilateral hearing impairment suggest its specific impact on hearing function in everyday situations. The increased risk of loneliness and poor health indicates that one normally functioning ear is also insufficient to protect against the adverse psychosocial impacts of unilateral hearing impairment. This impact was still significant after controlling for various health-related factors and can lead to perception of poor health comparable to that with having medical problems contributing to life-threatening conditions such as heart disease. The findings suggest the need for effective interventions to address the hearing-related problems and their impact on well-being in people with unilateral hearing impairment.
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.JAMDA.2022.07.011
Abstract: To investigate factors that influence hearing aid use according to the Theoretical Domains Framework (TDF). The TDF is a behavioral science framework that aids understanding of factors that influence behavior. Systematic review. People living in the community with dementia and age-related hearing loss who have air conduction hearing aids. Systematic literature review following PRISMA guidelines. We searched for studies in 9 databases, including Ovid MEDLINE, Scopus, and OpenGrey. We undertook an interpretive data synthesis by mapping findings onto the TDF. We assessed confidence in the findings according to the GRADE-CERQual approach. Twelve studies (6 quantitative, 3 qualitative, and 3 mixed methods) were included in the review. The majority of these were rated low-moderate quality. We identified 27 component constructs (facilitators, barriers, or noncorrelates of hearing aid use) nested within the 14 domains of the TDF framework. Our GRADE-CERQual confidence rating was high for 5 findings. These suggest that hearing aid use for people living in the community with dementia and hearing loss is influenced by (1) degree of hearing aid handling proficiency, (2) positive experiential consequences, (3) degree of hearing aid comfort or fit, (4) person-environment interactions, and (5) social reinforcement. Hearing aid interventions should adopt a multifaceted approach that optimizes the capabilities of people with dementia to handle and use hearing aids addresses or capitalizes on their motivation and ensures their primary support network is supportive and encouraging of hearing aid use. The findings also emphasize the need for further high-quality research that investigates optimal hearing aid use, influencing factors, and interventions that support hearing aid use.
Publisher: Springer Science and Business Media LLC
Date: 30-06-2021
DOI: 10.1186/S12877-021-02352-1
Abstract: The impact of severe second lockdown measures on older adults’ wellbeing is unknown. We aimed to (i) identify the impact of the second lockdown that resulted from the second wave of COVID-19 cases on older Australians’ quality of life (ii) compare the impact of second wave lockdowns in Victoria, Australia’s second most populous State, to those in other States and Territories not in lockdown. A national cross-sectional study of community-dwelling older adults completed online questionnaires for quality of life, social networks, healthcare access, and perceived impact of COVID-19 between July to September 2020. Tobit regression was used to measure the relationships of healthcare service access and social networks with quality of life of older adults in Victoria compared to those in the rest of Australia. A total of 2,990 respondents (mean [SD] age, 67.3 [7.0] 66.8 % female) participated. At time of data collection, Victoria’s second COVID-19 lockdown had been in force for an average 51.7 days. Median quality of life scores were significantly higher in Victoria compared to the rest of Australia (t 2,827 =2.25 p = 0.025). Being female (95 % CI, -0.051–0.020), having lower educational attainment (95 % CI, -0.089–-0.018), receiving government benefits (95 % CI, -0.054–-0.024), having small social networks (95 % CI, 0.006–0.009) and self-reported physical chronic health conditions were all independent predictors of lower quality of life. Longer-term studies are required to provide more robust evidence of the impact as restrictions lift and normal social conventions return.
Publisher: Informa UK Limited
Date: 02-01-2019
DOI: 10.1080/14992027.2018.1534007
Abstract: The present study investigated: (a) how motivated patients are to use their hearing aid, and (b) whether post-motivational variables (e.g. action planning, coping planning) have anything to offer in terms of developing interventions to boost hearing aid use. participants completed a questionnaire designed to tap Health Action Process Approach constructs prior to their hearing aid prescription and fitting. Sixty-seven patients attending NHS audiology clinics. Participants reported very strong intentions to use hearing aids (Median = 7.00 Q1 and Q3 = 6.67, 7.00, on a +1 to +7 scale) and high self-efficacy (Median = 7.00, Q1 and Q3 = 6.00, on a +1 to +7 scale) leaving little room for improvement. In contrast, participants reported moderate levels of post-motivational variables (action planning Median = 4.25, Q1 and Q3 = 1.13, 7.00 and coping planning Median = 2.75, Q1 and Q3 = 1.00, both measured on +1 to +7 scales) thereby showing significant scope for change. Future interventions to increase hearing aid use should focus on ensuring that patients' motivation is translated into action, rather than further trying to boost motivation.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JECP.2017.04.006
Abstract: Stress and fatigue from effortful listening may compromise well-being, learning, and academic achievement in school-aged children. The aim of this study was to investigate the effect of a signal-to-noise ratio (SNR) typical of those in school classrooms on listening effort (behavioral and pupillometric) and listening-related fatigue (self-report and pupillometric) in a group of school-aged children. A s le of 41 normal-hearing children aged 8-11years performed a narrative speech-picture verification task in a condition with recommended levels of background noise ("ideal": +15dB SNR) and a condition with typical classroom background noise levels ("typical": -2dB SNR). Participants showed increased task-evoked pupil dilation in the typical listening condition compared with the ideal listening condition, consistent with an increase in listening effort. No differences were found between listening conditions in terms of performance accuracy and response time on the behavioral task. Similarly, no differences were found between listening conditions in self-report and pupillometric markers of listening-related fatigue. This is the first study to (a) examine listening-related fatigue in children using pupillometry and (b) demonstrate physiological evidence consistent with increased listening effort while listening to spoken narratives despite ceiling-level task performance accuracy. Understanding the physiological mechanisms that underpin listening-related effort and fatigue could inform intervention strategies and ultimately mitigate listening difficulties in children.
Publisher: Informa UK Limited
Date: 04-11-2011
DOI: 10.3109/14992027.2010.527861
Abstract: The SCAN-A ( Keith, 1994 ) is a test for auditory processing disorders in adolescents aged 11+ and adults developed in the USA. It was previously found that the children's version (the SCAN-C) over diagnoses auditory processing disorder in UK children. This study was conducted to assess the use of the SCAN-A with UK adults. Comparison of UK adult's SCAN-A performance to US-based normative data. 31 UK adults aged 19 to 64 years (M 24, sd 10). The UK s le scored significantly worse on three subtests: the Filtered Words (FW), Competing Words (CW) and Competing Sentences (CS) sections as well as on the Total Score. Applying US norms to UK adult's performance results in a high rate of over-identification of listening difficulties. Alternative UK norms are provided and implications for use of the SCAN-A with UK adolescents and adults are discussed.
Publisher: Cambridge University Press (CUP)
Date: 10-07-2017
DOI: 10.1017/S104161021700120X
Abstract: Cognitive screening tests frequently rely on items being correctly heard or seen. We aimed to identify, describe, and evaluate the adaptation, validity, and availability of cognitive screening and assessment tools for dementia which have been developed or adapted for adults with acquired hearing and/or vision impairment. Electronic databases were searched using subject terms “hearing disorders” OR “vision disorders” AND “cognitive assessment,” supplemented by exploring reference lists of included papers and via consultation with health professionals to identify additional literature. 1,551 papers were identified, of which 13 met inclusion criteria. Four papers related to tests adapted for hearing impairment 11 papers related to tests adapted for vision impairment. Frequently adapted tests were the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MOCA). Adaptations for hearing impairment involved deleting or creating written versions for hearing-dependent items. Adaptations for vision impairment involved deleting vision-dependent items or spoken/tactile versions of visual tasks. No study reported validity of the test in relation to detection of dementia in people with hearing/vision impairment. Item deletion had a negative impact on the psychometric properties of the test. While attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, the primary limitation of these adaptations is that their validity in accurately detecting dementia among those with acquired hearing or vision impairment is yet to be established. It is likely that the sensitivity and specificity of the adapted versions are poorer than the original, especially if the adaptation involved item deletion. One solution would involve item substitution in an alternative sensory modality followed by re-validation of the adapted test.
Publisher: Springer Science and Business Media LLC
Date: 28-05-2014
Publisher: Springer Science and Business Media LLC
Date: 22-08-2019
DOI: 10.1038/S41746-019-0154-5
Abstract: Uncorrected refractive error is a major cause of vision impairment, and is indexed by visual acuity. Availability of vision assessment is limited in low/middle-income countries and in minority groups in high income countries. eHealth tools offer a solution two-thirds of the globe own mobile devices. This is a scoping review of the number and quality of tools for self-testing visual acuity. Software applications intended for professional clinical use were excluded. Keyword searches were conducted on Google online, Google Play and iOS store. The first 100 hits in each search were screened against inclusion criteria. After screening, 42 tools were reviewed. Tools assessed near and distance vision. About half ( n = 20) used bespoke optotypes. The majority ( n = 25) presented optotypes one by one. Four included a calibration procedure. Only one tool was validated against gold standard measures. Many self-test tools have been published, but lack validation. There is a need for regulation of tools for the self-testing of visual acuity to reduce potential risk or confusion to users.
Publisher: Springer Science and Business Media LLC
Date: 24-01-2012
Publisher: Informa UK Limited
Date: 04-2021
DOI: 10.1080/14992027.2021.1899314
Abstract: Baseline electroencephalography (EEG) alpha power, i.e. that measured prior to stimulus presentation, is a potential objective predictor of task performance. Here we assessed the predictive power of EEG alpha on performance accuracy in a digits-in-noise recognition task, factoring in hearing thresholds and age. EEG alpha power, recorded while participants listened to target digits presented in a noise background, was analysed during two different baseline periods: i) a pre-stimulus baseline (pre-STIM) free from any acoustic stimulus, and ii) a pre-target baseline (pre-TARG) recorded in background noise only. Eighty-five participants with either normal hearing or aided hearing impairment (age range: 55-85 years old, 42 male). Hierarchical multiple regression analyses indicated that i) lower hearing thresholds and, to a lesser extent, higher pre-STIM alpha power were associated with improved performance accuracy ii) alpha power in pre-STIM and pre-TARG were highly correlated across in iduals but pre-TARG alpha power was not a significant predictor of performance accuracy. Investigations of baseline EEG alpha power as a predictor of speech-in-noise performance accuracy should control for associations between hearing thresholds and measures of EEG baseline periods.
Publisher: Wiley
Date: 12-10-2016
DOI: 10.1111/PSYP.12772
Abstract: Hearing loss is associated with anecdotal reports of fatigue during periods of sustained listening. However, few studies have attempted to measure changes in arousal, as a potential marker of fatigue, over the course of a sustained listening task. The present study aimed to examine subjective, behavioral, and physiological indices of listening-related fatigue. Twenty-four normal-hearing young adults performed a speech-picture verification task in different signal-to-noise ratios (SNRs) while their pupil size was monitored and response times recorded. Growth curve analysis revealed a significantly steeper linear decrease in pupil size in the more challenging SNR, but only in the second half of the trial block. Changes in pupil dynamics over the course of the more challenging listening condition block suggest a reduction in physiological arousal. Behavioral and self-report measures did not reveal any differences between listening conditions. This is the first study to show reduced physiological arousal during a sustained listening task, with changes over time consistent with the onset of fatigue.
Publisher: Public Library of Science (PLoS)
Date: 24-08-2015
Publisher: Springer Science and Business Media LLC
Date: 11-09-2017
Publisher: Wiley
Date: 23-01-2012
DOI: 10.1002/DYS.1432
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2009
Publisher: Wiley
Date: 23-09-2020
DOI: 10.1111/AJAG.12845
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Publisher: Public Library of Science (PLoS)
Date: 20-11-2018
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-041290
Abstract: To assess incidence and changes in tinnitus and bothersome tinnitus as well as associated risk factors in a large s le of UK adults. Prospective cohort study. UK. For cross-sectional analysis, a group of 168 348 participants aged between 40 and 69 years with hearing and tinnitus data from the UK Biobank resource. Longitudinal analysis included a subset of 4746 people who attended a 4-year retest assessment. Presence and bothersomeness of tinnitus. 17.7% and 5.8% of participants reported tinnitus or bothersome tinnitus, respectively. The 4-year incidence of tinnitus was 8.7%. Multivariate logistic regression models suggested that age, hearing difficulties, work noise exposure, ototoxic medication and neuroticism were all positively associated with both tinnitus and bothersome tinnitus. Reduced odds of tinnitus, but not bothersome tinnitus, was seen in alcohol drinkers versus non-drinkers. Male gender was associated with increased odds of tinnitus, while female gender was associated with increased odds of bothersome tinnitus. At follow-up, of those originally reporting tinnitus, 18.3% reported no tinnitus. Of those still reporting tinnitus, 9% reported improvement and 9% reported tinnitus becoming more bothersome, with the rest unchanged. Male gender and alcohol consumption were associated with tinnitus being reported less bothersome, and hearing difficulties were associated with the odds of tinnitus being reported as more bothersome. This study is one of the few to provide data on the natural history of tinnitus in a non-clinical population, suggesting that resolution is relatively uncommon, with improvement and worsening of symptoms equally likely. There was limited evidence for any modifiable lifestyle factors being associated with changes in tinnitus symptoms. In view of the largely persistent nature of tinnitus, public health strategies should focus on: (1) primary prevention and (2) managing symptoms in people that have tinnitus and monitoring changes in bothersomeness.
Publisher: Oxford University Press (OUP)
Date: 06-10-2020
Abstract: Socioeconomic status is associated with health status among older adults, including hearing and vision impairments, and healthcare system performance is an important consideration in examining that association. We explored the link between a country’s healthcare system performance and the hearing and visual impairments of its people in Europe. This study enrolled 65 332 in iduals aged 50+ from 17 countries participating in the Survey of Health, Ageing and Retirement in Europe Wave 6. We used latent class analysis to identify groups of countries based on six domains of healthcare system performance. We then performed multiple logistic regressions to quantify the association between socioeconomic status and hearing and visual impairments adjusted for demographic and other co-variates finally, we compared the patterns of observed associations in each of the country groups. The latent class analysis separated countries into three groups based on the performance of their healthcare systems: poor, moderate and high. Respondents in countries with moderate and poor healthcare performance were more likely to experience hearing and visual impairment than those in countries with high healthcare performance. With respect to hearing and visual impairments, wealth gradients at the in idual level varied among countries in different healthcare performance groups, with less wealth associated with worse hearing and seeing only in the countries with moderate and poor healthcare performance. The relationships between wealth and hearing and visual impairments differ among countries with different healthcare performance.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.YEBEH.2017.04.043
Abstract: Previous research shows that children with Rolandic Epilepsy have deficits of auditory processing. We wanted to confirm the nature of this deficit and whether it aggregates in families. We compared 40 children with Rolandic Epilepsy and 32 unaffected siblings with 99 typically developing children and 71 parents of RE children with 31 healthy adults on a battery of auditory processing tests. We also examined ear advantage in children with RE, their siblings and parents using population norms and measured non-word reading performance. We found a specific deficit for competing words in patients, their siblings and their parents, suggesting that this particular impairment of auditory processing present in children with RE, is heritable and likely to be persistent. Importantly, scores on this subtest in patients and siblings were significantly correlated with non-word reading performance. We saw increased rates of atypical left ear advantage in patients and siblings but no evidence of this in parents. We present these findings as evidence of familial incidence of dichotic listening and ear advantage abnormalities in relatives of children with Rolandic Epilepsy.
Publisher: Public Library of Science (PLoS)
Date: 12-12-2014
Publisher: Cambridge University Press (CUP)
Date: 24-09-2019
DOI: 10.1017/S1041610218000728
Abstract: Age-related hearing and vision problems are common among people with dementia and are associated with poorer function, reduced quality of life and increased caregiver burden. Addressing sensory impairments may offer an opportunity to improve various aspects of life for people with dementia. Electronic databases were searched using key terms dementia, hearing impairment, vision impairment, intervention, and management. Database searches were supplemented by hand searching bibliographies of papers and via consultation with a network of health professional experts. Studies were eligible for inclusion if they included adults aged over 50 with dementia with adult-onset hearing or vision impairment who had received a hearing or vision intervention in relation to cognitive function, rate of decline, psychiatric symptoms, hearing/vision-related disability, quality of life, and/or caregiver burden outcomes. A range of study designs were included. Results were summarized descriptively according to level of evidence and effect sizes calculated where possible. Risk of bias was assessed using Downs and Black's (1998) checklist. The development of the intervention was summarized according to the CReDECI2 scheme. PROSPERO review registration number 2016:CRD42016039737. Twelve papers describing hearing interventions and five papers describing vision interventions were included. Most were of low to moderate quality. One high quality randomized controlled trial of a hearing aid intervention was identified. Hearing interventions included provision of hearing aids, assistive listening devices, communication strategies, hearing aid trouble shooting, and cochlear implantation. Vision interventions included prism lenses, rehabilitation training, and cataract surgery. There was no consistent evidence for the positive impact of hearing/vision interventions on cognitive function, rate of cognitive decline, quality of life, or caregiver burden. Sensory interventions may promote better outcomes, but there is a need for properly powered, controlled trials of hearing and vision interventions on outcomes relevant to people living with dementia.
Publisher: Wiley
Date: 16-10-2015
DOI: 10.1002/AJMG.B.32393
Abstract: Cognitive abilities (memory, processing speed, vocabulary, and fluid intelligence) are correlated with educational attainment and occupational status, as well as physical and mental health. The variation in cognitive abilities observed within a population has a substantial genetic contribution (heritability ∼50%) and yet the identification of genetic polymorphisms from both genome-wide association and candidate studies have to date only uncovered a limited number of genetic variants that exert small genetic effects. Here we impute human leukocyte antigens (HLA) using existing genome-wide association data from 1,559 non-pathological elderly volunteers who have been followed for changes in cognitive functioning between a 12- and 18-year period. Specifically, we investigate DRB1*05 (*11/*12) and DRB1*01, which have previously been associated with cognitive ability. We also analyze DRB1*0801, which shares close sequence homology with DRB1*1101. Together with DRB1*1101, DRB1*0801 has been associated with several diseases including multiple sclerosis and primary biliary cirrhosis, which themselves are associated with cognitive impairment. We observed that both DRB1*0801 and DRB1*1101 were significantly associated with vocabulary ability (cross-sectional and longitudinal scores) and that the effects were in opposite directions with DRB1*0801 associated with lower score and faster decline. This opposing affect is similar to that reported by other groups in systemic lupus erythematosus, type 1 diabetes, and primary biliary cirrhosis. DRB1*0801 was also significantly associated with reduced memory ability. We observed no associations between cognitive abilities and DRB1*01 or DRB1*12.
Publisher: Elsevier BV
Date: 2014
DOI: 10.1016/J.JPSYCHORES.2013.08.018
Abstract: Previous research has suggested that a substantial proportion of the population are severely affected by tinnitus, however recent population data are lacking. Furthermore, there is growing evidence that the perception of severity is closely related to personality factors such as neuroticism. In a subset (N=172,621) of a large population s le of >500,000 adults aged 40 to 69years, (from the UK Biobank dataset) we calculated the prevalence of tinnitus and that which is perceived as bothersome, and examined the association between tinnitus and a putative predisposing personality factor, neuroticism. Participants were recruited through National Health Service registers and aimed to be inclusive and as representative of the UK population as possible. The assessment included subjective questions concerning hearing and tinnitus. Neuroticism was self-rated on 13 questions from the Eysenck Personality Inventory. Associations between neuroticism and tinnitus were tested with logistic regression analyses. Prevalence of tinnitus was significantly higher for males, and increased with age, doubling between the youngest and oldest age groups (males 13% and 26% females 9% and 19% respectively). Of those with tinnitus, females were more likely to report bothersome tinnitus. Neuroticism was associated with current tinnitus and bothersome tinnitus, with the items: 'loneliness', 'mood swings', 'worrier/anxious' and 'miserableness', as the strongest associations of bothersome tinnitus. Neuroticism was identified as a novel association with tinnitus. In iduals with tinnitus and higher levels of neuroticism are more likely to experience bothersome tinnitus, possibly as a reflection of greater sensitivity to intrusive experiences.
Publisher: S. Karger AG
Date: 04-06-2021
DOI: 10.1159/000515892
Abstract: b i Introduction: /i /b Hearing, vision, and cognitive impairment commonly co-occur in older people. However, the rate of recognition and appropriate management of combined hearing and vision impairment in people with dementia impairment is low. The aim of this work was to codevelop internationally relevant, multidisciplinary practice recommendations for professionals involved in the diagnosis, care, and management of older people with these concurrent conditions. b i Methods: /i /b We applied consensus methods with professional and lay expert stakeholders, using an adapted version of the i World Health Organization Handbook for Guideline Development /i . The development involved 4 phases and included: (1) collating existing evidence, (2) filling the gaps in evidence, (3) prioritising evidence, and (4) refining the final list of recommendations. Each phase encompassed various methodologies including a review of existing guidelines within the 3 clinical domains, systematic reviews, qualitative studies, a clinical professional consortium, surveys, and consensus meetings with interdisciplinary domain experts. b i Results: /i /b The task force evaluated an initial list of 26 recommendations, ranking them in the order of priority. A consensus was reached on 15 recommendations, which are classified into 6 domains of “awareness and knowledge,” “recognition and detection,” “evaluation,” “management,” “support,” and “services and policies.” Pragmatic options for implementation for each domain were then developed. b i Conclusion: /i /b This is the first set of international, interdisciplinary practice recommendations that will guide the development of multidisciplinary services and policy to improve the lives of people with dementia and hearing and vision impairment.
Publisher: Informa UK Limited
Date: 15-01-2019
DOI: 10.1080/14992027.2018.1531154
Abstract: To conduct a systematic review of the evidence in relation to what hearing healthcare professionals do during hearing aid consultations and identifying which behaviours promote hearing aid use and benefit among adult patients. Searches were performed in electronic databases MEDLINE, EMBASE, CINAHL, PsycInfo, Web of Science, PubMed and Google Scholar. The Crowe Critical Appraisal Tool and Melnyk Levels of Evidence were used to assess quality and level of evidence of eligible studies. Behaviours of hearing healthcare professionals were summarised descriptively. 17 studies met the inclusion criteria. Twelve studies described behaviours of audiologists and five studies were intervention studies. Audiologists were typically task- or technically-oriented and/or dominated the interaction during hearing aid consultations. Two intervention studies suggested that use of motivational interviewing techniques by audiologists may increase hearing aid use in patients. Most studies of clinicians' behaviours were descriptive, with very little research linking clinician behaviour to patient outcomes. The present review sets the research agenda for better-controlled intervention studies to identify which clinician behaviours better promote patient hearing aid outcomes and develop an evidence base for best clinical practice.
Publisher: JMIR Publications Inc.
Date: 02-05-2019
Abstract: ools for app- and Web-based self-testing for identification of cognitive impairment are widely available but are of uncertain quality. he objective of this study was to undertake a scoping review of app- and Web-based self-tests for cognitive impairment and determine the validity of these tests. e conducted systematic searches in electronic databases, including Google search, Google Play Store, and iPhone Operating System App Store, using the search terms “Online OR Internet-based AND Memory OR Brain OR Dementia OR mild cognitive impairment OR MCI AND Test OR Screen OR Check.” e identified 3057 tools, of which 25 were included in the review. Most tools meeting the inclusion criteria assessed multiple cognitive domains. The most frequently assessed domains were memory, attention, and executive function. We then conducted an electronic survey with the developers of the tools to identify data relating to development and validation of each tool. If no response to the survey was received, Google (to identify gray literature), Google Scholar, and Medical Literature Analysis and Retrieval System Online were searched using key terms “(name of developer, if available)” AND “(the name of the tool)” to identify any additional data. Only 7 tools had any information concerning psychometric quality, and only 1 tool reported data on performance norms, reliability, validity, sensitivity, and specificity for the detection of cognitive impairment. he number of cognitive self-assessment electronic health tools for cognitive impairment is increasing, but most are of uncertain quality. There is a need for well-validated tools and guidance for users concerning which tools provide reliable information about possible cognitive impairment that could warrant further investigation.
Publisher: Wiley
Date: 18-08-2020
DOI: 10.1111/HEX.13096
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2016
DOI: 10.1097/AUD.0000000000000341
Abstract: To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a s le of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and in iduals identified as potential candidates for cochlear implantation (n = 211). These “candidates” were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52% p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63% p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72% p 0.001). Self-reported difficulties with sleep were similar among implant users (75%) and candidates (82% p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without ( p 0.001). The prevalence of sleep difficulties was not related to tinnitus persistence ( p = 0.28) or the extent to which tinnitus was distressing ( p = 0.55). The lack of association between tinnitus persistence and sleep difficulties is compatible with the notion that tinnitus is suppressed in implant users primarily during active electrical stimulation and may return when the implant is switched off at night time. This explanation is supported by the similar prevalence of sleep problems among implant users and potential candidates for cochlear implantation, despite differences between the groups in tinnitus persistence and related emotional distress. Cochlear implantation may therefore not be an appropriate intervention where the primary aim is to alleviate sleep difficulties.
Publisher: Public Library of Science (PLoS)
Date: 11-03-2015
Publisher: Informa UK Limited
Date: 06-04-2021
Publisher: Informa UK Limited
Date: 19-10-2023
Publisher: Informa UK Limited
Date: 15-12-2021
DOI: 10.1080/14992027.2021.2009131
Abstract: To establish whether ethnic inequalities exist in levels of self-reported hearing difficulty and hearing aid use among middle-aged adults. Cross-sectional data from the UK Biobank resource. 164,460 participants aged 40-69 who answered hearing questions at an assessment centre in England or Wales. After taking into account objectively assessed hearing performance and a corresponding correction for bias in non-native English speakers, as well as a range of correlates including demographic, socioeconomic, and health factors, there were lower levels of hearing aid use for people from Black African (OR 0.36, 95% CI 0.17-0.77), Black Caribbean (OR 0.38, 95% CI 0.22-0.65) and Indian (OR 0.60, 95% CI 0.41-0.86) ethnic groups, compared to the White British or Irish group. Men from most ethnic minority groups and women from Black African, Black Caribbean and Indian groups were less likely to report hearing difficulty than their White British or Irish counterparts. For equivalent levels of hearing loss, the use of hearing aids is lower among ethnic minority groups. Inequalities are partly due to lower levels of self-reported hearing difficulty among minority groups. However, even when self-reported hearing difficulty is considered, hearing aid use remains lower among many ethnic minority groups.
Publisher: Springer Science and Business Media LLC
Date: 14-02-2019
Publisher: BMJ
Date: 19-04-2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2011
Publisher: Elsevier BV
Date: 10-2019
Publisher: Wiley
Date: 08-07-2009
DOI: 10.1080/13682820902929073
Abstract: Auditory Processing Disorder (APD) does not feature in mainstream diagnostic classifications such as the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), but is frequently diagnosed in the United States, Australia and New Zealand, and is becoming more frequently diagnosed in the United Kingdom. To familiarize readers with current controversies surrounding APD, with an emphasis on how APD might be conceptualized in relation to language and reading problems, attentional problems and autistic spectrum disorders. Different conceptual and diagnostic approaches adopted by audiologists and psychologists can lead to a confusing picture whereby the child who is regarded as having a specific learning disability by one group of experts may be given an APD diagnosis by another. While this could be indicative of co-morbidity, there are concerns that different professional groups are using different labels for the same symptoms. APD, as currently diagnosed, is not a coherent category, but that rather than abandoning the construct, we need to develop improved methods for assessment and diagnosis, with a focus on interdisciplinary evaluation.
Publisher: Elsevier BV
Date: 06-2015
Abstract: To estimate service demand (willingness to seek or use services) for respite care among informal, primary carers of people with a psychological disability and to describe their characteristics. Analysis of data from the household component of the 2009 Survey of Disability Ageing and Carers (n=64,213 persons). In Australia in 2009, 1.0% of people aged 15 years or over (177,900 persons) provided informal, primary care to a co-resident with a psychological disability. One-quarter (27.2%) of these carers reported service demand for respite care, of whom one-third had used respite services in the past three months and four-fifths had an unmet need for any or more respite care. A significantly greater percentages of carers with service demand for respite care spent 40 or more hours per week on caregiving, provided care to a person with profound activity restrictions and reported unmet support needs, compared to carers without service demand. Lack of suitable, available respite care models was a barrier to utilisation. Findings confirm significant service demand for, and under-utilisation of, respite care among mental health carers. Increased coverage of respite services, more flexible service delivery models matched to carers' needs and better integration with other support services are indicated.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2018
DOI: 10.1097/AUD.0000000000000515
Abstract: To investigate the correlations between hearing handicap, speech recognition, listening effort, and fatigue. Eighty-four adults with hearing loss (65 to 85 years) completed three self-report questionnaires: the Fatigue Assessment Scale, the Effort Assessment Scale, and the Hearing Handicap Inventory for Elderly. Audiometric assessment included pure-tone audiometry and speech recognition in noise. There was a significant positive correlation between handicap and fatigue ( r = 0.39, p 0.05) and handicap and effort ( r = 0.73, p 0.05). There were significant (but lower) correlations between speech recognition and fatigue ( r = 0.22, p 0.05) or effort ( r = 0.32, p 0.05). There was no significant correlation between hearing level and fatigue or effort. Hearing handicap and speech recognition both correlate with self-reported listening effort and fatigue, which is consistent with a model of listening effort and fatigue where perceived difficulty is related to sustained effort and fatigue for unrewarding tasks over which the listener has low control. A clinical implication is that encouraging clients to recognize and focus on the pleasure and positive experiences of listening may result in greater satisfaction and benefit from hearing aid use.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2020
DOI: 10.1186/S13063-020-4135-4
Abstract: Optimising hearing and vision function may be important in improving a range of outcomes for people living with dementia (PwD) and their companions. The SENSE-Cog cross-national randomised controlled trial (RCT) is evaluating the effectiveness of a sensory intervention (SI) to improve quality of life for PwD with concurrent hearing and/or vision impairment, in five European countries. To ascertain how or why the intervention will, or will not, achieve its outcomes, we have designed a process evaluation to explore potential discrepancies between expected and observed outcomes. This will also help us to understand how context may influence the outcomes. Here we describe the protocol for this process evaluation, which is embedded within the RCT. We will use a mixed methods approach with a theoretical framework derived from the UK Medical Research Council’s’ guidance on process evaluations. It will include the following: (1) evaluating how key aspects of the intervention will be delivered , which will be important to scale the intervention in real world populations (2) characterising the contextual issues, which may shape the delivery and the impact of the intervention in different countries and (3) investigating possible causal mechanisms through analyses of potential moderators and mediators. To avoid bias, we will analyse the process data before the analysis of the main effectiveness outcomes. This evaluation will provide insight into how the complex SENSE-Cog SI will be tailored, enacted and received across the different European contexts, all of which have unique health and social care economies. The findings will provide insight into the causal mechanisms effecting change, and will determine whether we should implement the intervention, if effective, on a wider scale for PwD and concurrent sensory impairment. ISRCTN, ISRCTN17056211 . Registered on 19 February 2018.
Publisher: Wiley
Date: 10-04-2018
DOI: 10.1111/JGS.15363
Abstract: To test whether hearing aid use alters cognitive trajectories in older adults. US population-based longitudinal cohort study SETTING: Data were drawn from the Health and Retirement Study (HRS), which measured cognitive performance repeatedly every 2 years over 18 years (1996-2014). Adults aged 50 and older who who took part in a minimum of 3 waves of the HRS and used hearing aids for the first time between Waves 4 and 11 (N=2,040). Cognitive outcomes were based on episodic memory scores determined according to the sum of immediate and delayed recall of 10 words. Hearing aid use was positively associated with episodic memory scores (β=1.53, p<.001). Decline in episodic memory scores was slower after (β=-0.02, p<.001) than before using hearing aids (β=-0.1, p<.001). These results were robust to adjustment for multiple confounders and to attrition, as accounted for using a joint model. Hearing aids may have a mitigating effect on trajectories of cognitive decline in later life. Providing hearing aids or other rehabilitative services for hearing impairment much earlier in the course of hearing impairment may stem the worldwide rise of dementia.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2013
Publisher: Springer Science and Business Media LLC
Date: 04-01-2019
DOI: 10.1007/S10654-018-00478-Y
Abstract: To analyze the longitudinal relationships between vision loss and the risk of dementia in the first 2 years, from 2 to 4 years and beyond 4 years after inclusion and to determine the roles of depressive symptomatology and engagement in cognitively stimulating activities in these associations. This study is based on the Three-City (3C) study, a population-based cohort of 7736 initially dementia-free participants aged 65 years and over with 12 years of follow-up. Near visual impairment (VI) was measured and distance visual function (VF) loss was self-reported. Dementia was diagnosed and screened over the 12-year period. At baseline, 8.7% had mild near VI, 4.2% had moderate to severe near VI, and 5.3% had distance VF loss. Among the 882 dementia cases diagnosed over the 12-year follow-up period, 140 cases occurred in the first 2 years, 149 from 2 to 4 years and 593 beyond 4 years after inclusion. In Cox multivariate analysis, moderate to severe near VI was associated with an increased risk of dementia in the first 2 years (HR 2.0, 95% CI 1.2-3.3) and from 2 to 4 years (HR 1.8, 95% CI 1.1-3.1) but the association was not significant beyond 4 years after inclusion even if pointing in similar direction (HR 1.3, 95% CI 0.95-1.9). Mild near VI was associated with an increased risk of dementia only in the first 2 years (HR 1.6, 95% CI 1.1-2.5). Moreover, self-reported distance VF loss was associated with an increased risk beyond 4 years after inclusion (HR 1.5, 95% CI 1.1-2.0) but the association was no longer significant after taking into account baseline cognitive performances. Further adjustment for engagement in cognitively stimulating activities only slightly decreased these associations. However, there was an interaction between vision loss and depressive symptomatology, with vision loss associated with dementia only among participants with depressive symptomatology. These results suggest that poor vision, in particular near vision loss, may represent an indicator of dementia risk at short and middle-term, mostly in depressed elderly people.
Publisher: Springer Science and Business Media LLC
Date: 14-08-2019
Publisher: Cold Spring Harbor Laboratory
Date: 14-02-2019
DOI: 10.1101/549071
Abstract: Age-related hearing impairment (ARHI) is the most common sensory impairment in the aging population a third of in iduals are affected by disabling hearing loss by the age of 65 1 . ARHI is a multifactorial condition caused by both genetic and environmental factors, with estimates of heritability between 35% and 55% 2–4 . The genetic risk factors and underlying biological pathology of ARHI are largely unknown, meaning that targets for new therapies remain elusive. We performed genome-wide association studies (GWAS) for two self-reported hearing phenotypes, hearing difficulty ( HDiff ) and hearing aid use ( HAid ), using over 250,000 UK Biobank 5 volunteers aged between 40-69 years. We identified 44 independent genome-wide significant loci (P E-08), 33 of which have not previously been associated with any form of hearing loss. Gene sets from these loci are enriched in auditory processes such as synaptic activities, nervous system processes, inner ear morphology and cognition. Immunohistochemistry for protein localisation in adult mouse cochlea indicate metabolic, sensory and neuronal functions for NID2, CLRN2 and ARHGEF28 identified in the GWAS. These results provide new insight into the genetic landscape underlying susceptibility to ARHI.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2017
DOI: 10.1097/AUD.0000000000000361
Abstract: Hearing loss may increase listening-related effort and fatigue due to the increased mental exertion required to attend to, and understand, an auditory message. Because there have been few attempts to quantify self-reported effort and fatigue in listeners with hearing loss, that was the aim of the present study. Participants included three groups of hearing-impaired adults: (1) hearing aid users (HA, n = 50 31 male, 19 female age range = 55 to 85 years) (2) cochlear implant users (CI, n = 50 26 male, 24 female age range = 55 to 80 years) and (3) single sided deafness (SSD, n = 50 30 male, 20 female age range = 58 to 80 years). There was also a control group of adults who passed a hearing screen at 30 dB HL at the frequencies: 500, 1000, 2000, and 4000 Hz in both ears (n = 50 22 male, 28 female age range = 55 to 78 years). The fatigue assessment scale (FAS) was used to quantify fatigue. The FAS is a generic standardized self-report scale consisting of 10 items that are scored using a five-point Likert scale. An effort assessment scale (EAS), developed for the present study, consisted of six questions with responses provided on a visual analog scale that ranges from 0 to 10. All hearing-impaired groups reported significantly increased effort and fatigue compared to the control group. The median fatigue score for the control group was 14 and around 22 for the three hearing-impaired groups. The median effort score for the control group was 20 and around 70 for the three hearing-impaired groups. There was no significant difference in mean effort or fatigue between the three groups of hearing-impaired adults. There was a weak positive correlation between fatigue and effort scores ( r = 0.40, p 0.05). The proportion of participants with extreme fatigue (scores above the 95th percentile of the control group) was 22, 10, and 22%, for the HA, CI, and SSD groups, respectively. The proportion of those with extreme effort was 46, 54, and 52%, for the HA, CI, and SSD groups, respectively. Results of factor analysis using the in idual questions from both questionnaires indicated that the questions loaded into two factors: a “fatigue” factor for all of the FAS questions and an “effort” factor for all of the EAS questions. Hearing-impaired in iduals report high levels of listening effort and fatigue in everyday life. The similarity in listening-related effort and fatigue between the different hearing-impaired groups suggests that these aspects of listening experience are not predicted by the severity of hearing impairment. Factor analysis suggests that the FAS and the EAS assess two distinct dimensions. The low correlation between FAS and EAS means that fatigue cannot be reliably predicted from self-reported effort in in idual listeners.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 23-12-2021
DOI: 10.1097/AUD.0000000000001174
Abstract: Hearing impairment commonly co-occurs with dementia. Audiologists, therefore, need to be prepared to address the specific needs of people living with dementia (PwD). PwD have needs in terms of dementia-friendly clinical settings, assessments, and rehabilitation strategies tailored to support in idual requirements that depend on social context, personality, background, and health-related factors, as well as audiometric HL and experience with hearing assistance. Audiologists typically receive limited specialist training in assisting PwD and professional guidance for audiologists is scarce. The aim of this review was to outline best practice recommendations for the assessment and rehabilitation of hearing impairment for PwD with reference to the current evidence base. These recommendations, written by audiology, psychology, speech-language, and dementia nursing professionals, also highlight areas of research need. The review is aimed at hearing care professionals and includes practical recommendations for adapting audiological procedures and processes for the needs of PwD.
Publisher: BMJ
Date: 11-2017
DOI: 10.1136/BMJOPEN-2017-018744
Abstract: Quality of life and other key outcomes may be improved by optimising hearing and vision function in people living with dementia. To date, there is limited research assessing the efficacy of interventions aimed at improving hearing and vision in people with dementia. Here, we outline a protocol to field test a newly developed home-based intervention, designed to optimise sensory functioning in people with dementia in three European sites. The results of this study will inform the design and conduct of a full-scale randomised controlled trial (RCT) in five European sites. In this multisite, single arm, open label, feasibility study, participants with dementia (n=24) will be assessed for hearing and vision impairments and be prescribed a hearing aid and/or glasses. Each participant will have a study partner (‘dyads’). A subset of dyads will receive ‘sensory support’ from a ‘sensory support therapist’, comprising home visits over 12 weeks. The therapist will offer the following intervention: adherence support for corrective devices adaptations to the home environment to facilitate sensory function communication training and referral to community-based support services. The primary outcomes will be process measures assessing the feasibility, tolerability and acceptability of: (1) the intervention components (2) the method of implementation of the intervention and (3) the study procedures, including outcome assessment measures. Quantitative data will be collected at baseline and follow-up. Qualitative data using semistructured interviews will be collected postintervention and weekly, using participant diaries. Finally, we will explore a model of cost-effectiveness to apply in the subsequent full-scale trial. This feasibility study is a necessary step in the development of a complex, in idualised, psychosocial intervention. The data gathered will allow logistical and theoretical processes to be refined in preparation for a full-scale RCT. Ethical approval was obtained in all three participating countries. Results of the field trial will be submitted for publication in a peer-reviewed journal.
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJPO-2020-000789
Abstract: It is proven that adverse intrauterine environment results in ‘early life programming,’ alterations in metabolism and physiological development of the fetus, often termed as ‘Developmental Origins of Health and Disease’ (DOHaD) resulting in a smaller size at birth, greater non-communicable diseases (NCD) risk factors during childhood and adolescence, and cardiometabolic disorders in adulthood. Nevertheless, very few studies have examined the relationship between DOHaD programming and cognition. This study aims to examine if impaired prenatal growth indicated by birth weight is associated with cognition among adolescents in the Kisalaya cohort, a rural birth cohort in South India, thus providing newer insights into DOHaD programming for adolescent mental health in a low-income and middle-income country setting. Kisalaya cohort was established in 2008, to provide integrated antenatal care and HIV testing using mobile clinics to improve maternal and child health outcomes. This cohort included pregnant women residing in 144 villages of Mysuru Taluk (rural) who received antenatal care through mobile clinics and delivered their children between 2008 and 2011. Data related to mother–infant dyads for all pregnant women who received care in the Kisalaya programme are available for this study. Presently, children born to women who received care through Kisalaya are adolescents between 10 and 12 years. At this point, information would be collected on sociodemographic data and assessments of mental health, stressful life events, cognition, vision, speech, language, hearing and anthropometric measures would be done and relevant maternal data and child data, available from the cohort would be retracted for analysis. We plan to retrace as many adolescents as possible out of 1544 adolescents who are currently available for study excluding twins, abortions, stillbirths and postdelivery deaths. Analyses will be extended to construct a life course pathway for cognition using structural equation modelling.
Publisher: Informa UK Limited
Date: 29-08-2023
Publisher: Public Library of Science (PLoS)
Date: 17-09-2014
Publisher: Informa UK Limited
Date: 18-04-2013
DOI: 10.3109/14992027.2013.783718
Abstract: A recent study suggested that placebo effects are a source of bias in non-blinded hearing-aid trials. Given the potential impact of this finding on the interpretation of non-blinded trials and design of future research trials, the objective of the present study was to investigate the reliability of this effect. Using the same procedure as an earlier study, participants were told that they were taking part in a trial of new hearing-aid technology. Participants compared two devices that were acoustically identical, except one was described as "new" and the other as "conventional". Participants completed a speech-in-noise test, sound quality ratings, and rated overall personal preference for both hearing aids. Sixteen adult hearing-aid users. Participants had significantly better mean speech-in-noise performance (70.9% versus 66.8%, Z = 2.30, p = 0.02, effect size Pearson's r = 0.15) and sound quality ratings for the "new" hearing aid (8.1 versus 7.4, Z = - 2.99, p = 0.003, r = 0.28). A significant proportion of participants (75%) expressed an overall preference for the "new" hearing aid (p = 0.001, effect size φc = 0.66). Placebo effects reliably impact on hearing-aid trials. In order to control for placebo effects, double-blind methodology is optimal. However, when double-blinding is not possible other strategies may be appropriate.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2017
DOI: 10.1097/AUD.0000000000000366
Abstract: It is widely recognized by hearing aid users and audiologists that a period of auditory acclimatization and adjustment is needed for new users to become accustomed to their devices. The aim of the present study was to test the idea that auditory acclimatization and adjustment to hearing aids involves a process of learning to “tune out” newly audible but undesirable sounds, which are described by new hearing aid users as annoying and distracting. It was hypothesized that (1) speech recognition thresholds in noise would improve over time for new hearing aid users, (2) distractibility to noise would reduce over time for new hearing aid users, (3) there would be a correlation between improved speech recognition in noise and reduced distractibility to background sounds, (4) improvements in speech recognition and distraction would be accompanied by self-report of reduced annoyance, and (5) improvements in speech recognition and distraction would be associated with higher general cognitive ability and more hearing aid use. New adult hearing aid users (n = 35) completed a test of aided speech recognition in noise (SIN) and a test of auditory distraction by background sound lified by hearing aids on the day of fitting and 1, 7, 14, and 30 days post fitting. At day 30, participants completed self-ratings of the annoyance of lified sounds. Daily hearing aid use was measured via hearing aid data logging, and cognitive ability was measured with the Wechsler Abbreviated Scale of Intelligence block design test. A control group of experienced hearing aid users (n = 20) completed the tests over a similar time frame. At day 30, there was no statistically significant improvement in SIN among new users versus experienced users. However, levels of hearing loss and hearing aid use varied widely among new users. A subset of new users with moderate hearing loss who wore their hearing aids at least 6 hr/day (n = 10) had significantly improved SIN (by ~3-dB signal to noise ratio), compared with a control group of experienced hearing aid users. Improvements in SIN were associated with more consistent HA use and more severe hearing loss. No improvements in the test of auditory distraction by background sound were observed. Improvements in SIN were associated with self-report of background sound being less distracting and greater self-reported hearing aid benefit. There was no association between improvements in SIN and cognitive ability or between SIN and auditory distraction. Improvements in SIN were accompanied by self-report of background sounds being less intrusive, consistent with auditory acclimatization involving a process of learning to “tune out” newly audible unwanted sounds. More severe hearing loss may afford the room for improvement required to show better SIN performance with time. Consistent hearing aid use may facilitate acclimatization to hearing aids and better SIN performance.
Publisher: SAGE Publications
Date: 2019
Abstract: High levels of occupational noise exposure increase the risk of hearing difficulties and tinnitus. However, differences in demographic, health, and lifestyle factors could also contribute to high levels of hearing difficulties and tinnitus in some industries. Data from a subs le ( n = 22,936) of the U.K. Biobank were analyzed to determine to what extent differences in levels of hearing difficulties and tinnitus in high-risk industries (construction, agricultural, and music) compared with low-risk industries (finance) could be attributable to demographic, health, and lifestyle factors, rather than occupational noise exposure. Hearing difficulties were identified using a digits-in-noise speech recognition test. Tinnitus was identified based on self-report. Logistic regression analyses showed that occupational noise exposure partially accounted for higher levels of hearing difficulties in the agricultural industry compared with finance, and occupational noise exposure, older age, low socioeconomic status, and non-White ethnic background partially accounted for higher levels of hearing difficulties in the construction industry. However, the factors assessed in the model did not fully account for the increased likelihood of hearing difficulties in high-risk industries, suggesting that there are additional unknown factors which impact on hearing or that there was insufficient measurement of factors included in the model. The levels of tinnitus were greatest for music and construction industries compared with finance, and these differences were accounted for by occupational and music noise exposure, as well as older age. These findings emphasize the need to promote hearing conservation in occupational and music settings, with a particular focus on high-risk demographic subgroups.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-07-2019
DOI: 10.1097/AUD.0000000000000765
Abstract: Diet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large population study s le. The research was conducted using the UK Biobank resource. Tinnitus was based on report of ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time. Identification of a hearing problem was based on self-reported difficulties with hearing. Usual dietary intake and dietary patterns (involving statistical grouping of intake to account for how foods are combined in real-life diets) were estimated based on between two and five administrations of the Oxford Web-Q 24-hour dietary recall questionnaire over the course of a year for 34,576 UK adult participants aged 40 to 69. In a multivariate model, higher intake of vitamin B12 was associated with reduced odds of tinnitus, while higher intakes of calcium, iron, and fat were associated with increased odds (B12, odds ratio [OR] 0.85, 95% confidence interval [CI] 0.75 to 0.97 Calcium, OR 1.20, 95% CI 1.08 to 1.34 Iron, OR 1.20, 95% CI 1.05 to 1.37 Fat, OR 1.33, 95% CI 1.09 to 1.62, respectively, for quintile 5 versus quintile 1). A dietary pattern characterised by high protein intake was associated with reduced odds of tinnitus (OR 0.90, 95% CI 0.82 to 0.99 for quintile 5 versus quintile 1). Higher vitamin D intake was associated with reduced odds of hearing difficulties (OR 0.90, 95% CI 0.81 to 1.00 for quintile 5 versus quintile 1), as were dietary patterns high in fruit and vegetables and meat and low in fat (Prudent diet: OR 0.89, 95% CI 0.83 to 0.96 High protein: OR 0.88, 95% CI 0.82 to 0.95 High fat: OR 1.16, 95% CI 1.08 to 1.24, respectively, for quintile 5 versus quintile 1). There were associations between both single nutrients and dietary patterns with tinnitus and hearing difficulties. Although the size of the associations was small, universal exposure for dietary factors indicates that there may be a substantial impact of diet on levels of tinnitus and hearing difficulties in the population. This study showed that dietary factors might be important for hearing health.
Publisher: Elsevier BV
Date: 03-2022
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/14992020701545906
Abstract: The SCAN-C is a test for auditory processing disorders in children developed in the USA. There are concerns that the SCAN-C may over-diagnose auditory processing disorders in UK children. There are also questions concerning the impact of language level and interpretation of SCAN-C results. SCAN-C results from 99 Oxfordshire school children aged 6 to 10 were compared to US-based normative data. Across all age bands, the UK s le scored significantly worse on two subtests: the filtered words (FW) and auditory figure-ground (AFG) sections as well as on the composite score. Differences in performance were largely due to accent effects. Applying US norms to UK children's performance results in a high rate of over-identification of listening difficulties. However, we show that US norms can be used provided SCAN-C scores for children in the UK are adjusted by adding a constant. Using factor analysis, SCAN-C subtests mapped onto two factors FW and AFG onto a 'monaural low-redundancy degradation' factor, and CW and CS onto a 'binaural separation/competition' factor. Implications for use of the SCAN-C with UK children are discussed.
Publisher: Wiley
Date: 07-2017
Publisher: Elsevier BV
Date: 11-2022
Publisher: Acoustical Society of America (ASA)
Date: 06-2014
DOI: 10.1121/1.4874629
Abstract: The aim of this study was to investigate changes in central auditory processing following unilateral and bilateral hearing aid fitting using a combination of physiological and behavioral measures: late auditory event-related potentials (ERPs) and speech recognition in noise, respectively. The hypothesis was that for fitted ears, the ERP litude would increase over time following hearing aid fitting in parallel with improvement in aided speech recognition. The N1 and P2 ERPs were recorded to 500 and 3000 Hz tones presented at 65, 75, and 85 dB sound pressure level to either the left or right ear. New unilateral and new bilateral hearing aid users were tested at the time of first fitting and after 12 weeks hearing aid use. A control group of long-term hearing aid users was tested over the same time frame. No significant changes in the ERP were observed for any group. There was a statistically significant 2% improvement in aided speech recognition over time for all groups, although this was consistent with a general test–retest effect. This study does not support the existence of an acclimatization effect observable in late ERPs following 12 weeks' hearing aid use.
Publisher: Public Library of Science (PLoS)
Date: 18-06-2020
Publisher: Elsevier BV
Date: 09-2020
DOI: 10.1016/J.HEARES.2020.108021
Abstract: Musicians are at risk of hearing loss due to prolonged noise exposure, but they may also be at risk of early sub-clinical hearing damage, such as cochlear synaptopathy. In the current study, we investigated the effects of noise exposure on electrophysiological, behavioral and self-report correlates of hearing damage in young adult (age range = 18-27 years) musicians and non-musicians with normal audiometric thresholds. Early-career musicians (n = 76) and non-musicians (n = 47) completed a test battery including the Noise Exposure Structured Interview, pure-tone audiometry (PTA 0.25-8 kHz), extended high-frequency (EHF 12 and 16 kHz) thresholds, otoacoustic emissions (OAEs), auditory brainstem responses (ABRs), speech perception in noise (SPiN), and self-reported tinnitus, hyperacusis and hearing in noise difficulties. Total lifetime noise exposure was similar between musicians and non-musicians, the majority of which could be accounted for by recreational activities. Musicians showed significantly greater ABR wave I/V ratios than non-musicians and were also more likely to report experience of - and/or more severe - tinnitus, hyperacusis and hearing in noise difficulties, irrespective of noise exposure. A secondary analysis revealed that in iduals with the highest levels of noise exposure had reduced outer hair cell function compared to in iduals with the lowest levels of noise exposure, as measured by OAEs. OAE level was also related to PTA and EHF thresholds. High levels of noise exposure were also associated with a significant increase in ABR wave V latency, but only for males, and a higher prevalence and severity of hyperacusis. These findings suggest that there may be sub-clinical effects of noise exposure on various hearing metrics even at a relatively young age, but do not support a link between lifetime noise exposure and proxy measures of cochlear synaptopathy such as ABR wave litudes and SPiN. Closely monitoring OAEs, PTA and EHF thresholds when conventional PTA is within the clinically 'normal' range could provide a useful early metric of noise-induced hearing damage. This may be particularly relevant to early-career musicians as they progress through a period of intensive musical training, and thus interventions to protect hearing longevity may be vital.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Piers Dawes.