Research trends and hotspot analysis of age-related hearing loss: A bibliometric analysis from 2019 to 2023.

BACKGROUND: Age-related hearing loss (ARHL) - also termed presbycusis - is prevalent among older adults, leading to a range of issues. Although considerable progress in the understanding of ARHL over the decades, available reports lack data from recent years and do not comprehensively reflect the latest advancements and trends. Therefore, our study sought to assess research hotspots and trends in ARHL over the past 5 years to provide the basis for future research. MATERIALS AND METHODS: The Web of Science Core Collection database was searched and screened from January 1, 2019 to October 21, 2023, according to the inclusion criteria. CiteSpace (5.8.R3), VOSviewer (1.6.19), and Microsoft Excel 2019 were employed for bibliometric analysis and visualization. RESULTS: 3084 articles from 92 countries led by the United States and China were included. There has been a steady upward trend in the number of publications from 2019 to 2023. The most productive institutions, authors, and journals are Johns Hopkins University (n = 113), Lin FR (n = 66), and Ear and Hearing (n = 135), respectively. Trend topic analyses revealed that "cochlear synaptopathy" and "dementia" were the predominant foci. Keywords, including "individuals" and "national health", began to appear. CONCLUSION: Over the past 5 years, the annual number of publications has increased significantly and will continue to do so. Research on the mechanism of ARHL, represented by "oxidative stress", is a continuing focus. Emerging topics such as "individual differences" and "national health" may be potential future hotspots in this field.

Association between BCL11B gene polymorphisms and age-related hearing loss in the elderly: A case-control study in Qingdao, China.

Age-related hearing loss is a complex disease caused by a combination of genetic and environmental factors, and a study have conducted animal experiments to explore the association between BCL11B heterozygosity and age-related hearing loss. The present study used established genetic models to examine the association between BCL11B gene polymorphisms and age-related hearing loss. A total of 410 older adults from two communities in Qingdao, China, participated in this study. The case group comprised individuals aged ≥ 60 years with age-related hearing loss, and the control group comprised individuals without age-related hearing loss from the same communities. The groups were matched 1:1 for age and sex. The individual characteristics of the participants were analyzed descriptively using the Mann-Whitney U test and the chi-square test. To explore the association between BCL11B gene polymorphisms and age-related hearing loss, conditional logistic regression was performed to construct genetic models for two single-nucleotide-polymorphisms (SNPs) of BCL11B, and haplotype analysis was conducted to construct their haplotype domains. Two SNP sites of the BCL11B gene, four genetic models of rs1152781 (additive, dominant, recessive, and codominant), and five genetic models of rs1152783 (additive, dominant, recessive, codominant, and over dominant) were significantly associated with age-related hearing loss in the models both unadjusted and adjusted for all covariates (P < 0.05). Additionally, a linkage disequilibrium between rs1152781 and rs1152783 was revealed through haplotype analysis. Our study revealed that BCL11B gene polymorphisms were significantly associated with age-related hearing loss.

Polygenic Risk Score-Based Association Analysis Identifies Genetic Comorbidities Associated with Age-Related Hearing Difficulty in Two Independent Samples.

PURPOSE: Age-related hearing loss is the most common form of permanent hearing loss that is associated with various health traits, including Alzheimer's disease, cognitive decline, and depression. The present study aims to identify genetic comorbidities of age-related hearing loss. Past genome-wide association studies identified multiple genomic loci involved in common adult-onset health traits. Polygenic risk scores (PRS) could summarize the polygenic inheritance and quantify the genetic susceptibility of complex traits independent of trait expression. The present study conducted a PRS-based association analysis of age-related hearing difficulty in the UK Biobank sample (N = 425,240), followed by a replication analysis using hearing thresholds (HTs) and distortion-product otoacoustic emissions (DPOAEs) in 242 young adults with self-reported normal hearing. We hypothesized that young adults with genetic comorbidities associated with age-related hearing difficulty would exhibit subclinical decline in HTs and DPOAEs in both ears. METHODS: A total of 111,243 participants reported age-related hearing difficulty in the UK Biobank sample (> 40 years). The PRS models were derived from the polygenic risk score catalog to obtain 2627 PRS predictors across the health spectrum. HTs (0.25-16 kHz) and DPOAEs (1-16 kHz, L1/L2 = 65/55 dB SPL, F2/F1 = 1.22) were measured on 242 young adults. Saliva-derived DNA samples were subjected to low-pass whole genome sequencing, followed by genome-wide imputation and PRS calculation. The logistic regression analyses were performed to identify PRS predictors of age-related hearing difficulty in the UK Biobank cohort. The linear mixed model analyses were performed to identify PRS predictors of HTs and DPOAEs. RESULTS: The PRS-based association analysis identified 977 PRS predictors across the health spectrum associated with age-related hearing difficulty. Hearing difficulty and hearing aid use PRS predictors revealed the strongest association with the age-related hearing difficulty phenotype. Youth with a higher genetic predisposition to hearing difficulty revealed a subclinical elevation in HTs and a decline in DPOAEs in both ears. PRS predictors associated with age-related hearing difficulty were enriched for mental health, lifestyle, metabolic, sleep, reproductive, digestive, respiratory, hematopoietic, and immune traits. Fifty PRS predictors belonging to various trait categories were replicated for HTs and DPOAEs in both ears. CONCLUSION: The study identified genetic comorbidities associated with age-related hearing loss across the health spectrum. Youth with a high genetic predisposition to age-related hearing difficulty and other related complex traits could exhibit sub-clinical decline in HTs and DPOAEs decades before clinically meaningful age-related hearing loss is observed. We posit that effective communication of genetic risk, promoting a healthy lifestyle, and reducing exposure to environmental risk factors at younger ages could help prevent or delay the onset of age-related hearing difficulty at older ages.

Hearing and Balance in Healthy Aging Project: Characterization of Hearing, Balance, and Other Associated Disorders in Three Population Groups Aged 55 and Over.

INTRODUCTION: Active aging emphasizes optimizing health and participation for a better quality of life as people age. This paper explores the significant impact of hearing loss and balance disorders on the elderly. Age-related hearing loss is thought to contribute to communication breakdown and cognitive dysfunctions. The "hearing and balance in healthy aging" project focuses on early detection, mitigation, and advocacy. Objectives include exploring epidemiological traits, evaluating overall well-being impact, proving positive intervention effects, and advocating societal care for the elderly with hearing loss and balance disorders, aiming to reduce their broader impact on cognition, independence, and sociability. METHODS: This study is observational, prospective study. Subjects over 55 years old with a follow-up every year or every 2 years were divided into three groups, according to their hearing and balance: within the normal range (group A), detected and not treated (group B), and detected and treated (group C). At each visit, they underwent a series of tests or questionnaires, evaluating different areas: hearing, balance, cognition, depression, dependence, tinnitus, loneliness, health. RESULTS: A total of 710 patients were included in the study. The distribution of patients was as follows: group A - 210 patients, group B - 302 patients, and group C - 198 patients. Significant differences were found between the three groups related to age, sex, educational level, bilingualism, and work activity. In group C, there was a higher percentage of males, older than in groups A and B, and the percentage of individuals with a university education was lower (28%), as was the rate of bilingualism (23%). In terms of hearing, significant differences were found in the three groups in the mean PTA, speech discrimination in quiet, and the HINT test, with worse results for group C. Only patients in group C presented a perception of hearing impairment, and the handicap caused by hearing impairment worsened from group A to C. Concerning balance, both tests performed (TuGT and DHI) revealed increased difficulty in maintaining autonomous walking from group A to C, which, again, exhibited the worst results, with statistically significant differences across the group. Analysis about cognition revealed significant differences in DSST questionnaires and in TMT scores, where group C had the worst scores. In HUI3 questionnaire scores, the differences between each and every group were statistically significant, with group C showing moderate disability. CONCLUSION: This extensive analysis, encompassing a considerable number of subjects, reveals significant findings that have important implications for the early prevention of hearing loss and its consequent consequences. At the same time, these data represent an initial exploration, which raises the need for in-depth examinations of additional factors and longer follow-up to continue contributing insights and knowledge for a healthy aging.

Development and validation of the screening tool for age-related hearing loss in the community based on the information platform.

INTRODUCTION: Currently, age-related hearing loss has become prevalent, awareness and screening rates remain dismally low. Duing to several barriers, as time, personnel training and equipment costs, available hearing screening tools do not adequately meet the need for large-scale hearing detection in community-dwelling older adults. Therefore, an accurate, convenient, and inexpensive hearing screening tool is needed to detect hearing loss, intervene early and reduce the negative consequences and burden of untreated hearing loss on individuals, families and society. OBJECTIVES: The study harnessed "medical big data" and "intelligent medical management" to develop a multi-dimensional screening tool of age-related hearing loss based on WeChat platform. METHODS: The assessment of risk factors was carried out by cross-sectional survey, logistic regression model and receiver operating characteristic (ROC) curve analysis. Combining risk factor assessment, Hearing handicap inventory for the elderly screening version and analog audiometry, the screening software was been developed by JavaScript language and been evaluated and verified. RESULTS: A total of 401 older adults were included in the cross-sectional study. Logistic regression model (univariate, multivariate) and reference to literature mention rate of risk factors, 18 variables (male, overweight/obesity, living alone, widowed/divorced, history of noise, family history of deafness, non-light diet, no exercising habit, smoking, drinking, headset wearer habit, hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases, hyperuricemia, hypothyroidism, history of ototoxic drug use) were defined as risk factors. The area under the ROC curve (AUC) of the cumulative score of risk factors for early prediction of age-related hearing loss was 0.777 [95% CI (0.721, 0.833)]. The cumulative score threshold of risk factors was defined as 4, to classify the older adults into low-risk (< 4) and high-risk (≥ 4) hearing loss groups. The sensitivity, specificity, positive predictive value, and negative predictive value of the screen tool were 100%, 65.5%, 71.8%, and 100.0%, respectively. The Kappa index was 0.6. CONCLUSIONS: The screening software enabled the closed loop management of real-time data transmission, early warning, management, whole process supervision of the hearing loss and improve self-health belief in it. The software has huge prospects for application as a screening approach for age-related hearing loss.

Stumbling Blocks in the Investigation of the Relationship Between Age-Related Hearing Loss and Cognitive Impairment.

The relationship between age-related hearing loss (ARHL) and cognitive impairment (CI) remains intricate. However, there is no robust evidence from experimental or clinical studies to elucidate their relationship. The key unaddressed questions are (a) whether there is a causal effect of ARHL on CI and (b) whether efficacious treatment of ARHL (such as hearing-aid use) ameliorates CI and dementia-related behavioral symptoms. Because of several methodological and systematic flaws/challenges, rigorous verification has not been conducted. Addressing these stumbling blocks is essential to unraveling the relationship between ARHL and CI, which motivated us to undertake this review. Here, we discuss the methodological problems from the perspectives of potential confounding bias, assessments of CI and ARHL, hearing-aid use, functional-imaging studies, and animal models based on the latest information and our experiences. We also identify potential solutions for each problem from the viewpoints of clinical epidemiology. We believe that "objectivity," specifically the use of more objective behavioral assessments and new computerized technologies, may be the key to improving experimental designs for studying the relationship between ARHL and CI.

The genetic landscape of age-related hearing loss.

Age-related hearing loss (ARHL) is a prevalent concern in the elderly population. Recent genome-wide and phenome-wide association studies (GWASs and PheWASs) have delved into the identification of causative variants and the understanding of pleiotropy, highlighting the polygenic intricacies of this complex condition. While recent large-scale GWASs have pinpointed significant SNPs and risk variants associated with ARHL, the detailed mechanisms, encompassing both genetic and epigenetic modifications, remain to be fully elucidated. This review presents the latest advances in association studies, integrating findings from both human studies and model organisms. By juxtaposing historical perspectives with contemporary genomics, we aim to catalyze innovative research and foster the development of novel therapeutic strategies for ARHL.

Metabolic and Sensory Components of Age-Related Hearing Loss: Associations With Distortion- and Reflection-Based Otoacoustic Emissions.

Age-related hearing loss is difficult to study in humans because multiple genetic and environmental risk factors may contribute to pathology and cochlear function declines in older adults. These pathologies, including degeneration of the stria vascularis, are hypothesized to affect outer hair cells responsible for active cochlear amplification of low-level sounds. Otoacoustic emission (OAE) measures are used to quantify the energy added to the traveling wave in cochlear amplification, which typically weakens with increased pure-tone thresholds and for older individuals. Thus, the current study evaluated two OAE measures for individuals with different components of age-related hearing loss. We examined two retrospective adult lifespan datasets (18 to 89+ years of age) from independent sites (Medical University of South Carolina and Boys Town National Research Hospital), which included demographics, noise history questionnaires, distortion-product otoacoustic emissions (DPOAE), and cochlear reflectance (CR). Metabolic and sensory estimates of age-related hearing loss were derived from the audiograms in each dataset, and then tested for associations with DPOAE and CR. The results showed that metabolic estimates increased for older participants and were associated with lower overall DPOAE and CR magnitudes across frequency (i.e., lower fitted intercepts). Sensory estimates were significantly higher for males, who reported more positive noise histories compared to females and were associated with steeper negative across-frequency slopes for DPOAEs. Although significant associations were observed between OAE configurations, DPOAEs appeared uniquely sensitive to metabolic estimates. The current findings suggest that distortion-based measures may provide greater sensitivity than reflection-based measures to the components of age-related hearing loss.

The characteristics of hearing loss in outpatients with tinnitus over the age of 60: a 11-year cross-sectional study.

BACKGROUND: Presbycusis with tinnitus has a significant impact on the quality of life of elderly patients, becoming a serious socioeconomic problem. OBJECTIVES: We conducted an 11-year cross-sectional analysis of the audiometry results of elderly patients with tinnitus from 2011 to 2021. METHODS: 9642 patients aged 60 and over were divided into three groups: young-old (YO) (60-74), old-old (OO) (75-89), and longevous (LON) (90 and over). Pure-tone audiometry results of all patients were analyzed. RESULTS: Among 9642 patients, the cases of female with tinnitus were more than male in all years. The hearing curve showed a typical age-related decline. Hearing level of air conduction in female declined significantly at low frequencies while that of male was worse at high frequencies in YO and OO groups. Compared with right, left hearing level of air conduction was significantly decreased at all frequencies except 0.125 kHz. CONCLUSIONS: When the chief complaint was tinnitus, women were likely to experience more distress than men. However, men suffered from more hearing loss than women, at least in high frequencies. The influence weight of presbycusis and tinnitus on the auditory cortices might be a possible reason for the lateral distinction of hearing loss at different ages.

Construction and Effect of the Three-Level and Two-Stage Screening Mode for Age-Related Hearing Loss: A Study Based on the Community in Shanghai, China.

Background: There is a high incidence rate of age-related hearing loss. Severe hearing loss may increase the prevalence of mental illness, cognitive impairment, and even the risk of all-cause death. Purpose: Construction of the three-level and two-stage screening mode for age-related hearing loss of the community and to evaluate its effectiveness. Materials and Methods: A total of 401 participants (aged 60 years or older) from five typical communities were enrolled in the study. The risk factors assessment of age-related hearing loss was completed by using a cross-sectional survey and receiver operating characteristic (ROC) curve. Multiple screening method was adopted and verified by serial and parallel tests, respectively. Based on research data, incorporate risk factors assessment, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-s) and pure tone audiometry (PTA) were used to construct the screening mode. Results: Multiple screening series testing and multiple screening parallel testing, including risk factors assessment, HHIE-s, and PTA, were used for verification: the sensitivity, specificity, and Kappa index were 70.5% and 9.2%, 95.0% and 71.6%, 0.26 and 0.63, respectively. Finally, the three-level and two-stage screening mode for age-related hearing loss was established. "Three-level" was defined as the risk factors assessment/HHIE-s (high-risk population), PTA (suspect population), and comprehensive hearing loss assessment (confirmed population). "Two-stage" was defined as the population screening by general practitioner in the community and target screening by otolaryngologist of the tertiary hospitals. Conclusion: The three-level and two-stage screening mode for age-related hearing loss consists of the following framework: from population screening to target screening, from suspicious diagnosis to accurate diagnosis, from primary health care to tertiary hospitals. The study objective is to structure a new secondary prevention and treatment mode for age-related hearing loss with primary health care as the core, so as to help the front-end management of healthy aging.

Presbycusis and Hearing Preservation in Observed Vestibular Schwannomas.

OBJECTIVE: We reviewed a cohort of patients with untreated sporadic vestibular schwannoma (VS) and examined the relationship between high-frequency hearing loss (HFHL) in the non-VS ear and long-term hearing outcomes in the VS-affected ear. We hypothesized that the progression of HFHL is associated with accelerated hearing decline in sporadic VS. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary center. PATIENTS: We studied 102 patients with sporadic VS diagnosed from 1999 to 2015 with ≥5 years of observation (median, 6.92; interquartile range, 5.85-9.29). Sixty-six patients had AAO-HNS class A/B hearing at presentation and were included in analysis. INTERVENTIONS: Audiometry, serial magnetic resonance imaging for observation of VS. MAIN OUTCOME MEASURES: Four-frequency pure tone average (PTA) and word recognition scores (WRS) in the VS-affected ear. Decline in high-frequency PTA (average of thresholds at 4000, 6000, and 8,000 Hz) was defined as ≥10 dB during the study period. Decline in WRS was defined as ≥10%. RESULTS: Compared with those without, patients with progressive HFHL in the non-VS ear were more likely to experience a decline in WRS in the VS ear (80% vs. 54%, p = 0.031). However, the same group showed no difference (52% vs. 41%, p = 0.40) in decline in PTA of the VS ear. CONCLUSIONS: Patients with observed VS who experience progressive HFHL in the non-VS ear are more likely to experience significant declines in speech understanding in the VS-affected ear over time. Patients with a history of presbycusis may have an increased risk of losing serviceable hearing because of sporadic VS.

Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment.

At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system. Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued.

Hipoacusia súbita asociada a depresión: síntoma inusual en adultos mayores infectados por Sars-CoV-2 / Sudden hearing loss associated with depression: an unusual symptom in older adults infected with Sars-CoV-2

Se comienza acumular información sobre las alteraciones en pacientes positivos a Covid-19, donde relacionan el virus con el daño del oído medio y oído interno, tanto en la porción vestibular como la auditiva en adultos mayores, generando episodios depresivos. Por tal razón, se propuso como objetivo evaluar la relación hipoacusia súbita asociada a depresión en adultos mayores infectados por Sars-CoV-2 atendidos en el Hospital Básico Pillaros, perteneciente al sector Ciudadela Ciudad Nueva, Ecuador 2020-2021. El estudio fue cuantitavo, descriptivo correlacional de corte transversal con una muestra de 87 pacientes >65 años positivos para Sars-CoV-2. Para la recolección de datos se aplicó el Test audiométrico y la escala de depresión geriátrica de Yesavage. El análisis de los datos fue con estadística descriptiva en base a frecuencias, porcentajes, IC 95% y X2 a través de SPSS. Como resultado 73,6% eran fememnino y 26,4% masculino, 54,0% tenían de 65-75 años, el tipo de presbiacusia más existente fue neural (31,2%) y coclear (31,0%). Así mismo, 81,6% presentaron signos de depresión, mientras que 18,4% no. En el test Vasayage 88,5% expresó no sentirse lleno de energía y 59,8% sienten temor a que algo malo suceda. Como conclusión, la presencia de trastornos auditivos constituye un problema para la comunicación de los adultos mayores que pudiese conllevar a estados depresivos, por ello, incentivar el desarrollo de investigaciones pudieran orientar hacia el desarrollo de alternativas de intervención temprana que favorezcan el mejoramiento de la calidad de vida de este grupo poblacional(AU)

Information is beginning to accumulate on the alterations in patients positive for Covid -19, where they relate the virus to damage to the middle ear and inner ear, both in the vestibular and auditory portions in older adults, generating depressive episodes. For this reason, the objective was to evaluate the relationship between sudden hearing loss associated with depression in older adults infected with Sars-CoV- treated at the Pillaros Basic Hospital, belonging to the Ciudadela Ciudad Nueva sector, Ecuador 2020-2021. The study was quantitative, descriptive correlational cross-sectional with a sample of 87 patients >65 years positive for Sars-CoV-2. For data collection, the audiometric test and the Yesavage geriatric depression scale were applied. The analysis of the data was with descriptive statistics based on frequencies, percentages, CI 95% and X2 through SPSS. As a result, 73.6% were female and 26.4% male, 54.0% were 65-75 years old, the most common type of presbycusis was neural (31.2%) and cochlear (31.0%). Likewise, 81.6% presented signs of depression, while 18.4% did not. In the Vasayage test, 88.5% expressed not feeling full of energy and 59.8% were afraid that something bad would happen. In conclusion, the presence of hearing disorders constitutes a problem for the communication of older adults that could lead to depressive states, therefore, encouraging the development of research could guide the development of early intervention alternatives that favor quality improvement. life of this population group(AU)

Relationship between hearing, cognitive function, and quality of life in aging companion dogs.

BACKGROUND: Elderly people with presbycusis are at higher risk for dementia and depression than the general population. There is no information regarding consequences of presbycusis in dogs. OBJECTIVE: Evaluate the relationship between cognitive function, quality of life, and hearing loss in aging companion dogs. ANIMALS: Thirty-nine elderly companion dogs. METHODS: Prospective study. Hearing was evaluated using brainstem auditory evoked response (BAER) testing. Dogs were grouped by hearing ability. Owners completed the canine dementia scale (CADES) and canine owner-reported quality of life (CORQ) questionnaire. Cognitive testing was performed, and cognitive testing outcomes, CADES and CORQ scores and age were compared between hearing groups. RESULTS: Nineteen dogs could hear at 50 dB, 12 at 70 dB, and 8 at 90 dB with mean ages (months) of 141 ± 14, 160 ± 16, and 172 ± 15 for each group respectively (P = .0002). Vitality and companionship CORQ scores were significantly lower as hearing deteriorated (6.6-5.4, 50-90 dB group, P = .03 and 6.9-6.2, 50-90 dB group, P = .02, respectively). Cognitive classification by CADES was abnormal in all 90 dB group dogs and normal in 3/12 70 dB group and 11/19 50 dB group dogs (P = .0004). Performance on inhibitory control, detour and sustained gaze tasks decreased significantly with hearing loss (P = .001, P = .008, P = .002, respectively). In multivariate analysis, higher CADES score was associated with worse hearing (P = .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Presbycusis negatively alters owner-pet interactions and is associated with poor executive performance and owner-assessed dementia severity.

Age-related hearing loss and mild cognitive impairment: a meta-analysis and systematic review of population-based studies.

BACKGROUND: The aim of this study was to identify any relationship between hearing loss and mild cognitive impairment. METHOD: This was a systematic review and meta-analysis of randomised controlled trials conducted using Medline and the Cochrane Library up to 24 June 2020. Prospective, cohort and cross-sectional, and observational studies that reported on the relationship between mild cognitive impairment and hearing loss were included. RESULTS: A total of 34 studies reporting data on 48 017 participants were included. Twenty-three studies observed a significant association between hearing loss and mild cognitive impairment. The pooled risk ratio across all studies of prevalence of mild cognitive impairment in people with hearing loss was 1.44 (random-effects; 95 per cent CI = 1.27-1.64; p < 0.00001; I2 = 0 per cent). Significantly more people with mild cognitive impairment had peripheral hearing loss compared with those without (risk ratio, 1.40 random-effects; 95 per cent CI = 1.10-1.77; p = 0.005; I2 = 0 per cent). When the incidence was studied, significantly more people with peripheral hearing loss had mild cognitive impairment compared with those without (risk ratio = 2.06 random-effects; 95 per cent CI = 1.35-3.15; p = 0.0008; I2 = 97 per cent); however; a high level of statistical heterogeneity was evident. CONCLUSION: Most of the studies included in this systematic review observed a significant association between hearing loss and mild cognitive impairment.

Coprevalence of Presbycusis and Its Effect on Outcome of Voice Therapy in Patients With Presbyphonia.

OBJECTIVE: To identify the coprevalence of presbycusis and presbycusis and analyze the effect of presbycusis on compliance and result of voice therapy in presbycusis patients. METHODS: This cross-sectional, prospective cohort study initially screened patients aged ≥65 years who visited our hospital from February 2019 to January 2020. Unaided pure tone audiometry was performed in these subjects to determine the presence of presbycusis. Perceptual voice assessment by an examiner was conducted for screening of presbycusis, and its diagnosis was confirmed through the voice handicap index-10 (VHI-10) questionnaire and a laryngoscopic exam. Patients with presbycusis underwent voice therapy and were assessed for their compliance and outcomes of the treatment according to the coexistence of presbycusis. RESULTS: Among the 221 patients, presbycusis and presbycusis were diagnosed in 125 (56.6%) and 110 (49.8%) patients, respectively. The copresence of these two disorders were identified in 87 (39.4%) patients, and there was a significant correlation between presbycusis and presbycusis. The effects of voice therapy were examined in the consecutive 40 patients who were diagnosed with presbycusis. There were 21 patients without presbycusis and 19 patients with presbycusis. The average pretreatment voice handicap index-10 score was significantly higher in presbycusis patients; there was no significant difference in the incidence of dropout from voice therapy between the groups. The patients without presbycusis showed a significant improvement in the functional communication measurement (FCM) level and maximum phonation time (MPT) compared with those of patients with presbycusis after voice therapy. CONCLUSIONS: Presbyphonia and presbycusis coexisted in many elderly people. The improvement in the FCM level and MPT after voice therapy was relatively low if patients with presbycusis accompanied by presbycusis. The copresence of presbycusis did not significantly affect compliance with voice therapy in the patients.

Characteristics of hearing loss in elderly outpatients over 60 years of age: an annual cross-sectional study.

BACKGROUND: The prevention and treatment of presbycusis becomes a serious health challenge and socio-economic problem. OBJECTIVES: We performed a cross-sectional analysis of the audiometry results of all elderly patients who visited our department throughout the year of 2018. MATERIAL AND METHODS: A total of 5520 people aged 60 and over were included and divided into three groups: young-old group (60-74 years old), old-old group (75-89 years old), and longevous group (over 90 years old). Pure-tone audiometry results of all patients were analyzed. RESULTS: Among the 5520 patients, there were 4445 cases in the young-old group, 1029 cases in the old-old group, and 46 cases in the longevous group, accounting for 80.53, 18.64, and 0.83%, respectively. In the young-old group, normal hearing and mild-moderate hearing loss were the most common, while moderate and severe hearing loss were more common among the old-old group and the longevous group. The hearing curve showed typical age-related hearing loss with a drop at high frequencies. CONCLUSIONS: With an increase in age, patients tend to suffer from more serious hearing disorders. Presbycusis was associated with specific frequency and age characteristics. Understanding these characteristics is of great significance for the prevention and treatment of age-related hearing loss.

Association of Age-Related Hearing Impairment With Physical Functioning Among Community-Dwelling Older Adults in the US.

Importance: Hearing impairment, a common treatable condition, may contribute to poorer physical function with aging. Objective: To assess whether hearing impairment is associated with poorer physical function, reduced walking endurance, and faster decline in physical function. Design, Setting, and Participants: In this cohort study, cross-sectional and longitudinal analyses were performed using data from the 2011 to 2019 period of the Atherosclerosis Risk in Communities study, a population-based study of community-dwelling adults at 4 sites in the US. Exposures: Hearing thresholds (per 10 dB) assessed with pure tone audiometry and categorized as normal hearing or mild, moderate, or severe hearing impairment. Main Outcomes and Measures: Physical function was assessed using the short physical performance battery (SPPB), with composite scores ranging from 0 to 12. A composite score of 6 or less and a score for each component (balance, gait speed, and chair stands) of 2 or less indicated poor performance. Walking endurance was assessed using a 2-minute fast-paced walk test. Tobit regression models adjusted for sociodemographic factors and medical history were used to calculate the mean differences in SPPB composite scores; logistic regression models, to estimate the odds ratios (ORs) of low SPPB composite and component scores; and linear mixed-effects models, to estimate the mean rate of change in SPPB composite scores over time. Results: Of the 2956 participants (mean [SD] age, 79 [4.6] years) who attended study visit 6 between 2016 and 2017, 1722 (58.3%) were women, and 2356 (79.7%) were White. As determined by pure tone audiometry, 973 (33%) participants had normal hearing, 1170 (40%) had mild hearing impairment, 692 (23%) had moderate hearing impairment, and 121 (4%) had severe hearing impairment. In the Tobit regression model, severe hearing impairment was associated with a lower mean SPPB score (ß, -0.82; 95% CI, -0.34 to -1.30) compared with normal hearing. In fully adjusted logistic regression models, hearing impairment was associated with higher odds of low physical performance scores (severe impairment vs normal hearing: OR for composite physical performance, 2.51 [95% CI, 1.47-4.27]; OR for balance, 2.58 [95% CI, 1.62-4.12]; OR for gait speed, 2.11 [95% CI, 1.03-4.33]). Over time (2 to 3 visits; maximum, 8.9 years), participants with hearing impairment had faster declines in SPPB compared with those with normal hearing (moderate hearing impairment × time interaction, -0.34 [-0.52 to -0.16]). In adjusted models for walking endurance, participants with moderate or severe hearing impairment walked a mean distance of -2.81 m (95% CI, -5.45 to -0.17 m) and -5.31 m (95% CI, -10.20 to -0.36 m) than those with normal hearing, respectively, during the 2-minute walk test. Conclusions and Relevance: In this cohort study, hearing impairment was associated with poorer performance, faster decline in physical function, and reduced walking endurance. The results of the longitudinal analysis suggest that hearing impairment may be associated with poorer physical function with aging. Whether management of hearing impairment could delay decline in physical function requires further investigation.