Hearing Screening for Older Adults With Cognitive Impairment: A Systematic Review.

Background and Objectives: : Hearing loss is the largest potentially modifiable risk factor for dementia. Early evaluation and intervention are crucial for older adults with cognitive impairment. However, pure-tone audiometry (PTA), the gold standard, may have limitations. This study reviewed auditory tests for detecting hearing loss in this population, comparing to PTA. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a systematic review in PubMed, Scopus, and Embase. Ten studies (1,071 participants) comparing auditory tests and PTA in patients with dementia and mild cognitive impairment were included. Results: : Electrophysiological and behavioral tests demonstrated strong correlation and accurate hearing impairment detection compared to PTA. Conversely, self-reported assessment showed weaker correlations when aligned with hearing thresholds. Conclusions: : This study highlights the potential of electrophysiological and behavioral auditory tests in detecting hearing impairment in older adults with cognitive impairment, emphasizing the need for further research to develop practical screening protocols for this vulnerable population.

The efficacy of corticosteroid after facial nerve neurorrhaphy: a systematic review and meta-analysis of randomized controlled trial

Abstract Objectives: The benefit of corticosteroids following facial nerve neurorrhaphy in the setting of complete transection is questionable. This systematic review and meta-analysis aimed to evaluate corticosteroid efficacy on facial nerve regeneration and functional recovery after complete disruption and neurorrhaphy. Methods: Randomized controlled trials on both human and animal models from Ovid MEDLINE and Ovid EMBASE studying corticosteroid efficacy in complete facial nerve disruption followed by neurorrhaphy were included. Data were extracted and pooled for meta-analysis. The outcomes were evaluated from electrophysiology, histology, and functional recovery. However, no randomized controlled trial in human was performed. Possibly, performing human trials with histopathology may not be feasible in clinical setting. Results: Six animal studies (248 participants) met inclusion criteria. Electrophysiologic outcomes revealed no differences in latency (Standardized Mean Difference (SMD) = −1.97, 95% CI −7.38 to 3.44, p = 0.47) and amplitude (SMD = 0.37, 95% CI −0.44 to 1.18, p = 0.37) between systemic corticosteroids and controls. When analysis compared topical corticosteroid and control, the results provided no differences in latency (Mean Difference (MD)=0.10, 95% CI −0.04 to 0.24, p = 0.16) and amplitude (SMD = 0.01, 95% CI −0.08 to 0.10, p = 0.81). In histologic outcomes, the results showed no differences in axon diameter (MD = 0.13, 95% CI −0.15 to 0.41, p = 0.37) between systemic corticosteroid and control; however, the result in myelin thickness (MD = 0.06, 95% CI 0.04 to 0.08, p < 0.05) favored control group. When comparing systemic corticosteroid with control in eye blinking, the results favored control (MD= 1.33, 95% CI 0.60 to 2.06, p = 0.0004). Conclusions: This evidence did not show potential benefits of systemic or topical corticosteroid deliveries after facial nerve neurorrhaphy in complete transection when evaluating electrophysiologic, histologic, and functional recovery outcomes in animal models.

Attitudes towards hearing difficulties, health-seeking behaviour, and hearing aid use among older adults in Thailand.

Introduction: This qualitative study explores older adults' attitudes towards hearing difficulties, health-seeking behaviour and hearing aid use in Samutprakarn, Thailand. Method: Three focus groups (n=25), with adults aged 60-88 years, were conducted within a residential complex for older adults. Qualitative data analysis, employing a phenomenological approach was completed. Results: Four themes are presented: (1) Perception of hearing difficulties, (2) Experience of receiving care, (3) Attitudes towards wearing hearing aids, and (4) Raising awareness of hearing difficulties in older adults. Findings indicate that Thai older adults may not be aware or accepting of their hearing difficulties, due to the stigma associated hearing loss, older age, and disability. The consequential impact of these unacknowledged issues manifest in communication challenges and the adoption of avoidance behaviours across diverse situational contexts. Conclusion: This study enhances our understanding of how Thai older adults perceive hearing problems and ear care. Findings underscore the potential pivotal role of familial and social networks in mitigating barriers associated with hearing difficulties among older adults in Thailand. These insights can raise awareness and inform effective management for older adults and their families. Additionally, the findings could guide healthcare providers, researchers, and policy makers, fostering improved care for this demographic.