Prevalence of age-related hearing loss in Europe: a review.

Populations are becoming progressively older thus presenting symptoms of diminished organ function due to degenerative processes. These may be physiological or caused by additional factors damaging the organ. Presbyacusis refers to the physiological age-related changes of the peripheral and central auditory system leading to hearing impairment and difficulty understanding spoken language. In contrast to epidemiological data of other continents, the prevalence of age-related hearing loss (ARHL) in Europe is not well defined, due in part to the use of different classification systems. We performed a systematic literature review with the aim of gaining a picture of the prevalence of ARHL in Europe. The review included only population and epidemiological studies in English since 1970 with samples in European countries with subjects aged 60 years and above. Nineteen studies met our selection criteria and additional five studies reported self-reported hearing impairment. When these data were crudely averaged and interpolated, roughly 30% of men and 20% of women in Europe were found to have a hearing loss of 30 dB HL or more by age 70 years, and 55% of men and 45% of women by age 80 years. Apparent problems in comparing the available data were the heterogeneity of measures and cut-offs for grades of hearing impairment. Our systematic review of epidemiological data revealed more information gaps than information that would allow gaining a meaningful picture of prevalence of ARHL. The need for standardized procedures when collecting and reporting epidemiological data on hearing loss has become evident. Development of hearing loss over time in conjunction with the increase in life expectancy is a major factor determining strategies of detection and correction of ARHL. Thus, we recommend using the WHO classification of hearing loss strictly and including standard audiometric measures in population-based health surveys.

Health-related quality of life, psychosocial work conditions, and absenteeism in an industrial sample of blue- and white-collar employees: a comparison of potential predictors.

PROBLEM: There is a scarcity of data simultaneously evaluating the relationship of health behavior, health perception, work characteristics, and demographic variables with sickness absenteeism in industrial employees. METHOD: Predictors and possible confounders (smoking, physical activity, alcohol intake, age, gender, body mass index, income) were regressed against frequency indices and the time lost index derived from the day-to-day absence data of 1524 employees at a manufacturing plant in Germany. Frequency indices were the number of sick-leave spells of 1, 2-3, 4-5, and >5 days within 1 year. RESULTS/CONCLUSION: Effort-reward imbalance, lack of support by supervisors or coworkers, negative affectivity, exhaustion, and impaired health perception were significantly associated with absence spells and the time lost index. Job demands and job control as well as overcommitment were unrelated to absenteeism indices. Multivariate models suggest mediation through impaired health-related quality of life.

Opposite effect of negative and positive affect on stress procoagulant reactivity.

Exaggerated procoagulant responses to acute mental stress may contribute to coronary thrombosis, and continuing low-grade systemic coagulation activation may link negative affect with the development of coronary artery disease. We investigated whether negative and positive affect and perceived social support would moderate stress procoagulant reactivity. Psychological functioning, exhaustion, negative affectivity, depression, anxiety, worrying, vigor, and social support were assessed in 27 apparently healthy men (mean age 47 +/- 8 years) who underwent the 13-min Trier Social Stress Test combining preparation, speech, and mental arithmetic. Plasma levels of von Willebrand factor antigen (VWF:Ag), fibrinogen, factor VII clotting activity (FVII:C), FVIII:C, FXII:C, and D-dimer were measured immediately before and after stress. Acute stress elicited significant increases in hemodynamic, cortisol, and coagulant activity (p values < 0.05). VWF:Ag reactivity showed inverse relationships with exhaustion (r = -0.63, p < 0.001), negative affectivity (r = -0.53, p = 0.005), and worrying (r = -0.53, p = 0.005). Exhaustion and negative affectivity emerged as independent predictors of VWF:Ag reactivity explaining 54% of its variance. Fibrinogen reactivity showed inverse relationships with negative affectivity (r = -0.59, p = 0.002) and anxiety (r = -0.54, p = 0.005); negative affectivity emerged as an independent predictor of fibrinogen reactivity explaining 35% of its variance. Psychological functioning and FVII:C reactivity were also correlated (r = -0.52, p = 0.006). Whereas FVIII:C reactivity correlated positively with vigorous mood (r = 0.48, p = 0.012), positive associations between social support and procoagulant reactivity did not reach significance. Negative affect was associated with attenuated procoagulant reactivity to stress and the opposite was observed for positive affect. Negative affect is not likely to enhance the acute procoagulant stress response in healthy men.

Health-related quality of life measured by the SF12 in working populations: associations with psychosocial work characteristics.

This study investigated the contribution of psychosocial work characteristics (decision latitude, job demand, social support at work, and effort-reward imbalance) to health-related quality of life. Data were derived from 2 aircraft manufacturing plants (N=1,855) at the start of a longitudinal study. Regression analysis showed that work characteristics (1st model) explained 19% of the variance in the mental summary score of the Short Form-12 Health Survey. R2 change for work characteristics decreased to 13%, accounting for demographics, socioeconomic status, body mass index, and medical condition (5th model). Including health behavior and personality factors (full model), R2 change for work characteristics remained significant. Psychosocial work characteristics account for relevant proportions in the subjective perception of mental health beyond a wide array of medical variables and personality factors.

Aging images as a motivational trigger for smoking cessation in young women.

Recruiting adolescents into smoking cessation programs has been challenging, and there is a lack of effective smoking cessation interventions for this age group. We aimed to assess whether the approach of using aging images can be used to recruit young, female smokers for a smoking cessation course. In this study, 853 14- to 18-year-old subjects were photographed (2006-2007). After software-aided aging, the images evoked strong emotions, especially in subjects with an advanced motivational stage to quit. Twenty-four percent of current smokers reported that the aging images increased their motivation to quit smoking (pre-contemplation: 8%; contemplation: 32%; and preparation: 71%). In multivariate analyses, the aged images had a high motivational impact to quit smoking that was associated with an increased readiness to stop smoking and the individual's assessment of the aging images as shocking, but not with the number of previous attempts to quit and the assessment of the pictures as realistic. However, it was not possible to recruit the study population for a smoking cessation course. We concluded that aging images are a promising intervention for reaching young women and increasing their motivation to stop smoking. However, smoking cessation courses may not be appropriate for this age group: none of the recruits agreed to take a cessation course.

Delayed response and lack of habituation in plasma interleukin-6 to acute mental stress in men.

Acute mental stress induces a significant increase in plasma interleukin (IL)-6 levels as a possible mechanism for how psychological stress might contribute to atherosclerosis. We investigated whether the IL-6 response would habituate in response to a repetitively applied mental stressor and whether cortisol reactivity would show a relationship with IL-6 reactivity. Study participants were 21 reasonably healthy men (mean age 46+/-7 years) who underwent the Trier Social Stress Test (combination of a 3-min preparation, 5-min speech, and 5-min mental arithmetic) three times with an interval of 1 week. Plasma IL-6 and free salivary cortisol were measured immediately before and after stress, and at 45 and 105 min of recovery from stress. Cortisol samples were also obtained 15 and 30 min after stress. Compared to non-stressed controls, IL-6 significantly increased between rest and 45 min post-stress (p=.022) and between rest and 105 min post-stress (p=.001). Peak cortisol (p=.034) and systolic blood pressure (p=.009) responses to stress both habituated between weeks one and three. No adaptation occurred in diastolic blood pressure, heart rate, and IL-6 responses to stress. The areas under the curve integrating the stress-induced changes in cortisol and IL-6 reactivity were negatively correlated at visit three (r=-.54, p=.011), but not at visit one. The IL-6 response to acute mental stress occurs delayed and shows no adaptation to repeated moderate mental stress. The hypothalamus-pituitary-adrenal axis may attenuate stress reactivity of IL-6. The lack of habituation in IL-6 responses to daily stress could subject at-risk individuals to higher atherosclerotic morbidity and mortality.

Different contribution of interleukin-6 and cortisol activity to total plasma fibrin concentration and to acute mental stress-induced fibrin formation.

Acute mental stress may contribute to atherosclerosis by affecting inflammation and coagulation; however, the crosstalk between inflammation and coagulation during stress has not been studied. In the present study, we investigated the association of plasma fibrinogen, plasma IL-6 (interleukin-6) and free salivary cortisol with the procoagulant marker D-dimer reflecting fibrin formation both over a 2-h period and in response to acute mental stress. Twenty-one male volunteers (mean age, 47+/-8 years) underwent the Trier Social Stress Test combining a 3-min preparation phase, a 5-min job interview and 5-min mental arithmetic test before an audience. IL-6, fibrinogen, D-dimer and cortisol were measured immediately before and after stress, and after 45 min and 105 min of recovery from stress. Two distinct areas under the curve were computed to obtain integrated measures of total protein activity over the entire 2-h period and of stress reactivity of proteins. IL-6 (P < 0.001), fibrinogen (P = 0.001), D-dimer (P = 0.021) and cortisol (P < 0.001) had all significantly changed across the four time points assessed, as determined by ANOVA. For the entire 2-h period, total fibrinogen activity (R2 = 0.33, P = 0.007) and total cortisol activity (DeltaR2 = 0.17, P = 0.034) explained 50% of the variance in total D-dimer activity. Stress-induced changes in fibrinogen (R2 = 0.47, P = 0.001) and IL-6 (DeltaR2 = 0.18, P = 0.008) together explained 65% of the variance in D-dimer reactivity to stress. Total fibrin formation was independently predicted by fibrinogen and hypothalamo-pituitary-adrenal activity. Pro-inflammatory and procoagulant changes with stress were associated. Aside from fibrinogen reactivity, IL-6 reactivity was an independent predictor of stress-induced fibrin formation.