Age-related hearing loss and dementia: a 10-year national population-based study.

Age-related hearing loss (ARHL) is postulated to affect dementia. Our study aims to investigate the relationship between ARHL and the prevalence, and 10-year incidence of dementia in the Taiwan National Health Insurance Research Database (NHIRD). We selected patients diagnosed with ARHL from the NHIRD. A comparison cohort comprising of patients without ARHL was frequency-matched by age, sex, and co-morbidities, and the occurrence of dementia was evaluated in both cohorts. The ARHL cohort consisted of 4108 patients with ARHL and the control cohort consisted of 4013 frequency-matched patients without ARHL. The incidence of dementia [hazard ratio (HR), 1.30; 95% confidence interval (CI 1.14-1.49); P = 0.002] was higher among ARHL patients. Cox models showed that being female (HR, 1.34; 95% CI 1.07-1.68), as well as having co-morbidities, including chronic liver disease and cirrhosis, rheumatoid arthritis, hypertension, diabetes mellitus, stroke, head injury, chronic kidney disease, coronary artery disease, alcohol abuse/dependence, and tobacco abuse/dependence (HR, 1.27; 95% CI 1.11-1.45), were independent risk factors for dementia in ARHL patients. We found ARHL may be one of the early characteristics of dementia, and patients with hearing loss were at a higher risk of subsequent dementia. Clinicians should be more sensitive to dementia symptoms within the first 2 years following ARHL diagnosis. Further clinical studies of the relationship between dementia and ARHL may be necessary.

Effect of visual-verbal load and spatial compatibility on stimulus response.

This study examined the effects of visual-verbalload (as measured by a visually presented reading-memory task with three levels) on a visual/auditory stimulus-response task. The three levels of load were defined as follows: "No Load" meant no other stimuli were presented concurrently; "Free Load" meant that a letter (A, B, C, or D) appeared at the same time as the visual or auditory stimulus; and "Force Load" was the same as "Free Load," but the participants were also instructed to count how many times the letter A appeared. The stimulus-response task also had three levels: "irrelevant," "compatible," and "incompatible" spatial conditions. These required different key-pressing responses. The visual stimulus was a red ball presented either to the left or to the right of the display screen, and the auditory stimulus was a tone delivered from a position similar to that of the visual stimulus. Participants also processed an irrelevant stimulus. The results indicated that participants perceived auditory stimuli earlier than visual stimuli and reacted faster under stimulus-response compatible conditions. These results held even under a high visual-verbal load. These findings suggest the following guidelines for systems used in driving: an auditory source, appropriately compatible signal and manual-response positions, and a visually simplified background.

Using data linkage to generate 30-day crash-fatality adjustment factors for Taiwan.

Different countries have their own police reporting time standards for counting the number of fatalities in reported crashes. A rapid estimation method (such as adjustment factor) for the comparison is important. The data-linkage technique was used to combine police-reported crash data and vital registration data, in order to generate 30-day fatality adjustment factors for various reporting time standards, which could also shed light on the fatal injury trend over time. The major findings were as follows. Firstly, a conservative 30-day fatality adjustment factor for the first day (or 24 h) would be 1.54 (or 1.35) in an area with a large motorcycle population, like Taiwan. This produced 20-40% higher 30-day fatalities than UK Transport Research Laboratory predicted, and 15-25% higher fatalities than those in Europe/Japan. Secondly, after excluding motorcycle impacts, the Taiwanese factors suggested 8-14% higher fatalities within 30 days than those in Europe/Japan. Third, motorcycle fatalities influenced the overall 30-day fatality trend within 3 days. In the future, both the police under-reporting problem and the motorcycle/overall fatal injury pattern within 3 days after crashing in developing countries like Taiwan merit further investigation.

A virtual reality-based system for hand function analysis.

The goal of this study was to demonstrate the usability and usefulness of virtual reality technology in assessing hand functions. Ten healthy, non-disabled right-handed adult volunteers were recruited. Each volunteer used a dataglove to insert three-dimensional virtual representations of a cylinder and a prism into the target holes. To verify the reliability of the tests, each subject was retested twice. The performance testing assessed the visual-motor coordination a person needs to achieve a task accurately and within a set time. For each trial, the root mean square (RMS) value of the hand movement trajectory was projected onto the X, Y, and Z axes. This projection enabled us to measure the extent of the genuine, summative displacement of the manipulating hand. The reproducibility of the virtual reality assessment was analyzed using the intraclass correlation (ICC) approach. The total ICC values of 10 subjects demonstrated a high task completion time and RMS on the X and Z axes for the transferring of the prism. However, the values were low for the transferring of the cylinder. Because the individual coefficients of variations (CVs) varied widely in the moving of both the cylinder and the prism, the total (CVs) showed a high reading for the task completion time. Although rehabilitation clinics routinely carry out peg-moving exercises for disabled patients, our model provides a valuable quantitative real time and off-line measure of whole hand functions.

Survival risk factors for fatal injured car and motorcycle drivers in single alcohol-related and alcohol-unrelated vehicle crashes.

INTRODUCTION: A high percentage of drivers who die as a result of a single vehicle crash are under the influence of alcohol. We aimed to better understand the prevalence of these fatalities and the ratio of death to injuries based on various risk factors. We focused on alcohol-related and -unrelated single-vehicle crashes to investigate the influence of such risk factors on the time until death for car and motorcycle drivers. METHODS: We combined data from national police reports and a vital registration database in Taiwan. Survival analysis using Cox regression models was used to identify the risk factors of time until death. RESULTS: Overall, nearly 60% of car driver fatalities and 40% of motorcycle driver fatalities involved the consumption of alcohol. Survival analysis of single-vehicle crashes suggested that the traffic island separation between a car moving at a higher speed and motorcycle traffic resulted in a higher risk of death over time for motorcycle drivers who consumed alcohol. The factors attributed to a higher risk of death over time for motorcycle drivers were older age, crashing into trees, night-time driving, driving on curved roads, and driving on local roads. Driving without restraints and driving on roads with higher speed limits attributed to a higher risk of death over time for car drivers. CONCLUSIONS: The factors that influence the risk of death over time in a motor-vehicle accident involving alcohol depended on different elements, which should each be considered when attempting to reduce this risk. IMPACT ON INDUSTRY: More efforts should be made to investigate the various risk factors in areas with large motorcycle populations.

Evidence for the selective attention mechanism and dual-task interference.

In order to explore the selective attention mechanism and the dual-task information-processing model, two experiments were carried out involving a visual search task and a visual detection task. The results showed that the early period of attention selection is controlled in a bottom-up manner. With respect to the dual-task information-processing model, the results showed that the central information-processing model would include a sequence model for tasks that use the same perception resource, causing a bottleneck in information processing. Our study suggests that a simple and prominent signal could be used to attract drivers' attention prior to the emergent events. Moreover, any human-machine interface design in driving-associated systems should consider this information-processing bottleneck. With respect to signal type, targeted and easy to categorize were two useful elements to consider.

Survival hazards of road environment factors between motor-vehicles and motorcycles.

Motorcycles are frequently used in middle- and low-income societies. They are often involved in crashes, and account for a noticeable percentage of fatalities secondary to crashes. Comparing motor-vehicle occupants and motorcycle riders, the present study examined the survival hazard of crash injuries with respect to road environmental factors (i.e., area, road type, and location). We investigated the effects of such factors on survival and survival time after crashes via a binary logistic regression analysis and a Cox proportional hazard regression analysis, respectively. Results indicated that, for both motor-vehicle occupants and motorcycle riders, the fatal prevalence, occurrence likelihood, and risk based on time were decreased in urban areas and elevated on highways. The three indexes were also higher for motor-vehicle occupants on non-straight or non-level roadway sections. The prevalence of death on local roads and at intersections was relatively higher for motorcycle riders compared to motor-vehicle occupants. Speed may contribute to the survival hazard with respect to road environment factors. Speed management initiatives account for hazardous roadway, curve alignment re-examination, and increased traffic enforcement density are suggested. Collaboration among the roadway authorities, vehicle industry, and medical systems for a timely rescue is also advised. In addition, the attention to crashes at intersections and on local roads is a promising intervention for motorcycle riders.

Mortality burden from motor vehicle accidents in Taiwan.

OBJECTIVE: To examine the risk factors contributing to the mortality burden due to road traffic accidents (RTA) in Taiwan. DESIGN: We compared RTA years of life lost (YLL) rates of Taiwan with those of the surrounding region. We also investigated the risk factors described by the police in a Linked Database combined from police-reported accident data and vital registration data. SAMPLE: RTA deaths (3,234 males/1,160 females) in vital registration data and the deaths (2,918 males/1,063 females) in the Linked Database were used. MEASUREMENT: YLL and YLL rate. RESULTS: (1) YLL rates for 15-29 year olds were the highest for Taiwan and the surrounding region. (2) The YLL rate was remarkably high in the first 2 years of the legal motorcycle licensing age for males riding motorcycles. (3) The YLL rates were usually higher during the day, but were higher for young males at night. (4) Overall, the YLL rates were higher when multiple vehicles were involved and for motorcycles with large engines; however, the rate was higher for motorcycles with small engines for the older female group. CONCLUSIONS: The burden due to premature mortality in RTA showed gender disparities and varied by age among personal, environment, and structure factors.