[Speech intelligibility in adults after the new coronavirus infection (COVID-19)]. / Razborchivost' rechi u vzroslykh patsientov posle novoi koronavirusnoi infektsii (COVID-19).

OBJECTIVE: The research was aimed to assess speech intelligibility in adults after the new coronavirus infection (COVID-19), state of peripheral and central parts of auditory system and cognitive functions. MATERIAL AND METHODS: 26 people complaining about hearing loss, poor speech intelligibility and/or tinnitus after COVID-19 were examined. All the patients underwent the basic audiological assessment before COVID-19. Extended testing in patients after COVID-19 included: pure tone audiometry, impedancemetry, speech audiometry in quiet and noise (evaluation of monosyllabic words intelligibility and the Russian matrix sentence test RuMatrix), the alternating binaural speech test, the dichotic digits test and the Montreal Cognitive Assessment (MoCA). RESULTS: The most significant deviations from the normative values were obtained in the RuMatrix test and the dichotic digits test that may be due to both central auditory processing disorder and memory impairment. Low MoCA scores were obtained in 62% of patients. CONCLUSION: Deterioration of speech intelligibility after COVID-19 was revealed, both in patients with hearing loss and with normal hearing that corresponded to their complaints. It may be caused by central auditory disorder, memory impairment or cognitive status lesion. The correlation found between the results of the RuMatrix test in noise and the severity of the COVID-19 may indicate the impact of the virus on the auditory cortex.

[Audiological testing in complex geriatric assessment of patients.]

The aim of the study is to evaluate the advantage of including audiological testing in the system of comprehensive geriatric assessment (CGA) of patients. The results of a survey of 988 elderly and senile people (average age 77±7,4 years) are presented, each of whom underwent a CGA and hearing assessment by filling out a questionnaire Hearing Handicap Inventory for the Elderly, Screening version (HHIE-S). All patients were divided into two groups: the first group included 780 inpatient patients undergoing medical and social rehabilitation in different departments of the Saint-Petersburg City Geriatric Center. The second group included 208 outpatient patients, of whom 81 additionally underwent an audiological examination, which included ENT examination and pure tone audiometry to determine the degree of hearing loss. A correlation was revealed between the hearing state and the cognitive status of patients according to the results of the Mini-Mental State Examination (MMSE) questionnaire, as well as the senile asthenia index. The results of the work indicate the need to include the HHIE-S questionnaire in the system of comprehensive geriatric assessment for early detection and correction of hearing loss, and prevention of cognitive disorders.

[Analysis of hearing aids application in elderly patients.]

The aim of the study is to evaluate the possibility to implement machine learning to create a digital auditory profile for elderly patients and to analyze the hearing aid fitting efficacy depending on involvement of the peripheral and central auditory pathways in a pathological process. Data analysis of 375 people aged 60-93 years is presented. 355 patients with chronic bilateral hearing loss (230 of them used hearing aids) were included in the main group, and 20 normal hearing elderly people were included in the control group. Audiological examination consisted of standard tests (pure tone audiometry, impedancemetry, speech audiometry in quiet) and tests to evaluate the central auditory processing (binaural fusion, dichotic digits, speech audiometry in noise, random gap detection). The Montreal Cognitive Assessment was used to detect cognitive impairment. The hearing aid fitting efficiency was evaluated with COSI questionnaire and speech audiometry in free field. Processing of the results was carried out using Pearson's correlation analysis aimed at creating a polynomial model of a patient's hearing on the basis of the limited test battery. There were close correlations between the state of cognitive functions and age, results of tests to evaluate the central auditory processing, as well as patients' satisfaction of hearing aid. The results of the work indicate the possibility of using computer technologies of data analysis to develop rehabilitation programs for elderly hearing impaired patients.

[Transcranial electrical stimulation of audiology patients of different ages.]

The aim of the study was a comparative analysis of subjective assessments and audiological parameters of patients with hearing loss obtained before and after the course of transcranial electrical stimulation (TES). The study group included 99 patients (45 men and 54 women) with chronic mono- (16%) and bilateral (76%) sensorineural hearing loss (SNHL) aged 20 to 85 years. Groups of young and middle age (20-59 years old) amounted to 37 people; elderly (60-74 years old) - 48 and senile (75-90 years old) - 14 people. The observation included: anamnesis, ENT survey, tone threshold audiometry, impedancemetry, and questioning. All patients underwent a course of 10 TES procedures using the «Transair-7¼ device. The data indicated an improvement in subjective assessments regarding auditory perception in 54%, speech intelligibility in 53%, tinnitus in 24% and general well-being in 36% of patients in the study group. The distribution of hearing thresholds in the region of speech frequencies before and after the course also turned out to be significantly different (p<0,01). At the same time, gender and age-specific features of the effect of TES on hearing and general well-being were revealed, the most pronounced in senile patients who showed minimal positive dynamics. In general, taking into account age restrictions, the results confirm the feasibility of using TES in SNHL, even outside the combined (with audio loading) stimulation.

[Audiological correlates of age-related manifestations of auditory disorders.]

The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 firstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.

[Age-related issues of the quality of life in hearing impaired patients.]

The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old (R2=0,98 with statistically significant difference, p<0,05), with decreasing correlation in patients from 60 years and older (R2=0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.

[Hearing loss in adults in older age groups.]

There has been a steady increase in the prevalence of hearing loss among people in many countries around the world. One of the main reasons for this negative trend is an increase in life expectancy and an increase in the proportion of the elderly people, which means an increase in the number of people with age-related changes in the auditory system (presbycusis). Aging is accompanied primarily by damage to the structures of the inner ear, but it can also affect the central parts of the auditory analyzer, causing frustration at all levels of the auditory neural pathway. Presbycusis is accompanied by impaired hearing and speech intelligibility. Along with speech hearing, spatial hearing suffers. Just as in other countries of the world, in Russia the prevalence of age-related hearing loss is increasing year by year. The data on the prevalence of hearing impairment in the Russian Federation vary, due to the lack of uniform approaches to the registration of persons with hearing impairment. Creation of a surdologic register is necessary for information support of complex medical and social rehabilitation of surdological patients. Since hearing loss has a significant negative impact on the quality of life of patients, knowledge of the prevalence of hearing disorders among the population will allow to plan properly the need for technical means of hearing and speech rehabilitation at the state level, to promote social rehabilitation and active longevity of citizens of older age groups.

[The role of mono- and binaural hearing aid in the rehabilitation of the adult patients presenting with hearing impairment]. / Mono- i binaural'noe slukhoprotezirovanie v reabilitatsii vzroslykh patsientov s tugoukhost'iu.

The objective of the present study was to compare the effectiveness of mono- and binaural hearing aids in the rehabilitation of the adult patients of different age presenting with chronic symmetric hearing loss (CSHL). A total of 263 subjects at the age from 50 to 88 years complaining of moderate to severe (grade I-IV) chronic symmetric hearing impairment were available for the examination. Following the ENT examination with the application of pure tone audiometry and impedancometry, the participants of the study were supplied with the individually fitted digital behind-the-ear hearing instruments and underwent speech audiometry in the free sound field. The intelligibility of polysyllabic words in the calm and noisy environment was evaluated. A significant deterioration of the intelligibility was documented both under the quiet and noisy conditions. Its severity increased with the patients' age and the degree of hearing impairment. The comparison of the results of speech audiometry in the patients using either a single or two hearing aids gave evidence that binaural hearing aids were more efficient than monoaural ones in 86% of the patients. Re-examination of the same patients one year after the completion of the first study has demonstrated that 59% of them became permanent users of the hearing aids with 47% of them making regular use of simultaneously two hearing aids. It is concluded that speech audiometry in the free sound field can be recommended as a highly informative method that allows to substantiate the reasonable choice between the mono- and binaural hearing aids for the adult patients presenting with hearing impairment.

[Age related aspects of cochlear implantation.]

The objective of this study was to assess the long-term results of cochlear implantation in terms of age-related changes. 67 patients of different age with chronic bilateral severe sensorineural hearing loss and deafness with experience of use of cochlear implants (CI) for at least 5 years were tested. The 1st group included young patients (25,5±7,9 years), the 2nd group - middle-aged (51,4±5,4 years), the 3rd group - elderly patients (67±5,6 years). The examination, which conducted before and after the planned replacement of the speech processor, included: pure tone and speech audiometry in the free field, subjective assessment of satisfaction with CI, assessment of the state of speech function and psychological testing using the Montreal Cognitive Assessment and Mini-Mental State Examination. The increase in speech intelligibility in silence and in a background noise after the replacement of speech processors was revealed. The expediency of cochlear implantation in geriatric practice to maintain the mental and social status of elderly people, prevention of dementia, improving the quality of their lives in the conditions of increasing the age-related risks of sensory and cognitive dysfunction was shown.

[The effectiveness of hearing aids in elderly people].

The analysis of factors which influence on the hearing aid efficacy in elderly with presbycusis is presented in the article. 125 patients from 60 to 90 years old with moderate to severe hearing loss, hearing aid users, were examined. The audiology examination included standard methods as well as tests evaluating central auditory pathways processing. According to the results of speech audiometry in free field low efficacy of hearing aid is revealed in 21 % patients. The main factor that decreases hearing aid benefit is the presence of central auditory processing disorders, the additional one is poor technical characteristics of a hearing aid. To increase hearing aid benefit in elderly the correction of central auditory processing disorders, rational hearing aid fitting according to individual features of auditory system and help in adaptation to hearing aid using are required.

[Speech intelligibility in elderly hearing impaired people].

The results of studying the features of auditory perception of speech stimuli in aged patients with hearing loss are presented in the article. 145 patients with moderate to severe sensorineural hearing loss from 52 to 90 years old underwent the tonal threshold audiometry and the tests battery to evaluate central auditory pathways functioning: the gap detection test, frequency difference limens, masking level difference, dichotic digits test. After analyzing speech discrimination scores of monosyllable words in quiet and in noise significantly worse results of all listeners in comparison with listeners with normal hearing are revealed; the deterioration of speech discrimination scores depending on age is noted. The impairment of speech discrimination is maximal when the speech stimuli are presented in background noise. Direct correlation between the deterioration of speech discrimination and the degree of hearing loss, it's duration, the presence of central auditory pathways dysfunction was ascertained.

[The use of speech audiometry in the practice of the geriatric center].

The aim of the study was to evaluate a new test of speech audiometry while examining aged patients. 32 aged listeners from 60 to 88 years old were examined: 20 hearing aid (HA) users and 12 patients with normal hearing thresholds and mild cognitive impairment according to the results of the mini-mental state examination (MMSE). The speech audiometry consisted of the traditional polysyllabic words discrimination test and a new speech test with motor responses (Verbal Tasks and Motor Responses - VTMR); in both tests the signal was presented in background noise (polyphony) in free field. All listeners performed the VTMR test significantly better than the polysyllabic words discrimination test. In the group of hearing impaired patients the mean result in VTMR test was 73,2±29,2 % without HA and 88,6±20,5 % with it, in traditional test - 34,8±20,9 % without HA and 56±18,4 % with it. All patients of the group with normal hearing and mild cognitive impairment performed the VTMR test with 100 % result, their speech discrimination score in traditional test was 88±12 %. In the practice of the geriatric center the use of both the traditional speech audiometry and the new speech test with motor responses seems to be reasonable, that allows examining the auditory function in patients with significant deterioration of speech intelligibility or cognitive impairment.

[The speech audiometry test with the verbal tasks and motor responses]. / Rechevoĭ test s verbal'nymi zadaniiami i motornym otvetom.

The objective of the present study was to estimate the possibility of using the Russian version of the speech audiometry test with the verbal tasks and motor responses (VTMR test) for the examination of the patients of the advanced and senile age suffering from hearing impairment and cognitive disorders. A total of 20 subjects at the age between 60 and 83 years were enrolled in the study. All of them presented with grade II-III bilateral symmetric chronic sensorineural hearing loss associated with mild cognitive disorders. The patients used the hearing aids. Twelve subjects aged 64-88 years presenting with the normal hearing threshold in both ears and mild cognitive impairment (25-27 points in the MMSE test) were included in the study to serve as controls. All the listeners underwent tonal threshold audiometry in combination with speech tests in a free acoustic field (perception of polysyllabic words and VTMR) and filled in the relevant questionnaires (MMSE and HHIE). The results of the study indicate that the VTMR test can be recommended for the evaluation of the effectiveness of hearing aids prescribed to the elderlysubjects and for the study of the auditory function in the patients presenting with cognitive disorders.

[Hearing disorders in patients of older age groups].

Results of the investigation of hearing of elderly people living in nursing houses in Saint-Petersburg, obtained through a tonal threshold audiometry are described in this article. The analysis of hearing-loss prevalence depending on the age, the hearing-loss degrees, the presence of complaints about the hearing loss are also represented as well as the discussion about the possible causes of hearing loss (accompanying somatic diseases, working in noisy environment, hearing diseases inheritance).

[Rehabilitation in elderly people with hearing loss].

Data about rehabilitation in hearing impaired elderly people living in nursing houses in Saint-Petersburg are presented in the article. Hearing aid demand depending on age and degree of hearing loss is analyzed and problems of electro acoustic correction of hearing loss and possibilities to increase its efficacy in studied age group are discussed as well.