Methodology approaches and challenges in population-based longitudinal study of a neuroprotective model for healthy longevity.

AIM: The 36-month Long-Term Research Grant Scheme project: Towards Usual Aging - Neuroprotective Model for Healthy Longevity among Malaysian Elderly was designed to address multidimensional aspects including psychosocial, biophysical health, nutrition and dietary pattern, and auditory and visual function to highlight the magnitude of these associations in a single study. METHODS: A total of 2322 respondents aged ≥60 years were recruited at baseline using the multistage sampling method, followed up at 18 months and 36 months. RESULTS: Response rates at baseline, 18 months and 36 months were 87.8%, 77.3% and 67.1%, respectively. At baseline, the prevalence of successful aging, usual aging and mild cognitive impairment was 11%, 73% and 16%, respectively. The prevalence of single and multimorbidity at baseline were 25.9% and 50.3%, respectively. The incidence rates of mild cognitive impairment at 18 months and 36 months were 6.5 and 5.6 per 100 person-years. The incidence rates of multimorbidity at 18 months and 36 months were 23.7 and 21.5 per 100 person-years, respectively. CONCLUSIONS: The Long-Term Research Grant Scheme project: Towards Usual Aging study provides an opportunity to investigate the interactions between wide ranges of aspects of the older population in a nationally representative sample of the older population. Geriatr Gerontol Int 2019; 19: 233-239.

Changes in auditory memory performance following the use of frequency-modulated system in children with suspected auditory processing disorders.

OBJECTIVE: To examine the changes in the short-term auditory memory following the use of frequency-modulated (FM) system in children with suspected auditory processing disorders (APDs), and also to compare the advantages of bilateral over unilateral FM fitting. METHODS: This longitudinal study involved 53 children from Sekolah Kebangsaan Jalan Kuantan 2, Kuala Lumpur, Malaysia who fulfilled the inclusion criteria. The study was conducted from September 2007 to October 2008 in the Department of Audiology and Speech Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. The children's age was between 7-10 years old, and they were assigned into 3 groups: 15 in the control group (not fitted with FM); 19 in the unilateral; and 19 in the bilateral FM-fitting group. Subjects wore the FM system during school time for 12 weeks. Their working memory (WM), best learning (BL), and retention of information (ROI) were measured using the Rey Auditory Verbal Learning Test at pre-fitting, post (after 12 weeks of FM usage), and at long term (one year after the usage of FM system ended). RESULTS: There were significant differences in the mean WM (p=0.001), BL (p=0.019), and ROI (p=0.005) scores at the different measurement times, in which the mean scores at long-term were consistently higher than at pre-fitting, despite similar performances at the baseline (p>0.05). There was no significant difference in performance between unilateral- and bilateral-fitting groups. CONCLUSION: The use of FM might give a long-term effect on improving selected short-term auditory memories of some children with suspected APDs. One may not need to use 2 FM receivers to receive advantages on auditory memory performance.

Effects of age and working memory capacity on pitch pattern sequence test and dichotic listening.

This study assessed the effects of age and working memory capacity on dichotic listening and temporal sequencing. Double Dichotic Digit Test (DDT), Pitch Pattern Sequence Test (PPST) and Digit Span Test were administered on 40 healthy adults with hearing thresholds of not greater than 30 dB HL across octave frequencies from 250 to 4000 Hz. Twenty young (20-30 years old) and 20 older (50-65 years old) adults were included in the study. Results showed that the older group had significantly lower scores in DDT, PPST and working memory capacity measures than the young subjects. Working memory capacity was positively correlated with PPST but not with DDT, suggesting that DDT might be more auditory-modality-specific than PPST.

Progress towards early detection services for infants with hearing loss in developing countries.

BACKGROUND: Early detection of infants with permanent hearing loss through infant hearing screening is recognised and routinely offered as a vital component of early childhood care in developed countries. This article investigates the initiatives and progress towards early detection of infants with hearing loss in developing countries against the backdrop of the dearth of epidemiological data from this region. METHODS: A cross-sectional, descriptive study based on responses to a structured questionnaire eliciting information on the nature and scope of early hearing detection services; strategies for financing services; parental and professional attitudes towards screening; and the performance of screening programmes. Responses were complemented with relevant data from the internet and PubMed/Medline. RESULTS: Pilot projects using objective screening tests are on-going in a growing number of countries. Screening services are provided at public/private hospitals and/or community health centres and at no charge only in a few countries. Attitudes amongst parents and health care workers are typically positive towards such programmes. Screening efficiency, as measured by referral rate at discharge, was generally found to be lower than desired but several programmes achieved other international benchmarks. Coverage is generally above 90% but poor follow-up rates remain a challenge in some countries. The mean age of diagnosis is usually less than six months, even for community-based programmes. CONCLUSION: Lack of adequate resources by many governments may limit rapid nationwide introduction of services for early hearing detection and intervention, but may not deter such services altogether. Parents may be required to pay for services in some settings in line with the existing practice where healthcare services are predominantly financed by out-of-pocket spending rather than public funding. However, governments and their international development partners need to complement current voluntary initiatives through systematic scaling-up of public awareness and requisite manpower development towards sustainable service capacities at all levels of healthcare delivery.

Educational performance of pediatric cochlear implant recipients in mainstream classes.

OBJECTIVES: The present study documents the school performance of 20 pediatric cochlear implant recipients who attended mainstream classes and compares their educational performance with their normally hearing peers. METHODOLOGY: All 20 school-aged children who underwent cochlear implantation at the Universiti Kebangsaan Malaysia cochlear implant programme participated in this study. Three measures were employed to assess the school performance. First, using the SIFTER teacher-rating scale, the second measure was the child's examination results, and the third was the child's standing compared to his/her peers in language subject, mathematics, and the overall academic performance during the end of semester examinations. RESULTS: The SIFTER rating scale indicated that only 11.8% of the children were identified as not educationally at risk, 17.6% passed four of the SIFTER subtests, whereas the other 71.6% failed in at least two of the subtests on SIFTER. The highest pass rate was obtained in behavior subtest (76.5%), followed by classroom participation (70.6%), attention (58.8%), academic (47.1%), and communication (11.8%). On the educational performance, the cochlear implant recipients performed significantly better in mathematics (mean scores 62.67%; S.D. 22.24) than in language (mean scores 49.96%, S.D. 25.88) (p<0.01). In the overall examination performance, 25.00% had above average performance (>75th percentile), 18.75% had average performance (25-75th percentile), and another 56.25% performed at below average (<25th percentile). CONCLUSION: Children with cochlear implant were rated poorly in the SIFTER communication subtest. It is possible that language deficit presents an educational challenge in these children. The educational performance of children with cochlear implants in mainstream classes varies. Although 43.75% of them thrive well in a full-time mainstream setting, a significant percentage of them (56.25%) performed at below the average level. These findings reemphasize that although a cochlear implant has successfully provided deaf children with a good hearing potential, the majority of its recipients still require additional educational supports in order to function well in the mainstream educational setting.

Development and standardization of single and double dichotic digit tests in the Malay language.

Single and double dichotic digit tests in Malay language were developed and standardized as an initial attempt to incorporate tests of auditory processing within the scope of audiology practice in Malaysia. Normative data under free recall, directed right-ear first, and directed left-ear first listening conditions were determined using 120 Malay children between the ages of 6 and 11 years old with normal hearing and normal academic performance. Test-retest reliability was assessed in 15 of the study subjects. In general, the double dichotic digit test produced greater differences in scores between age groups, and a greater right-ear advantage than the single dichotic digit test. In addition, the double dichotic digit test also had higher test-retest reliability. These findings suggest the double dichotic digit test is more clinically applicable.