Cohort profile: Netherlands Longitudinal Study on Hearing (NL-SH).

PURPOSE: The Netherlands Longitudinal Study on Hearing (NL-SH) was set up to examine associations of hearing ability with psychosocial, work and health outcomes in working age adults. PARTICIPANTS: Inclusion started in 2006 and is ongoing. Currently the sample comprises 2800 adults with normal and impaired hearing, aged 18-70 years at inclusion. Five-year follow-up started in 2011, 10-year follow-up in 2016 and 15-year follow-up in 2021. All measurements are web-based. Participants perform a speech-in-noise recognition test to measure hearing ability and fill out questionnaires about their hearing status, hearing aid use, self-reported hearing disability and coping, work status and work-related outcomes (work performance, need for recovery), physical and psychosocial health (depression, anxiety, distress, somatisation, loneliness), healthcare usage, lifestyle (smoking, alcohol), and technology use. FINDINGS TO DATE: The NL-SH has shown the vast implications of reduced hearing ability for the quality of life and health of working-age adults. A selection of results published in 27 papers is presented. Age-related deterioration of hearing ability accelerates after the age of 50 years. Having a history of smoking is associated with a faster decline in hearing ability, but this relationship is not found for other cardiovascular risk factors. Poorer hearing ability is associated with increased distress, somatisation, depression and loneliness. Adults with impaired hearing ability are more likely to be unemployed or unfit for work, and need more time to recuperate from work effort. FUTURE PLANS: Participant data will be linked to a national database to enable research on the association between hearing ability and mortality. Linking to environmental exposure data will facilitate insight in relations between environmental factors, hearing ability and psychosocial outcomes. The unique breadth of the NL-SH data will also allow for further research on other functional problems, for instance, hearing ability and fall risk. TRIAL REGISTRATION NUMBER: NL12015.029.06.

A Novel Method to Measure Artificial Eye Motility.

PURPOSE: To measure objectively, reproducibly, and noninvasively artificial eye motility, a fundamental aspect in the (cosmetic) outcome of enucleation. METHOD: A gaze- and pupil-tracking system, the "iView X," was implemented to measure horizontal eye motility. The system, with adjusted software, was tested with patients wearing 1 prosthetic eye after enucleation for retinoblastoma. Measurements were repeated 5 times in every patient and analyses were performed twice by 2 independent observers. Reproducibility was tested via linear mixed models. After the implementation of the method, more data were obtained, including more patients with a history of enucleation for the treatment of retinoblastoma for eye tracker measurement, and differences in motility percentages between implant types and sizes were analyzed via Mann-Whitney U tests. RESULTS: The intraclass correlation coefficient of the interobserver variable in the patient test group (n = 27, 6-53 years) was 0.98 and 0.96 for measurement of left gaze and right gaze, respectively. Intraobserver variation was <0.001. In the total of 58 included patients for comparative analysis, mean difference of prosthesis motility compared with the contralateral eye in abduction was 57.1% (range 3.2-91.5%); in adduction 65.8% (range 24.0-92.0%). No statistical differences were found between the different implant types and sizes. CONCLUSION: Motility measurements of the prosthetic eye in comparison to the contralateral eye using the iView X system are reproducible and reliable. This is, to the authors' knowledge, the first easy applicable, noninvasive, reproducible, and commercially available instrument to evaluate prosthesis motility. With the adjusted software program (freely available on request), a similar objective measurement can be performed worldwide. The implant size or type did not influence the outcome of the motility measurement; this finding deserves additional study.

The influence of semantically related and unrelated text cues on the intelligibility of sentences in noise.

OBJECTIVES: In two experiments with different subject groups, we explored the relationship between semantic context and intelligibility by examining the influence of visually presented, semantically related, and unrelated three-word text cues on perception of spoken sentences in stationary noise across a range of speech-to-noise ratios (SNRs). In addition, in Experiment (Exp) 2, we explored the relationship between individual differences in cognitive factors and the effect of the cues on speech intelligibility. DESIGN: In Exp 1, cues had been generated by participants themselves in a previous test session (own) or by someone else (alien). These cues were either appropriate for that sentence (match) or for a different sentence (mismatch). A condition with nonword cues, generated by the experimenter, served as a control. Experimental sentences were presented at three SNRs (dB SNR) corresponding to the entirely correct repetition of 29%, 50%, or 71% of sentences (speech reception thresholds; SRTs). In Exp 2, semantically matching or mismatching cues and nonword cues were presented before sentences at SNRs corresponding to SRTs of 16% and 29%. The participants in Exp 2 also performed tests of verbal working memory capacity and the ability to read partially masked text. RESULTS: In Exp 1, matching cues improved perception relative to the nonword and mismatching cues, with largest benefits at the SNR corresponding to 29% performance in the SRT task. Mismatching cues did not impair speech perception relative to the nonword cue condition, and no difference in the effect of own and alien matching cues was observed. In Exp 2, matching cues improved speech perception as measured using both the percentage of correctly reported words and the percentage of entirely correctly reported sentences. Mismatching cues reduced the percentage of repeated words (but not the sentence-based scores) compared with the nonword cue condition. Working memory capacity and ability to read partly masked sentences were positively associated with the number of sentences repeated entirely correctly in the mismatch condition at the 29% SNR. CONCLUSIONS: In difficult listening conditions, both relevant and irrelevant semantic context can influence speech perception in noise. High working memory capacity and good linguistic skills are associated with a greater ability to inhibit irrelevant context when uncued sentence intelligibility is around 29% correct.

The association between hearing status and psychosocial health before the age of 70 years: results from an internet-based national survey on hearing.

OBJECTIVE: There is a substantial lack of knowledge of the impact of reduced hearing on psychosocial functioning in adults younger than 70 yr. The aim of this study was to examine the association between hearing status and psychosocial health in adults aged between 18 and 70 yr. DESIGN: This was a cross-sectional cohort study. Baseline data of the National Longitudinal Study on Hearing are analyzed using regression models. The cohort consisted of 1511 participants. Hearing status was determined using the National Hearing test, a recently launched speech-in-noise screening test over the Internet. We assessed self-reported psychosocial health using a set of online questionnaires. RESULTS: Adjusting for confounding variables, significant adverse associations between hearing status and distress, somatization, depression, and loneliness are found. For every decibel signal to noise ratio (dB SNR) reduction of hearing status, both the distress and somatization scores increased by 2% [distress: b = 0.02, 95% confidence interval (CI) = 0.00 to 0.03, p = 0.03; somatization: b = 0.02, 95% CI = 0.01 to 0.04, p < 0.001]. The odds for developing moderate or severe depression increase by 5% for every dB SNR reduction in hearing (odds ratio = 1.05, 95% CI = 1.00 to 1.09, p = 0.03). The odds for developing severe or very severe loneliness significantly increase by 7% for every dB SNR reduction in hearing (odds ratio = 1.07, 95% CI = 1.02 to 1.12, p = 0.004). Different age groups exhibit different associations between hearing status and psychosocial health, with loneliness being an issue particularly in the youngest age group (18 to 30 yr). In the group of middle-aged adults (40 to 50 yr), the number of significant associations is highest. CONCLUSIONS: Hearing status is negatively associated with higher distress, depression, somatization, and loneliness in young and middle-aged adults. The associations are different in different age groups. The findings underline the need to seriously address the adverse effects of limited hearing among young and middle-aged adults both in future research and in clinical practice.