The effective screening tools for detecting hearing loss in elderly population: HHIE-ST Versus TSQ

Abstract Background Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation. Trial registration The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. Date of registration October 14, 2015.

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The Effective Screening Tools for Detecting Hearing Loss in Elderly Population: HHIE-ST Versus TSQ

10.21203/rs.3.rs-69909/v3 ◽

2021 ◽

Author(s):

NICHTIMA CHAYAOPAS ◽

Pornthep Kasemsiri ◽

Panida Thanawirattananit ◽

Patorn Piromchai ◽

Kwanchanok Yimtae

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Screening Tool ◽

Diagnostic Value ◽

Screening Tools ◽

Effective Screening ◽

Hearing Disability ◽

Test Study ◽

Combined Test ◽

Single Question

Abstract Background: Globally increasing number of elders is concerned. Hearing loss process in older adults cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in older adults. Methods: This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results: The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77-91.64) and specificity of 52.19% (95% CI 48.24-56.13) for diagnosis hearing disability in Thai older adults, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions: Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai older adults. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss older adults who will benefit and recommended for hearing rehabilitation.

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The Effective Screening Tools for Detecting Hearing Loss in Elderly Population: HHIE-ST Versus TSQ

10.21203/rs.3.rs-69909/v1 ◽

2020 ◽

Author(s):

NICHTIMA CHAYAOPAS ◽

Pornthep Kasemsiri ◽

Panida Thanawirattananit ◽

Patorn Piromchai ◽

Kwanchanok Yimtae

Keyword(s):

Hearing Loss ◽

Screening Tool ◽

Diagnostic Value ◽

Screening Tools ◽

Elderly Subjects ◽

Effective Screening ◽

Hearing Disability ◽

Test Study ◽

Combined Test ◽

Single Question

Abstract BackgroundGlobally increasing number of elders is concerned. Hearing loss process in elderly cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in elderly individuals.MethodsThis prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai elderly participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard.ResultsThe prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77–91.64) and specificity of 52.19% (95% CI 48.24–56.13) for diagnosis hearing disability in Thai elderly subjects, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%.ConclusionsEither the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai elderly subjects. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss elderly individuals who will be benefit and recommended for hearing rehabilitation.Trial RegistrationThe study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. URL: http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1562

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The Effective Screening Tools for Detecting Hearing Loss in Elderly Population: HHIE-ST Versus TSQ

10.21203/rs.3.rs-69909/v2 ◽

2020 ◽

Author(s):

Nichtima Chayaopas ◽

Pornthep Kasemsiri ◽

Panida Thanawirattananit ◽

Patorn Piromchai ◽

Kwanchanok Yimtae

Keyword(s):

Hearing Loss ◽

Screening Tool ◽

Diagnostic Value ◽

Screening Tools ◽

Elderly Subjects ◽

Elderly Individuals ◽

Effective Screening ◽

Hearing Disability ◽

Combined Test ◽

Single Question

Abstract Background: Globally increasing number of elders is concerned. Hearing loss process in elderly cannot be avoided. An effective screening tool for hearing loss is essential for proper diagnosis and rehabilitation, which can improve QOL in elderly individuals. Methods: This prospective-diagnostic test study evaluates the diagnostic value of Thai version of the Hearing Handicap Inventory for Elderly Screening (HHIE-ST) and the Thai Single Question (TSQ) surveys in screening hearing disability in 1109 Thai elderly participants aged 60 years and older in communities in four provinces in Thailand. The HHIE-ST consisted of 10 selected questions from the validated HHIE-Thai version. A TSQ survey was developed to have the same meaning as an English Single Question survey. The participants answered both questionnaires, and a standard audiometry test assessed with air conduction from 250 to 8000 Hz was included as a gold standard. Results: The prevalence of hearing disability was 38.34%. The HHIE-ST achieved a sensitivity of 88.96% (95% CI 85.77-91.64) and specificity of 52.19% (95% CI 48.24-56.13) for diagnosis hearing disability in Thai elderly subjects, whereas the TSQ yielded a sensitivity of 88.73% and a specificity of 55.93%. A combined test including the HHIE-ST and TSQ achieved better performance with sensitivity of 85.29% and specificity of 60.13%. Conclusions: Either the HHIE-ST or the TSQ is a sensitive and useful tool for screening hearing disability in Thai elderly subjects. Using the HHIE-ST together with the TSQ resulted in a better screening tool for detecting moderate hearing loss elderly individuals who will benefit and recommended for hearing rehabilitation.Trial Registration: The study is registered with the following number in the Thai Clinical Trials Registry: TCTR20151015003. URL: http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1562

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Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418795982 ◽

2018 ◽

Vol 127 (11) ◽

pp. 798-805 ◽

Cited By ~ 1

Author(s):

Siti Zamratol Mai Sarah Mukari ◽

Wan Fazlina Wan Hashim

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Help Seeking ◽

Hearing Aid ◽

Pure Tone Audiometry ◽

Cognitive Status ◽

Community Dwelling ◽

Hearing Level ◽

Low Sensitivity ◽

Single Question

Introduction: The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. Methods: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. Results: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. Conclusion: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

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Screening Community-Living Older Adults for Protein Energy Malnutrition and Frailty: Update and Next Steps

Journal of Community Health ◽

10.1007/s10900-019-00739-1 ◽

2019 ◽

Vol 45 (3) ◽

pp. 640-660 ◽

Cited By ~ 5

Author(s):

Johanna T. Dwyer ◽

Jaime J. Gahche ◽

Mary Weiler ◽

Mary Beth Arensberg

Keyword(s):

Older Adults ◽

Predictive Validity ◽

Screening Tool ◽

Protein Energy Malnutrition ◽

The United States ◽

Community Dwelling ◽

Screening Tools ◽

World Health ◽

Community Settings ◽

Protein Energy

Abstract Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.

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Comparison of Malnutrition Screening Tools for Use in Hospitalized Older Adults (OR36-02-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz035.or36-02-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Rachel Deer ◽

Mackenzie McCall ◽

Elena Volpi

Keyword(s):

Older Adults ◽

Elderly Patients ◽

Screening Tool ◽

Screening Tools ◽

Good Sensitivity ◽

Predictive Values ◽

Hospitalized Elderly ◽

Nrs 2002 ◽

Hospitalized Elderly Patients ◽

Hospitalized Older Adults

Abstract Objectives Malnutrition is a common problem in geriatric patients that often goes unrecognized. Undernutrition is a primary health concern for older adults due to associations with increased mortality, complications, and length of hospital stay. Yet, there is no consensus on which malnutrition screening tool should be used for hospitalized older adults. Therefore, the objective of this study was to determine which screening tool is best to rapidly detect malnutrition in hospitalized older adults so that patient outcomes may be improved. Methods Older adult patients (n = 211; ≥65 yrs old) were enrolled during acute hospitalization. Testing occurring within 72 hours of admission and included the following screening tools included: Malnutrition Screening Tool (MST), Mini Nutritional Assessment Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening 2002 (NRS-2002), and Geriatric Nutritional Risk Index (GNRI). These screening tools were compared to a malnutrition diagnostic tool, the Subjective Global Assessment (SGA). Results According to SGA, 49% of patients were at risk of being malnourished. The other screening tools indicated a wide range of malnutrition prevalence, from 18% (MST) to 76% (MNA-SF). MST (93%) and MUST (92%) were highest in sensitivity. NRS-2002 had moderately good sensitivity (71%). MNA-SF and GNRI had poor sensitivity, eliminating them as good screening tools for hospitalized elderly patients. Of the remaining tools, NRS-2002 had the highest specificity (77%). MST and MUST had poor specificity (31%, 39%, respectively), eliminating them as good screening tools for hospitalized elderly patients. The remaining screening tool, NRS-2002, had moderately good positive and negative predictive values (76%, 72%, respectively). It also had the highest kappa (0.479). Overall, NRS-2002 had the best agreement to SGA and showed moderately good sensitivity, specificity and predictive values. Conclusions Our data suggests NRS-2002 is the best malnutrition screening tool for rapid detection of malnutrition in elderly hospitalized patients, when compared to the diagnostic tool, SGA. Future research is needed to determine which screening tool is most effective for use in different settings. Additional research can assist in standardizing malnutrition criteria and care processes. Funding Sources National Dairy Council, National Institutes of Health-National Center for Advancing Translational Sciences, and UTMB Claude D. Pepper OAIC. Supporting Tables, Images and/or Graphs

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Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis

European Journal of Clinical Nutrition ◽

10.1038/s41430-020-0629-0 ◽

2020 ◽

Vol 74 (11) ◽

pp. 1519-1535 ◽

Cited By ~ 2

Author(s):

Alex F. Bullock ◽

Sarah L. Greenley ◽

Gordon A. G. McKenzie ◽

Lewis W. Paton ◽

Miriam J. Johnson

Keyword(s):

Older Adults ◽

Food Intake ◽

Nutritional Status ◽

Clinical Outcomes ◽

Screening Tool ◽

Meta Analysis ◽

Screening Tools ◽

Narrative Synthesis ◽

Markers Of Inflammation ◽

Risk Of Cancer

Abstract Malnutrition predicts poorer clinical outcomes for people with cancer. Older adults with cancer are a complex, growing population at high risk of weight-losing conditions. A number of malnutrition screening tools exist, however the best screening tool for this group is unknown. The aim was to systematically review the published evidence regarding markers and measures of nutritional status in older adults with cancer (age ≥ 70). A systematic search was performed in Ovid Medline, EMBASE, Web of Science, CINAHL, British Nursing Database and Cochrane CENTRAL; search terms related to malnutrition, cancer, older adults. Titles, abstracts and papers were screened and quality-appraised. Data evaluating ability of markers of nutritional status to predict patient outcomes were subjected to meta-analysis or narrative synthesis. Forty-two studies, describing 15 markers were included. Meta-analysis found decreased food intake was associated with mortality (OR 2.15 [2.03–4.20] p = < 0.00001) in univariate analysis. Prognostic Nutritional Index (PNI) was associated with overall survival (HR 1.89 [1.03–3.48] p = 0.04). PNI markers (albumin, total lymphocyte count) could be seen as markers of inflammation rather than nutrition. There a suggested relationship between very low body mass index (BMI) (<18 kg/m2) and clinical outcomes. No tool was identified as appropriate to screen for malnutrition, as distinct from inflammatory causes of weight-loss. Risk of cancer-cachexia and sarcopenia in older adults with cancer limits the tools analysed. Measures of food intake predicted mortality and should be included in clinical enquiry. A screening tool that distinguishes between malnutrition, cachexia and sarcopenia in older adults with cancer is needed.

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Assessing hearing loss in older adults with a single question and person characteristics; Comparison with pure tone audiometry in the Rotterdam Study

PLoS ONE ◽

10.1371/journal.pone.0228349 ◽

2020 ◽

Vol 15 (1) ◽

pp. e0228349 ◽

Cited By ~ 1

Author(s):

Berthe C. Oosterloo ◽

Nienke C. Homans ◽

Rob J. Baatenburg de Jong ◽

M. Arfan Ikram ◽

A. Paul Nagtegaal ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Pure Tone ◽

Pure Tone Audiometry ◽

Rotterdam Study ◽

Person Characteristics ◽

Single Question

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SCREENING FOR VISION AND HEARING LOSS IN OLDER ADULTS WITH DEMENTIA: A FEASIBILITY STUDY

Innovation in Aging ◽

10.1093/geroni/igz038.442 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S120-S121

Author(s):

Katherine McGilton ◽

Fiona Höbler ◽

Marilyn Reed ◽

Tammy Labreche ◽

M Kathleen Pichora-Fuller ◽

...

Keyword(s):

Older Adults ◽

Hearing Loss ◽

Vision Loss ◽

Hearing Screening ◽

Screening Tools ◽

Sensory Loss ◽

Term Care ◽

Multi Stage ◽

Dual Sensory Loss

Abstract Sensory loss accounts for one of the most common chronic conditions among older adults, with hearing loss affecting half of adults aged over 65 years and vision loss almost one fifth of those aged 70 years and over. Together, dual sensory loss is found to be most prevalent in older adults with dementia. The highest prevalence is found in long-term care (LTC) settings. For this reason, we conducted a multi-stage study to identify the most effective vision and hearing screening tools for use with older adults living with dementia and to evaluate their feasibility of use by nurses working in LTC. We first conducted a comprehensive review of the literature, and supplemented this with an environmental scan of healthcare professionals and sensory specialists working with older adults who have dementia. Following this extensive review and consultative decision-making process, a package of vision and hearing screening tools was selected for use by nurses working in LTC. On-site training was provided by two experienced audiologists and optometrists, after which the feasibility of sensory screening by three nurses of 17 residents under their care was evaluated. We report on the six measures of hearing and seven measures of vision that were piloted for screening of older adults with dementia living in LTC, and on the findings for their feasibility of use by nurses working in this setting. Recommendations regarding the feasibility and reliability of screening for vision and hearing loss in older adults with dementia are discussed.

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Validation of the detection of elder abuse through emergency care technicians (DETECT) screening tool: a study protocol

BMJ Open ◽

10.1136/bmjopen-2020-037170 ◽

2020 ◽

Vol 10 (9) ◽

pp. e037170

Author(s):

Brad Cannell ◽

Julie Weitlauf ◽

Melvin D Livingston ◽

Jason Burnett ◽

Megin Parayil ◽

...

Keyword(s):

Older Adults ◽

Emergency Care ◽

Screening Tool ◽

Elder Abuse ◽

Well Being ◽

Living Environment ◽

Community Dwelling ◽

Screening Tools ◽

Semistructured Interview

IntroductionElder mistreatment (EM) is a high prevalence threat to the health and well-being of older adults in the USA. Medics are well-positioned to help with identification of older adults at risk for EM, however, field robust screening tools appropriate for efficient, observation-based screening are lacking. Prior work by this team focused on the development and initial pilot testing of an observation-based EM screening tool named detection of elder abuse through emergency care technicians (DETECT), designed to be implemented by medics during the course of an emergency response (911) call. The objective of the present work is to validate and further refine this tool in preparation for clinical dissemination.Methods and analysisApproximately 59 400 community-dwelling older adults who place 911 calls during the 36-month study observation period will be screened by medics responding to the call using the DETECT tool. Next, a random subsample of 2520 of the 59 400 older adults screened will be selected to participate in a follow-up interview approximately 2 weeks following the completion of the screening. Follow-up interviews will consist of a medic-led semistructured interview designed to assess the older adult’s likelihood of abuse exposure, physical/mental health status, cognitive functioning, and to systematically evaluate the quality and condition of their physical and social living environment. The data from 25% (n=648) of these follow-up interviews will be presented to a longitudinal, experts and all data panel for a final determination of EM exposure status, representing the closest proxy to a ‘gold standard’ measure available.Ethics and disseminationThis study has been reviewed and approved by the Committee for the Protection of Human Subjects at the University of Texas School of Public Health. The results will be disseminated through formal presentations at local, national and international conferences and through publication in peer-reviewed scientific journals.

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