Hearing Loss and Neuropsychiatric Symptoms in Persons With Dementia at the End of Life

Access to effective communication is critical to the conversations that occur at end-of-life and represents an unaddressed need within palliative care. These challenges may disproportionately affect persons with dementia (PWD). Hearing loss is one of the most common comorbidities among PWD and is independently associated with neuropsychiatric symptoms. However, relatively little is known about the potential impact of hearing loss on PWD at end-of-life. We examined last month of life (LML) data from 971 proxies of deceased PWD from the National Health and Aging Trends Study (2011-2020). Hearing difficulty was associated with increased anxiety/sadness in PWD, χ2(1)=4.596, p=.032, such that 65.6% of persons with hearing difficulty reported anxiety/sadness in the LML. Binary logistic regression found that hearing difficulty was significantly associated with increased anxiety/sadness (OR=1.40, 95% C.I. 1.00 – 1.80, p < 0.05). Interventions that optimize communication for PWD may be a meaningful approach to improving the end-of-life experience.

Blast Exposure and Self-Reported Hearing Difficulty in Service Members and Veterans Who Have Normal Pure-Tone Hearing Sensitivity: The Mediating Role of Posttraumatic Stress Disorder

Purpose Evidence suggests that military blast exposure may lead to self-reported hearing difficulties despite audiometrically normal hearing. Research identifying potential mechanisms of this association remains limited. The purpose of this article is to evaluate the associations between blast, posttraumatic stress disorder (PTSD), and self-reported hearing difficulty, and to examine PTSD as a possible mediator of the association between blast exposure and hearing difficulty. Method We used baseline data from the Noise Outcomes in Service members Epidemiology (NOISE) study ( n = 477). Participants in this study undergo a comprehensive hearing, and tinnitus if applicable, evaluation and complete a large number of surveys. Pertinent data extracted from these surveys included information on participant's demographics, military service history, including exposure to blast, and health conditions such as symptoms of PTSD. Using regression models and following a formal causal mediation framework, we estimated total associations, natural direct and indirect associations, and percent mediated. Results We found that individuals with blast exposure had higher prevalence of both probable PTSD and self-reported hearing difficulty than individuals who were not blast exposed. Compared with participants without blast exposure, those with blast exposure had twice the prevalence of self-reported hearing difficulty, with 41% of the association mediated through probable PTSD. Conclusion As PTSD is a possible mediator of the association between blast exposure and hearing difficulty, Service members and Veterans with normal pure-tone hearing sensitivity who report hearing difficulties and a history of blast exposure may benefit from evaluation for PTSD symptoms. Supplemental Material https://doi.org/10.23641/asha.16674247

Hearing difficulty is linked to Alzheimer’s disease by common genetic vulnerability, not shared genetic architecture

Age-related hearing loss was recently established as the largest modifiable risk factor for Alzheimer’s disease (AD), however, the reasons for this link remain unclear. We investigate shared underlying genetic associations using results from recent large genome-wide association studies (GWAS) on adult hearing difficulty and AD. Genetic correlation and Mendelian randomization (MR) analysis do not support a genetic correlation between the disorders, but suggest a direct causal link from AD genetic risk to hearing difficulty, driven by APOE. Systematic MR analyses on the effect of other traits revealed shared effects of glutamine, gamma-glutamylglutamine, and citrate levels on reduced risk of both hearing difficulty and AD. In addition, pathway analysis on GWAS risk variants suggests shared function in neuronal signalling pathways as well as etiology of diabetes and cardiovascular disease. However, after multiple testing corrections, neither analysis led to statistically significant associations. Altogether, our genetic-driven analysis suggests hearing difficulty and AD are linked by a shared vulnerability in molecular pathways rather than by a shared genetic architecture.

Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: Data From a Large Sample of Spanish Adults

ObjectiveIndividually, vision and hearing impairments have been linked to higher levels of anxiety and depression. We investigated the effect of dual sensory impairment (difficulty seeing and hearing) in a large representative sample of Spanish adults.MethodsData from a total of 23,089 adults (age range: 15–103 years, 45.9% men) from the Spanish National Health Survey 2017 were analyzed. Self-reported difficulty of seeing and hearing (exposures), and depression and chronic anxiety (outcomes) were analyzed. Multivariable logistic regression was assessed for difficulty with vision alone, hearing alone and with difficulty with both, adjusting for gender, age, marital status, living as a couple, education, smoking, alcohol consumption, BMI, physical activity, use of glasses/contact lenses, and hearing aid.ResultsVisual difficulty, hearing difficulty, and dual difficulties were all associated with significantly higher odds for depression (ORs 2.367, 2.098, and 3.852, respectively) and for chronic anxiety (ORs 1.983, 1.942, and 3.385, respectively). Dual sensory difficulty was associated with higher odds ratios for depression and anxiety when compared to either impairment alone.ConclusionDual sensory difficulty is associated with significantly higher odds of anxiety and depression when compared to either vision or hearing difficulty alone. Appropriate interventions are needed to address any reversible causes of vision and hearing as well as anxiety and depression in people in these specific groups.

Tinnitus Profiling in an Albanian Population (Preprint)

BACKGROUND Characteristics of tinnitus, the perception of sound in the absence of an external acoustic stimulus, can vary from one individual to another. This heterogeneity has been blamed for the lack of success in finding a cure. To our knowledge, no previous study on tinnitus in Albania has been published, although some studies in eastern Europe are available. A study investigating the characteristics of tinnitus in this region would be important, providing the basis for further research on tinnitus in Albania and contributing to a wider understanding of tinnitus heterogeneity across different geographic locations. OBJECTIVE The objective of this study was to develop an Albania translation of a standardized questionnaire for tinnitus research (the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire - ESIT-SQ) and use it to investigate characteristics of tinnitus in the Albanian population. METHODS Three translators were recruited to create the Albanian ESIT-SQ translation following good practice guidelines for translating questionnaires. This questionnaire was subsequently used to collect data from people attending otolaryngology clinics in Albania. RESULTS Self-report data from 107 people with varying degrees of tinnitus severity were collected using the Albanian ESIT-SQ. Using a Random Forest approach, we found that self-reported hearing difficulty, tinnitus duration, tinnitus pitch, and temporal manifestation of tinnitus were predictive of tinnitus symptom severity (cross-validated accuracy of 0.64, confidence Interval 0.54-0.73). CONCLUSIONS Overall, our study in an Albanian sample demonstrated that the ESIT-SQ can be used to investigate phenotypical characteristics and subgroup distinctions.

Self-reported hearing status and audiometric thresholds among college students using headphones

Purpose: The study aims to investigate headphone listening habits of college-going students and for those using headphones, correlate self-reported hearing status with average audiometric hearing thresholds. Method: Headphone listening habits and awareness of adverse effects of the same was profiled in college-going students using a questionnaire distributed through online platform. Hearing thresholds were then compared for those with and without self-report of hearing difficulty. 341 responses were obtained from students between 17 and 23 years of age. For the second part of the study, a convenience sample of 30 willing students from among these 341 was selected. Pure tone thresholds were obtained for various frequencies with a high frequency audiometer. PTA (average of 500, 1000, 2000 Hz) and HFPTA (average of 4000, 6000, 8000, 10000 Hz) were calculated for both the ears and compared for those with and without reported hearing difficulty. Results: 78% students reported headphone usage for less than 3 hours per day, while 22% reported usage for more than 3 hours per day. 77% respondents were aware that listening to loud sounds can alter hearing sensitivity, but many (54.83%) did not have awareness about the minimum safe hours of listening. There was a weak positive correlation between self-reported hearing difficulty and poor ear HFPTA (r = 0.2304). Conclusion: Majority of students used insert earphones even after knowing the adverse effect of the same. There was a weak correlation found between the self-reported hearing problems and audiometric hearing thresholds. Implication: More awareness is needed about the ill effects of headphone usage amongst the young teenage population. Proper counseling and management strategies are required for people who report difficulty in hearing.