Presbycusis among older Chinese people in Taipei,Taiwan: A community-based study

The purpose of this study was to estimate the prevalence and severity of presbycusis in older Chinese people in Taipei, Taiwan. Pure-tone audiometry and a questionnaire were administered to a randomly-recruited cohort of people > 65 years old (n=1221) from a community in Taipei. The study cohort showed pure-tone thresholds worsening, especially at frequencies >2 kHz, with increasing age. The mean pure-tone average at speech frequencies (0.5, 1, and 2 kHz) of the better ear of subjects stratified by five-year age groups ranged from 34.9 dB hearing level (HL) to 46.4 dB HL. The pure-tone average at speech frequency in women was slightly higher than that in men in all age groups. The prevalence of presbycusis (M3 ≥ 55 dBHL) was 1.6% (65–69 years), 3.2% (70–74 years), 7.5% (75–79 years), and 14.9% (≥80 years). Persistent tinnitus was present in 13.9% of subjects, and 18.8% of subjects had a history of vertigo. Of subjects with a clinically evident hearing impairment (M3 ≥ 55 dB HL), 18.4% used hearing aids. These data provide estimates of the prevalence and severity of presbycusis in community-dwelling older persons in Taiwan.     

Hearing among 75-year-old people in three Nordic localities: a comparative study

The aim of this study was to compare auditory functions and to analyse the prevalence of hearing impairment and the relationship of self-reported hearing disability with audiometric test results among 75-year-old people in three Nordic localities. The representative samples came from Glostrup, Denmark (n = 571), G?teborg, Sweden (n =450), and Jyv?skyl?, Finland (n =388). The median pure-tone thresholds were rather similar in all three populations. The prevalence of moderate hearing impairment varied between 26% and 34% in men, and between 17% and 23% in women. The corresponding figures in the prevalence of self-reported hearing difficulties were 41%-57%, and 28%-37%. The self-reported difficulties were broadly in accordance with the audiometric test results, but there also were individuals with conflicting results. It is concluded that the prevalence of hearing impairment in the three Nordic localities is fairly similar. To assess hearing disorders in elderly people, both audiometry and self-report data are needed.     

中文版筛选型老年听力障碍量表在老年性聋中的应用

目的探讨中文版筛选型老年听力障碍量表(HHIE-S)在老年性聋中的应用价值。方法对入选的170名非独居老年人及其亲属发放自评和代理者HHIE-S量表,并测其纯音听阈,分析量表得分与听阈之间的相关性。结果两份量表得分与纯音听阈间均呈正相关性。以25d B作为听力下降标准,HHIE-S量表对老年聋的特异性值为95.24%,对老年性聋的敏感性为59.06%,并随着听力损失级别的提高,量表的敏感性增加。共有149人(占总数87.65%)通过测听表明有不同程度的听力损失,轻至中度聋的患者中有50人得分>8,提示有听力障碍,10-22分的有39人,提示为轻至中度聋,有11人得分在24-40分之间,提示为重度听力障碍;听阈为重度聋及以上的患者共有38人得分>8,提示有听力障碍,10-22分的有9人,提示为轻至中度聋,29人得分在24-40分之间,提示为重度听力障碍。结论中文版HHIE-S量表在老年性聋筛查中表现出较好的敏感性和特异性,与纯音测听具有较强相关性,可以用于老年性聋的早期筛查,有利于推动老年性聋患者早期积极治疗和康复。     

Unilateral hearing impairment in Oman: a community-based cross-sectional study

This report on unilateral hearing loss is based on the findings of a national survey on hearing loss and blindness in Oman. The survey of randomly selected households was conducted by trained healthcare personnel between Oct. 1, 1996, and Feb. 28, 1997. A total of 11,402 subjects of all ages were screened for hearing loss. Those who reported hearing impairment in either ear were subsequently reexamined by otologists in hospitals to confirm the findings and to determine the cause of the hearing loss. Based on these findings, we calculated that the prevalence of unilateral hearing impairment throughout Oman was 30.06 per 1,000 population (95% confidence interval [CI]: 29.80 to 30.31). Males had a significantly higher rate (36.67/1,000 [95% CI: 34.55 to 38.79]) than females (23.88/1,000 [95% CI: 21.82 to 25.94]). The causes of unilateral hearing loss were different from the reported causes of bilateral hearing loss. Impacted earwax (16.0% of cases) and otitis media with effusion (13.1%) were the most common identifiable causes of unilateral hearing loss; genetic causes were responsible for less than 2% of cases. Just over one-half of the hearing-impaired patients had only a mild hearing loss. Impairment rates varied in different regions of the country.     

Hearing among 75-year-old people in three Nordic localities: A comparative study

The aim of this study was to compare auditory functions and to analyse the prevalence of hearing impairment and the relationship of self-reported hearing disability with audiometric test results among 75-year-old people in three Nordic localities. The representative samples came from Glostrup, Denmark (n=571), Göteborg, Sweden (n=450), and Jyväskylä, Finland (n=388). The median pure-tone thresholds were rather similar in all three populations. The prevalence of moderate hearing impairment varied between 26% and 34% in men, and between 17% and 23% in women. The corresponding figures in the prevalence of self-reported hearing difficulties were 41%–57%, and 28%–37%. The self-reported difficulties were broadly in accordance with the audiometric test results, but there also were individuals with conflicting results. It is concluded that the prevalence of hearing impairment in the three Nordic localities is fairly similar. To assess hearing disorders in elderly people, both audiometry and self-report data are needed.     

Dizziness in community-dewelling older adults: a population-based study

Dizziness is a common complaint among older adults.AimTo identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults.MethodsA prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function.ResultsThe prevalence of dizziness was 45%. Vertigo was found in 70.4% of older adults with dizziness and 43.8% of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004), memory difficulties complaints (p=0.015), bad health perception (p=0.001), depression (p<0.0001), five or more comorbidities (p=0.021), self-reported fatigue (p<0.0001), recurrent falls (p=0.001), excessive sleepiness (p=0.003), fear of falling (p<0.0001), left leg unipedal stance (p=0.002) and Short Performance Physical Battery score (p=0.009).ConclusionDizziness is a common complaint among older adults and it is associated with limiting clinical conditions, such as depression, fatigue, excessive sleepiness and impaired memory. It is highlighted the association between dizziness and recurrent falls, fear of falling and lower performance in physical function tests, which can restrict independence. These data suggest the importance of a multifactorial approach to dizziness in older adults.     

Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study

Objectives: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan. Design: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed. Study sample: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older. Results: The prevalence of HI?>25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%). Conclusions: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.     

The prevalence and causes of hearing impairment in Oman: a community-based cross-sectional study

A community-based nationwide survey for hearing loss was conducted in Oman in 1996-97. Audiometric tests and ear examinations were conducted for 12,400 persons in phase I. For children aged less than 4 years, subjective screening tests were used. In phase II, otologists examined the hearing-impaired subjects to determine the cause. The prevalence of bilateral hearing impairment was 55/1000 (95% CI 51.08-59.47). Gender difference was not significant. The rates were 325/1000 and 17/1000, respectively, in the > or = 60-year and < 10-year age groups. Presbyacusis and middle ear diseases, respectively, were the causes of 33% and 20% of bilateral hearing impairment. In 30% of the bilateral hearing-impaired subjects, the cause could not be determined. The prevalence of bilateral disabling hearing loss was 21/1000 (95% CI 18.07-23.29). Noise-induced trauma was responsible for only 1.4% of cases of disabling hearing loss. Establishing primary ear care, introducing hearing screening for neonates and schoolchildren, promoting safe preventive practices for ear care, strengthening secondary-level ear care services and introducing comprehensive rehabilitative initiatives for the hearing-disabled are recommended to reduce the hearing loss rates.     

The prevalence and causes of hearing impairment in Oman: a community-based cross-sectional study

A community-based nationwide survey for hearing loss was conducted in Oman in 1996–97. Audiometric tests and ear examinations were conducted for 12 400 persons in phase I. For children aged less than 4 years, subjective screening tests were used. In phase II, otologists examined the hearing-impaired subjects to determine the cause. The prevalence of bilateral hearing impairment was 55/1000 (95% CI 51.08–59.47). Gender difference was not significant. The rates were 325/1000 and 17/1000, respectively, in the _60-year and _10-year age groups. Presbyacusis and middle ear diseases, respectively, were the causes of 33% and 20% of bilateral hearing impairment. In 30% of the bilateral hearing-impaired subjects, the cause could not be determined. The prevalence of bilateral disabling hearing loss was 21/1000 (95% CI 18.07–23.29). Noise-induced trauma was responsible for only 1.4% of cases of disabling hearing loss. Establishing primary ear care, introducing hearing screening for neonates and schoolchildren, promoting safe preventive practices for ear care, strengthening secondary-level ear care services and introducing comprehensive rehabilitative initiatives for the hearing-disabled are recommended to reduce the hearing loss rates.     

Audiological rehabilitation of older people: visual and vibrotactile considerations

This paper discusses the peripheral and central visual and tactile pathways with respect to the diminishing integrity of the ageing nervous system. This discussion is based upon extant data derived from investigators in vision and vibrotactile sensation. The purpose in examining these investigations is to ascertain the problems associated with the use of vision and vibrotactile stimulation in the auditory rehabilitation of older people. Speed of processing and simultaneous use of pathways are factors to be considered carefully in order not to contribute to perceptual confusions. The writers hypothesize that the rehabilitative audiologist, when using the visual and tactile pathways of older patients for language processing is confronted with difficulties that are often encountered when using the auditory pathway in the presence of central auditory ageing effects. In view of the implications of the research findings in vision and vibrotactile sensation, suggestions are made to those professionals who work with older hearing-impaired people.     

Changes in hearing in 80-year-old people: a 10-year follow-up study

The aims of this prospective 10-year longitudinal population study were to report changes in hearing in people aged 80 years at baseline, and to assess such changes by comparing results from both cross-sectional and longitudinal analyses. The study population comprised all residents of the city of Jyv?skyl? born in 1910 (n = 291). The subjects' hearing was tested on three occasions at 5-year intervals with the use of pure-tone audiometry, speech audiometry, and self-report on hearing difficulties. The results showed a significant deterioration in hearing sensitivity in both the longitudinal and cross-sectional assessments over the 10-year follow-up. However, the change in self-assessed hearing difficulties was not significant. Hearing aids were not used by over 75%, of those who had moderate hearing impairment. Self-assessed hearing difficulties at baseline were associated with increased mortality. Hearing deterioration in elderly people and their low level of use of hearing aids deserve closer attention in the healthcare system.     

Changes in hearing in 80-year-old people: a 10-year follow-up study

The aims of this prospective 10-year longitudinal populationstudy were to report changes in hearing in peopleaged 80 years at baseline, and to assess such changes bycomparing results from both cross-sectional and longitudinalanalyses. The study population comprised all residentsof the city of Jyväskylä born in 1910 (n=291). The subjects' hearing was tested on three occasions at 5-yearintervals with the use of pure-tone audiometry, speechaudiometry, and self-report on hearing difficulties. Theresults showed a significant deterioration in hearing sensitivityin both the longitudinal and cross-sectionalassessments over the 10-year follow-up. However, thechange in self-assessed hearing difficulties was not signifi-cant. Hearing aids were not used by over 75% of thosewho had moderate hearing impairment. Self-assessedhearing difficulties at baseline were associated withincreased mortality. Hearing deterioration in elderly peopleand their low level of use of hearing aids deservecloser attention in the healthcare system.     

Presbycusis: a human temporal bone study of individuals with flat audiometric patterns of hearing loss using a new method to quantify stria vascularis volume

OBJECTIVE: The purpose of this study was to determine the prevalence of stria vascularis atrophy in individuals with presbycusis and flat audiometric patterns of hearing loss. Individuals with presbycusis have historically been categorized by the shape of their audiograms, and flat audiometric thresholds have been reported to be associated with atrophy of the stria vascularis. Stria vascularis volume was not measured in these studies. STUDY DESIGN: Retrospective case review. METHODS: Archival human temporal bones from individuals with presbycusis were selected on the basis of strict audiometric criteria for flat audiometric thresholds. Six temporal bones that met these criteria were identified and compared with 10 temporal bones in individuals with normal hearing. A unique quantitative method was developed to measure the stria vascularis volume in these temporal bones. The hair cell and spiral ganglion cell populations also were quantitatively evaluated. RESULTS: Only one of the six individuals with presbycusis and flat audiometric thresholds had significant atrophy of the stria vascularis. This individual with stria vascularis atrophy also had reduced inner hair cell, outer hair cell, and ganglion cell populations. Three of the individuals with presbycusis had spiral ganglion cell loss, three individuals had inner hair cell loss, and all six individuals had outer hair cell loss. CONCLUSIONS: The results of this investigation suggest that individuals with presbycusis and flat audiometric patterns of hearing loss infrequently have stria vascularis atrophy. Outer hair cell loss alone or in combination with inner hair cell or ganglion cell loss may be the cause of flat audiometric thresholds in individuals with presbycusis.     

Factors related to tinnitus and hyperacusis handicap in older people

Objective: The aim was to assess factors related to tinnitus and hyperacusis handicap in older people. Design: Retrospective cross-sectional. Study sample: Data were gathered for 184 patients with an average age of 69 years. Results: Tinnitus handicap as measured via the Tinnitus Handicap Inventory (THI) was significantly predicted by tinnitus annoyance as measured via the visual analogue scale (VAS) (regression coefficient, b?=?2.9, p?b?=?3.9, p?b?=?0.8, p?b?=?0.07, p?=?0.048). Insomnia scores as measured via the Insomnia Severity Index (ISI) were significantly predicted by scores on the depression subscale of the HADS (b?=?0.46, p?=?0.007). Conclusions: Since tinnitus annoyance significantly predicts tinnitus handicap, it is important to explore factors associated with annoyance that may be useful in designing appropriate rehabilitative interventions aimed at reducing tinnitus handicap in older people. Future studies should explore whether hyperacusis and insomnia in older people with tinnitus need to be managed in conjunction with treatment for depression.     

Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study

Tinnitus (ringing or buzzing in the ear or head) can range from barely noticeable to debilitating. Although a few studies have estimated the prevalence of this condition in adult populations, we know of no population-based estimates of incidence. As part of a population-based study of hearing loss in adults aged 48 to 92 years at baseline in Beaver Dam, Wisconsin, self-reported data on tinnitus were obtained at the baseline examination (1993-1995; N = 3753) and again 5 years later (1998-2000; N = 2800). A person was classified as having tinnitus if their tinnitus was at least moderate in severity or caused difficulty in falling asleep. The prevalence of tinnitus at baseline was 8.2 percent. The 5-year incidence of tinnitus among the 2513 participants at risk was 5.7 percent. Risk factors for prevalent and incident tinnitus were evaluated. The results suggest that tinnitus is a common problem for older adults and is associated with some modifiable risk factors.