Objectives
To evaluate the associations between sensory impairments and 10‐year risk of cognitive impairment.
Design
The Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population‐based ...study of aging in the Beaver Dam, Wisconsin community. Baseline examinations were conducted in 1993 and follow‐up examinations have been conducted every 5 years.
Setting
General community.
Participants
EHLS members without cognitive impairment at EHLS‐2 (1998–2000). There were 1,884 participants (mean age 66.7) with complete EHLS‐2 sensory data and follow‐up information.
Measurements
Cognitive impairment was defined as a Mini‐Mental State Examination score of <24 or history of dementia or Alzheimer's disease. Hearing impairment was a pure‐tone average of hearing thresholds (0.5, 1, 2, 4 kHz) of >25 dB hearing level in either ear, visual impairment was a Pelli‐Robson contrast sensitivity of <1.55 log units in the better eye, and olfactory impairment was a San Diego Odor Identification Test score of <6.
Results
Hearing, visual, and olfactory impairment were independently associated with cognitive impairment risk (hearing: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.11–3.26; vision: HR = 2.05, 95% CI = 1.24–3.38; olfaction: HR = 3.92, 95% CI = 2.45–6.26)). Nevertheless, 85% of participants with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow‐up.
Conclusion
The relationship between sensory impairment and cognitive impairment was not unique to one sensory system, suggesting that sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging.
Sensory Impairments and Risk of Mortality in Older Adults Schubert, Carla R; Fischer, Mary E; Pinto, A Alex ...
The journals of gerontology. Series A, Biological sciences and medical sciences,
05/2017, Letnik:
72, Številka:
5
Journal Article
Recenzirano
Odprti dostop
Sensory impairments increase with age and the majority of older people will experience a sensory impairment if they live long enough. However, the relationships of hearing, visual, and olfactory ...impairments with mortality are not well understood.
Epidemiology of Hearing Loss Study participants (n = 2,418) aged 53-97 years (mean = 69 years) were examined in 1998-2000 and hearing, visual acuity, and olfaction were measured. Participants were followed for mortality for up to 17 years (mean = 12.8 years). Cox proportional hazards models were used to assess the association between prevalent sensory impairments and the 15-year cumulative incidence of death.
A total of 1,099 (45.4%) of participants died during the follow-up period. In age- and sex-adjusted Cox models, the risk of mortality was higher among participants with one (hazard ratio HR = 1.40, 95% confidence interval CI = 1.19, 1.64) or two or more (HR = 2.12, 95% CI = 1.74, 2.58) sensory impairments than among participants with no sensory impairments. Olfactory impairment at baseline was significantly associated with mortality (HR = 1.28, 95% CI = 1.07, 1.52) after adjusting for age, sex, sensory comorbidities, cardiovascular risk factors and disease, cognitive impairment, frailty, subclinical atherosclerosis, and inflammatory marker levels (n = 1,745). Hearing and visual impairment were not associated with mortality after adjusting for subclinical atherosclerosis and inflammation.
Olfactory impairment, but not hearing or visual impairment, was associated with an increased risk of mortality. These results suggest that olfactory impairment may be a marker of underlying physiologic processes or pathology that is associated with aging and reduced survival in older adults.
Objectives
To determine associations between smoking, adiposity, diabetes mellitus, and other risk factors for cardiovascular disease (CVD) and the 15‐year incidence of hearing impairment (HI).
...Design
A longitudinal population‐based cohort study (1993–95 to 2009–10), the Epidemiology of Hearing Loss Study (EHLS).
Setting
Beaver Dam, Wisconsin.
Participants
Participants in the Beaver Dam Eye Study (1988–90; residents of Beaver Dam, WI, aged 43–84 in 1987–88) were eligible for the EHLS. There were 1,925 participants with normal hearing at baseline.
Measurements
Fifteen‐year cumulative incidence of HI (pure‐tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz greater than 25 decibels hearing level in either ear). Cigarette smoking, exercise, and other factors were ascertained according to questionnaire. Blood pressure, waist circumference, body mass index, and glycosylated hemoglobin were measured.
Results
Follow‐up examinations (≥1) were obtained from 87.2% (n = 1,678; mean baseline age 61). The 15‐year cumulative incidence of HI was 56.8%. Adjusting for age and sex, current smoking (hazard ratio (HR) = 1.31, P = .048), education (<16 years; HR = 1.35, P = .01), waist circumference (HR = 1.08 per 10 cm, P = .02), and poorly controlled diabetes mellitus (HR = 2.03, P = .048) were associated with greater risk of HI. Former smokers and people with better‐controlled diabetes mellitus were not at greater risk.
Conclusion
Smoking, central adiposity, and poorly controlled diabetes mellitus predicted incident HI. These well‐known risk factors for CVD suggest that vascular changes may contribute to HI in aging. Interventions targeting reductions in smoking and adiposity and better glycemic control in people with diabetes mellitus may help prevent or delay the onset of HI.
Abstract
Background
Sensorineural impairments and cardiovascular risk factors (CVRF) and disease (CVD) in midlife may be important predictors of future cognitive health, but longitudinal studies that ...include multiple sensorineural measures in middle-aged adults are lacking.
Methods
Hearing, vision, and olfaction, and CVRF and CVD were measured at the Beaver Dam Offspring Study baseline (2005–2008) examination. The Mini-Mental State Examination and Trail Making Tests A and B were administered at all phases and additional cognitive function measures were obtained at 5 (2010–2013) and 10 years (2015–2017). Cox proportional hazards models were used to evaluate associations between baseline sensorineural impairments, CVRF, CVD, and 10-year cumulative incidence of cognitive impairment and decline.
Results
There were 2,556 participants (22–84 years) without cognitive impairment at baseline and data from at least one follow-up. In a multivariable model including age, sex, education, and head injury, visual impairment (hazard ratio = 2.59, 95% confidence interval = 1.34, 5.02), olfactory impairment (hazard ratio = 3.18, 95% confidence interval = 1.53, 6.59), CVD (hazard ratio = 2.37, 95% confidence interval = 1.24, 4.52), and not consuming alcohol in the past year (hazard ratio = 2.21, 95% confidence interval = 1.16, 4.19) were associated with the 10-year cumulative incidence of cognitive impairment. Current smoking and diabetes were associated with increased risk, and exercise with decreased risk, of 10-year decline in cognitive function.
Conclusions
Visual and olfactory impairments, CVRF, and CVD were associated with the 10-year cumulative incidence of cognitive impairment and decline in middle-aged adults. Identifying modifiable factors associated with cognitive decline and impairment in midlife may provide opportunities for prevention or treatment and improve cognitive health later in life.
Hearing impairment is common in adults, but few studies have addressed it in the US Hispanic/Latino population.
To determine the prevalence of hearing impairment among US Hispanic/Latino adults of ...diverse backgrounds and determine associations with potential risk factors.
The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a population-based sample of Hispanics/Latinos in four US communities (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). Examinations were conducted from 2008 through 2011. The HCHS/SOL examined 16,415 self-identified Hispanic/Latino persons aged 18 to 74 years recruited from randomly selected households using a stratified 2-stage area probability sample design based on census block groups and households within block groups.
Hearing thresholds were measured by pure-tone audiometry. Hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2, and 4 kHz greater than 25 dB hearing level. Bilateral hearing impairment required a PTA greater than 25 dB hearing level in both ears. Multivariable analyses included adjustments for sociodemographic and lifestyle variables, body mass index, and medical conditions.
The prevalence of hearing impairment was 15.06% (SE, 0.44%) overall, and 8.24% (SE, 0.33%) had bilateral hearing impairment. The prevalence of hearing impairment was higher among people 45 years and older, ranging by Hispanic/Latino background from 29.35% to 41.20% among men and 17.89% to 32.11% among women. The multivariable-adjusted odds of hearing impairment was greater for participants of Puerto Rican background compared with Mexican background (odds ratio OR, 1.57 95% CI, 1.10-2.25). The odds of hearing impairment were lower with more education (OR, 0.71 95% CI, 0.59-0.86 for at least high school) and higher income (OR, 0.58 95% CI, 0.36-0.92 for >$75,000 vs ≤$10,000). Noise exposure (OR, 1.35 95% CI, 1.07-1.70), diabetes (OR, 1.57 95% CI, 1.27-1.94), and prediabetes (OR, 1.37 95% CI, 1.12-1.67) were associated with hearing impairment.
Hearing impairment is a common problem for older Hispanics/Latinos in these communities and is associated with socioeconomic factors, noise exposure, and abnormal glucose metabolism. Longitudinal studies are needed to determine whether these factors are involved in the etiology of hearing impairment and to identify ways to prevent or delay age-related changes in hearing.
Clinicians encounter patients who report experiencing hearing difficulty (HD) even when audiometric thresholds fall within normal limits. When there is no evidence of audiometric hearing loss, it ...generates debate over possible biomedical and psychosocial etiologies. It is possible that self-reported HDs relate to variables within and/or outside the scope of audiology. The purpose of this study is to identify how often, on a population basis, people with normal audiometric thresholds self-report HD and to identify factors associated with such HDs.
This was a cross-sectional investigation of participants in the Beaver Dam Offspring Study. HD was defined as a self-reported HD on a four-item scale despite having pure-tone audiometric thresholds within normal limits (<20 dB HL0.5, 1, 2, 3, 4, 6, 8 kHz bilaterally, at each frequency). Distortion product otoacoustic emissions and word-recognition performance in quiet and with competing messages were also analyzed. In addition to hearing assessments, relevant factors such as sociodemographic and lifestyle factors, environmental exposures, medical history, health-related quality of life, and symptoms of neurological disorders were also examined as possible risk factors. The Center for Epidemiological Studies-Depression was used to probe symptoms associated with depression, and the Medical Outcomes Study Short-Form 36 mental score was used to quantify psychological stress and social and role disability due to emotional problems. The Visual Function Questionnaire-25 and contrast sensitivity test were used to query vision difficulties.
Of the 2783 participants, 686 participants had normal audiometric thresholds. An additional grouping variable was created based on the available scores of HD (four self-report questions), which reduced the total dataset to n = 682 (age range, 21-67 years). The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0% (82 of 682). The prevalence in the entire cohort was therefore 2.9% (82 of 2783). Performance on audiological tests (distortion product otoacoustic emissions and word-recognition tests) did not differ between the group self-reporting HD and the group reporting no HD. A multivariable model controlling for age and sex identified the following risk factors for HD: lower incomes (odds ratio OR $50,000+ = 0.55, 95% confidence interval CI = 0.30-1.00), noise exposure through loud hobbies (OR = 1.48, 95% CI = 1.15-1.90), or firearms (OR = 2.07, 95% CI = 1.04-4.16). People reporting HD were more likely to have seen a doctor for hearing loss (OR = 12.93, 95% CI = 3.86-43.33) and report symptoms associated with depression (Center for Epidemiological Studies-Depression OR = 2.39, 95% CI = 1.03-5.54), vision difficulties (Visual Function Questionnaire-25 OR = 0.93, 95% CI = 0.89-0.97), and neuropathy (e.g., numbness, tingling, and loss of sensation OR = 1.98, 95% CI = 1.14-3.44).
The authors used a population approach to identify the prevalence and risk factors associated with self-reported HD among people who perform within normal limits on common clinical tests of auditory function. The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0%, resulting in an overall prevalence of 2.9%. Auditory and nonauditory risk factors were identified, therefore suggesting that future directions aimed at assessing, preventing, and managing these types of HDs might benefit from information outside the traditional scope of audiology.
Abstract
Background
Age-related hearing loss (impairment in hearing sensitivity and/or higher-order auditory processing) and cognitive decline are common co-occurring impairments in elderly adults. ...Their relation in the process of aging remains insufficiently understood. We aim to assess the temporal relations of decline in hearing sensitivity, higher-order auditory processing, and cognition in middle-aged adults.
Methods
This study included 1,274 Beaver Dam Offspring Study participants who participated in three examinations (baseline, 5-year, and 10-year follow-up). We assessed hearing sensitivity through pure-tone audiometry (PTA, averaged thresholds of 0.5, 1, 2, 4 kHz of the better ear), higher-order auditory processing as word recognition in competing message (WRCM) using the Northwestern University 6 word list in the better ear, and cognition through trail-making test performance (TMT). Linear mixed-effects models and linear regression models were used to determine associations over time and to what extent these measures influence each other over time.
Results
The longitudinal decline between all functions was associated with the strongest relationships between PTA and WRCM. The effect of baseline PTA on WRCM 10 years later (standardized ß = –.30) was almost twice as big as the effect of baseline WRCM on PTA 10 years later (standardized ß = –.18). The effect of baseline WRCM on TMT 10 years later and vice versa were small (standardized ß = –.05). No directional relationship between PTA and TMT was identified (standardized ß ≤ .02).
Conclusions
While hearing sensitivity might affect higher-order auditory processing, associations between hearing and cognition appear bidirectional and weak in midlife. We need to be cautious before inferring causal effects of hearing on cognition.
Abstract
Objective: To assess the prevalence of tinnitus along with factors potentially associated with having tinnitus. Design: Data were from the Beaver Dam Offspring Study, an epidemiological ...cohort study of aging. Study Sample: After a personal interview and audiometric examination, participants (n = 3267, ages 21-84 years) were classified as having tinnitus if in the past year they reported having tinnitus of at least moderate severity or that caused difficulty in falling asleep. Results: The prevalence of tinnitus was 10.6%. In a multivariable logistic regression model adjusting for age and sex, the following factors were associated with having tinnitus: hearing impairment (Odds Ratio (OR) = 3.20), currently having a loud job (OR = 1.90), history of head injury (OR = 1.84), depressive symptoms (OR = 1.82), history of ear infection (men, OR = 1.75), history of target shooting (OR = 1.56), arthritis (OR = 1.46), and use of NSAID medications (OR = 1.33). For women, ever drinking alcohol in the past year was associated with a decreased risk of having tinnitus (OR = 0.56). Conclusions: These results suggest that tinnitus is a common symptom in this cohort and may be associated with some modifiable risk factors.
Sumario
Objetivo: Evaluar la prevalencia del acúfeno junto con los factores potencialmente asociados para tenerlo. Diseño: Los datos fueron obtenidos del Estudio "Beaver Dam Offspring", una cohorte epidemiológica para el estudio del envejecimiento. Muestra: Después de una entrevista personal y un examen audiométrico, los participantes (n = 3267, edades 21-84 años) fueron clasificados como portadores de acúfeno si en el pasado año habían reportado tener acúfeno al menos de severidad moderada o si éste les ocasionaba dificultad conciliar el sueño. Resultados: La prevalencia del acúfeno fue de 10.6%. En modelo de regresión logística multivariada ajustada para edad y sexo, los siguientes factores fueron asociados al acúfeno: hipoacusia (tasa de probabilidad (OR) = 3.20), tener un empleo ruidoso (OR = 1.90), historia de traumatismo cefálico (OR = 1.84), síntomas depresivos (OR = 1.82), historia de infección ótica (hombres, OR = 1.75), historia de tiro con arma de fuego (OR = 1.56), artritis (OR = 1.46), y uso de AINES (OR = 1.33). Para las mujeres, el no haber bebido alcohol en el pasado año fue asociado con un decremento en el riesgo de tener acúfeno (OR = 0.56). Conclusiones: Estos resultados sugieren que el acúfeno es un síntoma común en esta cohorte y que puede estar asociado con algunos de los factores de riesgo modificables.
We determined factors associated with hearing aid acquisition in older adults.
We conducted a population-based, prospective study that used information from 3 examinations performed on study ...participants as part of the Epidemiology of Hearing Loss Study (1993-2005). We included participants (n = 718; mean age = 70.5 years) who exhibited hearing loss at baseline or the first follow-up and had no prior history of hearing aid use. We defined hearing loss as a pure tone threshold average (PTA) at 0.5, 1, 2, and 4 kilohertz in the better ear of greater than 25 decibels Hearing Level.
The 10-year cumulative incidence of hearing aid acquisition was 35.7%. Associated factors included education (college graduate vs all others: hazard ratio HR = 2.5; 95% confidence interval CI = 1.5, 4.1), self-perception of hearing (poor vs good or better: HR = 2.5; 95% CI = 1.3, 5.0), score on a perceived hearing handicap inventory (+1 difference: HR = 1.1; 95% CI = 1.0, 1.1), and PTA (+ 5 dB difference: HR = 1.4; 95% CI = 1.2, 1.6).
The low rate of hearing aid ownership among older adults is a problem that still needs to be addressed.
The purpose of this study was to determine the 10-yr cumulative incidence of hearing impairment and associations of education, occupation and noise exposure history with the incidence of hearing ...impairment in a population-based cohort study of 3753 adults ages 48–92
yr at the baseline examinations during 1993–1995 in Beaver Dam, WI. Hearing thresholds were measured at baseline, 2.5
yr-, 5
yr-, and 10-yr follow-up examinations. Hearing impairment was defined as a pure-tone average (PTA)
>
25
dB HL at 500, 1000, 2000, and 4000
Hz. Demographic characteristics and occupational histories were obtained by questionnaire. The 10-yr cumulative incidence of hearing impairment was 37.2%. Age (5
yr; Hazard Ratio (HR)
=
1.81), sex (M vs W; HR
=
2.29), occupation based on longest held job (production/operations/farming vs others; HR
=
1.34), marital status (unmarried vs married; HR
=
1.29) and education (<16 vs 16
+
yr; HR
=
1.40) were associated with the 10
yr incidence. History of noisy jobs was not associated with the 10-yr incidence of hearing impairment. The risk of hearing impairment was high, with women experiencing a slightly later onset. Markers of socioeconomic status were associated with hearing impairment, suggesting that hearing impairment in older adults may be associated with modifiable lifestyle and environmental factors, and therefore, at least partially preventable.
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