Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections

Patients with age-related hearing loss face hearing difficulties in daily life.The causes of age-related hearing loss are complex and include changes in peripheral hearing,central processing,and cognitive-related abilities.Furthermore,the factors by which aging relates to hearing loss via changes in audito ry processing ability are still unclear.In this cross-sectional study,we evaluated 27 older adults(over 60 years old) with age-related hearing loss,21 older adults(over 60years old) with normal hearing,and 30 younger subjects(18-30 years old) with normal hearing.We used the outcome of the uppe r-threshold test,including the time-compressed thres h old and the speech recognition threshold in noisy conditions,as a behavioral indicator of auditory processing ability.We also used electroencephalogra p hy to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state.The timecompressed threshold and speech recognition threshold data indicated significant diffe rences among the groups.In patients with age-related hearing loss,information masking(babble noise) had a greater effect than energy masking(speech-shaped noise) on processing difficulties.In terms of resting-state electroencephalography signals,we observed enhanced fro ntal lobe(Brodmann’s area,BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing,and greater activation in the parietal(BA7) and occipital(BA19) lobes in the individuals with age-related hearing loss compared with the younger adults.Our functional connection analysis suggested that compared with younger people,the older adults with normal hearing exhibited enhanced connections among networks,including the default mode network,sensorimotor network,cingulo-opercular network,occipital network,and frontoparietal network.These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced audito ry processing capabilities and that hearing loss accele rates the decline in speech comprehension,especially in speech competition situations.Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the to p-down active listening mechanism,while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

Evaluation of Digits-in-Noise Test and Hearing Handicap Inventory for Adults Screening in Patients with Occupational Noise-Induced Hearing Loss

Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.

The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population:challenges to the study of this issue

The objectives of this review were to 1)summarize the available evidence on the impact of hearing loss on quality of life(QOL)among U.S.active-duty service members,2)describe the QOL instruments that have been used to quantify the impact of hearing loss on quality of life,3)examine national population-level secondary databases and report on their utility for studying the impact of hearing loss on QOL among active-duty service members,and 4)provide recommendations for future studies that seek to quantify the impact of hearing loss in this population.There is a lack of literature that addresses the intersection of hearing impairment,the military population,and quality of life measures.For audiological research,U.S.military personnel offer a unique research population,as they are exposed to noise levels and blast environments that are highly unusual in civilian work settings and can serve as a model population for studying the impact on QOL associated with these conditions.This review recommends conducting a study on the active-duty service member population using a measurement instrument suitable for determining decreases in QOL specifically due to hearing loss.

Anti-apoptotic treatment in mouse models of age-related hearing loss

Age-related hearing loss (AHL), or presbycusis, is the most common neurodegenerative disorder and top communication deficit of the aged population. Genetic predisposition is one of the major factors in the development of AHL. Generally, AHL is associated with an age-dependent loss of sensory hair cells, spiral ganglion neurons and stria vascularis cells in the inner ear. Although the mechanisms leading to genetic hearing loss are not completely understood, caspase-family proteases function as important signals in the inner ear pathology. It is now accepted that mouse models are the best tools to study the mechanism of genetic hearing loss or AHL. Here, we provide a brief review of recent studies on hearing improvement in mouse models of AHL by anti-apoptotic treatment.

Expression ofα2-Na/K-ATPase in C57BL/6J Mice Inner Ear and Its Relationship with Age-related Hearing Loss

K^(+)cycling in the cochlea is critical to maintain hearing.Many sodium-potassium pumps are proved to participate in K^(+)cycling,such as Na/K-ATPase.Theα2-Na/K-ATPase is an important isoform of Na/K-ATPase.The expression ofα2-Na/K-ATPase in the cochlea is not clear.In this study,we used C57BL/6 mice as a model of presbycusis and implemented immunohistochemistry staining and quantitative real time-PCR,and theα2-Na/K-ATPase expression pattern was confirmed in the inner ear.It was foundα2-Na/K-ATPase was expressed widely in cochlea and its mRNA and protein expression was gradually reduced with aging(4-,14-,26-and 48-weeks old mice).We suspected that,the down-regulation ofα2-Na/K-ATPase expression might be associated with the remodeling of K^(+)cycling,degeneration of morphological structure and decrease of hearing function in aging C57 mice.In conclusion,we speculated that the reduction ofα2-Na/K-ATPase might play an important role in the pathogenesis of age-related hearing loss.

An update on hearing impairment in patients with rheumatoid arthritis

Rheumatoid arthritis(RA) is a systemic, autoimmune disease that present with intra-articular and extra-articular manifestations. Auditory system may be involved during the course of RA disease due to numbers of pathologies. The link between hearing impairment and RA has been discussed in the previous literature. In this study we provide an update on the clinical aspect of hearing impairment in RA. We suggest to test hearing in all newly diagnosed RA patients at diagnosis as well as regularly during the course of disease.

Myosin-7A Mutation Screening in Patients with Prelingual Non-Syndromic Hearing Impairment

Objective To screen for mutations in myosin-7A gene(MYO7A) in patients with prelingual nonsyndromic hearing impairment. Methods 31 sporadic patients with congenital hearing impairment and 65 patients from 34 families with prelingual hereditary hearing impairment in China were tested in this study, and 100 hearing normal individuals were used as control. Genomic DNA isolated from whole blood of all subjects was subjected to polymerase chain reaction(PCR) to amplify selected exons of MYO7A gene. The PCR products were subsequently screened using single strand conformational polymorphism analysis(SSCP) and direct sequencing when the fragments showed an abnormal electrophoretic pattern. Results GgA transition at position 617 in exon 7, which would produce an A206G amino acid substitution, was detected in two patients but in none of the unaffected members in the families. This heterozygous missense mutation happened within a highly conserved heptapeptide sequence of MYO7A protein, and is closely relevant to preligual nonsyndromic deafness. Conclusions The A206G substitution is possibly a new mutation to cause preligual nonsyndromic hearing impairment. Our results provide evidence that exon 7 of MYO7A is a mutational hotspot in genetic hearing impairment.

Peri-Operative Hearing Impairment

Peri-operative hearing impairment is a poorly reported morbidity following any type of anaesthesia. We report a case where the patient developed temporary hearing impairment after a gynaecological surgery. This recovered in a couple of week time. The causes of such hearing impairment in various types of anaesthesia are discussed.

Disability and Quality of Life among Elderly Persons with Self-Reported Hearing Impairment: Report from the Ibadan Study of Aging

Background: Despite a high prevalence of hearing impairment (HI) among the elderly, the effect on their quality of life (QOL) has not been well studied in this environment. Aim: To determine the prevalence of disability and profile of QOL among elderly persons (aged ≥65 years) with HI. Design of Study: Cross-sectional. Setting: Eight contiguousYoruba-speaking states in Nigeria. Methods: Face-to-face interviews of respondents selected using a multi-stage, stratified area probability sampling of households;HI was based on self report and observer confirmation and the QOL was measured with the World Health Organization brief version (WHOQOL-Bref). Results: The prevalence of disability in Activities of Daily Living (ADL) was 35.4% while it was 10.1% in Instrumental ADL. Prevalence increased significantly with increasing age (P = 0.05). Disability in ADL (P = 0.01), poor family interaction (P = 0.01), poor community involvement (P = 0.01) cognitive impairment (P = 0.05) and poor report of overall health (P = 0.05) were significantly more common among the elderly with HI than those without. No significant differences were found in regard to current depression or the likelihood of experiencing verbal, physical or emotional abuses. Logistic regression analyses adjusting for age, sex, chronic medical conditions and disability confirmed the salient effect of HI on the decrement in the physical domains (P = 0.05). Conclusion: HI is associated with high prevalence of disability and has adverse effect on the quality of life. This observation strengthens the need for hearing rehabilitation in the policy formulation on the care of the elderly in resource-poor settings.

AB035.The link between cognitive impairment and drusen quantity in age-related macular degeneration

Background:Age-related macular degeneration(AMD)is a common cause of severe vision impairment in populations over 50 years old.It is characterized by drusen;the accumulation of waste between the retinal pigment epithelium and Bruch’s membrane.Drusen have been identified in the eyes of Alzheimer’s patients,post-mortem.Further,beta-amyloid,best known as a pathological component of the senile plaques in Alzheimer’s disease,has been identified as a component of drusen in AMD.Researchers have also demonstrated an increased prevalence of cognitive impairment in individuals with AMD.The current study uses optical coherence tomography(OCT)and a cognitive assessment to investigate the potential use of drusen as a biomarker of cognitive impairment.The overall number of drusen detectable on the OCT scans of individuals who exhibit mild cognitive impairment is compared to the number of drusen detectable on the OCT scans of individuals who do not exhibit mild cognitive impairment.Methods:To date,10 participants(nine women)aged 74 to 95 years with a diagnosis of AMD and/or drusen have been recruited.The Optos®OCT/SLO imaging system was used to take cross-sectional images of the retina.The images were then manually graded by two trained graders to determine the number of drusen present along the retina.The Montreal Cognitive Assessment(MoCA)was used to assess overall cognitive status.Results:Of the 10 participants,three passed the full MoCA(i.e.scored at or above 26 out of 30 possible points)and seven did not pass,scoring positive for mild cognitive impairment(Mpass=27.33,SDpass=0.58;Mfail=21.86,SDfail=2.55).Preliminary analyses have demonstrated that individuals who pass the MoCA seem to have fewer drusen present overall(Mdn=35)compared to those who score positive for cognitive impairment(Mdn=63).However,a Mann-Whitney U test revealed that these findings are not significant;U=5,P=0.27.Conclusions:The results agree with previous literature demonstrating an increased prevalence of mild cognitive impairment in individuals with AMD.The larger average number of drusen found in individuals who score positive for cognitive impairment points to a difference in retinal abnormalities based on cognitive status.Beyond sample size,the insignificance of the difference between groups at this stage can be explained by the number of individuals who failed the MoCA who have wet AMD(n=5).The wet AMD makes grading of drusen on OCT scans more difficult due to scarring and warping of the retina.This could result in an under-representation of the number of drusen.Data collection is still underway,and an accurate depiction is expected with a larger sample size.Researchers have also suggested the importance of peripherally located drusen and its link to cognitive impairment,therefore,future analysis will consider this as well.

AB099.Cognitive impairment and age-related macular degeneration:a possible genetic link

Background:The number of older adults affected by age-related macular degeneration(AMD)and early cognitive changes is on the rise.Recent studies have shown a high co-occurrence of these conditions.This,along with shared risk factors and similar histopathology suggests they may share genetic risk factors as well.The goal of this study was to explore the possibility of known AMD SNPs contributing to the co-morbidity.Methods:Participants(AMD and controls)aged 70 years or older with no known neurological or cognitive impairments were recruited for this study.Visual function was evaluated using ETDRS visual acuity,Mars Contrast sensitivity and the scanning laser ophthalmoscope.Cognitive status was measured using the Mini-Mental State Exam(MMSE)and the Montreal Cognitive Assessment(MoCA).Genotyping was conducted using a panel of AMD single nucleotide polymorphisms(SNPs).Analysis was focused on the CFH Y402H and ARMS2 A69S SNPs due their association with drusen and evidence of their association with cognitive impairment.Results:According to the MMSE,two participants from the AMD group(N=21)and none from the control group(N=18)scored positive for cognitive impairment.The MoCA indicated 33.3%of the AMD group and 27.7%of the control group had MCI.There were no significant differences between MoCA scores based on the carrier versus non-carrier status of either the CFH or ARMS SNPs.The SNP in FADS1(rs174547)that was part of the original panel,but not in the analysis,was found in a large number of participants.All those who scored positive for MCI were homozygous carriers of the FADS1 SNP.Conclusions:Although more people from the AMD group scored positive for MCI,scores between groups were significantly different.The AMD and control groups did differ on which cognitive domains they had difficulty with,indicating those with AMD and MCI may be at a higher risk of converting to AD.There were no significant differences on cognitive scores between CFH and ARMS2 SNP carriers and non-carriers.The FADS1 SNP,not originally intended to be part of this study,will be included in future analyses to explore the possibility of a founder effect and a potential link to mild cognitive impairment(MCI).

Does Hearing Impairment Have an Impact on the Children’s Education in Casamance, South of Senegal?

Goal: To determine the impact of deafness on the schooling of children in Casamance and the factors that characterize these repercussions. Patients and Methods: This was a retrospective, cross-sectional and multicenter study carried out in the ENT departments of the peace and regional hospitals of Ziguinchor over a period of 7 years from January 1, 2012 to December 31, 2019. It included hearing impaired children aged 1 to 18. Results: 178 hearing impaired children were collected during the study period. One hundred and forty-seven children were in school (82, 58%), the majority (85.03%) attending formal schools. Fifty-seven children had a speech disorder (32.02%). The average age of screening for deafness was 9 years. Deafness was mild in 53 patients. Thirteen patients had severe deafness. Two patients presented with cophosis. Conclusion: Our study shows that deafness does indeed have an impact on a child’s education in Casamance, but this impact is hardly taken into account.

Subclinical hearing loss associated with aging

Objective:Contribute to clarifying the existence of subclinical hearing deficits associated with aging.Design:In this work,we study and compare the auditory perceptual and electrophysiological performance of normal-hearing young and adult subjects(tonal audiometry,high-frequency tone threshold,a triplet of digits in noise,and click-evoked auditory brainstem response).Study sample:45 normal hearing volunteers were evaluated and divided into two groups according to age.27 subjects were included in the“young group”(mean 22.1 years),and 18 subjects(mean 42.22 years)were included in the“adult group.”Results:In the perceptual tests,the adult group presented significantly worse tonal thresholds in the high frequencies(12 and 16 kHz)and worse performance in the digit triplet tests in noise.In the electrophysiological test using the auditory brainstem response technique,the adult group presented significantly lower I and V wave amplitudes and higher V wave latencies at the supra-threshold level.At the threshold level,we observed a significantly higher latency in wave V in the adult group.In addition,in the partial correlation analysis,controlling for the hearing level,we observed a relationship(negative)between age and speech in noise performance and high-frequency thresholds.No significant association was observed between age and the auditory brainstem response.Conclusion:The results are compatible with subclinical hearing loss associated with aging.

The Effectiveness of Life Skills Training on Enhancing the Self-Esteem of Hearing Impaired Students in Inclusive Schools

This research investigates the effectiveness of life skills training on enhancing the self-esteem of 8-16 years-old students with hearing impairment in inclusive schools. The sample was included of 54 students with hearing impairment from inclusive school whom their age and IQ were matched. They were randomly divided into an experimental and a control group (27 students in each group). The participants were assessed by Coopersmith Self-esteem Inventory (58-items version). The gathered data were analysed using the t-test method through the SPSS package. The results showed that training life skills to students with hearing impairment promote their self-esteem. In other words, life skills training is effective for enhancing the self-esteem of hearing impaired students in inclusive schools.

Effects of Environmental Noise on School Performance among Hearing-Impaired Students

Background and Purpose: Our study examined the effect of ambient noise on hearing and school performance in children with hearing loss, and the relationship between hearing loss and cognition. Method: A pilot study involving 728 people (aged 11 to 16 years) was conducted in Kinshasa, Democratic Republic of the Congo. All participants completed the ENAFEP test, the SIFTER short scale, pure tone audiometry, and a three-digit test. Teachers and investigators completed a 6-day listening training course. Results: Correlation and structural equation modeling indicated that ambient noise and five cognitive domains were associated with hearing in noise, but only unmeasured cognition was associated with hearing loss and poor academic performance. Cognitive compensation significantly reduces communication problems and improves concentration and academic performance. Noise and deafness had significant and moderate effects on academic performance (r = -0.13). Conclusion: The sample size and relatively high participation rate meant the study was representative. However, the results showed an association between ambient noise, hearing loss and cognition, and reduced school performance. Large-scale randomized interventions for hearing loss and long-term noise exposure studies are needed to measure cognitive outcomes after short- and multi-year noise exposure.

Educational Assistance Through Modeling in Tsukuba University of Technology-Professional Education for the Hearing or Visually Impaired

The National University Corporation Tsukuba University of Technology（NTUT） is the only institute of higher education for the hearing and the visually impaired in Japan. In our university, hearing or visually impaired students are studying to be technicians after they graduate, toward social independence. From previous experience of higher education for students with disabilities, effects are increased when modeling is used by the teachers involved in professional education. In the Mechanical Engineering Course, we are using modeling, to match the drawing and shape for beginning students. It includes support for enhancing one＇s view, and how to draw out the ability of mechanical engineering students for the basics. For students to study Mechanical Design and Drawing, Modeling of Gear Pump, Jack and Globe Valve are easily shown through drawings and the operation of each mechanism through sample drawings in the textbook. It is possible to make an opportunity to think about the machine mechanism. It will be shown by students＇ works. The assembling of the model triggers the need for form accuracy by making a function, and improves the quality of learning. It is possible that a three-dimensional molding machine can be produced through experiential learning by the model, and modeling with the dimension numerical data. Moreover, it is also embodied in a three-dimensional modeling which results in the image processing programming created. Confirming the improvement of the program through the shape with the quality. In the Department of Synthetic Design, students have chances to realize and self-evaluate from the design of the lamp shade with a complicated shape. In the Faculty of Health Science from Department of Health, high quality teaching of visually-impaired students through the use of bone model teaching materials has become possible in the medical-related courses.

中文简版Spatial Hearing Questionnaire的信效度分析

目的空间听觉指在复杂声环境下,患者能够理解言语和识别不同方位声音的能力,可以采用Spatial Hearing Questionnaire评估。本研究在正常听力受试者及耳聋受试者中进行中文简版Spatial Hearing Questionnaire信效度分析。方法首先对Spatial Hearing Questionnaire进行汉化形成C-SHQ12。纳入50例正常听力受试者及57例耳聋受试者进行研究,采用内部一致性检验评价量表的信度,采用探索性因子分析评价量表的结构效度。采用t检验分析正常听力受试者与耳聋受试者C-SHQ12得分的差别,采用pearson相关分析SHQ量表得分与实验室声源定位测试的相关性。采用配对t检验对人工耳蜗植入术前和术后的C-SHQ12得分进行比较。结果 Cronbach’sα系数为0.98,说明量表具有良好的内部一致性信度。采用探索性因子分析提取了2个公因子,分别是声源定位和噪声环境下言语能力,累计贡献率为94.8%。正常听力受试者C-SHQ12得分为87.74±7.99,耳聋受试者得分为52.80±21.76,P=2.2×10-16<0.01,两者差异有显著统计学意义。C-SHQ12量表得分与实验室声源定位得分有很好的相关性,P=2.858×10-6<0.01。人工耳蜗植入术前和术后的C-SHQ12得分有显著差异。结论 C-SHQ12量表信效度很高,可用于耳聋人群的空间听觉能力评估。

Auditory characteristics of noise-exposed memberscrossing age-related groups

Objective： To report audiological characteristics in a group of noise-exposed crew members on board ships. Methods and materials： Clinical and audiological measurements including pure-tone thresholds, acoustic immittance results and tinnitus questionnaires were collected from both the ship crew members （study subjects） and their land based colleagues （controls）. Results： 1） Noise exposed crew members showed not only high frequency, but also low frequency hearing loss; 2） Hearing impairment increased with age, with 65.5% of crew members younger than 50 years showing normal hearing while only 14.9% of those older than 50 years had normal hearing; 3） hearing loss gradually increased with the extension of on board career time; and 4） Most study subjects reported high pitch tinnitus, significantly more than the control group although not significantly different among different age groups. Conclusion： Noise induced hearing impairment from working on board ships shows specific frequency and age characteristics. Understanding these characteristics is important for advancing relevant studies and for effective prevention of noise-induced hearing loss in ship crew members.

Current trends in outcome studies for children with hearing loss and the need to establish a comprehensive framework of measuring outcomes in children with hearing loss in China

Since the 1970s, outcome studies for children with hearing loss expanded from focusing on assessing auditory awareness and speech perception skills to evaluating language and speech development. Since the early 2000s, the multi-center large scale research systematically studied outcomes in the areas of auditory awareness, speech-perception, language development, speech development, educational achievements, cognitive development, and psychosocial development. These studies advocated the establishment of baseline and regular follow-up evaluations with a comprehensive framework centered on language development. Recent research interests also include understanding the vast differences in outcomes for children with hearing loss, understanding the relationships between neurocognitive development and language acquisition in children with hearing loss, and using outcome studies to guide evidence-based clinical practice. After the establishment of standardized Mandarin language assessments, outcomes research in China's Mainland has the potential to expand beyond auditory awareness and speech perception studies.

Evaluation of hearing in middle-aged patients with diabetes mellitus type 2

Introduction: Involvement of auditory pathway is one of the examples of central neuropathy in diabetics. The purpose of this study is to compare the auditory function of patients with type 2 diabetes mellitus with healthy subjects. Methodology: 30 diabetic and 30 healthy subjects participated in this study. For all participants conventional pure-tone audiometry (PTA) and Auditory Brainstem Evoked Responses (ABER) study were performed. Results: In PTA Hearing threshold only at 2, 4, 8 KHz frequencies were significantly higher than healthy subjects but were in normal range in patients with diabetes. ABER revealed that absolute latencies of waves I, III, V and inter wave latencies of III-V, I-V, I-III were significantly prolonged in diabetics. Conclusion: In this study, 50% of diabetic patients had hearing defects in ABER test despite normal hearing threshold and good meta-bolic control. Prolonged inter wave latencies of I-III, III-V, I-V explains retrocochlear and brain stem involvement.