Gender Modifies the Association of Cognition With Age-Related Hearing Impairment in the Health and Retirement Study

Introduction: Despite growing recognition of hearing loss as a risk factor for late life cognitive disorders, sex and gender analysis of this association has been limited. Elucidating this is one means to advocate for holistic medicine by considering the psychosocial attributes of people. With a composite Gender Score (GS), we aimed to assess this among aging participants (50+) from the 2016 Health and Retirement Study (HRS) cohort.Methods: The GS was derived from gender-related variables in HRS by factor analyses and logistic regression, ranging from 0 (toward masculinity) to 100 (toward femininity). GS tertiles were also used to indicate three gender types (GS tertile 1: lower GS indicates masculinity; GS tertile 2: middle GS indicates androgyny; GS tertile 3: higher GS indicates femininity). Univariate followed by multiple logistic regressions were used to estimate the Odds Ratio (OR) and 95% confidence intervals (CI) of cognitive impairment (assessed by adapted Telephone Interview for Cognitive Status) from hearing acuity, as well as to explore the interactions of sex and gender with hearing acuity. The risk of cognitive impairment among hearing-impaired participants was assessed using multivariable models including sex and gender as exposure variables.Results: Five variables (taking risks, loneliness, housework, drinking, and depression) were retained to compute the GS for each participant. The distribution of GS between sexes partly overlapped. After adjusting for confounding factors, the OR for cognitive impairment associated with hearing impairment was significantly higher (OR = 1.65, 95% CI: 1.26, 2.15), and this association was not modified by female sex (OR = 0.77, 95% CI: 0.46, 1.27), but by androgynous gender (OR = 0.44, 95% CI: 0.24, 0.81). In the multivariable models for participants with hearing impairment, androgynous and feminine gender, as opposed to female sex, was associated with lower odds of cognitive impairment (OR of GS tertile 2 = 0.59, 95% CI: 0.41, 0.84; OR of GS tertile 3 = 0.60, 95% CI: 0.41, 0.87; OR of female sex = 0.78, 95% CI: 0.57, 1.08).Conclusions: Hearing impairment was associated with cognitive impairment among older people, and this association may be attenuated by a more feminine GS.

Measurement of Centre of Pressure Using the Wii Balance Board in Older Adults with Simulated Visual Impairment

Postural stability is a complex skill dependent upon the coordination of motor, sensory and cognitive systems. The purpose of this project was therefore to explore how older adults’ balance performance is impacted by increased cognitive load, hearing loss, and simulated vision loss. Twenty-eight older adults between the ages of 50 and 93 years (M = 73.86, SD = 10.43) were tested. Participants underwent standard sensory acuity and cognitive functioning tests. The balance trials varied as a function of cognitive load and visual challenge resulting in five conditions: (1) eyes closed, (2) normal vision clear goggles (NV) (3) simulated low vision (20/80) goggles (LV) (4) LV and math task, (5) NV and math task. Postural stability was assessed with three key center of pressure parameters: total path length (TPL), anterior-posterior amplitude (APA) and medial-lateral amplitude (MLA). A mixed-model ANOVA using hearing acuity as a covariate revealed significant effects of complexity in sway amplitude: (APA: p < .017; MLA: p < .020), while TPL approached significance (p < .074). T-tests revealed significant (p < .05) decreases in balance performance across all 3 centre of pressure parameters when comparing single task NV to dual-task NV, NV vs. eyes closed and single task NV vs. LV dual-task. There were significant positive correlations between hearing acuity and balance (MLA) under single task NV (r = .491) and LV conditions (r = .497). Results suggest the attentional demands from increased cognitive load and sensory loss lead to decreases in older adults’ single- and dual-task balance performance.

Assessing a Sensory-Motor-Cognition Triad in Amnestic Mild Cognitive Impairment With Dichotic Listening While Walking: A Dual-Task Paradigm

A contemporary topic in aging research relates to the significance of cognitive changes proper to mild cognitive impairment (MCI) to higher risk of falls and gait deteriorations. The present study addresses this question in the amnestic type of MCI (aMCI) by examining a triad of interrelated comorbidities occurring in the MCI condition: attentional impairments, hearing loss and gait disturbances. To this end, we applied a dichotic listening (DL) test during over-ground walking. DL assesses spontaneous and lateralized auditory attention in three conditions (i.e., free report or Non-forced (NF), Forced-Right (FR) ear and Forced-Left (FL) ear). Earlier reports suggest that this dual-task paradigm evoke asymmetric gait effects on healthy controls, which are moderated by degree of hearing loss. Therefore, the aim of the present study was to evaluate the effects of DL on bilateral (data from both limbs) and lateralized (each limb separately) gait outcomes in a group of forty-three aMCI participants (mean = 71.19) and fifty-two healthy older controls (mean = 70.90) by using hearing loss as a covariate in all analyses. Results showed the aMCI group presented overall compromised gait parameters, especially higher gait variability in all DL conditions during lateralized attentional control. These findings were observed bilaterally, and no lateralized effects on gait were observed. Only after controlling for hearing acuity, gait asymmetries on step length variability emerged almost exclusively in healthy controls. It was concluded that hearing loss in the aMCI group together with higher attentional impairments preclude aMCI individuals to properly execute DL and therefore, they do not display gait asymmetries. The present data demonstrate that varied demands on attentional control dependent on hearing acuity affects gait negatively in healthy older adults and aMCI individuals in very different ways. The appearance of asymmetric effects seems to be a perturbation related to normal aging, while the lack of asymmetries but exaggerated gait variability characterizes aMCI. The present findings show the intricate interplay of sensory, cognitive, and motor deteriorations in different group of older adults, which stresses the need of addressing co-occurring comorbidities behind gait perturbations in individuals prone to develop a dementia state.

A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities

BackgroundReconciling results obtained using different types of sensory measures is a challenge for autism sensory research. The present study used questionnaire, psychophysical, and neurophysiological measures to characterize autistic sensory processing in different measurement modalities.MethodsParticipants were 46 autistic and 21 typically-developing adolescents. Participants and their caregivers completed questionnaires regarding sensory experiences and behaviours. Auditory and somatosensory ERPs were recorded as part of a multisensory ERP task. Auditory, tactile static detection, and tactile spatial resolution psychophysical thresholds were measured.ResultsSensory questionnaires strongly differentiated between autistic and typically-developing individuals, while little evidence of group differences was observed in psychophysical thresholds. Crucially, the different types of measures (neurophysiological, psychophysical, questionnaire) appeared to be largely independent of one another. However, we unexpectedly found autistic participants with larger auditory Tb ERP amplitudes had reduced hearing acuity, even though all participants had hearing acuity in the non-clinical range.LimitationsThe autistic and typically-developing groups were not well-matched, although this limitation does not affect our main analyses regarding convergence of measures within ASD. The autistic sample in the present study is not representative of the whole autistic constellation, limiting generalizability. Auditory ERPs and auditory thresholds were measured with non-equivalent stimuli.ConclusionsOverall, based on these results, measures in different sensory modalities appear to capture distinct aspects of sensory processing in autism, with relatively limited convergence between questionnaires and laboratory-based tasks. Generally, this might reflect the reality that laboratory tasks are often carried out in controlled environments without background stimuli to compete for attention, a context which may not closely resemble the busier and more complex environments in which autistic people’s atypical sensory experiences commonly occur. For this reason, sensory questionnaires may be more practically useful assessments of autistic people’s real-world sensory challenges. Further research is needed to replicate and investigate the drivers of the unexpected association we observed between auditory Tb ERP amplitudes and hearing acuity, which could represent an important confound for ERP researchers to consider in their studies.

Synergistic associations of visual and self-reported hearing acuity with low handgrip strength in older adults: a population-based cross-sectional study

Background It is unclear whether visual and hearing acuity are independently or synergistically associated with muscle strength. We aimed to examine the associations of visual and self-reported hearing acuity with low handgrip strength and the additive interaction between visual and hearing acuity on low handgrip strength in people over 60 years. Method Data of 3,075 individuals aged over 60 years from the 2017 and 2018 Korea National Health and Nutrition Examination Survey were used for this cross-sectional study. Low handgrip strength was defined based on the 20th percentile of the study population (< 30.4 kg for male and < 17.7 kg for female). Visual and self-reported hearing acuity were each divided into three categories: good, moderate, and impaired. Multiple logistic regression and relative excess risk due to interaction (RERI) were performed. Results Of the 3,075 participants, 993 (32.3 %) demonstrated low handgrip strength. Low handgrip strength was more prevalent in participants with moderate (adjusted odds ratio [AOR] = 1.54, 95 % confidence interval [CI] = 1.12–2.12) and impaired visual acuity (AOR = 2.00, 95 % CI = 1.34–2.96). Both moderate and impaired self-reported hearing acuity were significantly associated with low handgrip strength (moderate: AOR = 1.25, 95 % CI = 1.01–1.55; impaired: AOR = 1.66, 95 % CI = 1.15–2.38). The more severe the sensory function decline, the higher the association with muscle weakness. Moreover, combined sensory impairments were associated with deteriorating low handgrip strength (AOR = 8.38), with significantly strong additive interactions (RERI = 2.61, 95 % CI = 2.52–2.70). Conclusions Awareness is needed regarding the risk of reduced muscle strength in individuals with moderate and impaired sensory function. Older people with sensory function decline in clinical settings may benefit from programs such as exercise prescription to prevent muscle weakness.

Association of Hearing Acuity and Cognitive Function Among a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional Study

Hearing loss is a modifiable risk factor for dementia and cognitive decline. However, the association between cognition and hearing acuity at different frequencies is unknown. We aimed to assess the relationships between hearing acuity at different frequencies with global cognitive function and five domains of cognition among a low-income elderly population in northern rural China. A population-based cross-sectional study was conducted to collect basic information from elderly residents aged 60 years and older in rural areas of Tianjin, China from April 2012 to November 2013. Pure tone averages (PTAs) at different frequencies in the ear with better hearing and Mini-Mental State Examination (MMSE) scores were measured, and the relationships between these variables were assessed. A total of 737 residents aged 60 years or more were enrolled in this study, and the prevalence of hearing impairment was 60.7%. After adjusting for sex, age, education, income, smoking, drinking, systolic blood pressure (SBP), total cholesterol (TC), and low-density lipoprotein cholesterol level (LDL-C), MMSE score and immediate recall score were negatively associated with overall PTA (OPTA) at four frequencies (0.5, 1, 2, and 4 kHz), PTA at low frequencies (LPTA; 0.5, 1, and 2 kHz), and PTA at high frequencies (HPTA; 3, 4, and 8 kHz) in the ear with better hearing. Moreover, orientation score was negatively associated with OPTA and LPTA, and the attention and calculation scores were negatively associated with OPTA and HPTA. Each 10-dB increase in OPTA was associated with a MMSE score decrease of 0.464. Each 10-dB increase in LPTA or HPTA was associated with a MMSE score decrease of 0.441 (95% CI: −0.795, −0.086) and 0.351 (95% CI: −0.592, −0.110), respectively. The present study demonstrated significant but weak relationships between OPTA, LPTA, and HPTA with global cognitive function, as defined using MMSE scores; these relationships were independent of age, education, lifestyle factors, and laboratory test values. These results indicated that hearing was associated with cognitive decline among older individuals, who should be screened routinely to identify risk for cognitive decline.

Otorhinolaryngological contusions in mine-explosive injury

Modern trends in the conduct of military conflicts dictate their own characteristics of the formation of the size and structure of sanitary losses of the otorhinolaryngological profile. Combat trauma to the organ of hearing is characterized not only by an increase in the total number of sanitary losses, but also by various features of the course of the wound process. The organ of hearing, with the development of weapons, becomes an increasingly unprotected and vulnerable area of impact of mine explosive weapons. However, such important characteristics as treatment, duration, and outcomes of ear, throat, and nose contusions are not sufficiently presented for adequate organization of medical support. Otorhinolaryngological contusions were considered in the total mass of contusion sanitary losses with a predominance of closed brain injury and often without taking into account otorhinolaryngological contusions. Victims completed treatment in separate medical battalions, hospitals and wards for the lightly wounded. The number of injured by shrapnel and concussion increases with the use of explosive weapons, due to an increase in associated wounds. The experience of the Great Patriotic War showed that otorhinolaryngological shell-shocked patients in frequency account for about 32.5% of all shell-shocked, therefore, in 67.5% of the remaining shell-shocked otorhinolaryngological contusions were concomitant, the main manifestation of the trauma was a closed brain injury. Otorhinolaryngological shell-shocked patients are a special case of general contusion or concussion-contusion syndrome from the direct impact of a sharp drop in air pressure during explosions. The leading manifestation of otorhinolaryngological contusion syndrome is vestibular and auditory disorders, decreased hearing acuity with a whole eardrum, which occurred in all victims. There were also neurological abnormalities such as short-term loss of consciousness, dizziness, fading nystagmus, stuttering, etc., which subsided a few days after the start of conservative therapy.

Clinical Study of Memory Disorders in Aging Patients and Associated Pathology

We have observed semantic memory and episodic memory disorders in patients ranging from 40 to 92 years-old (100%), with associated cardiovascular diseases and blood hypertension (82%), sleep disorders (50%), neurobehavioral disorders (44%), such as depression, anxiety, aggression, and vascular demencia, disorders of language (36%), neurosensory disorders (28%), as diminution of visual and hearing acuity, dizziness (26%), Parkinson disease (34%), Alzheimer disease (21%), gait disturbances (10%), vertigo (10%), cervicalgia and cervicogenic headache (10%) trigeminal neuralgia (2%), We found as comorbidities the following non-nervous diseases: metabolic diseases as diabetes (21%) and hypothyroidism (5%), gastrointestinal pathology (21%), such as constipation, loss of sphincter control, and gastritis, arthritis (13%), prostatic hypertrophy (1%) and loss of weight (1%). A detailed discussion of every pathological condition is provided.

Objective Measurement of Listening Device Use and Its Relation to Hearing Acuity

Objectives To examine whether adolescents exceed recommended noise exposure limits when using personal listening devices (PLDs) and to investigate the relationship between objectively measured PLD use and hearing thresholds Study Design Cross-sectional study. Setting This study was embedded within an ongoing prospective birth cohort study in Rotterdam, the Netherlands. Data were collected from May 2017 to September 2019. Methods A smartphone application was developed to measure daily noise exposure from PLDs. Listening habits were monitored among 314 adolescents with a mean age of 13 years 7 months (SD, 5 months), of whom 51.6% were male. Hearing acuity was measured by pure tone audiometry, and tympanometry was performed in both ears. Results Within the study group, 2.2% adolescents exceeded the recommended daily noise dose (85 dBA as an 8-hour time-weighted average) among all days when the application was active and 9.9% when among only the listening days. No significant correlation was found between the daily noise dose from PLDs and pure tone thresholds. Conclusions The majority of adolescents exhibited listening habits that could be considered safe. As noise-induced hearing loss develops slowly over time, it could be that the effects of PLD use on hearing are not evident yet in this young population with a relatively short duration of PLD use.

“Clinical Study of Memory Disorders in Aging Patients with Associated Cardiovascular, Neurological, Neurobehavioral and Metabolic Diseases”. A Review

We have observed semantic memory and episodic memory disorders (100%) in patients ranging from 40 to 92 years-old, associated to cardiovascular diseases and blood hypertension (82%), sleep disorders (50%), neurobehavioral disorders (44%), such as depression, anxiety, aggression, and vascular demencia, disorders of language (36%), neurosensory disorders (28%), as diminution of visual and hearing acuity, dizziness (26%), Parkinson disease (34%), Alzheimer disease (21%), gait disturbances (10%), vertigo (10%), cervicalgia and cervicogenic headache (10%) trigeminal neuralgia (2%,), We observed as comorbidities the following non-nervous diseases: metabolic diseases as diabetes (21%) and hypothyroidism (5%), gastrointestinal pathology (21%), such as constipation, loss of sphincter control, and gastritis, arthritis (13%), prostatic hypertrophy (1%) and loss of weight (1%). We consider that according to their high frequency the most risk factors associated to memory disorders are cardiovascular diseases and blood hypertension (82%), sleep disorders (50%), neurobehavioral disorders (44%), such as depression, anxiety, aggression, and vascular demencia, disorders of language (36%), neurosensory disorders (28%), as diminution of visual and hearing acuity, dizziness (26%), and Parkinson disease (34%).