Is gout associated with a higher risk of hearing loss in adults?

A new cohort study examines whether gout is associated with a higher risk of hearing loss in older adults. 

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Abstract

Objectives To evaluate whether gout is associated with a higher risk of hearing loss in older adults.
Design Retrospective cohort study.
Setting USA.
Participants 5% random sample of US Medicare claims 2006–2012, representative of US adults aged 65 years or older.
Primary and secondary outcomes Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 389.xx, with no respective claim in the baseline 1-year observation period.
Results Among the 1.71 million eligible people, 89 409 developed incident hearing impairment. The crude incidence rates of incident hearing impairment in people with versus without gout were 16.9 vs. 8.7 per 1000 person-years. Using Cox regression analyses adjusted for demographics, medical comorbidity and common cardiovascular and gout medications, we found that gout was associated with a significantly higher HR of incident hearing impairment, HR was 1.44. Findings were confirmed in sensitivity analyses that substituted continuous Charlson-Romano Index with categorical variable or all comorbidities and additionally cardiovascular risk factors, with minimal attenuation of HR.
Conclusions Gout is associated with a higher risk of development of hearing loss in older adults. Future studies need to assess the underlying mechanisms of this association.

The full article is available to read at BMJ Open  

Full reference: Singh, J.A.Cleveland, J.D. | 2018| Gout and hearing impairment in the elderly: a retrospective cohort study using the US Medicare claims data| 

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The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss

A new article published in the journal Ear and Hearing considers how a hearing aid contributes to the ability to perceive a gap in noise for children and adults with hearing loss.

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ObjectivesThe objective of this experiment was to examine the contributions of audibility to the ability to perceive a gap in noise for children and adults. Sensorineural hearing loss (SNHL) in adulthood is associated with a deficit in gap detection. It is well known that reduced audibility in adult listeners with SNHL contributes to this deficit; however, it is unclear the extent to which hearing aid amplification can restore gap-detection thresholds, and the effect of childhood SNHL on gap-detection thresholds have not been described. For adults, it was hypothesized that restoring the dynamic range of hearing for listeners with SNHL would lead to approximately normal gap-detection thresholds. Children with normal hearing (NH) exhibit poorer gap-detection thresholds than adults. Because of their hearing losschildren with SNHL have less auditory experience than their peers with NH. Yet, it is unknown the extent to which auditory experience impacts their ability to perceive gaps in noise. Even with the provision of amplification, it was hypothesized that children with SNHL would show a deficit in gap detection, relative to their peers with normal hearing, because of reduced auditory experience.

DesignThe ability to detect a silent interval in noise was tested by adapting the stimulus level required for detection of gap durations between 3 and 20 ms for adults and children with and without SNHL. Stimulus-level thresholds were measured for participants with SNHL without amplification and with two prescriptive procedures—the adult and child versions of the desired sensation level i/o program—using a hearing aid simulator. The child version better restored the normal dynamic range than the adult version. Adults and children with NH were tested without amplification.

ResultsWhen fitted using the procedure that best restored the dynamic range, adults with SNHL had stimulus-level thresholds similar to those of adults with normal hearing. Compared to the children with NH, the children with SNHL required a higher stimulus level to detect a 5-ms gap, despite having used the procedure that better restored the normal dynamic range of hearing. Otherwise, the two groups of children had similar stimulus-level thresholds.

ConclusionThese findings suggest that apparent deficits in temporal resolution, as measured using stimulus-level thresholds for the detection of gaps, are dependent on age and audibility. These novel results indicate that childhood SNHL may impair temporal resolution as measured by stimulus-level thresholds for the detection of a gap in noise. This work has implications for understanding the effects of amplification on the ability to perceive temporal cues in speech.

Full reference: Brennan, M. A., McCreery, R. W., Buss, E., & Jesteadt, W. |2018| The Influence of Hearing Aid Gain on Gap-Detection Thresholds for Children and Adults With Hearing Loss|Ear and hearing| Vol. 39|(5)| P. 969-979.

This article can be requested by Rotherham NHS staff here 

Supporting older people with hearing loss in care settings

This guide has been produced to help staff working in longer-term care settings provide high-quality care and support to older people with hearing loss. It is written for care home managers | Action on Hearing Loss

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Image source: actiononhearingloss.org.uk

The guide covers the following:

  • The need to support older people with hearing loss
  • Identifying and checking for hearing loss
  • Improving hearing aid use and management
  • Meeting residents’ communication needs
  • Providing assistive listening devices
  • Managing tinnitus
  • Managing ear wax
  • Appointing Hearing Loss Champions
  • Meeting the requirements of the CQC Inspection Framework

Full document: Guidance for supporting older people with hearing loss in care settings: A guide for managers and staff

Updates on Unilateral Hearing Loss

The Hearing Journal has published an update on unilateral hearing loss. It is based on the Unilateral Hearing Loss in Children Conference 2017, which featured current research presented by many of the foremost experts on Unilateral Hearing Loss (UHL). 

close-up-18753_1280Highlights include :

  • Can we Predict Outcomes of Children with UHL?
  • UHL in the Real World
  • Supporting the Whole Child

It can be read here 

Smith, J. & Wolfe, J. |The Hearing JournalFebruary 2018 | Vol. 71 |2 |  p. 18 -20|

doi: 10.1097/01.HJ.0000530648.17182.22

It can be downloaded here 

Owls May Shed Light on Age-Related Hearing Loss Prevention

Researchers have found that barn owls have what they call “ageless ears,” which could potentially help with identifying new treatment options for hearing-impaired humans.

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In a study published in Proceedings of Biological  Science, researchers measured the auditory sensitivity of seven barn owls ranging from less than 2 years old to 23 years old by training them to fly to a perch to receive a food reward in response to an auditory cue. Young and old owls both responded to the varying levels of auditory cues, and the oldest owl at 23 years old heard just as well as the younger owls.

​According to Georg Klump, one of the study authors “birds can repair their ears like humans can repair a wound”.  “Humans cannot re-grow the sensory cells of the ears but birds can do this.” Work is underway to investigate the differences between birds and mammals, which commonly lose their hearing at old age. ​

Full reference: Krumm, B. et al. Barn owls have ageless ears Proc Biol Sci. 2017 Sep 27;284

Hearing aids for mild to moderate hearing loss in adults

Ferguson MA, et al. | Hearing aids for mild to moderate hearing loss in adults Cochrane Database of Systematic Reviews 2017, Issue 9. | Published online 25th September 2017

This study reviewed the evidence on the effects that hearing aids have on everyday life in adults with mild to moderate hearing loss. Authors were interested in (1) a person’s ability to take part in everyday situations, (2) general health-related quality of life, (3) ability to listen to other people, and (4) harm, such as pain or over-exposure to noise.

Background

The main goal of hearing aids is to reduce the impact of hearing loss and to improve a person’s ability to take part in everyday life. Although hearing aids are the most common technology for adults with hearing loss and are in widespread use, it is not clear how beneficial they are.

Study characteristics

The evidence is up to date to 23 March 2017. Authors found five clinical studies involving 825 adults with mild to moderate hearing loss who were randomly given either hearing aids, no hearing aids or placebo hearing aids. Studies involved older adults with the average age within studies between 69 and 83 years. The duration of the studies was between six weeks and six months.

Key results

Evidence was found in three studies that hearing aids have a large beneficial effect in improving the ability of adults with mild to moderate hearing loss to take part in everyday situations. Hearing aids have a small beneficial effect in improving general health-related quality of life, such as physical, social, emotional and mental well-being, and have a large effect in improving the ability to listen to other people.

Only one study attempted to measure harms due to hearing aids. None were reported.

Conclusions

This review found that hearing aids improve the ability of adults with mild to moderate hearing loss to take part in everyday life, their general quality of life and their ability to listen to other people. If an adult with mild to moderate hearing loss seeks help for their hearing difficulties, hearing aids are an effective clinical option. It is important that future studies measure benefits consistently and report benefits separately for different age groups, genders, levels of hearing loss and types of hearing aids.

Hearing aids for mild to moderate hearing loss in adults:

 

The shaping of sustainable careers post hearing loss

Toward greater understanding of adult onset disability, disability identity, and career transitions | Human Relations

Through this interview-based study with 40 respondents in the United States we have outlined enablers of career transitions and sustainable careers for professionals who have experienced severe hearing loss as adults.

To sustain careers after adult onset disability, respondents engaged in a quest for meaning and big picture answers to ‘who am I?’ and ‘am I still successful?’ This included redefining themselves – e.g. I am now both a person with a disability (disability identity) and a successful professional (professional identity) – and career success (e.g. now I care about service to society as much as I care about material artifacts).

Respondents also adopted new work roles where disability was a key to success (e.g. becoming an equal employment officer) and utilized social networks to continue being successful. Such redefining of work and networks supported the aforesaid quest for meaning and big picture answers.

Findings not only indicate how individuals experience career success after a life-changing event but also help defamiliarize extant notions of ableism in workplace contexts.

Full reference: Baldridge, D.C. & Kulkarni, M. (2017) The shaping of sustainable careers post hearing loss: Toward greater understanding of adult onset disability, disability identity, and career transitions. Human Relations. Vol. 70 (Issue 10) pp. 1217 – 1236