Untreated Hearing Loss: Higher Health Care Costs, More ER Visits and Readmissions

MedicalResearch.com Interview with:

Nicholas S. Reed, AuD Assistant Professor | Department of Otolaryngology-Head/Neck Surgery Core Faculty  | Cochlear Center for Hearing and Public Health Johns Hopkins University School of Medicine Johns Hopkins University Bloomberg School of Public Health

Nicholas Reed AuD

Nicholas S. Reed, AuD
Assistant Professor | Department of Otolaryngology-Head/Neck Surgery
Core Faculty  | Cochlear Center for Hearing and Public Health
Johns Hopkins University School of Medicine
Johns Hopkins University Bloomberg School of Public Health

MedicalResearch.com: What is the background for this study?

 

Response: This study was a true team effort. It was funded by AARP and AARP Services, INC and the research was a collaboration of representatives from Johns Hopkins University, OptumLabs, University of California – San Francisco, and AARP Services, INC. Given all of the resent research on downstream effects of hearing loss on important health outcomes such as cognitive decline, falls, and dementia, the aim was to explore how persons with hearing loss interacted with the healthcare system in terms of cost and utilization.

MedicalResearch.com: What are the main findings? 

Response: Over a 10 year period, untreated hearing loss (hearing aid users were excluded from this study as they are difficult to capture in the claims database) was associated with higher healthcare spending and utilization. Specifically, over 10 years, persons with untreated hearing loss spent 46.5% more, on average, on healthcare (to the tune of approximately $22000 more) than those without evidence of hearing loss. Furthermore, persons with untreated hearing loss had 44% and 17% higher risk for 30-day readmission and emergency department visit, respectively.

Similar relationships were seen across other measures where persons with untreated hearing loss were more likely to be hospitalized and spent longer in the hospital compared to those without evidence of hearing loss.  Continue reading

Hyperbaric Oxygen Therapy Can Salvage Hearing In Some Sensorineural Loss Cases

MedicalResearch.com Interview with:
Tae-Min Rhee, M.D.
Chief of Undersea and Diving Medicine,
Underwater Medical Institute,
National Maritime Medical Center,
Republic of Korea Navy, Changwon
Republic of Korea

MedicalResearch.com: What is the background for this study?

Response: The sudden sensorineural hearing loss (SSNHL) has an incidence of 5 to 20 per 100,000 person-years in the general population and sometimes results in permanent deafness followed by considerable socio-economic costs. The causes of SSNHL are often unclear, and in these cases there are no treatment of choice that is proven to be effective. In addition, spontaneous recovery is not uncommon in SSNHL, making it difficult to predict the natural course of the disease, and thus a well-controlled clinical trial is rare in spite of its clinical significance.

Many treatment options (systemic or intratympanic steroids, antiviral agents, vasodilators, and hyperbaric oxygen therapy) have been suggested and tried to date, but only systemic steroid therapy has been the most effective among them. However, for the cases with contraindications to steroids, or steroid-refractory SSNHL, there is paucity of information on the second line treatment option.

Hyperbaric oxygen therapy (HBOT), i.e., high-pressurized oxygen therapy, is a method of treating patients within a chamber saturated with 100% oxygen maintained at a high pressure of 2.0 to 2.5 atm. Cochlea is an organ that relies more on the diffusion of oxygen than the direct vascular supply, and thus it is known to be vulnerable to ischemia. Since this is suggested as one of the main pathophysiology of SSNHL, we wanted to prove the hypothesis that, by providing high-pressure oxygen, the partial pressure of oxygen delivered to the inner ear is maximized, and the additional or complementary therapeutic effects can be observed. A number of reports have been published for 20 years, but there is no systematically organized evidence except a Cochrane Review in 2012. Therefore, our research team tried to integrate the evidence through a comprehensive meta-analysis and to provide important clues for further research.  Continue reading

Deaf Children With Cochlear Implants Learn New Words Faster

MedicalResearch.com Interview with:

BruceBlaus - Own work An illustration of a cochlear implant.

An illustration of a cochlear implant: Wikipedia image

Niki Katerina Vavatzanidis MSc
Department of Neuropsychology
Max Planck Institute for Human and Cognitive Brain Science
Leipzig, Germany
Technische Universität Dresden, Germany 

 

 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Cochlear implants (CIs) are a way of providing hearing to sensorineural deaf individuals. The implant works by first picking up sounds from the environment and transforming them into an electric signal. Via an array of electrodes the implant then transmits the signal directly to the auditory nerve, which then leads to auditory sensations in the brain.

In our study, we were interested to see how language acquisition is affected when language immersion occurs at an untypically late age. Children with cochlear implants that grow up in exclusively or predominantly hearing environments will have their first language encounter at the time of implantation, which nowadays is roughly between the age of one and three. Besides the later starting point in language acquisition, children with CIs are facing a compromised input quality compared to typical hearing.

We know from typically hearing children that it is around the age of 14 months that their vocabulary becomes robust enough to react to name violations. That is, when a picture is labelled incorrectly, their brain waves will display with the so-called N400 effect. In our study we were interested whether children with CIs would also show the N400 effect and if so, how many months of hearing experience are necessary. We measured the brain activity of children implanted between the age of one and four at three time points: 12, 18, and 24 months after implant activation. To our surprise, congenitally deaf children whose only language input had been via the cochlear implant already displayed the N400 effect after 12 months of language immersion, i.e. earlier than seen in typically hearing children.   Continue reading

Hearing Loss Associated With Higher Risk of Cognitive Decline and Dementia

MedicalResearch.com Interview with:
“Hear” by Jaya Ramchandani is licensed under CC BY 2.0David G. Loughrey, BA(Hons)

NEIL (Neuro Enhancement for Independent Lives) Programme
Trinity College Institute of Neuroscience, School of Medicine
Trinity College Dublin, Dublin, Ireland

MedicalResearch.com: What is the background for this study?

Response: Age-related hearing loss, a common chronic condition among older adults, has emerged in the literature as a potential modifiable risk factor for dementia. This is of interest as current pharmacological therapies for dementias such as Alzheimer’s disease only offer symptom-modifying effects. Treatment of risk factors such as hearing loss may help delay the onset of dementia and may provide an alternate therapeutic strategy. However, there is variance in the research on hearing loss and cognition with some studies reporting a small or non-significant association. In this meta-analysis, we investigated this association and we only included observational studies that used standard assessments of cognitive function and pure-tone audiometry (the clinical standard).

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