Age-Related Hearing Loss Linked to Dementia, Depression, Heart Attacks and Stroke

MedicalResearch.com Interview with:

David Loughrey PhD Atlantic Fellow for Equity in Brain Health Global Brain Health Institute DeafHear Research Partner NEIL Programme Trinity College Institute of Neuroscience

Dr. Loughrey

David Loughrey PhD
Atlantic Fellow for Equity in Brain Health
Global Brain Health Institute
DeafHear Research Partner
NEIL Programme
Trinity College Institute of Neuroscience

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

Response: The World Organisation (WHO) estimate that one-third of older adults aged 65 and over have a disabling hearing loss. Increasingly, research is finding that age-related hearing loss (ARHL) may be associated with other negative health outcomes, including dementia which currently affects 50 million people worldwide.

A study recently published in The Lancet reported that of nine possible modifiable risk factors, addressing age-related hearing loss (ARHL) could potentially lead to the largest reduction in the prevalence of dementia globally.

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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

Majority of Older Adults With Heart Failure Have Hearing Loss

MedicalResearch.com Interview with:
“Handicapped Hearing Impaired” by Mark Morgan is licensed under CC BY 2.0Madeline Sterling M.D., M.P.H.

Fellow, Department of Medicine
Weill Cornell Medical College – New York Presbyterian Hospital

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

Response: Heart Failure currently affects 5.8 million people in the United States and is becoming increasingly common as the population ages. Because it has no cure and tends to get progressively worse, physicians recommend that patients control their symptoms by taking multiple medications, maintain a diet low in salt, monitor their weight and blood pressure, and watch for changes in their symptoms.

At the most basic level, in order to understand and follow these instructions, heart failure patients must be able to hear them.  Hearing loss, however, had not been studied in heart failure.  There are a lot of chronic diseases in which hearing loss is more common than in the general population, including coronary heart disease, hypertension, and diabetes. And many adults with heart failure also have these conditions. So, we thought it would be important to understand if hearing loss was prevalent among adults with heart failure, especially since so much of heart failure management revolves around effective communication between patients and their healthcare providers. Continue reading

Late Menopause and Oral Hormone Therapy Linked To High Risk of Hearing Loss

MedicalResearch.com Interview with:

Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115

Dr. Curhan

Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02115

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

Response: Hearing loss affects approximately 48 million Americans and the number is expected to increase as the population ages. Some previous studies suggested that menopause may increase the risk for hearing loss, presumably due to the reduction in circulating estrogen levels, and that postmenopausal hormone therapy might slow hearing decline by “replacing” estrogen. To evaluate the role of menopause and postmenopausal hormone therapy as risk factors for hearing loss, we examined the independent associations between menopausal status, oral hormone therapy, and risk of self-reported hearing loss in 80,972 women who are participants in the Nurses’ Health Study II, aged 27-44 years at baseline, and were followed from 1991 to 2013.

After more than 1.4 million person-years of follow-up, 18,558 cases of hearing loss were reported (~23% of the women developed hearing loss). We did not observe an overall independent association between menopausal status and risk of hearing loss.

However, the risk among women who underwent natural menopause at an older age was higher. Specifically, the risk among women who underwent natural menopause at age 50 or older was 10% higher than among those who underwent natural menopause before age 50 [multivariable-adjusted relative risk (MVRR): 1.10, 95% CI 1.03, 1.17]. When we conducted an analysis restricted to women who underwent natural menopause and did not use hormone therapy (HT), the multivariable-adjusted relative risk among women who underwent natural menopause at age 50-54 years was 21% higher (MVRR: 1.12, 95% CI: 1.10, 1.34), and among women who underwent natural menopause at age 55+ years was 29% higher (MVRR: 1.29, 95% CI: 1.11, 1.50), compared with women who underwent natural menopause before age 50.

Among postmenopausal women, we also found that use of oral HT was associated with higher risk of hearing loss, and the magnitude of the risk tended to increase with longer duration of use (p-trend < 0.001). Compared with women who never used any type of HT, the MVRR of hearing loss among women who used oral HT for 5-9.9 years was 15% higher (MVRR: 1.15, 95% CI: 1.06, 1.24), and for 10+ years was 21% higher (MVRR: 1.21, 95% CI: 1.07, 1.37). When specific types of oral HT were examined, longer duration of use of either oral estrogen-only or of combined estrogen plus progestogen HT were each associated with higher risk. Fewer women reported use of progestogen-only oral HT, yet among these women a higher risk was suggested, but not significant (MVRR: 1.15, 95% CI: 0.98, 1.35). Transdermal HT use was less common, but the associations observed were similar to those with oral hormone therapy. When examined separately by type of menopause, the results for HT use were similar.

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Iron Deficiency Anemia Linked to Hearing Loss

MedicalResearch.com Interview with:
Kathleen Schieffer, BS, PhD Candidate
Biomedical Sciences and Clinical and Translational Science
Clinical and Translational Science Fellow
Hershey, PA 17033

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

Response: Hearing loss is common in the United States, with its prevalence increasing with each decade of life. Iron deficiency anemia is a common, reversible condition, associated with negative health outcomes. The inner ear is highly sensitive to ischemic damage and previous animal studies have shown that iron deficiency anemia alters the inner ear physiology. Understanding the association between iron deficiency anemia and hearing loss may open new possibilities for treatment.

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Hearing Loss Linked To Increased Depression and Dementia Risk

MedicalResearch.com Interview with:

Dr-Frank-Lin.jpg

Dr. Lin

Frank Robert Lin, M.D., Ph.D.
Associate Professor of Geriatric Medicine, Head and Neck Surgery
Johns Hopkins Medicine

MedicalResearch.com Editor’s note: Dr. Lin discussed his research during Cochlear’s Global Research Symposium, which brought together international experts from the audiology community.

MedicalResearch.com: Is there a link between hearing loss and the risk of developing dementia?

Response: In the last few years, we have investigated the link between hearing loss and dementia in large studies of older adults who have been followed for many years. In these studies, we and others have found that those with greater hearing loss have a higher risk of developing dementia even after we account for factors like age, education, medical comorbidities, etc. We think this is because there are some pathways through which hearing loss can directly affect our thinking and memory abilities

MedicalResearch.com: Is there an association between hearing loss and cognitive decline or premature death?

Response: There is a link between hearing loss and accelerated cognitive decline. There is also external research that links hearing loss and premature death (Friburg 2014, Contrera 2015). Hearing loss can also increase a person’s chance of using medical and social services

MedicalResearch.com: How is hearing loss linked to increased social isolation and depression in the elderly?

Response: Older people with hearing loss are at a greater risk of social isolation due to their difficulty communicating with people. These individuals may be less likely to go out, particularly to settings where listening can be difficult (e.g., restaurants), and even if they do go out, they may feel isolated from the conversation and not able to engage with others.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that we’re increasingly understanding that hearing loss can detrimentally impact our thinking and memory abilities, risk of dementia, and our ability to remain engaged with others. Ongoing research is now studying to what extent our current hearing loss therapies can reduce and mitigate these risks and promote healthy aging.

MedicalResearch.com: Is there anything else you would like to add?

Response: Readers should know that hearing loss is a growing public health issue. It has been estimated that by 2050 1.2 billion people will suffer from hearing loss, underscoring the need for us to address it and recognize the burden of hearing loss on wider health. To learn more visit,www.linresearch.org and www.nas.edu/hearing

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Cochlear’s Global Research Symposium October 2016

Disclosure:  Symposium supported by Cochlear Limited (ASX: COH), together with Macquarie University and the Australian Hearing Hub

www.cochlear.com

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Greater the Hearing Loss, Greater the Risk of Death

Kevin J. Contrera, MPH MD Candidate Johns Hopkins School of MedicineMedicalResearch.com Interview with:
Kevin J. Contrera, MPH
MD Candidate
Johns Hopkins School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Response: Hearing impairment is common in older adults. The prevalence of clinically significant hearing loss doubles with every decade of life, affecting two-thirds of adults 70 years of age or older. Hearing loss has been shown to be associated with various negative cognitive, mental, and physical health outcomes.

In a nationally representative sample of 1,666 adults aged 70 years or older, moderate or greater hearing impairment was associated with a 54% increased risk of mortality. This was after we statistically took into account factors that could influence this association. Essentially, the worse the patient’s hearing loss, the greater the risk of death.

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Osteoporosis May Increase Risk of Hearing Loss

Dr. Kai-Jen Tien MD Division of Endocrinology and Metabolism, Department of Internal Medicine Chi Mei Medical Center, Tainan, TaiwanMedicalResearch.com Interview with:
Dr. Kai-Jen Tien MD
Division of Endocrinology and Metabolism, Department of Internal Medicine
Chi Mei Medical Center, Tainan, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Response: Previous studies investigating the relationship between osteoporosis and sudden sensorineural hearing loss were rare. Most of the studies were of small sample size, or cross-sectional designs and their results were inconclusive. Our population-based study found an approximately 1.76-fold increase in the incidence of sensorineural hearing loss for patients with osteoporosis compared with the comparison group.Patients with more severe osteoporosis may have a higher risk of SSNHL than patients with osteoporosis of milder severity.

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No Link Found Between Alcohol Use and Hearing Loss in Women

Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Internal Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115MedicalResearch.com Interview with:
Sharon G. Curhan, MD, ScM

Channing Division of Network Medicine
Department of Internal Medicine
Brigham and Women’s Hospital
Harvard Medical School Boston, MA 02115

Medical Research: What is the background for this study?

Dr. Curhan: Hearing loss is a highly prevalent and disabling chronic condition that can impair communication, quality of life, and health. Although it is often perceived as an inevitable companion of aging, recent evidence suggests modifiable factors can potentially aid in prevention or slow progression of hearing loss. Alcohol consumption may influence several mechanisms that have been proposed to underlie age-related hearing decline. Although chronic excess alcohol intake has been associated with irreversible hearing loss and acute alcohol intake may temporarily impair auditory function, some evidence suggests that long-term moderate alcohol intake may protect against hearing loss.
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Eating Fish May Reduce Risk Of Hearing Loss In Women

Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Internal Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115MedicalResearch.com Interview with:
Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Internal Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02115

Medical Research: What are the main findings of the study?

Dr. Curhan: We followed more than 65,000 women who were participants in the Nurses’ Health Study II over 18 years and found that eating 2 or more servings of fish per week was associated with a lower risk of hearing loss. For example, after adjusting for potential confounders in multivariable analyses, in comparison with women who rarely or never ate fish, women who consumed 2 or more servings of fish per week had a 20% lower risk of hearing loss. Eating any type of fish (tuna, dark fish, light fish or shellfish) tended to be associated with lower risk. Also, we found that higher intake of long-chain omega-3 polyunsaturated fatty acids (PUFAs) was inversely associated with risk. For example, in comparison with women with the lowest intake, women with the highest intake of long-chain omega-3 PUFAs had a 22% lower risk of hearing loss.

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Hearing Loss Contributes to Personality Changes in Elderly

Dr. Anne Ingeborg Berg: University of Gothenburg, SwedenMedicalResearch.com Interview with:
Dr. Anne Ingeborg Berg:
University of Gothenburg, Sweden
MedicalResearch.com: What are the main findings of the study?

Answer: In our study of personality change in individuals aged 80+ we found that over a 6 year period individuals did not change in emotional stability, however, in line with previous research they got less extravert or outgoing. The only health aspect that could be related to an accelerated change in extraversion was impaired hearing at the first measurement occasion.

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Depression and Hearing Impairment in Adults

Dr. Chuan-Ming Li MD, PhD Statistician (Health/Medicine) Division of Scientific Programs The National Institute on Deafness and Other Communication DisordersMedicalResearch.com Interview with:
Dr. Chuan-Ming Li MD, PhD
Statistician (Health/Medicine)
Division of Scientific Programs
The National Institute on Deafness and Other Communication Disorders

MedicalResearch.com: What are the main findings of the study?

Dr. Chuan-Ming Li: We used data on adults 18 years or older from the National Health and Nutrition Examination Survey for the study and found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 years and older; however, an association between moderate HI measured by pure-tone threshold hearing exams and depression was found in women aged 70 years and older but not in men.
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Hearing Loss and Dietary Antioxidants

http://ajcn.nutrition.org/content/early/2013/11/06/ajcn.113.068437.abstractMedicalResearch.com Interview with:
Sung Kyun Park, Sc.D., M.P.H

Assistant Professor, Epidemiology
Assistant Professor, Environmental Health Sciences
Departments of Epidemiology and Environmental Health Sciences
University of Michigan School of Public Health
Ann Arbor, MI

MedicalResearch.com: What are the main findings of the study?


Answer: This study reports that persons who eat more dietary antioxidants (beta carotene and vitamin C) or magnesium have a lower risk of hearing loss. This finding was seen in the levels currently observed in the general US population and independent of demographic and socioeconomic factors, noise exposures from workplaces, recreations or firearms, and other potential risk factors.
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Hearing Loss in Women: BMI, Waist Circumference, Physical Activity

MedicalResearch.com Interview with:
Sharon Curhan, MD, ScM
Channing Division of Network Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02115

MedicalResearch.com: What are the main findings of the study?

Dr. Curhan: The main findings of our study are that higher body mass index and larger waist circumference are associated with an increased risk of acquired hearing loss, and higher level of physical activity is associated with a decreased risk of acquired hearing loss in women. Specifically, after adjusting for potential confounders, compared with women with BMI <25 kg/m2, the relative risk for hearing loss was 25% higher for women with BMI >40. Compared with women with waist circumference <71 cm, the relative risk for hearing loss was 27% higher for women with waist circumference >88 cm. Higher physical activity was inversely related to risk; compared with women in the lowest quintile of physical activity, women in the highest quintile of physical activity had a 17% lower risk of hearing loss. Walking, the most common form of physical activity among these women, was associated with a lower risk; women who walked 2 hours per week or more had a 15% lower risk of hearing loss than women who walked less than one hour per week. These findings provide evidence that maintaining healthy weight and staying physically active, potentially modifiable lifestyle factors, may help reduce the risk of hearing loss.

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