scholarly journals Screening for Hearing Impairment in Older Adults by Smartphone-Based Audiometry, Self-Perception, HHIE Screening Questionnaire, and Free-Field Voice Test: Comparative Evaluation of the Screening Accuracy With Standard Pure-Tone Audiometry

10.2196/17213 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e17213
Author(s):  
Lok Yee Joyce Li ◽  
Shin-Yi Wang ◽  
Cheng-Jung Wu ◽  
Cheng-Yu Tsai ◽  
Te-Fang Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Impairment ◽  
Pure Tone ◽  
Free Field ◽  
Pure Tone Audiometry ◽  
High Sensitivity ◽  
High Specificity ◽  
The Self ◽  
Self Perception

Background Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. In fact, hearing impairment is not merely a health problem, but it also has a great impact on the educational performance, economic income, and quality of life. Hearing impairment is therefore an important social concern. Objective We aimed to evaluate and compare the accuracy of self-perception, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire, free-field voice test, and smartphone-based audiometry as tests for screening moderate hearing impairment in older adults in China. Methods In this study, 41 patients were recruited through a single otology practice. All patients were older than 65 years. Patients with otorrhea and cognitive impairment were excluded. Moderate hearing impairment was defined as mean hearing thresholds at 500, 1000, 2000, and 4000 Hz >40 dB hearing loss (pure-tone average > 40 dB hearing loss). All patients completed 5 hearing tests, namely, the self-perception test, HHIE-S questionnaire test, free-field voice test, smartphone-based audiometry test, and standard pure-tone audiometry by the same audiologist. We compared the results of these tests to the standard audiogram in the better-hearing ear. Results The sensitivity and the specificity of the self-perception test were 0.58 (95% CI 0.29-0.84) and 0.34 (95% CI 0.19-0.54), respectively. The sensitivity and the specificity of the HHIE-S questionnaire test were 0.67 (95% CI 0.35-0.89) and 0.31 (95% CI 0.316-0.51), respectively. The sensitivity and the specificity of the free-field voice test were 0.83 (95% CI 0.51-0.97) and 0.41 (95% CI 0.24-0.61), respectively. The sensitivity and the specificity of the smartphone-based audiometry test were 0.92 (95% CI 0.60-0.99) and 0.76 (95% CI 0.56-0.89), respectively. Smartphone-based audiometry correctly diagnosed the presence of hearing loss with high sensitivity and high specificity. Conclusions Smartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.

scholarly journals Screening for Hearing Impairment in Older Adults by Smartphone-Based Audiometry, Self-Perception, HHIE Screening Questionnaire, and Free-Field Voice Test: Comparative Evaluation of the Screening Accuracy With Standard Pure-Tone Audiometry (Preprint)

2019 ◽  
Author(s):  
Lok Yee Joyce Li ◽  
Shin-Yi Wang ◽  
Cheng-Jung Wu ◽  
Cheng-Yu Tsai ◽  
Te-Fang Wu ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Hearing Impairment ◽  
Pure Tone ◽  
Free Field ◽  
Pure Tone Audiometry ◽  
High Sensitivity ◽  
High Specificity ◽  
The Self ◽  
Self Perception

BACKGROUND Hearing impairment is the most frequent sensory deficit in humans, affecting more than 360 million people worldwide. In fact, hearing impairment is not merely a health problem, but it also has a great impact on the educational performance, economic income, and quality of life. Hearing impairment is therefore an important social concern. OBJECTIVE We aimed to evaluate and compare the accuracy of self-perception, Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) questionnaire, free-field voice test, and smartphone-based audiometry as tests for screening moderate hearing impairment in older adults in China. METHODS In this study, 41 patients were recruited through a single otology practice. All patients were older than 65 years. Patients with otorrhea and cognitive impairment were excluded. Moderate hearing impairment was defined as mean hearing thresholds at 500, 1000, 2000, and 4000 Hz >40 dB hearing loss (pure-tone average > 40 dB hearing loss). All patients completed 5 hearing tests, namely, the self-perception test, HHIE-S questionnaire test, free-field voice test, smartphone-based audiometry test, and standard pure-tone audiometry by the same audiologist. We compared the results of these tests to the standard audiogram in the better-hearing ear. RESULTS The sensitivity and the specificity of the self-perception test were 0.58 (95% CI 0.29-0.84) and 0.34 (95% CI 0.19-0.54), respectively. The sensitivity and the specificity of the HHIE-S questionnaire test were 0.67 (95% CI 0.35-0.89) and 0.31 (95% CI 0.316-0.51), respectively. The sensitivity and the specificity of the free-field voice test were 0.83 (95% CI 0.51-0.97) and 0.41 (95% CI 0.24-0.61), respectively. The sensitivity and the specificity of the smartphone-based audiometry test were 0.92 (95% CI 0.60-0.99) and 0.76 (95% CI 0.56-0.89), respectively. Smartphone-based audiometry correctly diagnosed the presence of hearing loss with high sensitivity and high specificity. CONCLUSIONS Smartphone-based audiometry may be a dependable screening test to rule out moderate hearing impairment in the older population.

scholarly journals Hearing Screening for Residents in Long-Term Care Homes Who Live with Dementia: A Scoping Review

2021 ◽  
pp. 1-24
Author(s):  
Fiona Höbler ◽  
Katherine S. McGilton ◽  
Walter Wittich ◽  
Kate Dupuis ◽  
Marilyn Reed ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Nursing Staff ◽  
Scoping Review ◽  
Pure Tone ◽  
Long Term Care ◽  
Pure Tone Audiometry ◽  
Care Homes ◽  
Term Care

Background: Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. Objective: To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. Methods: Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O’Malley’s scoping review and appraisal process was followed. Results: There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. Conclusion: Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.

scholarly journals Assessing hearing loss in older adults with a single question and person characteristics; Comparison with pure tone audiometry in the Rotterdam Study

PLoS ONE ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. e0228349 ◽  
Author(s):  
Berthe C. Oosterloo ◽  
Nienke C. Homans ◽  
Rob J. Baatenburg de Jong ◽  
M. Arfan Ikram ◽  
A. Paul Nagtegaal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Rotterdam Study ◽  
Person Characteristics ◽  
Single Question

Self-Reported Hearing Problems among Older Adults: Prevalence and Comparison to Measured Hearing Impairment

2011 ◽  
Vol 22 (08) ◽  
pp. 550-559 ◽  
Author(s):  
Samuli Hannula ◽  
Risto Bloigu ◽  
Kari Majamaa ◽  
Martti Sorri ◽  
Elina Mäki-Torkko
Keyword(s):  
Older Adults ◽  
Hearing Impairment ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Population Based ◽  
Single Frequency ◽  
Hearing Level ◽  
Hearing Thresholds ◽  
Hearing Difficulties ◽  
Hearing Problems

Background: There are not many population-based epidemiological studies on the association between self-reported hearing problems and measured hearing thresholds in older adults. Previous studies have shown that the relationship between self-reported hearing difficulties and measured hearing thresholds is unclear and, according to our knowledge, there are no previous population-based studies reporting hearing thresholds among subjects with hyperacusis. Purpose: The aim was to investigate the prevalence of self-reported hearing problems, that is, hearing difficulties, difficulties in following a conversation in noise, tinnitus, and hyperacusis, and to compare the results with measured hearing thresholds in older adults. Research Design: Cross-sectional, population-based, and unscreened. Study Sample: Random sample of subjects (n = 850) aged 54-66 yr living in the city of Oulu (Finland) and the surrounding areas. Data Collection and Analysis: Otological examination, pure tone audiometry, questionnaire survey Results: The prevalence of self-reported hearing problems was 37.1% for hearing difficulties, 43.3% for difficulties in following a conversation in noise, 29.2% for tinnitus, and 17.2% for hyperacusis. More than half of the subjects had no hearing impairment, or HI (BEHL[better ear hearing level]0.5–4 kHz < 20 dB HL) even though they reported hearing problems. Subjects with self-reported hearing problems, including tinnitus and hyperacusis, had significantly poorer hearing thresholds than those who did not report hearing problems. Self-reported hearing difficulties predicted hearing impairment in the pure-tone average at 4, 6, and 8 kHz, and at the single frequency of 4 kHz. Conclusions: The results indicate that self-reported hearing difficulties are more frequent than hearing impairment defined by audiometric measurement. Furthermore, self-reported hearing difficulties seem to predict hearing impairment at high frequencies (4–8 kHz) rather than at the frequencies of 0.5–4 kHz, which are commonly used to define the degree of hearing impairment in medical and legal issues.

scholarly journals Η συμβολή των ωτοακουστικών εκπομπών στη μελέτη της κοχλιακής λειτουργίας σε ασθενείς με υποθυρεοειδισμό

2013 ◽  
Author(s):  
Βασίλειος Ψαλτάκος
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Otoacoustic Emissions ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Otoacoustic Emission ◽  
Upper Respiratory Tract ◽  
Anatomic Site ◽  
Cochlear Function ◽  
Hearing Thresholds

Although several reports exist concerning the occurrence of hearing loss in patients withdisorders of thyroid function, there are still several unsettled issues, such as theincidence and the severity of hearing impairment, the anatomic site of the auditorypathway involved, and the possible pathogenetic mechanisms. Both congenitalhypothyroidism and environmentally based iodine deficiency are established causes ofhearing loss in humans and rodents. Congenital thyroid deficiency in humans can resultin a profound, hearing deficit, which may be prevented by early hormonal replacementtreatment in infants with hypothyroidism. However, the effect of acute or chronichypothyroidism in adults has not been adequately studied, and most information hasbeen obtained from animal experiments, whereas research in humans has been basicallybased on behavioral audiometry. The use of otoacoustic emissions may provide moreinsight into the hearing function of these patients than pure-tone audiometry, since it isconsidered as a sensitive test of the cochlear status. The aim of this study was toevaluate the hearing in a group of patients with acute hypothyroidism, using bothconventional audiometry and transiently evoked otoacoustic emissions (TEOAEs). Material and methods:A group of 52 patients with thyroid carcinoma who underwent total thyroidectomy wasstudied prospectively, All patients were examined before surgery and 6-8 weekspostoperatively. During this period there was no replacement with levothyroxine and themagnitude of thyroxin depletion was monitored by serum thyroid-stimulating hormone levels. On preoperative encounter with each patient, a detailed questionnaire of historyof hearing loss, tinnitus, vertigo, previous ear infections, noise exposure, medications,and recent upper respiratory tract infection was completed. Patients were excluded ifthey were older than 50 years, in order to avoid the phenomenon of presbycusis, or ifthey had a history of cochleovestibular, vascular or neurologic disease, or any other riskfactor for hearing impairment. Pure-tone audiometry, tympanometry and transientlyevoked otoacoustic emissions were performed. A group of healthy volunteers of similarage and sex were used for comparison.Results:(1) Tympanograms were normal, either on initial testing (75%) or on repeat testing(25%).(2) Audiometry showed elevation of all postoperative hearing thresholds, whereas thethresholds varied significantly across frequency.(3) TEOAE testing showed response signal to noise ratios lower in the postoperativesession (hypothyroid state) than in the preoperative session on all measured frequencies.(4) Emission levels varied significantly across frequency, with maximum responseobserved at 2 kHz.(5) Comparison of significant pure-tone and otoacoustic emission shifts for individualears showed more ears affected in otoacoustic emission testing, indicating subclinicalcochlear involvement.(6) Comparison of hearing thresholds and otoacoustic emission levels between patientsand controls showed significant differences on postoperative testing. Conclusions:Acute hypothyroidism in adults causes elevation of hearing thresholds and reducedotoacoustic emissions. The effect on otoacoustic emissions is greater, indicatingsubclinical damage of the cochlear function.

scholarly journals Association of Midlife Hypertension with Late-Life Hearing Loss

2019 ◽  
Vol 161 (6) ◽  
pp. 996-1003 ◽  
Author(s):  
Nicholas S. Reed ◽  
Matthew G. Huddle ◽  
Joshua Betz ◽  
Melinda C. Power ◽  
James S. Pankow ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Hearing Loss ◽  
Diastolic Blood Pressure ◽  
Hearing Impairment ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Late Life ◽  
Community Dwelling ◽  
Pure Tone Average ◽  
Prospective Longitudinal

Objective To investigate the association of midlife hypertension with late-life hearing impairment. Study Design Data from the Atherosclerosis Risk in Communities study, an ongoing prospective longitudinal population-based study (baseline, 1987-1989). Setting Washington County, Maryland, research field site. Subjects and Methods Subjects included 248 community-dwelling men and women aged 67 to 89 years in 2013. Systolic blood pressure (SBP) and diastolic blood pressure were measured at each of 5 study visits from 1987-1989 to 2013. Hypertension was defined by elevated systolic or diastolic blood pressure or antihypertensive medication use. A 4-frequency (0.5-4 kHz) better-hearing ear pure tone average in decibels hearing loss (dB HL) was calculated from pure tone audiometry measured in 2013. A cutoff of 40 dB HL was used to indicate clinically significant moderate to severe hearing impairment. Hearing thresholds at 5 frequencies (0.5-8 kHz) were also considered separately. Results Forty-seven participants (19%) had hypertension at baseline (1987-1989), as opposed to 183 (74%) in 2013. The SBP association with late-life pure tone average differed by the time of measurement, with SBP measured at earlier visits associated with poorer hearing; the difference in pure tone average per 10–mm Hg SBP measured was 1.43 dB HL (95% CI, 0.32-2.53) at baseline versus −0.43 dB HL (95% CI, −1.41 to 0.55) in 2013. Baseline hypertension was associated with higher thresholds (poorer hearing) at 4 frequencies (1, 2, 4, 8 kHz). Conclusion Midlife SBP was associated with poorer hearing measured 25 years later. Further analysis into the longitudinal relationship between hypertension and hearing impairment is warranted.

scholarly journals A comparative study of smartphone based app with free field hearing for possible use as a screening test

2017 ◽  
Vol 3 (3) ◽  
pp. 710
Author(s):  
Himanshu Swami ◽  
Aditya Bhargava ◽  
Sabarigirish K. ◽  
Arvind B. M.
Keyword(s):  
Hearing Loss ◽  
Comparative Study ◽  
Gold Standard ◽  
Military Service ◽  
Pure Tone ◽  
Early Stage ◽  
Pearson Correlation ◽  
Free Field ◽  
Pure Tone Audiometry ◽  
Hearing Assessment

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative study</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH).  </p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing.</p><p class="abstract"><span lang="EN-US"> </span></p>

scholarly journals Impact of Hearing Loss and Amplification on Performance on a Cognitive Screening Test

2018 ◽  
Vol 29 (07) ◽  
pp. 648-655 ◽  
Author(s):  
Gabrielle H. Saunders ◽  
Ian Odgear ◽  
Anna Cosgrove ◽  
Melissa T. Frederick
Keyword(s):  
Hearing Loss ◽  
Hearing Impairment ◽  
Hearing Aids ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Cognitive Screening ◽  
Strong Correlations ◽  
Speech In Noise ◽  
Hearing Ability ◽  
The Individual

AbstractThere have been numerous recent reports on the association between hearing impairment and cognitive function, such that the cognition of adults with hearing loss is poorer relative to the cognition of adults with normal hearing (NH), even when amplification is used. However, it is not clear the extent to which this is testing artifact due to the individual with hearing loss being unable to accurately hear the test stimuli.The primary purpose of this study was to examine whether use of amplification during cognitive screening with the Montreal Cognitive Assessment (MoCA) improves performance on the MoCA. Secondarily, we investigated the effects of hearing ability on MoCA performance, by comparing the performance of individuals with and without hearing impairment.Participants were 42 individuals with hearing impairment and 19 individuals with NH. Of the individuals with hearing impairment, 22 routinely used hearing aids; 20 did not use hearing aids.Following a written informec consent process, all participants completed pure tone audiometry, speech testing in quiet (Maryland consonant-nucleus-consonant [CNC] words) and in noise (Quick Speech in Noise [QuickSIN] test), and the MoCA. The speech testing and MoCA were completed twice. Individuals with hearing impairment completed testing once unaided and once with amplification, whereas individuals with NH completed unaided testing twice.The individuals with hearing impairment performed significantly less well on the MoCA than those without hearing impairment for unaided testing, and the use of amplification did not significantly change performance. This is despite the finding that amplification significantly improved the performance of the hearing aid users on the measures of speech in quiet and speech in noise. Furthermore, there were strong correlations between MoCA score and the four frequency pure tone average, Maryland CNC score and QuickSIN, which remain moderate to strong when the analyses were adjusted for age.It is concluded that the individuals with hearing loss here performed less well on the MoCA than individuals with NH and that the use of amplification did not compensate for this performance deficit. Nonetheless, this should not be taken to suggest the use of amplification during testing is unnecessary because it might be that other unmeasured factors, such as effort required to perform or fatigue, were decreased with the use of amplification.

scholarly journals A Study on Effects of Diabetes Mellitus on Auditory System

2017 ◽  
Vol 24 (1) ◽  
pp. 49-55
Author(s):  
Kamal Deep Joshi ◽  
Jeevan Ramachandra Galagali ◽  
Sanajeet Kumar Singh
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Statistical Tests ◽  
Free Field ◽  
Pure Tone Audiometry ◽  
Diabetic Patients ◽  
Clinical Tests ◽  
Auditory Dysfunction ◽  
Auditory Functions

AbstractBackground and aims: Auditory dysfunctions in diabetes are known but are difficult to identify. Role of clinical tests and routine audiological tools are still to be established in early detection of diabetes-related auditory complication. The study aims to establish a link between diabetes and auditory dysfunction and assess the role of clinical examination and audiological investigations as a sensitive indicator of auditory dysfunctions in diabetics.Material and Methods: The auditory functions of 100 diabetic patients and 100 non-diabetics were assessed by clinical otological examination including free-field hearing and pure tone audiometry (PTA) in this descriptive study. The data for diabetic and non-diabetic groups and effect of age on auditory functions were analyzed with suitable statistical tests using SPSS 2.0 software with an error margin of 10%.Results: The demographical variables were comparable in both groups. The results showed a decline in free field hearing, which are furthur adversely affected by duration of diabetes and patient’s age. Overall pure tone thresholds were not significantly higher in diabetics, however the thresholds were higher in diabetics in older age groups. The hearing loss appears at an early age in diabetics but gradually becomes indistinguishable from age-related hearing loss.Conclusions: The auditory dysfunction can be linked to diabetes. It is usually not detectable at earliest stages with routine clinical and audiological tests but the clinical tests and pure tone audiometry can have a utility in monitoring the auditory dysfunction.

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