Neuropsychiatric Symptoms and Hearing Loss in Dementia: Unmet Need and Opportunity for Intervention

Hearing loss is one of the most common comorbidities among persons with dementia, with prevalence of 60->90%. Most go untreated and disparities exist. However, sensory impairment may influence the health of individuals and care partners. We will share findings from a clinic-based cohort of persons with dementia (n=101). Controlling for demographic and clinical factors, we found that every 10 decibel increase in hearing loss was associated with nearly an additional neuropsychiatric symptom (b = 0.7 per 10 dB; p = 0.01) and 1.3-point increase in severity (b = 1.3 per 10 dB; p = 0.04). These findings provide the first estimates that utilize objective audiometry. Furthermore, hearing aid use appeared to be protective. Hearing care may represent an additional, but underutilized, non-pharmacological intervention. We will discuss these findings in the context of the epidemiology of hearing loss in dementia and highlight new opportunities for managing hearing loss through community-based approaches.

EEG-based diagnostics of the auditory system using cochlear implant electrodes as sensors

The cochlear implant is one of the most successful medical prostheses, allowing deaf and severely hearing-impaired persons to hear again by electrically stimulating the auditory nerve. A trained audiologist adjusts the stimulation settings for good speech understanding, known as “fitting” the implant. This process is based on subjective feedback from the user, making it time-consuming and challenging, especially in paediatric or communication-impaired populations. Furthermore, fittings only happen during infrequent sessions at a clinic, and therefore cannot take into account variable factors that affect the user’s hearing, such as physiological changes and different listening environments. Objective audiometry, in which brain responses evoked by auditory stimulation are collected and analysed, removes the need for active patient participation. However, recording of brain responses still requires expensive equipment that is cumbersome to use. An elegant solution is to record the neural signals using the implant itself. We demonstrate for the first time the recording of continuous electroencephalographic (EEG) signals from the implanted intracochlear electrode array in human subjects, using auditory evoked potentials originating from different brain regions. Furthermore, we show that the response morphologies and amplitudes depend crucially on the recording electrode configuration. The integration of an EEG system into cochlear implants paves the way towards chronic neuro-monitoring of hearing-impaired patients in their everyday environment, and neuro-steered hearing prostheses, which can autonomously adjust their output based on neural feedback.

EXPLORATION OF MOBILE USERS WITH QUESTIONNAIRE METHOD AND OBJECTIVE AUDIOMETRY (OTOACOUSTIC EMISSION)

Background: The main purpose of study was to assess the impact of using mobile phones among young Ukrainians (age 17-25) on auditory system. We conducted a study using anonymous questionnaires and with using a method of objective audiometry (otoacoustic emission). Finally, we compared our results with results of studies which were conducted in Sweden and Finland. Those studies were first among all the others with assessment of association between amount of mobile phone use and frequency of headache, tinnitus or hearing loss at 4-year follow-up. Methods: The participants were chosen among volunteers (n=251). All of them received anonymous questionnaires. We made stratified sample by age, sex, type of phone used, duration of phone calls, using of headphones during calls, symptoms appearing after using cell phone (headache, tinnitus, hearing loss). Results: The age of respondents was 17-25 years (32,3% - 22 years, 13,1% - 19 years, 12,4% - 20 years, 10,8% - 23 years., 8,4% - 21 years., 8% - 18 years, 7,6% - 17 years, 2,8% - 24р., 2,8% - 25 years). Due to this data the median age of participants was 22 years. Sex: female – 74.3%, male – 25.7%. Most of participants were using mobile phones (99.2%). 51.8% of respondents were always using headphones during phone calls, 8.8% - never used headphones during phone calls, 39,4% - were rarely using headphones during phone calls. We assess the association between mobile phone use and appearing symptoms after phone calls. 3.6% of respondents reported a headache after phone calls, 96.4% were free of this symptom after phone calls. 58.2% reported headache at least once a week, 41.8% - were free of this symptom. 42.2% of respondents reported tinnitus: 1.6% reported tinnitus every day, 4.8% once in 2-3 days, 35.9% reported this symptom rarely (less than once a week). 57.8% of respondents were free of tinnitus. 21.5% of respondents reported hearing loss, 78.5% were free of hearing loss. Most of respondents associate headache with fatigue, sleep deprivation, stress, weather change, sleep disorders, arterial hypertension, hunger, frequent phone calls. Respondents who complained of hearing loss were offered to pass objective audiometry (optoacoustic emission).6 respondents took part in this examination. In 85 ears of respondents (71%) who complained of hearing loss it occurs on 8000 Hz. In 95 ears of respondents (79%) who complained of hearing loss it occurs on 5714 Hz. Pearson correlation coefficient between our results and results of Northern Europe studies was 0.935, suggesting a strong linear association.

Assessment of Objective Audiometry to Predict Subjective Satisfaction in Patients With Hearing Aids

Objectives. To investigate the correlation of objective audiometry with user satisfaction as measured with the questionnaire scores.Methods. Twenty patients with hearing loss, who agreed to wear a hearing aid and were referred for hearing aid fitting, were included in this prospective clinical study. All patients used the in-the-canal type of Wide7 hearing aid provided by BSL Co., Ltd. We performed the Korean version of the Hearing Handicap Inventory for the Elderly (K-HHIE) and the International Outcome Inventory for Hearing Aids (K-IOI-HA) before and 1, 3, and 6 months after wearing the hearing aid. We also performed pure tone audiometry (PTA), speech audiometry (SA), functional gain (FG), hearing in noise test (HINT), and central auditory processing disorder tests, such as frequency pattern test (CA-f), duration pattern test (CA-d), and dichotic test (CA-Di). Patients were divided into two groups (group A-HHIE, improved; group B-HHIE, same or worse) by comparing the score of K-HHIE before and 6 months after wearing the hearing aid. In the 6-month K-IOI-HA questionnaire, 21 points were considered as the average score. Based on this, we further divided patients into two groups (group A-IOI, >21 points; group B-IOI, ≤21 points).Results. Group A-HHIE included six patients and group B-HHIE included 14 patients. In PTA, SA, HINT, CA-d, and CA-Di, group A-HHIE showed higher improvements than group B-HHIE, which were not statistically significant. Group A-IOI included 12 patients and group B-IOI included eight patients. No statistically significant difference was noted in the improvement of audiometric results over a period of 6 months after wearing the hearing aid between groups A-IOI and B-IOI.Conclusion. There were no significant and consistent audiometric results to reflect patient’s satisfaction with the hearing aid. Therefore, when analyzing the hearing aid-fitting outcome, both the objective audiometric tests and subjective questionnaire should be performed together for validating hearing aid performance.

Features of objective audiometry tests and their diagnostic value in the research of hearing in children

The article highlights the features of the conduct and interpretation of data on audiological tests at the children in order to identify the degree, type and level of damage of the auditory disorders. According to a survey of 121 children with a diagnosis of sensorineural hearing loss, it was confirmed that using a complex algorithm of audiological tests such as OAE, DPOAE, BERA and ASSR in hearing diagnosis of the children allows to obtain more accurate and detailed information and avoid possible errors in determining various forms of hearing disorders.

Issues of simulation, aggravation and dissimulation in expert questions for hearing disorders

Those who are working in the conditions accompanied with industrial noise exceeding normal rates and who receive irreversible decrease in hearing of sensorineural nature, proceeding from the existing legislation, have to be exposed to expert assessment of the audiologist-otorhinolaryngologist, for the purpose of examination of professional suitability. Medical experts should face such phenomena as aggravation and simulation of hearing loss which exposure and also definition of a true threshold for sound perception, nature of the available violations, is their paramount task.The tests serving for simulation identification are carried out with application of subjective audiometry, i.e. with active participation of the examined person or by means of the objective audiometry excluding participation of the patient. Observation of the patient behavior, analysis of the anamnestic data, carrying out the acumetry and tuning testing, subjective and objective audiometry and also comparison of the obtained data allows to make expert assessment of a clinical case. The objective audiometry (OET, KSVP, ECOG, acoustic impedancemetry) is crucial in case of the doubts arising after carrying out a subjective audiometric research.