The effect of hearing impairment on the vocal characteristics of older people

Measures of vocal intensity, frequency and harshness were compared for 19 hearing-impaired and 21 normal-hearing people over 60 years of age. Significantly greater comfortable intensity levels were found in the hearing-impaired group, but the other measures of frequency and harshness were not significantly different. A large proportion of the subjects in both groups reported a history of gastro-oesophageal reflux (GER), a condition associated with vocal fold pathology and hoarseness. Comparison of the GER and non-GER subjects on the measures of vocal function showed that the female GER speaker exhibited lower frequency on the vowel /u/ than the non-GER subjects. Clinicians need to be aware of the effect of highly prevalent disorders such as hearing impairment and GER on the voices of elderly speakers.

Outcomes of hearing aid fitting for older people with hearing impairment and their significant others

As hearing impairment affects communication. it seems intuitive that both the person with hearing impairment and the significant other (SO) will experience effects as a result of the impairment and subsequent rehabilitation. The present study examined the effect that hearing impairment and aural rehabilitation has on the person with hearing impairment and the SO's quality of life (QOL). Ninety-three people with hearing impairment completed a measure of hearing-specific QOL (Hearing Handicap Inventory for the Elderly) and health-related QOL (Short Form-36), while 78 SOs completed a modified version of the Quantified Denver Scale and the Short Form-36. prior to and 3 months following hearing aid fitting. The results emphasize the significant impact of hearing impairment on both the person with hearing impairment and the SO. The results also demonstrate the effective role that hearing aids play in reducing Such negative effects for both parties.

Older people with hearing impairment: A literature review of the spouse's perspective

Spouses of older people with hearing impairment frequently urge their hearing impaired partners to seek help for their hearing difficulties. Only a minority of individuals with hearing impairment are self-motivated, with the majority of clients, especially older clients, presenting at audiology clinics under the persuasion or influence of their spouse or significant other. This highlights the important role that spouses play in initiating aural rehabilitation and indicates that spouses of older people with hearing impairment may become so frustrated with their partners' hearing loss that they are often the primary reason why the hearing impaired person presents for audiological services. To date, however, the number of studies addressing the effect of hearing loss on significant others is limited. Those studies that have investigated the effect of hearing impairment on families are commonly focused on the person with the impairment and most commonly, the significant other has merely been used as a proxy to describe the perceived problems of his or her spouse. Further, there has been no systematic indepth investigation of the needs of spouses of older people with hearing impairment, including the effect of retirement and the increase in time spent together, with the majority of studies focusing primarily on younger spouses of workers affected by noise-induced hearing loss. The cumulative effect of experiencing many years of hearing difficulties with a partner may also influence the extent to which older spouses are affected by hearing impairment. The primary purpose of this article is therefore to critically review the existing literature on the effects of hearing impairment on spouses. It will also provide a rationale for the importance of this topic as a clinical issue and suggest some future directions for research in this area.

Benefits of amplification for speech recognition in background noise

The purpose of the present study was to examine the benefits of providing audible speech to listeners with sensorineural hearing loss when the speech is presented in a background noise. Previous studies have shown that when listeners have a severe hearing loss in the higher frequencies, providing audible speech (in a quiet background) to these higher frequencies usually results in no improvement in speech recognition. In the present experiments, speech was presented in a background of multitalker babble to listeners with various severities of hearing loss. The signal was low-pass filtered at numerous cutoff frequencies and speech recognition was measured as additional high-frequency speech information was provided to the hearing-impaired listeners. It was found in all cases, regardless of hearing loss or frequency range, that providing audible speech resulted in an increase in recognition score. The change in recognition as the cutoff frequency was increased, along with the amount of audible speech information in each condition (articulation index), was used to calculate the "efficiency" of providing audible speech. Efficiencies were positive for all degrees of hearing loss. However, the gains in recognition were small, and the maximum score obtained by an listener was low, due to the noise background. An analysis of error patterns showed that due to the limited speech audibility in a noise background, even severely impaired listeners used additional speech audibility in the high frequencies to improve their perception of the "easier" features of speech including voicing

Cherbourg revisited: hearing health changes in an Aboriginal community, 1972 to 2000

The aim of this study was to investigate current audiological outcomes of Cherbourg schoolchildren and compare these outcomes to those obtained in a 1972 study of hearing health in the same community. Seventy-eight primary school children of Cherbourg State School participated in the study. Their peripheral hearing and middle ear function were tested using pure-tone air conduction audiometry and tympanometry respectively. A significant improvement in the hearing status of this population was noted compared to that reported in 1972. The improvements in the hearing status of Indigenous schoolchildren at Cherbourg can be attributed to a number of factors, including increased awareness of both ear health and general health, as well as the introduction of hearing health care services, over the past three decades.

Tympanometry and TEOAE testing of children with Down Syndrome in Special Schools

Despite widespread awareness that children with Down syndrome are particularly susceptible to hearing pathologies, the audiological status of students with Down syndrome in special schools is all too often unknown. Unfortunately, hearing screening for this population is unable to rely on standard, behavioural test batteries. To facilitate future improvements in screening protocols, this study investigated the results of tympanometry and transient evoked otoacoustic emission (TEOAE) testing for a group of children with Down syndrome. Assessments were not conducted in the artificial context of a clinic or laboratory, but within the school environment. Outcomes are reported for 27 subjects with a mean age of 10 years 5 months (SD = 4;11). Tympanometry testing was failed in at least one ear by 41.7% of subjects, while a failure rate of 81.5% of subjects was observed for TEOAE testing. Therefore, it is concluded that immediate review of hearing screening programs for students with Down syndrome is highly advisable.

Hearing sensitivity and bone mineral density in older adults: the Health, Aging and Body Composition Study

Bone mineral density (BMD) may be associated with hearing loss in older adults. Demineralization of the cochlear capsule has been associated with hearing loss in those with Paget's disease of the bone and otosclerosis. Osteoporosis may also result in cochlear capsule demineralization. We hypothesized that lower hip BMD and lower heel ultrasound measurements would be associated with hearing loss in a population-based sample of 2,089 older black and white men and women. Bone parameters and hearing function were measured at the fourth clinical follow-up visit. Audiometric threshold testing was used to measure air- and bone-conduction hearing sensitivity. BMD of the hip and its subregions was measured using dual-energy X-ray absorptiometry. Calcaneal bone measurements [broadband ultrasound attenuation (BUA), speed of sound (SOS) and the quantitative ultrasound index (QUI)] were obtained using heel ultrasound. After adjusting for known hearing loss risk factors, no association was found between hearing and any of the bone measurements in whites and black women. In black men, however, lower hip BMD was associated with higher odds of hearing loss; for each standard deviation decrease in total hip BMD, the odds of hearing loss were 1.41 (95% confidence interval 1.08, 1.83), 1.39 (95% CI 1.07, 1.82) for femoral neck BMD and 1.65 (95% CI 1.26, 2.16) for trochanter BMD. Conductive hearing loss was associated with lower heel ultrasound measurements, though only among white men. The results of this study are mixed and inconclusive. Lower BMD of the hip and its subregions was associated with hearing loss among black men, but not among whites or black women. Lower measurements on heel ultrasound were associated with conductive hearing loss, though only among white men. These results suggest that axial and appendicular bone parameters may be modestly associated with hearing loss in older men, but not in women.

Postnatal developmental expression of the PDZ scaffolds Na+-H+ exchanger regulatory factors 1 and 2 in the rat cochlea

Sensory transduction in the mammalian cochlea requires the maintenance of specialized fluid compartments with distinct ionic compositions. This is achieved by the concerted action of diverse ion channels and transporters, some of which can interact with the PDZ scaffolds, Na+-H+ exchanger regulatory factors 1 and 2 (NHERF-1, NHERF-2). Here, we report that NHERF-1 and NHERF-2 are widely expressed in the rat cochlea, and that their expression is developmentally regulated. Reverse transcription/polymerase chain reaction (RT-PCR) and Western blotting initially confirmed the RNA and protein expression of NHERFs. We then performed immunohistochemistry on cochlea during various stages of postnatal development. Prior to the onset of hearing (P8), NHERF-1 immunolabeling was prominently polarized to the apical membrane of cells lining the endolymphatic compartment, including the stereocilia and cuticular plates of the inner and outer hair cells, marginal cells of the stria vascularis, Reissner's epithelia, and tectorial membrane. With maturation (P21, P70), NHERF-1 immunolabeling was reduced in the above structures, whereas labeling increased in the apical membrane of the interdental cells of the spiral limbus and the inner and outer sulcus cells, Hensen's cells, the inner and outer pillar cells, Deiters cells, the inner border cells, spiral ligament fibrocytes, and spiral ganglion neurons (particularly type II). NHERF-1 expression in strial basal and intermediate cells was persistent. NHERF-2 immunolabeling was similar to that for NHERF-1 during postnatal development, with the exception of expression in the synaptic regions beneath the outer hair cells. NHERF-1 and NHERF-2 co-localized with glial fibrillary acidic protein and vimentin in glia. The cochlear localization of NHERF scaffolds suggests that they play important roles in the developmental regulation of ion transport, homeostasis, and auditory neurotransmission.

Comparison of cognitive screening tasks in an elderly veteran population

Screening measures of cognitive status are traditionally administered face to face. In survey research such screening mcasurcs, while desirable, must he administered by other means. As part of pilot survey research on a New Zealand war veteran population with some degree of hearing impairment, a face-to-face administration of the Mini-Mental State Examination (MMSE; Folstein, Folstein and McHugh, 1975) and a telephoneadministration of the Telephonc Interview for Cognitive Status (TICS; Brandt, Spencer and Folstein. 1988) were compared. Brandt ('/ u/. (1988) reported a very strong linear relationship between scores on the MMSE and the TICS (r=0.94, p < .0001) in an Alzheimer patient population with a mcan MMSE score of 12.06 (6.78). For a sample of 44 mildly to moderately hearing impaired veterans, with a mean MMSE score of 25.52 (2.16) and a mean TICS score of 32.52(5.43), the correlation between the instruments was .39. When veterans who wore hearing aids during the telephone interview ( N = 2 2 ) wcrc separated out from those who did not, the correlation rose to .54. Age was ncgatively correlated with the MMSE ( r = -0.41, / I < .01) and not significantly correlated with the TICS. Education level was unrelated to either measure. The data suggest that the wearing or non-wearing of hearing aids may contribute significantly to the reliability of the TICS. Furthermore, on non-demented populations with a less restricted range of scores. the correlation of the MMSE and TICS may he lower than previously reported.