Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review

Purpose

The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population.

Method

A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools.

Results

Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems.

Conclusion

Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

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Hearing Loss Treatment in Older Adults With Cognitive Impairment: A Systematic Review

Purpose

The purpose of this systematic review was to assess studies of treating hearing loss in older adults with cognitive impairment. Of interest to this review is identifying clinical adaptations that may be used to tailor hearing loss treatment to older adults with cognitive impairment in order to better serve this vulnerable population.

Method

A systematic search with controlled vocabulary and key word terms was applied to PubMed, the Cochrane Library, Embase, CINAHL, and PsycINFO. Search concepts included terms related to hearing loss and cognitive impairment. The overall search resulted in 4,945 unique references, 50 of which were eligible for full-text review and 13 of which were included in the final review. Included manuscripts were categorized according to the American Speech-Language-Hearing Association's levels of evidence and the National Institutes of Health Quality Assessment Tools.

Results

Only 1 study implemented a randomized controlled trial design to assess cognitive function and behavioral symptoms after treatment with hearing aids. Other quasiexperimental studies evaluated dementia-related symptoms and/or auditory function after treating hearing loss in pre/post research designs. Finally, evidence from case studies suggested that hearing loss treatment is feasible, reduces stressful communication for caregivers, and improves dementia-related behavior problems.

Conclusion

Based on the systematic review, evidence suggests that treating hearing loss in persons with cognitive impairment can have benefits to communication and quality of life. Because of the quasi- and nonexperimental nature of most of the evidence found in this review, further studies are necessary to understand the effect of treatment in the context of a variable and progressive disease.

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Spatial variation in signal and sensory precision both constrain auditory acuity at high frequencies

Publication date: Available online 4 October 2018

Source: Hearing Research

Author(s): Andrew D. Brown, Victor Benichoux, Heath G. Jones, Kelsey L. Anbuhl, Daniel J. Tollin

Abstract

Sensory performance is constrained by the information in the stimulus and the precision of the involved sensory system(s). Auditory spatial acuity is robust across a broad range of sound frequencies and source locations, but declines at eccentric lateral angles. The basis of such variation is not fully understood. Low-frequency auditory spatial acuity is mediated by sensitivity to interaural time difference (ITD) cues. While low-frequency spatial acuity varies across azimuth and some physiological models predict strong medial bias in the precision of ITD sensitivity, human psychophysical ITD sensitivity appears to vary only slightly with reference ITD magnitude. Correspondingly, recent analyses suggest that spatial variation in human low-frequency acuity is well-accounted for by acoustic factors alone. Here we examine the matter of high-frequency auditory acuity, which is mediated by sensitivity to interaural level difference (ILD) cues. Using two different psychophysical tasks in human subjects, we demonstrate decreasing ILD acuity with increasing ILD magnitude. We then demonstrate that the multiplicative combination of spatially variant sensory precision and physical cue information (local slope of the ILD cue) provides improved prediction of classic high-frequency spatial acuity data. Finally, we consider correlates of magnitude dependent acuity in neurons that are sensitive to ILDs.

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Spatial variation in signal and sensory precision both constrain auditory acuity at high frequencies

Publication date: Available online 4 October 2018

Source: Hearing Research

Author(s): Andrew D. Brown, Victor Benichoux, Heath G. Jones, Kelsey L. Anbuhl, Daniel J. Tollin

Abstract

Sensory performance is constrained by the information in the stimulus and the precision of the involved sensory system(s). Auditory spatial acuity is robust across a broad range of sound frequencies and source locations, but declines at eccentric lateral angles. The basis of such variation is not fully understood. Low-frequency auditory spatial acuity is mediated by sensitivity to interaural time difference (ITD) cues. While low-frequency spatial acuity varies across azimuth and some physiological models predict strong medial bias in the precision of ITD sensitivity, human psychophysical ITD sensitivity appears to vary only slightly with reference ITD magnitude. Correspondingly, recent analyses suggest that spatial variation in human low-frequency acuity is well-accounted for by acoustic factors alone. Here we examine the matter of high-frequency auditory acuity, which is mediated by sensitivity to interaural level difference (ILD) cues. Using two different psychophysical tasks in human subjects, we demonstrate decreasing ILD acuity with increasing ILD magnitude. We then demonstrate that the multiplicative combination of spatially variant sensory precision and physical cue information (local slope of the ILD cue) provides improved prediction of classic high-frequency spatial acuity data. Finally, we consider correlates of magnitude dependent acuity in neurons that are sensitive to ILDs.

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Programa de educación para padres sobre estimulación del desarrollo del lenguaje de lactantes prematuros con riesgo de daño cerebral

Publication date: Available online 4 October 2018

Source: Revista de Logopedia, Foniatría y Audiología

Author(s): Amaya Soberón, María Elizabeth Mónica Carlier, Claudia Jiménez, Thalía Harmony, Lauren M. Cycyk

Resumen

Introducción

La interacción temprana madre-hijo es crítica para el desarrollo adecuado del lactante; sin embargo, la interacción de los padres con los lactantes prematuros presenta una dificultad particular por las circunstancias que acompañan un nacimiento prematuro, como son los factores de riesgo de daño cerebral, y la necesidad de estimulación temprana tanto motora como cognitiva que demandan estos bebés. Se ha observado que los programas educativos tienen efectos positivos en los padres de lactantes prematuros ya que mejoran los resultados de sus hijos en evaluaciones motrices, cognitivas y del lenguaje.

Método

En este trabajo se examina el efecto de un programa de educación para padres para estimular el desarrollo de las habilidades comunicativas de los lactantes prematuros. Se examinó cómo cambió la interacción padres-hijo después del programa de intervención. Adicionalmente, se compararon los resultados de las evaluaciones de lenguaje de los niños, hijos de los padres que participaron en el programa de intervención comparados con niños pares, hijos de padres que no participaron en dicho programa.

Resultados

El programa contribuyó a cambiar la interacción de los padres con los lactantes y a mejorar los puntajes en las evaluaciones posteriores del lenguaje de sus hijos.

Conclusión

Se recomienda la participación de los padres de niños prematuros en programas de educación para padres para estimular el desarrollo del lenguaje de sus hijos.

Abstract

Introduction

Early mother-child interaction is critical for proper infant development; however, the interaction of parents with preterm infants presents a particular difficulty due to the circumstances that accompany premature birth, such as risk factors for brain damage and the early motor and cognitive stimulation that these infants demand. It has been observed that educational programmes have positive effects on the parents of preterm infants as they improve the outcomes of their children in motor, cognitive and language assessments.

Method

This paper examines the effect of a parent education programme designed to stimulate the development of the early communicative skills of preterm infants. We examined how the parent-child interaction changed following the intervention programme. In addition, the results of the language evaluations of the children whose parents participated in the intervention programme and those whose parents did not participate were compared.

Results

The programme helped to change the interaction of parents with their infants and to improve scores in the children's subsequent language assessments.

Conclusion

Parents of premature children are encouraged to participate in parent education programmes to encourage the development of their child's language abilities.

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Programa de educación para padres sobre estimulación del desarrollo del lenguaje de lactantes prematuros con riesgo de daño cerebral

Publication date: Available online 4 October 2018

Source: Revista de Logopedia, Foniatría y Audiología

Author(s): Amaya Soberón, María Elizabeth Mónica Carlier, Claudia Jiménez, Thalía Harmony, Lauren M. Cycyk

Resumen

Introducción

La interacción temprana madre-hijo es crítica para el desarrollo adecuado del lactante; sin embargo, la interacción de los padres con los lactantes prematuros presenta una dificultad particular por las circunstancias que acompañan un nacimiento prematuro, como son los factores de riesgo de daño cerebral, y la necesidad de estimulación temprana tanto motora como cognitiva que demandan estos bebés. Se ha observado que los programas educativos tienen efectos positivos en los padres de lactantes prematuros ya que mejoran los resultados de sus hijos en evaluaciones motrices, cognitivas y del lenguaje.

Método

En este trabajo se examina el efecto de un programa de educación para padres para estimular el desarrollo de las habilidades comunicativas de los lactantes prematuros. Se examinó cómo cambió la interacción padres-hijo después del programa de intervención. Adicionalmente, se compararon los resultados de las evaluaciones de lenguaje de los niños, hijos de los padres que participaron en el programa de intervención comparados con niños pares, hijos de padres que no participaron en dicho programa.

Resultados

El programa contribuyó a cambiar la interacción de los padres con los lactantes y a mejorar los puntajes en las evaluaciones posteriores del lenguaje de sus hijos.

Conclusión

Se recomienda la participación de los padres de niños prematuros en programas de educación para padres para estimular el desarrollo del lenguaje de sus hijos.

Abstract

Introduction

Early mother-child interaction is critical for proper infant development; however, the interaction of parents with preterm infants presents a particular difficulty due to the circumstances that accompany premature birth, such as risk factors for brain damage and the early motor and cognitive stimulation that these infants demand. It has been observed that educational programmes have positive effects on the parents of preterm infants as they improve the outcomes of their children in motor, cognitive and language assessments.

Method

This paper examines the effect of a parent education programme designed to stimulate the development of the early communicative skills of preterm infants. We examined how the parent-child interaction changed following the intervention programme. In addition, the results of the language evaluations of the children whose parents participated in the intervention programme and those whose parents did not participate were compared.

Results

The programme helped to change the interaction of parents with their infants and to improve scores in the children's subsequent language assessments.

Conclusion

Parents of premature children are encouraged to participate in parent education programmes to encourage the development of their child's language abilities.

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Characteristics, behaviours and readiness of persons seeking hearing healthcare online

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Characteristics, behaviours and readiness of persons seeking hearing healthcare online

.


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Spatial variation in signal and sensory precision both constrain auditory acuity at high frequencies

Publication date: Available online 4 October 2018

Source: Hearing Research

Author(s): Andrew D. Brown, Victor Benichoux, Heath G. Jones, Kelsey L. Anbuhl, Daniel J. Tollin

Abstract

Sensory performance is constrained by the information in the stimulus and the precision of the involved sensory system(s). Auditory spatial acuity is robust across a broad range of sound frequencies and source locations, but declines at eccentric lateral angles. The basis of such variation is not fully understood. Low-frequency auditory spatial acuity is mediated by sensitivity to interaural time difference (ITD) cues. While low-frequency spatial acuity varies across azimuth and some physiological models predict strong medial bias in the precision of ITD sensitivity, human psychophysical ITD sensitivity appears to vary only slightly with reference ITD magnitude. Correspondingly, recent analyses suggest that spatial variation in human low-frequency acuity is well-accounted for by acoustic factors alone. Here we examine the matter of high-frequency auditory acuity, which is mediated by sensitivity to interaural level difference (ILD) cues. Using two different psychophysical tasks in human subjects, we demonstrate decreasing ILD acuity with increasing ILD magnitude. We then demonstrate that the multiplicative combination of spatially variant sensory precision and physical cue information (local slope of the ILD cue) provides improved prediction of classic high-frequency spatial acuity data. Finally, we consider correlates of magnitude dependent acuity in neurons that are sensitive to ILDs.

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Spatial variation in signal and sensory precision both constrain auditory acuity at high frequencies

Publication date: Available online 4 October 2018

Source: Hearing Research

Author(s): Andrew D. Brown, Victor Benichoux, Heath G. Jones, Kelsey L. Anbuhl, Daniel J. Tollin

Abstract

Sensory performance is constrained by the information in the stimulus and the precision of the involved sensory system(s). Auditory spatial acuity is robust across a broad range of sound frequencies and source locations, but declines at eccentric lateral angles. The basis of such variation is not fully understood. Low-frequency auditory spatial acuity is mediated by sensitivity to interaural time difference (ITD) cues. While low-frequency spatial acuity varies across azimuth and some physiological models predict strong medial bias in the precision of ITD sensitivity, human psychophysical ITD sensitivity appears to vary only slightly with reference ITD magnitude. Correspondingly, recent analyses suggest that spatial variation in human low-frequency acuity is well-accounted for by acoustic factors alone. Here we examine the matter of high-frequency auditory acuity, which is mediated by sensitivity to interaural level difference (ILD) cues. Using two different psychophysical tasks in human subjects, we demonstrate decreasing ILD acuity with increasing ILD magnitude. We then demonstrate that the multiplicative combination of spatially variant sensory precision and physical cue information (local slope of the ILD cue) provides improved prediction of classic high-frequency spatial acuity data. Finally, we consider correlates of magnitude dependent acuity in neurons that are sensitive to ILDs.

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Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).

Related Articles

Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).

Eur J Cancer. 2018 Oct 01;103:249-258

Authors: Nutting CM, Morden JP, Beasley M, Bhide S, Cook A, De Winton E, Emson M, Evans M, Fresco L, Gollins S, Gujral D, Harrington K, Joseph M, Lemon C, Luxon L, van den Blink Q, Mendes R, Miah A, Newbold K, Prestwich R, Robinson M, Sanghera P, Simpson J, Sivaramalingam M, Srihari NN, Sydenham M, Wells E, Witts S, Hall E, COSTAR Investigators

Abstract
PURPOSE: About 40-60% of patients treated with post-operative radiotherapy for parotid cancer experience ipsilateral sensorineural hearing loss. Intensity-modulated radiotherapy (IMRT) can reduce radiation dose to the cochlea. COSTAR, a phase III trial, investigated the role of cochlear-sparing IMRT (CS-IMRT) in reducing hearing loss.
METHODS: Patients (pT1-4 N0-3 M0) were randomly assigned (1:1) to 3-dimensional conformal radiotherapy (3DCRT) or CS-IMRT by minimisation, balancing for centre and radiation dose of 60Gy or 65Gy in 30 daily fractions. The primary end-point was proportion of patients with sensorineural hearing loss in the ipsilateral cochlea of ≥10 dB bone conduction at 4000 Hz 12 months after radiotherapy compared using Fisher's exact test. Secondary end-points included hearing loss at 6 and 24 months, balance assessment, acute and late toxicity, patient-reported quality of life, time to recurrence and survival.
RESULTS: From Aug 2008 to Feb 2013, 110 patients (54 3DCRT; 56 CS-IMRT) were enrolled from 22 UK centres. Median doses to the ipsilateral cochlea were 3DCRT: 56.2Gy and CS-IMRT: 35.7Gy (p < 0.0001). 67/110 (61%) patients were evaluable for the primary end-point; main reasons for non-evaluability were non-attendance at follow-up or incomplete audiology assessment. At 12 months, 14/36 (39%) 3DCRT and 11/31 (36%) CS-IMRT patients had ≥10 dB loss (p = 0.81). No statistically significant differences were observed in hearing loss at 6 or 24 months or in other secondary end-points including patient-reported hearing outcomes.
CONCLUSION: CS-IMRT reduced the radiation dose below the accepted tolerance of the cochlea, but this did not lead to a reduction in the proportion of patients with clinically relevant hearing loss.

PMID: 30286418 [PubMed - as supplied by publisher]

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Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).

Related Articles

Results of a multicentre randomised controlled trial of cochlear-sparing intensity-modulated radiotherapy versus conventional radiotherapy in patients with parotid cancer (COSTAR; CRUK/08/004).

Eur J Cancer. 2018 Oct 01;103:249-258

Authors: Nutting CM, Morden JP, Beasley M, Bhide S, Cook A, De Winton E, Emson M, Evans M, Fresco L, Gollins S, Gujral D, Harrington K, Joseph M, Lemon C, Luxon L, van den Blink Q, Mendes R, Miah A, Newbold K, Prestwich R, Robinson M, Sanghera P, Simpson J, Sivaramalingam M, Srihari NN, Sydenham M, Wells E, Witts S, Hall E, COSTAR Investigators

Abstract
PURPOSE: About 40-60% of patients treated with post-operative radiotherapy for parotid cancer experience ipsilateral sensorineural hearing loss. Intensity-modulated radiotherapy (IMRT) can reduce radiation dose to the cochlea. COSTAR, a phase III trial, investigated the role of cochlear-sparing IMRT (CS-IMRT) in reducing hearing loss.
METHODS: Patients (pT1-4 N0-3 M0) were randomly assigned (1:1) to 3-dimensional conformal radiotherapy (3DCRT) or CS-IMRT by minimisation, balancing for centre and radiation dose of 60Gy or 65Gy in 30 daily fractions. The primary end-point was proportion of patients with sensorineural hearing loss in the ipsilateral cochlea of ≥10 dB bone conduction at 4000 Hz 12 months after radiotherapy compared using Fisher's exact test. Secondary end-points included hearing loss at 6 and 24 months, balance assessment, acute and late toxicity, patient-reported quality of life, time to recurrence and survival.
RESULTS: From Aug 2008 to Feb 2013, 110 patients (54 3DCRT; 56 CS-IMRT) were enrolled from 22 UK centres. Median doses to the ipsilateral cochlea were 3DCRT: 56.2Gy and CS-IMRT: 35.7Gy (p < 0.0001). 67/110 (61%) patients were evaluable for the primary end-point; main reasons for non-evaluability were non-attendance at follow-up or incomplete audiology assessment. At 12 months, 14/36 (39%) 3DCRT and 11/31 (36%) CS-IMRT patients had ≥10 dB loss (p = 0.81). No statistically significant differences were observed in hearing loss at 6 or 24 months or in other secondary end-points including patient-reported hearing outcomes.
CONCLUSION: CS-IMRT reduced the radiation dose below the accepted tolerance of the cochlea, but this did not lead to a reduction in the proportion of patients with clinically relevant hearing loss.

PMID: 30286418 [PubMed - as supplied by publisher]

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