Alex Pinto

Factors Related to Fungiform Papillae Density: The Beaver Dam Offspring Study

The distribution of fungiform papillae density and associated factors were examined in the Beaver Dam Offspring Study. Data were from 2371 participants (mean age = 48.8 years, range = 21-84 years) with 1108 males and 1263 females. Fungiform papillae were highlighted with blue food coloring and the number of fungiform papillae within a standard 6-mm circle was counted. Whole mouth suprathreshold taste intensity was measured. The mean fungiform papillae density was 103.5 papillae/cm(2) (range = 0-212.2 papillae/cm(2)). For each 5-year increase in age, the mean fungiform papillae density was 2.8 papillae/cm(2) lower and the mean density for males was 10.2 papillae/cm(2) lower than for females. Smokers had significantly lower mean densities (former smokers: -5.1 papillae/cm(2); current smokers: -9.3 papillae/cm(2)) than nonsmokers, and heavy alcohol drinkers had a mean density that was 4.7 papillae/cm(2) lower than nonheavy drinkers. Solvent exposure was related to a significantly higher density (+6.8 papillae/cm(2)). The heritability estimate for fungiform papillae density was 40.2%. Propylthiouracil taster status, TAS2R38 haplotype, and perceived taste intensity were not related to density. In summary, wide variability in fungiform papillae density was observed and a number of related factors were found including the modifiable factors of smoking and alcohol consumption.

Taste intensity in the Beaver Dam Offspring Study.

To determine the distribution of the perceived intensity of salt, sweet, sour, and bitter in a large population and to investigate factors associated with perceived taste intensity.

Self-Reported Hearing Difficulties Among Adults With Normal Audiograms: The Beaver Dam Offspring Study.

Objective: Clinicians encounter patients who report experiencing hearing difficulty (HD) even when audiometric thresholds fall within normal limits. When there is no evidence of audiometric hearing loss, it generates debate over possible biomedical and psychosocial etiologies. It is possible that self-reported HDs relate to variables within and/or outside the scope of audiology. The purpose of this study is to identify how often, on a population basis, people with normal audiometric thresholds self-report HD and to identify factors associated with such HDs. Design: This was a cross-sectional investigation of participants in the Beaver Dam Offspring Study. HD was defined as a self-reported HD on a four-item scale despite having pure-tone audiometric thresholds within normal limits (<20 dB HL0.5, 1, 2, 3, 4, 6, 8 kHz bilaterally, at each frequency). Distortion product otoacoustic emissions and word-recognition performance in quiet and with competing messages were also analyzed. In addition to hearing assessments, relevant factors such as sociodemographic and lifestyle factors, environmental exposures, medical history, health-related quality of life, and symptoms of neurological disorders were also examined as possible risk factors. The Center for Epidemiological Studies-Depression was used to probe symptoms associated with depression, and the Medical Outcomes Study Short-Form 36 mental score was used to quantify psychological stress and social and role disability due to emotional problems. The Visual Function Questionnaire-25 and contrast sensitivity test were used to query vision difficulties. Results: Of the 2783 participants, 686 participants had normal audiometric thresholds. An additional grouping variable was created based on the available scores of HD (four self-report questions), which reduced the total dataset to n = 682 (age range, 21–67 years). The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0% (82 of 682). The prevalence in the entire cohort was therefore 2.9% (82 of 2783). Performance on audiological tests (distortion product otoacoustic emissions and word-recognition tests) did not differ between the group self-reporting HD and the group reporting no HD. A multivariable model controlling for age and sex identified the following risk factors for HD: lower incomes (odds ratio [OR]

Age-Related Sensory Impairments and Risk of Cognitive Impairment.

50,000+ = 0.55, 95% confidence interval [CI] = 0.30–1.00), noise exposure through loud hobbies (OR = 1.48, 95% CI = 1.15–1.90), or firearms (OR = 2.07, 95% CI = 1.04–4.16). People reporting HD were more likely to have seen a doctor for hearing loss (OR = 12.93, 95% CI = 3.86–43.33) and report symptoms associated with depression (Center for Epidemiological Studies-Depression [OR = 2.39, 95% CI = 1.03–5.54]), vision difficulties (Visual Function Questionnaire-25 [OR = 0.93, 95% CI = 0.89–0.97]), and neuropathy (e.g., numbness, tingling, and loss of sensation [OR = 1.98, 95% CI = 1.14–3.44]). Conclusions: The authors used a population approach to identify the prevalence and risk factors associated with self-reported HD among people who perform within normal limits on common clinical tests of auditory function. The percentage of individuals with normal audiometric thresholds who self-reported HD was 12.0%, resulting in an overall prevalence of 2.9%. Auditory and nonauditory risk factors were identified, therefore suggesting that future directions aimed at assessing, preventing, and managing these types of HDs might benefit from information outside the traditional scope of audiology.

The associations between 6-n-propylthiouracil (PROP) intensity and taste intensities differ by TAS2R38 haplotype.

To evaluate the associations between sensory impairments and 10‐year risk of cognitive impairment.

Sensory Impairments and Risk of Mortality in Older Adults

Background/Aims: The influence of TAS2R38 haplotype on the relationship between the perceived intensity of propylthiouracil (PROP) and the basic tastes of salt, sweet, sour, and bitter (quinine) was evaluated in the Beaver Dam Offspring Study. Methods: Genotyping was performed on 1,670 participants aged ≥45 years (mean age = 54.4; range = 45-84), and suprathreshold taste intensity was measured using filter paper disks and a general labeled magnitude scale (0-100). Results: Among those with taste intensity data and the PAV or AVI haplotype (n = 1,258), the mean perceived intensity of PROP was 37.3 (SD = 30.0), but it varied significantly (p < 0.0001) by diplotype (PAV/PAV = 60.1; PAV/AVI = 46.5; AVI/AVI = 14.4). PROP intensity was correlated with the basic taste intensities (salt: r = 0.22; sweet: r = 0.25; sour: r = 0.21; quinine bitterness: r = 0.38; p < 0.001 for all tastes); however, a significant effect modification of the PROP-taste intensity relationships by TAS2R38 diplotype was observed. There was a stronger association between PROP and each of the basic tastes in the PAV/PAV diplotype group than in the other groups. Conclusions: Directly measuring the perceived intensity of the 4 tastes, rather than using PROP intensity as an indicator of taste responsiveness, is recommended for studies of taste perception.

Carotid Intima Media Thickness, Atherosclerosis, and 5-Year Decline in Odor Identification: The Beaver Dam Offspring Study

Background Sensory impairments increase with age and the majority of older people will experience a sensory impairment if they live long enough. However, the relationships of hearing, visual, and olfactory impairments with mortality are not well understood. Methods Epidemiology of Hearing Loss Study participants (n = 2,418) aged 53-97 years (mean = 69 years) were examined in 1998-2000 and hearing, visual acuity, and olfaction were measured. Participants were followed for mortality for up to 17 years (mean = 12.8 years). Cox proportional hazards models were used to assess the association between prevalent sensory impairments and the 15-year cumulative incidence of death. Results A total of 1,099 (45.4%) of participants died during the follow-up period. In age- and sex-adjusted Cox models, the risk of mortality was higher among participants with one (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.19, 1.64) or two or more (HR = 2.12, 95% CI = 1.74, 2.58) sensory impairments than among participants with no sensory impairments. Olfactory impairment at baseline was significantly associated with mortality (HR = 1.28, 95% CI = 1.07, 1.52) after adjusting for age, sex, sensory comorbidities, cardiovascular risk factors and disease, cognitive impairment, frailty, subclinical atherosclerosis, and inflammatory marker levels (n = 1,745). Hearing and visual impairment were not associated with mortality after adjusting for subclinical atherosclerosis and inflammation. Conclusion Olfactory impairment, but not hearing or visual impairment, was associated with an increased risk of mortality. These results suggest that olfactory impairment may be a marker of underlying physiologic processes or pathology that is associated with aging and reduced survival in older adults.

Inflammatory and vascular markers and olfactory impairment in older adults

BACKGROUND The purpose of this study was to determine if subclinical markers of atherosclerosis are associated with a decline in olfactory function. METHODS The San Diego Odor Identification Test was administered to 2,302 participants (age 21-84 years) at the baseline (2005-2008) and 5-year follow-up (2010-2013) examinations of the Beaver Dam Offspring Study. A decline in odor identification was defined as a decrease in San Diego Odor Identification Test score of 2 or more (range 0-8) from Beaver Dam Offspring Study 1 to Beaver Dam Offspring Study 2. Carotid intima media thickness and plaque, blood pressure, pulse wave velocity, and body mass index were measured and other risk factor data were obtained by interview. RESULTS Overall 3.2% of participants had a decline in San Diego Odor Identification Test score at 5 years. In age- and sex-adjusted models, mean intima media thickness (odds ratio = 1.17, 95% CI = 1.01, 1.34, per 0.1 mm) and number of sites (range 0-6) with carotid artery plaque (odds ratio = 1.35, 95% CI = 1.11, 1.65, per site) at baseline were associated with an increased risk for decline. Plaque score (odds ratio = 1.24, 95% CI = 1.01, 1.53) remained a significant independent predictor of olfactory decline in a model that included age, sex, hypertension, body mass index, alcohol, and smoking. CONCLUSIONS Subclinical atherosclerosis was associated with an increased risk for olfactory decline indicating that atherosclerosis may be one of the risk factors for the decline in olfactory function seen with aging. Strategies to improve vascular health may also benefit olfactory health.

Hearing impairment and retirement.

BACKGROUND the incidence of olfactory impairment increases sharply in the eighth and ninth decades of life but the aetiology of age-related olfactory decline is not well understood. Inflammation and atherosclerosis are associated with many age-related conditions and atherosclerosis has been associated with olfactory decline in middle-aged adults. OBJECTIVE to determine if inflammatory markers and atherosclerosis are associated with the development of olfactory impairment in older adults. DESIGN longitudinal, population-based study. SETTING/PARTICIPANTS a total of 1,611 participants, aged 53-97 years in the Epidemiology of Hearing Loss Study without olfactory impairment at the 1998-2000 examination and with follow-up at a subsequent examination 5 and/or 10 years later. METHODS the San Diego Odor Identification Test was used to measure olfaction. High sensitivity C-reactive protein, interleukin-6 and tumour necrosis factor-α were measured in serum and carotid ultrasound images were obtained for the measurement of carotid intima media thickness (IMT) and plaque assessment. Medical history, behavioural and lifestyle information were obtained by interview. RESULTS inflammatory markers, IMT and plaque were not associated with the 10-year cumulative incidence of olfactory impairment in adjusted Cox proportional hazard models. Among those <60 years, the mean IMT [hazard ratio (HR) = 4.35, 95% confidence interval (CI) = 1.69-11.21, tertile 3 versus tertile 1] and the number of sites with plaque (HR = 1.56, 95% CI = 1.17-2.08, per site) were associated with an increased risk of developing an olfactory impairment at follow-up. CONCLUSION subclinical atherosclerosis at a younger age may be a risk factor for the development of olfactory impairment.

Odor detection thresholds in a population of older adults.

BACKGROUND Many factors influence the decision to retire including age, insurance, and pension availability along with physical and mental health. Hearing impairment may be one such factor. PURPOSE The purpose of this study was to compare the 15 yr retirement rate among subjects with and without hearing impairment. RESEARCH DESIGN Prospective, population-based study. STUDY SAMPLE Subjects were participants in the Epidemiology of Hearing Loss Study (EHLS), a longitudinal investigation of age-related hearing loss. Participants who were working full- or part-time in 1993-1995 were included (n = 1410, mean age = 57.8 yr). DATA COLLECTION AND ANALYSIS Data from four EHLS phases (1993-1995, 1998-2000, 2003-2005, and 2009-2010) were analyzed in 2010-2012. Hearing impairment was defined as a pure tone threshold average (at 0.5, 1, 2, and 4 kHz) greater than 25 dB HL in the worse ear. Employment status was determined at each of the four phases. Kaplan-Meier estimates of the cumulative incidence of retirement were calculated, and Cox discrete-time modeling was used to determine the effect of hearing impairment on the rate of retirement. RESULTS The cumulative incidence of retirement was significantly (p < 0.02) higher in those with a hearing impairment (77%) compared to those without a hearing impairment (74%). After adjustment for age, gender, self-reported health, and history of chronic disease, there was no significant difference in the rate of retirement between those with and without a hearing impairment (hazard ratio [HR] = 0.9, 95% confidence interval (CI) = 0.7, 1.1). Similar results were observed when hearing aid users were excluded, when hearing impairment was based on the better ear thresholds, and when analyses were restricted to those under 65 yr of age and working full-time at baseline. Participants with a hearing impairment were less likely to state that the main reason for retirement was that the time seemed right. CONCLUSIONS Hearing impairment was found to be associated with a higher rate of retirement, but the association was not independent of the effects of age, gender, and health.