Chuan-Ming Li

Hearing Impairment Associated With Depression in US Adults, National Health and Nutrition Examination Survey 2005-2010

IMPORTANCE Depression among hearing impaired US adults has not been studied previously. OBJECTIVE To estimate the prevalence of and risk factors for depression among adults with hearing loss. DESIGN, SETTING, AND PARTICIPANTS Adults aged 18 years or older (N = 18 318) who participated in the National Health and Nutrition Examination Survey (NHANES), 2005-2010, a nationally representative sample. INTERVENTIONS Multistage probability sampling of US population. MAIN OUTCOMES AND MEASURES Depression, assessed by the 9-item Patient Health Questionnaire (PHQ-9) scale, and hearing impairment (HI), assessed by self-report and audiometric examination for adults aged 70 years or older. RESULTS The prevalence of moderate to severe depression (PHQ-9 score, ≥10) was 4.9% for individuals reporting excellent hearing, 7.1% for those with good hearing, and 11.4% for participants who reported a little trouble or greater HI. Using excellent hearing as the reference, after adjusting for all covariates, multivariate odds ratios (ORs) for depression were 1.4 (95% CI, 1.1-1.8) for good hearing, 1.7 (1.3-2.2) for a little trouble, 2.4 (1.7-3.2) for moderate trouble, 1.5 (0.9-2.6) for a lot of trouble, and 0.6 (0.1-2.6) for deaf. Moderate HI (defined by better ear pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz within the range 35- to 49-dB hearing level) was significantly associated with depression among older women (OR, 3.9; 95% CI, 1.3-11.3), after adjusting for age, sex, race/ethnicity, lifestyle characteristics, and selected health conditions. CONCLUSIONS AND RELEVANCE After accounting for health conditions and other factors, including trouble seeing, self-reported HI and audiometrically determined HI were significantly associated with depression, particularly in women. Health care professionals should be aware of an increased risk for depression among adults with hearing loss.

Breastfeeding and risk of infections at 6 years.

BACKGROUND: Previous studies have shown that breastfeeding is associated with reductions in the risk of common infections among infants; however, whether breastfeeding confers longer term protection is inconclusive. METHODS: We linked data from the 2005–2007 IFPS II (Infant Feeding Practices Study II) and follow-up data collected when the children were 6 years old. Multivariable logistic regression was used, controlling for sociodemographic variables, to examine associations of initiation, duration, exclusivity of breastfeeding, timing of supplementing breastfeeding with formula, and breast milk intensity (proportion of milk feedings that were breast milk from age 0–6 months) with maternal reports of infection (cold/upper respiratory tract, ear, throat, sinus, pneumonia/lung, and urinary) and sick visits in the past year among 6-year-olds (N = 1281). RESULTS: The most common past-year infections were colds/upper respiratory tract (66%), ear (25%), and throat (24%) infections. No associations were found between breastfeeding and colds/upper respiratory tract, lung, or urinary tract infections. Prevalence of ear, throat, and sinus infections and number of sick visits differed according to breastfeeding duration, exclusivity, and timing of supplementing breastfeeding with formula (P < .05). Among children ever breastfed, children breastfed for ≥9 months had lower odds of past-year ear (adjusted odds ratio [aOR]: 0.69 [95% confidence interval (95% CI): 0.48–0.98]), throat (aOR: 0.68 [95% CI: 0.47–0.98]), and sinus (aOR: 0.47 [95% CI: 0.30–0.72]) infections compared with those breastfed >0 to <3 months. High breast milk intensity (>66.6%) during the first 6 months was associated with lower odds of sinus infection compared with low breast milk intensity (<33.3%) (aOR: 0.53 [95% CI: 0.35–0.79]). CONCLUSIONS: This prospective longitudinal study suggests that breastfeeding may protect against ear, throat, and sinus infections well beyond infancy.

Sex-specific predictors of hearing-aid use in older persons: The age, gene/environment susceptibility - Reykjavik study

Abstract Objective: We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Design: Population-based cohort study. Study sample: A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Results: Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Conclusions: Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women.

Occupational noise exposure, hearing loss, and notched audiograms in the HUNT Nord‐Trøndelag hearing loss study, 1996–1998

To study the prevalence and usefulness of audiometric notches in the diagnosis of noise‐induced hearing loss (NIHL).

Hearing in older adults with exfoliation syndrome/exfoliation glaucoma or primary open-angle glaucoma

To determine whether adults, aged 66–96 years, with exfoliation syndrome (XFS)/exfoliation glaucoma (XFG), or primary open‐angle glaucoma (POAG) have poorer hearing than controls of similar age.

Hearing Disability Prevalence and Risk Factors in Two Recent National Surveys

INTRODUCTION Hearing loss is a worldwide societal and public health concern. Globally, disabling hearing loss affects 538 million adults (men, 12.2%; women, 9.8%). This study examined the prevalence and risk factors associated with deafness or serious difficulty hearing in two nationally representative surveys. METHODS Data were analyzed in 2017 from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) and the 2014 National Health Interview Survey. The BRFSS collected data through telephone interviews. The 2014 National Health Interview Survey collected face-to-face household interview data that included a hearing health supplement in the Sample Adult Core. Both surveys asked adults aged ≥18 years the disability question on deafness or serious difficulty hearing as defined by the American Community Survey. Weighted prevalence, prevalence ratios, and 95% CIs were calculated. Logistic regression was used to adjust for sociodemographic and geographic characteristics. RESULTS Prevalence of deafness or serious difficulty hearing was 5.8% (BRFSS) and 6.0% (National Health Interview Survey); males had a 60% higher prevalence than females. The prevalence was significantly associated with increasing age, lower educational level and income, and was higher among non-Hispanic whites than among non-Hispanic blacks and Hispanics. Deafness or serious difficulty hearing was strongly associated with increasing degree of self-reported trouble hearing in the National Health Interview Survey. The BRFSS state-specific prevalence varied from 3.8% to 13.3%, with higher prevalence in the most public health-challenged states according to Americas Health Rankings. CONCLUSIONS The prevalence of deafness or serious difficulty hearing was approximately 6% in the National Health Interview Survey and BRFSS, but increased considerably for older, less advantaged individuals and in more public health-challenged states.

Impact of Sensory Impairments on Functional Disability in Adults With Arthritis

INTRODUCTION Mobility is reduced in people with sensory impairments and those with arthritis. The combined impact of these conditions may be underappreciated. This study examines the associations between impairments in vision, hearing, and balance and functional ability in adults with versus without arthritis. METHODS Using National Health and Nutrition Examination Survey data from 1999-2004, arthritis status, functional ability, and sensory impairments (vision, hearing, and balance) were assessed from self-reported responses by 6,654 individuals aged ≥50 years (mean age, 63.4 years; 46.3% male). Multivariable regression analyses, conducted in 2014, assessed the associations between sensory impairment and arthritis on functional ability and mobility. RESULTS Among study participants, 41.8% reported having arthritis; of these, 27.1%, 44.9%, and 35.1% reported impaired vision, hearing, or balance, respectively. Having multiple sensory impairments was significantly associated with reduced functional ability in people with arthritis; individuals with three sensory impairments reported the highest levels of disability for all functional domains (compared with no impairment; lower extremity mobility, 80.2% vs 39.1%; general physical activities, 94.7% vs 75.9%; activities of daily living, 69.7% vs 27.2%; instrumental activities of daily living, 77.2% vs 37.4%; leisure and social activities, 66.3% vs 30.6%; impaired gait speed, 48.1% vs 16.3%; all p<0.001). Importantly, visual deficits, in combination with arthritis, had the greatest impact on mobility, with odds of impaired mobility at least twice as high as for individuals without arthritis. CONCLUSIONS Addressing sensory deficits, especially difficulties with vision, may improve functional ability, which may be particularly helpful for adults with arthritis.