Mark Edmondson-Jones

Hearing loss and cognition: the role of hearing AIDS, social isolation and depression.

Hearing loss is associated with poor cognitive performance and incident dementia and may contribute to cognitive decline. Treating hearing loss with hearing aids may ameliorate cognitive decline. The purpose of this study was to test whether use of hearing aids was associated with better cognitive performance, and if this relationship was mediated via social isolation and/or depression. Structural equation modelling of associations between hearing loss, cognitive performance, social isolation, depression and hearing aid use was carried out with a subsample of the UK Biobank data set (n = 164,770) of UK adults aged 40 to 69 years who completed a hearing test. Age, sex, general health and socioeconomic status were controlled for as potential confounders. Hearing aid use was associated with better cognition, independently of social isolation and depression. This finding was consistent with the hypothesis that hearing aids may improve cognitive performance, although if hearing aids do have a positive effect on cognition it is not likely to be via reduction of the adverse effects of hearing loss on social isolation or depression. We suggest that any positive effects of hearing aid use on cognition may be via improvement in audibility or associated increases in self-efficacy. Alternatively, positive associations between hearing aid use and cognition may be accounted for by more cognitively able people seeking and using hearing aids. Further research is required to determine the direction of association, if there is any direct causal relationship between hearing aid use and better cognition, and whether hearing aid use results in reduction in rates of cognitive decline measured longitudinally.

Re-examining the relationship between audiometric profile and tinnitus pitch

Abstract Objective: We explored the relationship between audiogram shape and tinnitus pitch to answer questions arising from neurophysiological models of tinnitus: ‘Is the dominant tinnitus pitch associated with the edge of hearing loss?’ and ‘Is such a relationship more robust in people with narrow tinnitus bandwidth or steep sloping hearing loss?’ Design: A broken-stick fitting objectively quantified slope, degree and edge of hearing loss up to 16 kHz. Tinnitus pitch was characterized up to 12 kHz. We used correlation and multiple regression analyses for examining relationships with many potentially predictive audiometric variables. Study Sample: 67 people with chronic bilateral tinnitus (43 men and 24 women, aged from 22 to 81 years). Results: In this ample of 67 subjects correlation failed to reveal any relationship between the tinnitus pitch and the edge frequency. The tinnitus pitch generally fell within the area of hearing loss. The pitch of the tinnitus in a subset of subjects with a narrow tinnitus bandwidth (n = 23) was associated with the audiometric edge. Conclusions: Our findings concerning subjects with narrow tinnitus bandwidth suggest that this can be used as an a priori inclusion criterion. A large group of such subjects should be tested to confirm these results. Sumario Objetivo: Exploramos la relación entre la forma del audiograma y el tono del acufeno para responder a preguntas provenientes de modelos neurofisiológicos del acúfeno: ‘Es el tono dominante del acúfeno asociado con el borde de la hipoacusia?’y ‘Será tal relación más robusta en personas con un acúfeno de banda angosta o con una hipoacusia de caída abrupta?’ Diseño: Una pendiente tipo “palo roto” objetivamente cuantificada, con severidad y borde de la hipoacusia hasta 16 kHz. El tono del acúfeno fue caracterizado hasta 12 kHz. Utilizamos un análisis de correlación y regresión múltiple para examinar la relación con muchas de las variables potencialmente predictivas. Muestra del estudio: 67 personas con acúfeno bilateral crónico (43 hombres y 24 mujeres con edades entre 22 y 81 años). Resultados: En esta amplia muestra de 67 sujetos, la correlación no demostró ninguna relación entre el acúfeno y el borde de la frecuencia. El tono del acúfeno generalmente cayó dentro del área de la hipoacusia. En un subgrupo de sujetos, que tenían un acúfeno de banda angosta (n=23), si hubo asociación con el borde audiométrico. Conclusiones: Nuestros hallazgos que corresponden a los sujetos con un acúfeno de banda angosta, sugieren que esto puede ser utilizado a priori como un criterio de inclusión. Un grupo grande de sujetos debe ser examinado para confirmar estos resultados.

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age

Background Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition. Methods and Findings About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing. Conclusions Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.

Hearing in middle age: A population snapshot of 40- to 69-year olds in the united kingdom

Objectives: To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of U.K. adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. Design: The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure, as well as demographic variables were collected. Results: Overall, 10.7% of adults (95% confidence interval [CI] 10.5–10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6–17.1%) and hearing aid use was 2.0% (95%CI 1.9–2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Conclusions: Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underuse of hearing aids has altered little since the 1980s, and is a major cause for concern.

Agreement and Reliability of Tinnitus Loudness Matching and Pitch Likeness Rating

The ability to reproducibly match tinnitus loudness and pitch is important to research and clinical management. Here we examine agreement and reliability of tinnitus loudness matching and pitch likeness ratings when using a computer-based method to measure the tinnitus spectrum and estimate a dominant tinnitus pitch, using tonal or narrowband sounds. Group level data indicated a significant effect of time between test session 1 and 2 for loudness matching, likely procedural or perceptual learning, which needs to be accounted in study design. Pitch likeness rating across multiple frequencies appeared inherently more variable and with no systematic effect of time. Dominant pitch estimates reached a level of clinical acceptability when sessions were spaced two weeks apart. However when dominant tinnitus pitch assessments were separated by three months, acceptable agreement was achieved only for group mean data, not for individual estimates. This has implications for prescription of some sound-based interventions that rely on accurate measures of individual dominant tinnitus pitch.

Relationship between tinnitus pitch and edge of hearing loss in individuals with a narrow tinnitus bandwidth

Abstract Objective: Psychoacoustic measures of tinnitus, in particular dominant tinnitus pitch and its relationship to the shape of the audiogram, are important in determining and verifying pathophysiological mechanisms of the condition. Our previous study postulated that this relationship might vary between different groups of people with tinnitus. For a small subset of participants with narrow tinnitus bandwidth, pitch was associated with the audiometric edge, consistent with the tonotopic reorganization theory. The current study objective was to establish this relationship in an independent sample. Design: This was a retrospective design using data from five studies conducted between 2008 and 2013. Study sample: From a cohort of 380 participants, a subgroup group of 129 with narrow tinnitus bandwidth were selected. Results: Tinnitus pitch generally fell within the area of hearing loss. There was a statistically significant correlation between dominant tinnitus pitch and edge frequency; higher edge frequency being associated with higher dominant tinnitus pitch. However, similar to our previous study, for the majority of participants pitch was more than an octave above the edge frequency. Conclusions: The findings did not support our prediction and are therefore not consistent with the reorganization theory postulating tinnitus pitch to correspond to the audiometric edge.

Vision impairment and dual sensory problems in middle age

Vision and hearing impairments are known to increase in middle age. In this study we describe the prevalence of vision impairment and dual sensory impairment in UK adults aged 40–69 years in a very large and recently ascertained data set. The associations between vision impairment, age, sex, socioeconomic status, and ethnicity are reported.

The Effect of Prenatal and Childhood Development on Hearing, Vision and Cognition in Adulthood

It is unclear what the contribution of prenatal versus childhood development is for adult cognitive and sensory function and age-related decline in function. We examined hearing, vision and cognitive function in adulthood according to self-reported birth weight (an index of prenatal development) and adult height (an index of early childhood development). Subsets (N = 37,505 to 433,390) of the UK Biobank resource were analysed according to visual and hearing acuity, reaction time and fluid IQ. Sensory and cognitive performance was reassessed after ~4 years (N = 2,438 to 17,659). In statistical modelling including age, sex, socioeconomic status, educational level, smoking, maternal smoking and comorbid disease, adult height was positively associated with sensory and cognitive function (partial correlations; pr 0.05 to 0.12, p < 0.001). Within the normal range of birth weight (10th to 90th percentile), there was a positive association between birth weight and sensory and cognitive function (pr 0.06 to 0.14, p < 0.001). Neither adult height nor birth weight was associated with change in sensory or cognitive function. These results suggest that adverse prenatal and childhood experiences are a risk for poorer sensory and cognitive function and earlier development of sensory and cognitive impairment in adulthood. This finding could have significant implications for preventing sensory and cognitive impairment in older age.

Association of Dietary Factors with Presence and Severity of Tinnitus in a Middle-Aged UK Population

Objective The impact of dietary factors on tinnitus has received limited research attention, despite being a considerable concern among people with tinnitus and clinicians. The objective was to examine the link between dietary factors and presence and severity of tinnitus. Design This study used the UK Biobank resource, a large cross-sectional study of adults aged 40–69. 171,722 eligible participants were asked questions specific to tinnitus (defined as noises such as ringing or buzzing in the head or ears). Dietary factors included portions of fruit and vegetables per day, weekly fish consumption (oily and non-oily), bread type, cups of caffeinated coffee per day, and avoidance of dairy, eggs, wheat and sugar. We controlled for lifestyle, noise exposure, hearing, personality and comorbidity factors. Results Persistent tinnitus, defined as present at least a lot of the time, was elevated with increased: (i) fruit/vegetable intake (OR = 1.01 per portion/day), (ii) bread (wholemeal/wholegrain, OR = 1.07; other bread, 1.20) and (iii) dairy avoidance (OR = 1.27). Persistent tinnitus was reduced with: (i) fish consumption (non-oily, OR = 0.91; oily, 0.95), (ii) egg avoidance (OR = 0.87) and (iii) caffeinated coffee consumption (OR = 0.99 per cup/day). Reports of “bothersome” tinnitus (moderate-severe handicap) increased with wholemeal/wholegrain bread intake (OR = 0.86). Reports of less frequent transient tinnitus increased with dairy avoidance (OR = 1.18) and decreased with caffeinated coffee (OR = 0.98 per cup/day) and brown bread (OR = 0.94). Conclusions This is the first population study to report the association between dietary factors and tinnitus. Although individually dietary associations are mostly modest, particular changes in diet, such as switching between foodstuffs, may result in stronger associations. These findings offer insights into possible dietary associations with tinnitus, and this may be useful when discussing management options in combination with other lifestyle changes and therapies.

A Controlled Approach to the Emotional Dilution of the Stroop Effect

We re-examined a modified emotional Stroop task that included an additional colour-word alongside the emotional word, providing the response conflict of the traditional Stroop task. Negative emotionally salient (i.e. unpleasant’) words are claimed to capture attention, producing a smaller Stroop effect for negative words compared to neutral words; this phenomenon is called the emotional dilution of the Stroop effect. To address previous limitations, this study compared negative words with lexically matched neutral words in a powered sample of 45 participants. Results demonstrated an emotional Stroop effect (slower colour-naming responses for negative words) and a traditional Stroop effect but not an emotional dilution of the Stroop effect. This finding is at odds with claims that other processing resources are diminished through the failure to disengage attention from emotional information. No matter how attention towards emotional information builds up over time, our findings indicate that attentional resources are not fully captured by negative words.