Association Between Age-Related Hearing Loss and Stroke in an Older Population

Department of Ophthalmology, Westmead Millennium Institute and Australian Health Policy Institute, Centre for Vision Research, University of Sydney, Westmead Hospital, Westmead, NSW, Australia.
Stroke (Impact Factor: 6.02). 02/2009; 40(4):1496-8. DOI: 10.1161/STROKEAHA.108.535682
Source: PubMed

ABSTRACT Very few studies have investigated the association between hearing loss and stroke. A recent article in Stroke reported an increased incidence of stroke among patients with sudden hearing loss over a 5-year follow-up period. Our study aimed to explore this association among subjects with age-related hearing loss from a representative population. Further, we looked at the association between severity of hearing loss and risk of stroke in older persons, acknowledged as a limitation by the authors of the Stroke report.
The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss conducted during 1997 to 1999 and 2002 to 2004, among participants of the Blue Mountains Eye Study. Pure-tone air conduction hearing thresholds from 0.25 to 8.0 kHz were measured by audiologists. Hearing loss was defined as the pure-tone average of frequencies 0.5, 1.0, 2.0, and 4.0 kHz >25 dB HL in the better ear.
Persons with moderate to severe hearing loss had a significantly higher likelihood of reporting previous stroke (OR, 2.04; 95% CI, 1.20-3.49) after multivariable adjustment. However, moderate to severe hearing loss did not predict incident stroke after 5-year follow-up (OR, 1.14; 95% CI, 0.59-2.23).
We observed a strong cross-sectional association between stroke and moderate to severe hearing loss. However, age-related hearing loss did not increase risk of incident stroke in our cohort. Insufficient study power or differing underlying pathologies of sudden sensorineural hearing loss and typical age-related hearing loss may account for the discrepant findings between these studies.

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    ABSTRACT: Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD) is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.
    01/2014; 2014:261824. DOI:10.1155/2014/261824
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    ABSTRACT: Age-related hearing loss (ARHL), the progressive loss of hearing associated with aging, is the most common sensory disorder in the elderly population. The pathology of ARHL includes the hair cells of the organ of Corti, stria vascularis, and afferent spiral ganglion neurons as well as the central auditory pathways. Many studies have suggested that the accumulation of mitochondrial DNA damage, the production of reactive oxygen species, and decreased antioxidant function are associated with subsequent cochlear senescence in response to aging stress. Mitochondria play a crucial role in the induction of intrinsic apoptosis in cochlear cells. ARHL can be prevented in laboratory animals by certain interventions, such as caloric restriction and supplementation with antioxidants. In this review, we will focus on previous research concerning the role of the oxidative stress and mitochondrial dysfunction in the pathology of ARHL in both animal models and humans and introduce concepts that have recently emerged regarding the mechanisms of the development of ARHL.
    Oxidative medicine and cellular longevity 07/2014; 2014:582849. DOI:10.1155/2014/582849 · 3.36 Impact Factor
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    ABSTRACT: Objective This study was conducted to determine the concentration of EPCs in patients with ARHL. Methods Twenty patients with ARHL were evaluated. The number of EPCs was analyzed by flow cytometry analysis of peripheral blood CD34+/CD133+ cells. Results The concentration of circulating EPCs, both for CD34+/CD133+ cells, were significantly lower in ARHL patients compared to controls (p < 0.05). No statistically significant differences were found between these two groups in terms of the level of total cholesterol, LDL, HDL, triglycerides and GLU. Conclusions The possible role of circulating epithelial progenitor cells in the pathogenesis of age related hearing loss should be considered based on their significant reduction in patients with ARHL, although the association alone does not prove causality. Further studies were warranted to confirm the role of circulating EPCs in the pathogenesis of ARHL.
    American Journal of Otolaryngology 08/2014; 35(6). DOI:10.1016/j.amjoto.2014.08.005 · 1.08 Impact Factor


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May 16, 2014