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ABSTRACT: Hearing difficulties are a large public health problem. Knowledge is scarce regarding risk of disability pension among people who have been sickness absent due to these difficulties.
A cohort including all 4,687,756 individuals living in Sweden in 2005, aged 20-64, and not on disability or old-age pension, was followed through 2009. Incidence rate ratios (RR) of disability pension with 95% confidence intervals (CI) were estimated using Cox proportional hazard models.
In multivariable models, individuals who had a sick-leave spell due to otoaudiological diagnoses in 2005 had a 1.52-fold (95% CI: 1.43-1.62) increased risk of being granted a disability pension compared to individuals on sick leave due to other diagnoses. Hearing and tinnitus sick-leave diagnoses were associated with risk of disability pension: RR 3.38, 95% CI: 3.04-3.75, and 3.30, 95% CI: 2.95-3.68, respectively. No association was observed between sick leave due to vertigo diagnoses and disability pension whereas otological diagnoses and no sick leave were inversely associated with risk of disability pension compared to non-otoaudiological sick-leave diagnoses. Sick leave due to otoaudiological diagnoses was positively associated with risk of disability pension due to otoaudiological diagnoses and sick leave due to a tinnitus diagnosis was also associated with risk of disability pension due to mental diagnoses. The risk of disability pension among individuals with hearing or tinnitus sick-leave diagnoses was highest in the age group 35-44. Moreover, men had a slightly higher risk.
This large cohort study suggests an increased risk of disability pension among those with sickness absence due to otoaudiological diagnoses, particularly hearing and tinnitus diagnoses, compared to those with sickness absence due to non-otoaudiological diagnoses.
PLoS ONE 01/2012; 7(1):e29966. · 4.09 Impact Factor
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ABSTRACT: Audiological data from a population based epidemiological investigation were studied on elderly persons. Specific diagnoses of otological and audiological disorders, which can result in hearing loss, were searched for.
A retrospective register study.
Three age cohorts, 474 70- and 75-year olds ("younger"), and 252 85-year olds ("older"), were studied. Clinical pure tone and speech audiometry was used. Data from medical files were included.
Conductive hearing loss was diagnosed in 6.1% of the "younger" elderly persons, and in 10.3% of the "older" ones. Specific diagnoses (chronic otitis media and otosclerosis) were established in about half of the cases. Sensorineural hearing loss, other than age-related hearing loss and noise induced hearing loss, was diagnosed in 3.4 % and 5.2% respectively. Severely impaired speech recognition, possibly reflecting age-related auditory neuropathy, was found in 0.4% in the "younger" group, and in 10% in the "older" group. Bilateral functional deafness was present in 3.2% of the 85-year-old persons, but was not present in the 70-75-year group.
The incidence of probable age-related auditory neuropathy increases considerably from 70-75 to 85 years. There are marked differences between "younger" and "older" elderly persons regarding hearing loss that severely affects oral communication.
International journal of audiology 09/2011; 50(9):578-81. · 1.34 Impact Factor
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ABSTRACT: Hearing difficulties is a growing public health problem and more knowledge of consequences of those difficulties in working life is warranted.
To study the future risk of being granted a disability pension (DP) among people with sickness absence with an otoaudiological diagnoses (OAD) compared to other sickness absentees.
A population-based prospective cohort study of all 40,786 people in a Swedish county who in 1985 were aged 16-64 and had a new sick-leave spell >7 days. Those were followed for 12 years with regard to DP. Hazard ratios (HR) + 95% confidence intervals (CI) of being granted DP was calculated among those with sick leave due to OAD compared to people with sickness absence with other diagnoses.
In 1985, 515 people had a new sick-leave spell with an OAD. Twelve years later, 36% of those had been granted DP, compared to 24% of all other sickness absentees. Their HR for DP was 1.42 (95% CI 1.23-1.64) adjusting for gender and age. Compared to men, women with an OAD had a HR of DP of 1.24 (95% CI 0.90-1.71), when adjusted for age. The HR for DP regarding those aged>45 years and sickness absent with OAD was 2.63 (95% CI 1.95-3.55) compared to the sickness absentees with OAD below 45 years of age, adjusted for gender.
The risk for future DP was more than 40% higher among those initially on sickness absence due to OAD than among other sickness absentees.
Scandinavian Journal of Public Health 03/2011; 39(5):501-7. · 1.39 Impact Factor
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ABSTRACT: to investigate auditory function in subjects with early Alzheimer's disease, mild cognitive impairment and with subjective memory complaints, in search of signs of central auditory processing dysfunction even in early stages of cognitive impairment.
a consecutive group of men and women, referred to the Memory Clinic at the Karolinska University Hospital, was approached for inclusion in this prospective study. One hundred and thirty-six subjects, mean age 64 years (range 50-78 years), diagnosed with Alzheimer's disease (n = 43), mild cognitive impairment (n = 59) or with subjective memory complaints (n = 34), were included.
auditory function was assessed with pure tone audiometry, speech perception in quiet and in background noise and dichotic digits tests with two or three digits.
pure tone audiometry and speech perception scores in quiet and in background noise were normal for age and without between-group differences. Dichotic digits tests showed strongly significant differences between the three groups, where the Alzheimer's disease group performed significantly poorer than the other two groups, with the mild cognitive impairment group in an intermediate position.
our results demonstrate that central auditory processing dysfunction is highly evident in subjects with Alzheimer's disease, and to a considerable extent even in subjects with mild cognitive impairment.
Age and Ageing 03/2011; 40(2):249-54. · 3.09 Impact Factor
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ABSTRACT: To investigate the validity and reproducibility of a newly developed internet-based self-administered hearing test using clinical pure-tone air-conducted audiometry as gold standard.
Cross-sectional intrasubject comparative study.
Karolinska University Hospital, Solna, Sweden.
Seventy-two participants (79% women) with mean age of 45 years (range, 19-71 yr). Twenty participants had impaired hearing according to the gold standard test.
Hearing tests.
The Pearson correlation coefficient between the results of the studied Internet-based hearing test and the gold standard test, the greatest mean differences in decibel between the 2 tests over tested frequencies, sensitivity and specificity to diagnose hearing loss defined by Heibel-Lidén, and test-retest reproducibility with the Pearson correlation coefficient.
The Pearson correlation coefficient was 0.94 (p < 0.0001) for the right ear and 0.93 for the left (p = 0.0001). The greatest mean differences were seen for the frequencies 2 and 4 kHz, with -5.6 dB (standard deviation, 8.29), and -5.1 dB (standard deviation, 6.9), respectively. The 75th percentiles of intraindividual test-gold standard differences did not exceed -10 dB for any of the frequencies. The sensitivity for hearing loss was 75% (95% confidence interval, 51%-90%), and the specificity was 96% (95% confidence interval, 86%-99%). The test-retest reproducibility was excellent, with a Pearson correlation coefficient of 0.99 (p < 0.0001) for both ears.
It is possible to assess hearing with reasonable accuracy using an Internet-based hearing test on a personal computer with headphones. The practical viability of self-administration in participants' homes needs further evaluation.
Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 05/2010; 31(5):708-14. · 1.44 Impact Factor
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ABSTRACT: The aim of the study was to estimate the prevalence of the exposure to ototraumatic factors and auditory symptoms, and to analyse the relations between these factors in a group of young healthy men. A total of 839 men, 19-22 years old, were recruited for the study when reporting for primary military service. A questionnaire was distributed and audiometry was performed. The prevalence of tinnitus, sensitivity to noise, and measured hearing impairment in the study group was 23.2%, 15.5%, and 14.5% respectively. Exposure to occupational noise often was reported by 21.4%, and playing loud music often by 16.5%. The young men who had experienced tinnitus after noise exposure had an elevated risk of high frequency hearing impairment, tinnitus, and sensitivity to noise. Those who played loud music had elevated prevalence values of tinnitus but not of hearing impairment. In this young group we observed high prevalence values of ototraumatic factors and auditory symptoms. We also observed significant correlations between tinnitus after noise exposure, self-assessed hearing symptoms, and hearing impairment.
International journal of audiology 03/2010; 49(4):317-25. · 1.34 Impact Factor
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Hearing research 01/2010; 259(1-2):118. · 2.18 Impact Factor
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ABSTRACT: Sixty patients, 37 women and 23 men, aged 30−65 years, were included in the study. All had adult-onset hearing loss to an extent that necessitated hearing-aid fitting. The objective was to describe the audiometric features and extent of hearing loss, and to determine the aetiology of hearing impairments in hard-of-hearing patients in working life. The extent of hearing loss varied considerably; about one-third of the patients had moderate to severe hearing loss in both ears, about one-third had bilateral, mild hearing loss, and somewhat less than one-third had unilateral or asymmetrical hearing loss, with mild loss or even normal hearing in one ear. In 77% of the cases a diagnosis, verified or tentative, could be established. Middle ear disease with conductive or mixed hearing loss was found in 20% of the cases. Noise-induced hearing loss was diagnosed in 10% of the cases. The most common, but highly tentative, diagnosis was hereditary hearing loss. Including cases of otosclerosis, genetic hearing loss was suspected in 50% of the patients. Other diagnoses were occasionally encountered. Most of the patients had gently sloping audiograms of the better ear, followed by steeply sloping and U-shaped audiograms. It is concluded that a thorough audiological and medical investigation is an essential part of the process of aural rehabilitation.
07/2009; 6(2):149-154.
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ABSTRACT: As part of the longitudinal gerontological and geriatric population study of 70-year-olds in Göteborg, Sweden, the possible correlation between presbyacusis and extrinsic factors affecting health in elderly persons was investigated. Participants from one cohort (F 01) were studied longitudinally at ages 70, 75, 79 and 85 years, and from another cohort (F 06) at age 70 years. A weak correlation between hearing loss and smoking, alcohol abuse and head trauma was found for men and between hearing loss and intake of pharmaceutical agents (especially salicylates) for women.
07/2009; 32(4):234-243.
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ABSTRACT: The aim of this study was to compare auditory functions and to analyse the prevalence of hearing impairment and the relationship of self-reported hearing disability with audiometric test results among 75-year-old people in three Nordic localities. The representative samples came from Glostrup, Denmark (n=571), Göteborg, Sweden (n=450), and Jyväskylä, Finland (n=388). The median pure-tone thresholds were rather similar in all three populations. The prevalence of moderate hearing impairment varied between 26% and 34% in men, and between 17% and 23% in women. The corresponding figures in the prevalence of self-reported hearing difficulties were 41%–57%, and 28%–37%. The self-reported difficulties were broadly in accordance with the audiometric test results, but there also were individuals with conflicting results. It is concluded that the prevalence of hearing impairment in the three Nordic localities is fairly similar. To assess hearing disorders in elderly people, both audiometry and self-report data are needed.
07/2009; 44(9):500-508.
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ABSTRACT: A study of hearing disability and handicap was performed in a sample of elderly persons living in an urban area of Goteborg, Sweden. The aim was to describe the psychosocial consequences of presbyacusis. For this purpose, elderly persons with fairly uncontaminated presbyacusis were chosen. The study group consisted of 154 persons (59 men and 95 women) between the ages of 70 and 91 with a median age of 78 years. The methods used included a self-assessed hearing instrument, pure-tone audiometry, and registration of desired services regarding rehabilitative audiology. The questionnaire included 26 items, 20 of them within four areas: assessment of normality, communication, quality of life and environment/orientation. The results showed that the assessment, whether the hearing was normal or not, was correlated with audiometrically measured hearing. Many of the participants expressed concern that their hearing had deteriorated. Communication situations with background noise were troublesome for many of the participants, but they had only minor problems when performing daily activities like shopping. The quality of life in general was only mildly affected by hearing loss. Items regarding environment and orientation showed varying results. Some everyday aspects of listening were related to hearing ability, but directional hearing was not correlated with measured hearing. In spite of the participants' worry about hearing deterioration, only 8% requested hearing aids as a result of the examination. Sumario Se realizo un estudio de discapacidad y deventaja auditiva en una muestra de ancianos que habitan en el area urbana de Goteborg, Suecia. El objetivo fue describir las consecuencias psicosociales de la presbiacusia. Para ello se seleccionaron ancianos con presbiacusia sin contamination por otros factores etiologicos. El grupo fue integrado por 154 personas (59 hombres y 95 mujeres) de edades entre 70–91 arios con una media de 78. Los metodos que se usaron incluyeron un instrumento de auto-evaluacion de la audicion, audiometria por tonos puros y registro de los servicios requeridos de audiologia rehabilitativa. El cuestionario incluyo 26 puntos, 20 de ellos en 4 areas: evaluacion de la normalidad, comunicacion, calidad de vida y orientacion y ambientacion. Los resultados muestran que la evaluacion, sea normal o no la audicion, se correlaciona con las mediciones audiometricas. Muchos de los participantes expresaron preocupacion acerca del deterioro de su audicion. Las situaciones comunicativas con ruido ambiental fueron consideradas como muy dificiles para muchos de los participantes pero solo tenian problemas menores al realizar actividades cotidianas, como ir de compras. La calidad de vida en general fue solo medianamente afectada por la perdida auditiva. Las preguntas sobre orientacion y ambiente mostraron resultados diversos. Algunos aspectos cotidianos se relacionaron con las habilidades auditivas, pero la audicion direccional no se correlaciono con la audicion medida. A pesar de la preocupacion de los participantes sobre su deterioro auditivo, solamente el 8% solicitaron auxiliares auditivos como resultado del examen.
07/2009; 41(2):125-135.
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ABSTRACT: Turner syndrome is a chromosomal aberration affecting 1:2000 newborn girls, in which all or part of one X chromosome is absent. This leads to ovarial dysgenesis and little or no endogenous estrogen production. These women have, among many other syndromal features, a high occurrence of ear and hearing problems, and neurocognitive dysfunctions, including reduced visual-spatial abilities; it is assumed that estrogen deficiency is at least partially responsible for these problems. In this, study 30 Turner women aged 40-67, with mild to moderate hearing loss, performed a battery of hearing tests aimed at localizing the lesion causing the sensorineural hearing impairment and assessing central auditory function, primarily sound localization. The results of TEOAE, ABR and speech recognition scores in noise were all indicative of cochlear dysfunction as the cause of the sensorineural impairment. Phase audiometry, a test for sound localization, showed mild disturbances in the Turner women compared to the reference group, suggesting that auditory-spatial dysfunction is another facet of the recognized neurocognitive phenotype in Turner women.
Hearing research 01/2009; 252(1-2):3-8. · 2.18 Impact Factor
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ABSTRACT: Young and middle-aged women with Turner syndrome (TS) have a progressive type of hearing impairment, deteriorating rapidly in adult age. The hearing decline seems to consist of two patterns: a mid-frequency dip, likely of a genetic origin, and a high-frequency loss resembling age-related hearing impairment -- possibly influenced by estrogen deficiency.
This was a longitudinal study of hearing thresholds in a group of women with TS that also aimed to determine whether the factors initial age, initial hearing level, karyotype, and presence/absence of a mid-frequency dip influence the rate of decline and could serve as prognostic markers.
Audiograms of air conduction thresholds in 69 women with TS (aged 28-62 years) were performed twice with an average interval of 10 years.
The rate of hearing decline is much higher in women with TS than in age-matched women from the general population. The decline rate is comparable to that seen in 70-90-year-old women, regardless of initial age, hearing level, karyotype, or presence of a mid-frequency dip. The rate of decline is especially high in the high-frequency region, 0.8-2.2 dB per year. The presence of a mid-frequency dip is an especially strong predictor for a future high rate of hearing decline with subsequent social consequences.
Acta oto-laryngologica 01/2009; 129(12):1434-41. · 0.98 Impact Factor
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Age and Ageing 06/2008; 37(3):333-6. · 3.09 Impact Factor
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ABSTRACT: Hormone replacement therapy (HRT) may have a protective effect on hearing impairment in postmenopausal women. New guidelines for classification of audiometric configuration in age-related hearing loss are suggested.
To describe prevalence of hearing loss and audiometric configuration in a group of middle-aged women with respect to menopausal stage and HRT.
A total of 143 women around menopause were sampled through the Swedish population register. The mean hearing threshold levels were compared according to menopausal status. The audiograms in the 57 women with hearing loss were classified according to audiometric configuration.
In all, 57 women (40%) had any kind of hearing loss; 42 had very minute hearing loss; 15 had a 4FA (average of thresholds at 0.5, 1, 2, and 4 kHz) of at least 20-39 dB HL in at least one ear. Two of these had a 4FA of 40-69 dB HL in at least one ear. The most common configurations were: gently sloping (47%), steeply sloping (14%), and high-frequency U-shaped (14%). The postmenopausal women who were not on HRT had poorer hearing mainly at 2 and 3 kHz, compared with pre- and perimenopausal women, and postmenopausal women on HRT.
Acta Oto-Laryngologica 03/2007; 127(2):149-55. · 1.08 Impact Factor
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ABSTRACT: To study the hearing of 18-year-old men by using screening audiograms obtained at military conscription.
The study group comprised 301,873 Swedish men belonging to six age cohorts born from 1953 to 1977 who had been screened at age 18 years from 1971 to 1995. The prevalence of mild to moderate hearing loss was investigated.
Of the entire study group, 13.1% had elevation of one or more pure tone thresholds. In most cases, 11.9%, the elevation was situated in the high-frequency region. High-frequency hearing loss was more common in the left ear (7.5%) than in the right ear (6.2%). The prevalence of hearing loss decreased during the period 1971 to 1981 from 15.7% to 8.3%. During the last part of the study period, 1986 to 1995, the prevalence increased from 9.8% to 16.3%. The increase included mild to moderate degrees of hearing loss with thresholds below 35 dB HL. The prevalence of threshold elevations was highest in sparsely populated areas of Sweden and lowest in large, metropolitan areas of Sweden from 1971 to 1986. During the last part of the study period the geographical differences decreased or disappeared.
The total prevalence of hearing loss was in accordance with other reports. The frequency 6 kHz was most affected by threshold elevations. The prevalence of hearing loss decreased in the first part of the study period, and increased at the end of the study period. Hearing loss was most commonly seen in rural areas.
Scandinavian Journal of Public Health 02/2007; 35(5):524-32. · 1.39 Impact Factor
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ABSTRACT: The aim of this study was to compare auditory functions and to analyse the prevalence of hearing impairment and the relationship of self-reported hearing disability with audiometric test results among 75-year-old people in three Nordic localities. The representative samples came from Glostrup, Denmark (n = 571), Göteborg, Sweden (n =450), and Jyväskylä, Finland (n =388). The median pure-tone thresholds were rather similar in all three populations. The prevalence of moderate hearing impairment varied between 26% and 34% in men, and between 17% and 23% in women. The corresponding figures in the prevalence of self-reported hearing difficulties were 41%-57%, and 28%-37%. The self-reported difficulties were broadly in accordance with the audiometric test results, but there also were individuals with conflicting results. It is concluded that the prevalence of hearing impairment in the three Nordic localities is fairly similar. To assess hearing disorders in elderly people, both audiometry and self-report data are needed.
International Journal of Audiology 10/2005; 44(9):500-8. · 1.40 Impact Factor
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ABSTRACT: The prevalence of balance symptoms (vertigo, dizziness, and dysequilibrium) was investigated in an epidemiological study of elderly people, the longitudinal and cross-sectional gerontological and geriatric population study from Göteborg, Sweden (H70). Three different age cohorts were studied, one at age 70, one at age 75 and one at ages 79, 82, 85, 88 and 90 years. Altogether 2011 participants answered the questionnaire at 3197 occasions. The overall prevalence of balance problems at age 70 was 36% (women) and 29% (men). Balance symptoms were more common among women than men, and increased with increasing age. At ages 88-90 years the corresponding values were 51-45%. The most common symptom was poor balance/general unsteadiness (11-41%). Rotatory symptoms occurred in 2-17%. Other types of symptoms were less common. Precipitating factors were rising from supine to sitting position in 17-40%. Balance symptoms in a side position were uncommon, but occurred more often when tilting the head backwards (up to 14%). Signs that possibly could indicate neurological involvement were uncommon. Falls in conjuncture to dizziness, vertigo and similar symptoms occurred in 7-15%, in about equal proportions indoors as outdoors.
Journal of Vestibular Research 02/2004; 14(1):47-52. · 1.35 Impact Factor
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ABSTRACT: The demands/needs for audiological/otological services under optimal conditions were investigated within the framework of three epidemiological investigations. The study population consisted of 559 people, 318 women and 241 men, 70-91 years old. The participants were offered audiological and otological services, including hearing aid fitting. Fifteen per cent of the participants asked for audiological/otological services. Six per cent of the participants were equipped with hearing aids as a result of the study. Almost all of those with severe hearing loss either had been equipped with hearing aids prior to the study, or took advantage of the offer to get such devices. This figure represented about half of those with moderate hearing loss and about 20% of those with mild hearing loss. After the study, 19% were equipped with hearing aids, but in all 25% had hearing aids or had expressed a wish to get one. The percentages of elderly people with mild-to-moderate hearing loss, who contemplated purchasing an aid, but did not do so, were large, between 10%, and 22%. More than 11% consulted a doctor when the opportunity was offered to them. Most of them wanted the consultation because of progressive hearing loss. Middle ear disease was another important reason for a consultation.
International Journal of Audiology 08/2003; 42 Suppl 2:2S53-7. · 1.40 Impact Factor
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ABSTRACT: To study a controversy that has been discussed for more than two decades: whether or not children with autism have abnormalities affecting the cochlear nerve or the auditory pathway in the brain stem and, if so, to describe these abnormalities.
A group of 153 children and adolescents with autistic disorder were included in an investigation of auditory brain stem responses (ABR). Two thirds of this group, 101 individuals (75 boys, 26 girls), had normal hearing and they were selected for an in-depth ABR study. The results from the study group were compared with those of an age-matched comparison group.
The III-V interpeak latency (IPL) was significantly prolonged in both boys and girls with autism, compared with the controls. The latencies of ABR waves I and V were also significantly lengthened in the study groups. The individual test results showed that more than half of this normal-hearing autistic disorder group (58%) had abnormalities of one or more of eight ABR parameters studied. The most common abnormalities were prolongation of wave V (38%), and of I-V IPL (28%). A lengthening of the I-V IPL was also recorded in 27% of 49 children who were difficult to test or who had hearing loss. Abnormal left-right differences of ABR latencies were found in 18% of autism cases with normal hearing.
Possible causes of the reported ABR abnormalities, observed here as well as in other studies, are discussed. Brain stem lesion, occult cochlear dysfunction, and involvement of the cochlear efferent system are probable factors that can explain the ABR findings
Ear and Hearing 07/2003; 24(3):206-14. · 2.58 Impact Factor
