Article

The Effects of Smoking and Alcohol Consumption on Age-Related Hearing Loss: The Blue Mountains Hearing Study

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Abstract

We aimed to investigate the temporal association between smoking or alcohol consumption and hearing loss, and to confirm previously published cross-sectional associations. The Blue Mountains Hearing Study is a population-based survey of age-related hearing loss conducted in a defined suburban area, west of Sydney. Hearing loss was measured in 2956 participants (aged 50+ yrs) and 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 (bilateral hearing loss). Alcohol consumption and smoking status were measured using an interviewer-administered questionnaire. Logistic regression was used to obtain odds ratios (OR) with 95% confidence intervals (95% CI) that compared the chances of having hearing loss in participants who did or did not smoke or consume alcohol, after adjusting for other factors previously reported to be associated with hearing loss. The prevalence of hearing loss at baseline was 33.0% (N = 929) and the 5-year incidence of hearing loss was 17.9% (N = 156). Cross-sectional analysis demonstrated a significant protective association between the moderate consumption of alcohol (>1 but < or =2 drinks/day) and hearing function in older adults (compared with nondrinkers), OR 0.75 (95% CI, 0.57 to 0.98). Current smokers not exposed to occupational noise had a significantly higher likelihood of hearing loss after adjusting for multiple variables, OR 1.63 (95% CI, 1.01 to 2.64). A formal likelihood ratio test demonstrated that the interaction between smoking and noise exposure was not significant (p = 0.23). When the joint effects of alcohol consumption and smoking on hearing were explored, there was a trend for alcohol to have a protective relationship with hearing loss in smokers, but this was not statistically significant. However, the 5-year incidence of hearing loss was not predicted by either smoking or alcohol consumption. This study confirms previously reported associations between alcohol consumption or smoking and prevalent hearing loss, but these were not demonstrated in temporal data. Other risk factors could confer greater vulnerability or cause the initial damage to hearing. Future large population-based studies, exploring the influence of other risk factors on the development of age-related hearing loss are warranted.

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... Otherwise, an increasing body of evidence suggests that long-term moderate alcohol intake may protect against ARHL [64,65]. Some cross-sectional analyses reported an inverse association between alcohol consumption and ARHL [66,67], although other reports did not confirm this protective effect [63,64]. ...
... Otherwise, an increasing body of evidence suggests that long-term moderate alcohol intake may protect against ARHL [64,65]. Some cross-sectional analyses reported an inverse association between alcohol consumption and ARHL [66,67], although other reports did not confirm this protective effect [63,64]. In a prospective study of 870 men and women aged 49 and older, no association was observed between alcohol consumption and the 5-year incidence of measured hearing loss, although cross-sectional analysis demonstrated a significant protective association between the moderate consumption of alcohol and ARHL [64]. ...
... Some cross-sectional analyses reported an inverse association between alcohol consumption and ARHL [66,67], although other reports did not confirm this protective effect [63,64]. In a prospective study of 870 men and women aged 49 and older, no association was observed between alcohol consumption and the 5-year incidence of measured hearing loss, although cross-sectional analysis demonstrated a significant protective association between the moderate consumption of alcohol and ARHL [64]. In a prospective study of 26,809 older men, no association between total alcohol consumption and the risk of self-reported hearing loss was found [68]. ...
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Age related hearing loss (ARHL) affects about one third of the elderly population. It is suggested that the senescence of the hair cells could be modulated by inflammation. Thus, intake of anti- and pro-inflammatory foods is of high interest. Methods: From the MICOL study population, 734 participants were selected that participated in the 2013 to 2018 examination including hearing ability and from which past data collected in 2005/2008 was available. ARHL status was determined and compared cross-sectionally and retrospectively according to clinical and lifestyle data including food and micronutrient intake. Results: ARHL status was associated with higher age but not with education, smoking, relative weight (BMI), and clinical-chemical blood markers in the crossectional and retrospective analyses. Higher intake of fruit juices among ARHL-participants was seen cross-sectionally, and of sugary foods, high-caloric drinks, beer, and spirits retrospectively. No difference was found for the other 26 food groups and for dietary micronutrients with the exception of past vitamin A, which was higher among normal hearing subjects. Conclusions: Pro-inflammatory foods with a high-sugar content and also beer and spirits were found to be assocated with positive ARHL-status, but not anti-inflammatory foods. Diet could be a candidate for lifestyle advice for the prevention of ARHL.
... Smoking emerged as a risk factor for an increase in the prevalence of hearing loss in a meta-analysis of mainly cross-sectional studies (Nomura et al. 2005). While some longitudinal studies failed to find a temporal effect of tobacco smoking on pure-tone thresholds (Karlsmose et al. 2000;Gopinath et al. 2010;Kiely et al. 2012), other studies demonstrated such an effect (Nakanishi et al. 2000;Cruickshanks et al. 2015). Having a history of smoking has also been found to be associated with the development of (self-reported) hearing loss (Burr et al. 2005). ...
... However, moderate alcohol consumption was found to have a protective effect on hearing (Popelka et al. 2000). Longitudinal studies did not show an association between changes in puretone thresholds and alcohol use (Brant et al. 1996;Karlsmose et al. 2000;Gopinath et al. 2010;Cruickshanks et al. 2015). ...
... The absence of a (longitudinal) association between speech recognition in noise and alcohol consumption in this study seems to be consistent with previous research in this domain. To date, there are no longitudinal studies in which a significant association between hearing loss and the use of alcohol was observed (Brant et al. 1996;Karlsmose et al. 2000;Gopinath et al. 2010;Cruickshanks et al. 2015). ...
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Objectives: Previous findings of longitudinal cohort studies indicate that acceleration in age-related hearing decline may occur. Five-year follow-up data of the Netherlands Longitudinal Study on Hearing (NL-SH) showed that around the age of 50 years, the decline in speech recognition in noise accelerates compared with the change in hearing in younger participants. Other longitudinal studies confirm an accelerated loss in speech recognition in noise but mostly use older age groups as a reference. In the present study, we determined the change in speech recognition in noise over a period of 10 years in participants aged 18 to 70 years at baseline. We additionally investigated the effects of age, sex, educational level, history of tobacco smoking, and alcohol use on the decline of speech recognition in noise. Design: Baseline (T0), 5-year (T1), and 10-year (T2) follow-up data of the NL-SH collected until May 2017 were included. The NL-SH is a web-based prospective cohort study which started in 2006. Central to the NL-SH is the National Hearing test (NHT) which was administered to the participants at all three measurement rounds. The NHT uses three-digit sequences which are presented in a background of stationary noise. The listener is asked to enter the digits using the computer keyboard. The outcome of the NHT is the speech reception threshold in noise (SRT) (i.e., the signal to noise ratio where a listener recognizes 50% of the digit triplets correctly). In addition to the NHT, participants completed online questionnaires on demographic, lifestyle, and health-related characteristics at T0, T1, and T2. A linear mixed model was used for the analysis of longitudinal changes in SRT. Results: Data of 1349 participants were included. At the start of the study, the mean age of the participants was 45 years (SD 13 years) and 61% of the participants were categorized as having good hearing ability in noise. SRTs significantly increased (worsened) over 10 years (p < 0.001). After adjustment for age, sex, and a history of tobacco smoking, the mean decline over 10 years was 0.89 dB signal to noise ratio. The decline in speech recognition in noise was significantly larger in groups aged 51 to 60 and 61 to 70 years compared with younger age groups (18 to 30, 31 to 40, and 41 to 50 years) (p < 0.001). Speech recognition in noise in participants with a history of smoking declined significantly faster during the 10-year follow-up interval (p = 0.003). Sex, educational level, and alcohol use did not appear to influence the decline of speech recognition in noise. Conclusions: This study indicated that speech recognition in noise declines significantly over a 10-year follow-up period in adults aged 18 to 70 years at baseline. It is the first longitudinal study with a 10-year follow-up to reveal that the increased rate of decline in speech recognition ability in noise already starts at the age of 50 years. Having a history of tobacco smoking increases the decline of speech recognition in noise. Hearing health care professionals should be aware of an accelerated decline of speech recognition in noise in adults aged 50 years and over.
... Within the extensive research on alcohol consumption, comparatively little has focused on the gender differences in the association between MAC and hearing impairment. Among the studies indicating that MAC had a protective effect on hearing impairment, some did not find different effects between women and men 4,21,23 , while others did not analyze gender effects 22,24 . ...
... Several studies have suggested that alcohol consumption has a protective effect on hearing impairment. Compared to never drinkers, some studies reported that the protective effect was only noted in current drinkers with MAC (a U-shaped association was presented between alcohol consumption and hearing impairment with no risk for AMAC and lower risk for MAC) 4,21,22,24 , and other studies report that the protective effect was observed in current drinkers with all categories, even above average or higher levels 25,26 . The results of the Japanese epidemiological cross-sectional study with 496 subjects by Itoh et al. 22 and the Blue Mountains Hearing Study with 2956 subjects in Australia by Gopinath et al. 24 showed the protective effect of MAC. ...
... Compared to never drinkers, some studies reported that the protective effect was only noted in current drinkers with MAC (a U-shaped association was presented between alcohol consumption and hearing impairment with no risk for AMAC and lower risk for MAC) 4,21,22,24 , and other studies report that the protective effect was observed in current drinkers with all categories, even above average or higher levels 25,26 . The results of the Japanese epidemiological cross-sectional study with 496 subjects by Itoh et al. 22 and the Blue Mountains Hearing Study with 2956 subjects in Australia by Gopinath et al. 24 showed the protective effect of MAC. However, Itoh et al. did not differentiate high and low frequency hearing loss, Gopinath et al. ...
Article
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Hearing loss is a global public health problem with a high prevalence, significantly impairing communication and leading to a decrease in the quality of life. The association between moderate alcohol consumption (MAC) and hearing impairment has been addressed in several studies with inconsistent results. The intent of our study is to clarify the correlation between MAC and the hearing threshold and further investigate the interplay between MAC and the hearing threshold categorized by gender. The study included 4,075 participants aged 20–69 years from the 1999–2004 data of National Health and Nutrition Examination Survey (NHANES). The associations among MAC, gender differences, and high-frequency and low-frequency hearing thresholds were analyzed. We found that current female drinkers with MAC tended to have lower hearing thresholds. There is a significant protective effect of MAC on hearing threshold shifts in the US adult population, especially in females. Our research was the first study to further indicate that there is a gender difference in the association between MAC and hearing impairment. In accordance with our results, if people drink, they should consume moderate rather than higher amounts, especially in women, which may result in a reduced risk of hearing loss.
... 12 However, evidence from prospective studies conflicts. Of eight cohort studies on the associations between smoking and hearing loss, [13][14][15][16][17][18][19][20] only three reported a significant positive association. [18][19][20] Of five cohort studies that assessed the dose-response association between smoking intensity and hearing loss, 14,17-20 only two found a dose- response relationship. ...
... 19,20 Cohort studies based on self-reported hearing loss found that past smoking was also associated with hearing loss, 17,20 whereas cohort studies with audiometric assess- ments did not detect risk elevation among past smokers. 18,19 All these cohort studies had some limitations, including relatively small sample sizes (500-2000 participants), [13][14][15][16]18,19 short follow- up period (≤5 years), 15,16,19,20 or self-reported hearing loss. 17,20 To understand better the association between smoking and hearing loss, large-scale studies using audiometry over long periods of follow-up are needed. ...
... 19,20 Cohort studies based on self-reported hearing loss found that past smoking was also associated with hearing loss, 17,20 whereas cohort studies with audiometric assess- ments did not detect risk elevation among past smokers. 18,19 All these cohort studies had some limitations, including relatively small sample sizes (500-2000 participants), [13][14][15][16]18,19 short follow- up period (≤5 years), 15,16,19,20 or self-reported hearing loss. 17,20 To understand better the association between smoking and hearing loss, large-scale studies using audiometry over long periods of follow-up are needed. ...
Article
Introduction: We aimed to determine the prospective association of smoking status, smoking intensity, and smoking cessation with the risk of hearing loss in a large Japanese cohort. Methods: The cohort study included 50195 employees, who were aged 20-64 years and free of hearing loss at baseline. Participants were followed up for a maximum of 8 years. Pure-tone audiometric testing was performed annually to identify hearing loss at 1 and 4 kHz. Cox proportional hazards regression models were used to investigate the association between smoking and hearing loss. Results: During follow-up, 3532 individuals developed high-frequency hearing loss, and 1575 developed low-frequency hearing loss. The hazard ratio (HR) associated with current smokers was 1.6 (95% confidence interval [CI] = 1.5 to 1.7) and 1.2 (95% CI = 1.1 to 1.4) for high- and low-frequency hearing loss, respectively, as compared with never smokers. The risk of high- and low-frequency hearing loss increased with the number of cigarettes smoked per day (both p for trend <.001). The HR associated with former smokers was 1.2 (95% CI = 1.1 to 1.3) and 0.9 (95% CI = 0.8 to 1.1) for high- and low-frequency hearing loss, respectively. The analysis by quitting years showed a decline in risk of hearing loss after quitting smoking, even among those who quitted less than 5 years before baseline. Conclusions: Smoking is associated with increased risk of hearing loss, especially at the high frequency, in a dose-response manner. The excess risk of hearing loss associated with smoking disappears in a relatively short period after quitting. Implications: The prospective association between smoking and hearing loss has not been well studied. To the best of our knowledge, our study is the largest to date investigating the association between smoking and incident hearing loss. Our results indicate that smoking is associated with increased risk of hearing loss in a dose-response manner. Quitting smoking virtually eliminates the excess risk of hearing loss, even among quitters with short duration of cessation. These results suggest that smoking may be a causal factor for hearing loss, although further research would be required to confirm this. If so, this would emphasize the need for tobacco control to prevent or delay the development of hearing loss.
... To date, several cross-sectional cohort studies have identified multiple contributing determinants to ARHL such as hypertension [Gates et al., 1993;Helzner et al., 2005;Rosenhall and Sundh, 2006], diabetes mellitus [Helzner et al., 2005], body mass index (BMI) [Fransen et al., 2008], smoking [Fransen et al., 2008;Gopinath et al., 2010;Dawes et al., 2014a, b], an inverse correlation of alcohol consumption [Fransen et al., 2008;Gopinath et al., 2010;Dawes et al., 2014a, b], occupational noise [Agra-wal et al., 2008;Fransen et al., 2008], education [Agrawal et al., 2008], and race [Helzner et al., 2005;Agrawal et al., 2008]. Although consensus has been established about the associations with age, sex and occupational noise, less consistent results were found for determinants related to systemic diseases and lifestyle factors. ...
... To date, several cross-sectional cohort studies have identified multiple contributing determinants to ARHL such as hypertension [Gates et al., 1993;Helzner et al., 2005;Rosenhall and Sundh, 2006], diabetes mellitus [Helzner et al., 2005], body mass index (BMI) [Fransen et al., 2008], smoking [Fransen et al., 2008;Gopinath et al., 2010;Dawes et al., 2014a, b], an inverse correlation of alcohol consumption [Fransen et al., 2008;Gopinath et al., 2010;Dawes et al., 2014a, b], occupational noise [Agra-wal et al., 2008;Fransen et al., 2008], education [Agrawal et al., 2008], and race [Helzner et al., 2005;Agrawal et al., 2008]. Although consensus has been established about the associations with age, sex and occupational noise, less consistent results were found for determinants related to systemic diseases and lifestyle factors. ...
... Furthermore, we found a substantial effect of smoking in both low-and high-frequency hearing loss in women and in high-frequency hearing loss in men. Associations with smoking were found in other studies [Gopinath et al., 2010;Dawes et al., 2014], but those studies did not stratify on gender, nor did they differentiate between high-and low-frequency hearing loss [Fransen et al., [Nakashima et al., 2003]. The consistent associations found for high-frequency loss suggest that at least the basal part of the cochlea is involved. ...
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To contribute to a better understanding of the etiology in age-related hearing loss, we carried out a cross-sectional study of 3,315 participants (aged 52-99 years) in the Rotterdam Study, to analyze both low- and high-frequency hearing loss in men and women. Hearing thresholds with pure-tone audiometry were obtained, and other detailed information on a large number of possible determinants was collected. Hearing loss was associated with age, education, systolic blood pressure, diabetes mellitus, body mass index, smoking and alcohol consumption (inverse correlation). Remarkably, different associations were found for low- and high-frequency loss, as well as between men and women, suggesting that different mechanisms are involved in the etiology of age-related hearing loss.
... However, they may also indicate less healthy lifestyle factors, which are the nonmedical determinants of health (Tsimpida et al., 2018b). Evidence shows that several modifiable lifestyle factors-such as smoking (Gopinath et al., 2010), alcohol consumption (Zhan et al., 2011), having a high body mass index (BMI), eating high fat and high-calorie food (Curhan et al., 2013;€ Uc¸ler et al., 2016), and insufficient exercise (Curhan et al., 2013;Spankovich & Le Prell, 2013)increase the likelihood that a person will have poor hearing health. Hence, adopting a healthy lifestyle, not smoking, maintaining proper nutrition, and exercising regularly, can minimize the lifestyle risk factors for hearing loss in older adults (Davis et al., 2016). ...
... Also, even though Tsimpida et al.'s (2019b) recent study shows that drinking above the low-risk-level guidelines-that is, more than 14 units of alcohol in the last 7 daysincreases the likelihood of hearing loss, the crosssectional nature of the study does not allow for the generalization of the findings. By contrast, the longitudinal study of Gopinath et al. (2010) does not confirm the association between alcohol consumption and prevalent hearing loss. It can thus be suggested that, to date, the impact of alcohol intake on hearing loss is not fully understood. ...
... A lower level of education and income may also lessen one's engagement in healthy daily behaviors such as physical activity (Zhan et al., 2011). Besides, high levels of stress due to lower resources can induce unhealthy behaviors, such as sugar consumption (Spankovich & Le Prell, 2013) and reliance on tobacco and alcohol (Gopinath et al., 2010), as attempts of short-term stress release. Also, evidence shows that those in a lower SEP, in terms of having a lower level of education and lower income, are more likely to smoke. ...
Article
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Hearing loss is a major health challenge that can have severe physical, social, cognitive, economic, and emotional consequences on people’s quality of life. Currently, the modifiable factors linked to socioeconomic inequalities in hearing health are poorly understood. Therefore, an online database search (PubMed, Scopus, and Psych) was conducted to identify literature that relates hearing loss to health inequalities as a determinant or health outcome. A total of 53 studies were selected to thematically summarize the existing literature, using a critical interpretive synthesis method, where the subjectivity of the researcher is intimately involved in providing new insights with explanatory power. The evidence provided by the literature can be summarized under four key themes: (a) There might be a vicious cycle between hearing loss and socioeconomic inequalities and lifestyle factors, (b) socioeconomic position may interact with less healthy lifestyles, which are harmful to hearing ability, (c) increasing health literacy could improve the diagnosis and prognosis of hearing loss and prevent the adverse consequences of hearing loss on people’s health, and (d) people with hearing loss might be vulnerable to receiving low-quality and less safe health care. This study uses elements from theoretical models of health inequalities to formulate a highly interpretive conceptual model for examining hearing health inequalities. This model depicts the specific mechanisms of hearing health and their evolution over time. There are many modifiable determinants of hearing loss, in several stages across an individual’s life span; tackling socioeconomic inequalities throughout the life-course could improve the population’s health, maximizing the opportunity for healthy aging.
... For example, smoking seems to have a negative effect on hearing [3,8,[16][17][18]. In contrast, alcohol consumption, with the exception of life-long abstainers, was found to be protective of hearing [16,19,20]. ...
... Binary regression was used to assess the association between the hearing variables and the health-related outcomes. All analyses were completed using Statistical Product and Service Solutions (SPSS) 23 [20]. The a priori alpha level was set at <0.05. ...
Article
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Purpose: The purpose of this study was to identify the current health status of adults in the United States with self-reported hearing loss and compare it with US adults with a self-reported excellent or good hearing in three areas: (1) chronic disease states and general health status, (2) medical screening behaviors, and (3) lifestyle behaviors. Methods: A secondary data analysis was conducted using the 2014 data set from the National Health Interview Survey (NHIS), specifically the Sample Adult Public Use File (samadult). For this questionnaire set, one adult per family was randomly selected. This individual self-reported their response to the questionnaire items. Binary regressions were used to analyze the odds ratio to find differences for selected disease states, screenings, and lifestyle behaviors. Respondents were grouped into one of four categories: excellent/good hearing, a little trouble hearing, moderate/a lot of trouble hearing, and deaf. Results: The excellent/good hearing group was used as the comparison group for the other three levels of hearing. There are many differences in likelihood to self-report disease states; the greatest increased likelihoods include tinnitus and heart disease, with tinnitus being 8.6 times more likely for those who identified as having moderate/a lot of hearing loss. Those with any level of hearing loss were 3 to 5 times more likely to self-report heart disease. Regarding lifestyle factors, individuals with any level of hearing loss were less likely to consume alcohol and 2.5 to 9 times more likely to be unable to engage in moderate or vigorous activity on a weekly basis, respectively. Conclusions: There is a difference in the health status of individuals with hearing loss across all three areas examined (chronic disease states and general health status, medical screening behaviors, and lifestyle behaviors), and those differences vary based on level of hearing loss, the most notable being the self-reported inability to engage in moderate and vigorous physical activity. Disproportionate rates of tinnitus and heart disease were evident in all levels of hearing loss but most notable in those identifying as having moderate/a lot of trouble hearing. Further interdisciplinary research is necessary to improve the health of individuals with all levels of hearing loss, increase awareness of the hearing/health connection, and decrease hearing loss in general.
... In contrast there is a large literature on the association between self-reported alcohol use on hearing sensitivity [30][31][32][33][34], however, the results are mixed. Specifically, self-reported moderate alcohol use was associated with a protective effect (i.e., better hearing sensitivity) on hearing [31,32] whereas others have found no significant association between self-reported moderate or heavy alcohol use and hearing sensitivity [33][34][35]. ...
... In contrast there is a large literature on the association between self-reported alcohol use on hearing sensitivity [30][31][32][33][34], however, the results are mixed. Specifically, self-reported moderate alcohol use was associated with a protective effect (i.e., better hearing sensitivity) on hearing [31,32] whereas others have found no significant association between self-reported moderate or heavy alcohol use and hearing sensitivity [33][34][35]. Conversely, self-reported high alcohol use was associated with an increased risk of hearing loss [30,31]. ...
Article
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Young adults with normal hearing may exhibit risk factors for hearing loss. The purpose of this study was to evaluate how self-reported personal music (PM) system volume use, preferred listening level, and self-reported alcohol use affects distortion product otoacoustic emissions (DPOAEs). Two-hundred, sixteen young adults, 161 women and 55 men, participated. Questionnaire data included the PM system and alcohol use. DPOAEs were obtained from 1–6 kHz and collapsed into 1/3rd octave bands and a probe microphone was used to determine preferred listening level. Alcohol was defined as drinks per month (DPM), categorized as No, Light (≤14), and Heavy (>14). Men who reported loud/very loud volume use had statistically significant lower DPOAEs at 1.5, 2, and 3 kHz than men who reported lower volume use. Light and Heavy DPM men had lower DPOAEs at 1.5, 2, and 3 kHz than no DPM men, but this was not statistically significant. There were no DPOAE differences for either variable in women and there was no association between preferred listening level and DPOAEs for women or men. Men who reported loud/very loud volume use and any DPM had poorer mid-frequency DPOAEs. There was not an association for volume use or DPM and DPOAEs in women.
... Findings from studies of the relation among past smokers, or the amount and duration of smoking, have been inconsistent. [14][15][16][17][18][19][20] Few studies have prospectively examined how the magnitude of the risk is influenced by smoking cessation and time since quitting. 17,21 Therefore, we prospectively investigated the relation between the amount and duration of smoking, time since smoking cessation, and risk of self-reported moderate or worse hearing loss among 81,505 women in the Nurses' Health Study II (NHS II) over a 22-year follow-up period. ...
... [58][59][60] Nicotine from tobacco may induce vasoconstriction, impair tissue perfusion, and lead to cellular dysfunction. [59][60][61] Our findings that smoking is associated with higher risk of hearing loss are consistent with previous epidemiologic studies, [13][14][15][16][17][18][19][20][21] however, most studies have been crosssectional and many did not evaluate the amount of smoking, particularly among former smokers. In our longitudinal study, we observed that the magnitude of the risk was larger among women with greater number of pack-years smoked, suggesting that cumulative lifetime exposure to smoking may contribute an elevated risk of hearing loss among past as well as current smokers. ...
Article
Background Previous studies demonstrated higher risk of hearing loss among cigarette smokers, but longitudinal data on whether the risk is influenced by smoking cessation are limited. We prospectively investigated relations between smoking, smoking cessation and risk of self-reported moderate or worse hearing loss among 81,505 women in the Nurses’ Health Study II (1991-2013). Methods Information on smoking and hearing status was obtained from validated biennial questionnaires. Cox proportional hazards regression was used to estimate multivariable-adjusted relative risks (MVRR,95%CI). Results During 1,533,214 person-years of follow-up, 2760 cases of hearing loss were reported. Smoking was associated with higher risk of hearing loss and the risk tended to be higher with greater number of pack-years smoked. Compared with never smokers, the MVRR(95% CI) among past smokers with 20+ pack-years of smoking was 1.30(1.09,1.55) and 1.21(1.02,1.43) for current smokers. The magnitude of elevated risk diminished with greater time since smoking cessation. Compared with never smokers, the MVRR among smokers who quit <5 years prior was 1.43(1.17,1.75); 5-9 years prior was 1.27(1.03,1.56); 10-14 years prior was 1.17(0.96,1.41); and plateaued thereafter. Additional adjustment for pack-years smoking attenuated the results. Conclusions The higher risk of hearing loss associated with smoking may diminish over time after quitting.
... Several CVD risk factors were also adjusted for, however, these factors may not have been fully accounted for in the current analysis. We determined which factors were associated with both hearing loss and DP to ensure that true confounding factors were adjusted for, and we adjusted for similar potential confounding factors which have been previously used in the literature when examining diet and hearing loss (10,14,15,20,49) . Various models were investigated further since it is possible that BMI, SBP and total cholesterol could actually be intermediate markers rather than confounders and that we therefore overadjusted the models. ...
... Energy requirements vary according to age, sex, BMI and PAL; therefore, as the overall food intake will differ by these factors, it is generally considered more appropriate to adjust for energy intake in analyses of dietary intake. Energy adjustment is required for a number of reasons; to control for confounding, to give a measure of dietary composition, not just dietary intake, and to mitigate the effects of measurement error (49,51) . In this current analysis, adjustment for energy intake of the WI data did not appreciably alter effect sizes. ...
Article
The association between dietary patterns (DP) and prevalence of hearing loss in men enrolled in the Caerphilly Prospective Study was investigated. During 1979–1983, the study recruited 2512 men aged 45–59 years. At baseline, dietary data were collected using a semi-quantitative FFQ, and a 7-d weighed food intake (WI) in a 30 % subsample. Five years later, pure-tone unaided audiometric threshold was assessed at 0·5, 1, 2 and 4 kHz. Principal component analysis (PCA) identified three DP and multiple logistic and ordinal logistic regression models examined the association with hearing loss (defined as pure-tone average of frequencies 0·5, 1, 2 and 4 kHz >25 dB). Traditional, healthy and high-sugar/low-alcohol DP were found with both FFQ and WI data. With the FFQ data, fully adjusted models demonstrated significant inverse association between the healthy DP and hearing loss both as a dichotomous variable (OR=0·83; 95 % CI 0·77, 0·90; P <0·001) and as an ordinal variable (OR=0·87; 95 % CI 0·81, 0·94; P <0·001). With the WI data, fully adjusted models showed a significant and inverse association between the healthy DP and hearing loss (OR=0·85; 95 % CI 0·73, 0·99; P <0·03), and a significant association between the traditional DP (per fifth increase) and hearing loss both as a dichotomous variable (OR=1·18; 95 % CI 1·02, 1·35; P =0·02) and as an ordinal variable (OR=1·17; 95 % CI 1·03, 1·33; P =0·02). A healthy DP was significantly and inversely associated with hearing loss in older men. The role of diet in age-related hearing loss warrants further investigation.
... (Nomura et al, 2005). Similar effect sizes have also been found in later studies (Dawes et al, 2014;Agrawal et al, 2009;Gopinath et al, 2010;Nash et al, 2011;Sung et al, 2013) although one recent study reported no effects (Lin et al, 2011). We found an effect of smoking on highfrequency hearing loss only after controlling for other covariates (model 2). ...
... Several studies have found small to medium protective effects of moderate alcohol consumption on hearing loss (Gopinath et al, 2010;Dawes et al, 2014;Fransen et al, 2008;Popelka et al, 2000). There was a protective effect also in our data, but the effect was negligible. ...
Article
Objective: The purpose of the present paper was to examine the association between prospectively and cross-sectionally assessed cardiovascular risk factors and hearing loss. Design: Hearing was assessed by pure-tone average thresholds at low (0.25–0.5 kHz), middle (1–2 kHz), and high (3–8 kHz) frequencies. Self-reported or measured cardiovascular risk factors were assessed both 11 years before and simultaneously with the audiometric assessment. Cardiovascular risk factors were smoking, alcohol use, physical inactivity, waist circumference, body mass index, resting heart rate, blood pressure, triglycerides, total serum cholesterol, LDL cholesterol, HDL cholesterol, and diabetes. Study sample: A population-based cohort of 31 547 subjects. Results: After adjustment for age, sex, level of education, income, recurrent ear infections, and noise exposure, risk factors associated with poorer hearing sensitivity were smoking, diabetes, physical inactivity, resting heart rate, and waist circumference. Smoking was only associated with hearing loss at high frequencies. The effects were very small, in combination explaining only 0.2–0.4% of the variance in addition to the component explained by age and the other cofactors. Conclusion: This cohort study indicates that, although many cardiovascular risk factors are associated with hearing loss, the effects are small and of doubtful clinical relevance. © 2015 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society
... Household net income was divided by the number of consumption units in the household (first adult with weight 1, other adults 0.7 and children under 18 years 0.5) to yield the participant's income. Self-reported diseases and health behavior that have been found to be associated with hearing loss, namely cardiovascular disease (myocardial infarction, angina pectoris, hypertension, lower limb arterial embolism) [5], stroke [28], arthritis (rheumatoid or osteoarthritis) [29], diabetes [30], alcohol use (8+ units/week vs. less) [31] and smoking (former or current vs. never) [32] were obtained from the home interview and self-administered questionnaire. Hearing aid use was defined as daily or almost daily use, and was based on two questions: "Do you have a hearing aid?" (yes/no) and "Do you use it daily or almost daily?" ...
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Background Older adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults. Methods Data on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, health promotion groups, vision test, hearing test, mammography, PSA test) and perceived unmet health care needs. Multivariable logistic regression analyses were used. ResultsAfter adjusting for socio-economic and health-related confounders, persons with hearing loss (hearing level of better ear 0.5–2 kHz > 40 dB) were more likely to have used mental health services than those with non-impaired hearing (OR = 3.2, 95 % CI 1.3–7.9). Self-reported hearing difficulty was also associated with higher odds for mental health service use (OR = 2.1 95 % CI 1.2–3.5). Hearing was not associated with use of the other health services studied, except presenting for a hearing test. Persons with self-reported hearing difficulty were more likely to perceive unmet health care needs than those without hearing difficulty (OR = 1.7, 95 % CI 1.4–2.1). Conclusions Older adults with hearing loss or self-reported hearing difficulty are as likely to use most health services as those without hearing loss. However, self-reported hearing difficulty is associated with experiencing unmet health care needs. Adequate health services should be ensured for older adults with hearing difficulties.
... This condition can be accelerated by noise exposure ( Lie et al., 2016;D. I. Nelson, Nelson, Concha-Barrientos, & Fingerhut, 2005), lifestyle factors including smoking ( Gopinath et al., 2010;Nomura, Nakao, & Morimoto, 2005), and chronic health conditions that include diabetes (Fowler & Jones, 1999), and cardiovascular disease (Gates, Cobb, D'Agostino, & Wolf, 1993). Hearing loss is more common among men than women ( Stevens et al., 2013); however, this sex difference may be explained by the higher prevalence of other hearing loss risk factors (e.g., noise exposure) in men ( Helzner et al., 2005). ...
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Hearing impairment is associated with poorer cognitive function in later life. We tested for the potential contribution of childhood cognitive ability to this relationship. Childhood cognitive ability is strongly related to cognitive function in older age, and may be related to auditory function through its association with hearing impairment risk factors. Using data from the Lothian Birth Cohort, 1936, we tested whether childhood cognitive ability predicted later-life hearing ability then whether this association was mediated by demographic or health differences. We found that childhood cognitive ability was negatively associated with hearing impairment risk at age 76 (odds ratio = .834, p = .042). However, this association was nonsignificant after subsequent adjustment for potentially mediating demographic and health factors. Next, we tested whether associations observed in older age between hearing impairment and general cognitive ability level or change were accounted for by childhood cognitive ability. At age 76, in the minimally adjusted model, hearing impairment was associated with poorer general cognitive ability level (β = -.119, p = .030) but was not related to decline in general cognitive ability. The former association became nonsignificant after additional adjustment for childhood cognitive ability (β = -.068, p = .426) suggesting that childhood cognitive ability contributes (potentially via demographic and health differences) to the association between levels of hearing and cognitive function in older age. Further work is needed to test whether early life cognitive ability also contributes to the association (documented in previous studies) between older-age hearing impairment and cognitive decline. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
... Alcohol disrupts the balance between stimulating and inhibitory incidents in the brain, causing sedation and anxiolysis (24). Cross-sectional analysis confirmed a significant protective association between the moderate alcohol consumption (1-2 drinks/day) and agerelated hearing function in older adults (aged > 50 years) compared with nondrinkers (25). ...
Article
Background: Historical evidence revealed that alcoholic beverages have been produced, used and abused thousands of years before the discovery of alcohol by Rhazes for medical purposes. Alcohol-induced liver disease (e.g., steatosis, steatohepatitis, fibrosis and cirrhosis) is one of the most prevalent causes of chronic liver disease all over the world. This study aims to find the early report of this complication in an ancient Persian historical text. Methods: In this study, the book of Minooye Kherad, a Zoroastrian manuscript on wisdom which was written in the late Sassanid Empire (224-637 CE) is reviewed. Results: However, the concept of alcohol hepatotoxicity as one of the most important complications of alcoholism is a new terminology, by researching historical documents it can be found that one of the oldest reports of benefits and disadvantages of drinking wine focusing on liver complications is mentioned in the book of Minooye. Conclusion: Description of the liver disease and damage caused by excessive alcohol consumption in this valuable book can be considered as the early report of hepatotoxicity of alcoholic beverages in the medical history.
... However, moderate alcohol consumption was associated with reduced odds of hearing loss, OR 0.61 (95% CI 0.57-0.65) (Dawes et al. 2014), which is in alignment with previous studies reporting an association between moderate alcohol intake with better hearing (Popelka et al. 2000;Fransen et al. 2008;Gopinath et al. 2010). In a European multicentre study utilizing 4083 subjects between 53 and 67 years, in addition to smoking they also found that high body mass index (BMI) correlated with hearing loss (Fransen et al. 2008). ...
Article
Age-related hearing loss (ARHL) is the most prevalent sensory deficit in the elderly. This progressive hearing impairment leads to social isolation and is also associated with comorbidities, such as frailty, falls, and late-onset depression. Moreover, there is a growing evidence linking it with cognitive decline and increased risk of dementia. Given the large social and welfare burden that results from ARHL, and because ARHL is potentially a modifiable risk factor for dementia, there is an urgent need for therapeutic interventions to ameliorate age-related auditory decline. However, a prerequisite for design of therapies is knowledge of the underlying molecular mechanisms. Currently, our understanding of ARHL is very limited. Here, we review recent findings from research into ARHL from both human and animal studies and discuss future prospects for advances in our understanding of genetic susceptibility, pathology, and potential therapeutic approaches in ARHL.
... Prior research has established health disparities in a wide range of health conditions according to socioeconomic position (SEP). 8 Furthermore, there is an evidence that several modifiable lifestyle factors, such as smoking, 9 alcohol consumption, 10 high body mass index (BMI) and physical inactivity 11 are associated with hearing health. Of course, causal paths have not been established, and these associations may be confounded by deprivation or aspects of deprivation (eg, type of occupation). ...
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Objectives Aims were (1) to examine whether socioeconomic position (SEP) is associated with hearing loss (HL) among older adults in England and (2) whether major modifiable lifestyle factors (high body mass index, physical inactivity, tobacco consumption and alcohol intake above the low-risk-level guidelines) are associated with HL after controlling for non-modifiable demographic factors and SEP. Setting We used data from the wave 7 of the English Longitudinal Study of Ageing, which is a longitudinal household survey dataset of a representative sample of people aged 50 and older. Participants The final analytical sample was 8529 participants aged 50–89 that gave consent to have their hearing acuity objectively measured by a screening audiometry device and did not have any ear infection. Primary and secondary outcome measures HL defined as >35 dBHL at 3.0 kHz (better-hearing ear). Those with HL were further subdivided into two categories depending on the number of tones heard at 3.0 kHz. Results HL was identified in 32.1% of men and 22.3% of women aged 50–89. Those in a lower SEP were up to two times more likely to have HL; the adjusted odds of HL were higher for those with no qualifications versus those with a degree/higher education (men: OR 1.87, 95%CI 1.47 to 2.38, women: OR 1.53, 95%CI 1.21 to 1.95), those in routine/manual occupations versus those in managerial/professional occupations (men: OR 1.92, 95%CI 1.43 to 2.63, women: OR 1.25, 95%CI 1.03 to 1.54), and those in the lowest versus the highest income and wealth quintiles (men: OR 1.62, 95%CI 1.08 to 2.44, women: OR 1.36, 95%CI 0.85 to 2.16, and men: OR1.72, 95%CI 1.26 to 2.35, women: OR 1.88, 95%CI 1.37 to 2.58, respectively). All regression models showed that socioeconomic and the modifiable lifestyle factors were strongly associated with HL after controlling for age and gender. Conclusions Socioeconomic and lifestyle factors are associated with HL among older adults as strongly as core demographic risk factors, such as age and gender. Socioeconomic inequalities and modifiable lifestyle behaviours need to be targeted by the health policy strategies, as an important step in designing interventions for individuals that face hearing health inequalities.
... In this same cohort, education, central adiposity, and poorly controlled diabetes were also associated with the 15-year cumulative incidence of hearing loss (41). Other longitudinal studies with shorter durations of follow-up have not demonstrated an association between smoking and the incidence of hearing loss (42). ...
Article
Objective: Studies have demonstrated that glycated hemoglobin (HbA1c) is a significant predictor of hearing impairment in type 1 diabetes. We identified additional factors associated with hearing impairment in participants with type 1 diabetes from the Diabetes Control and Complications Trial and its observational follow-up, the Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. Methods: A total of 1,150 DCCT/EDIC participants were recruited for the Hearing Study. A medical history, physical measurements, and a self-administered hearing questionnaire were obtained. Audiometry was performed by study-certified personnel and assessed centrally. Logistic regression models assessed the association of risk factors and comorbidities with speech- and high-frequency hearing impairment. Results: Mean age was 55 ± 7 years, duration of diabetes 34 ± 5 years, and DCCT/EDIC HbA1c 7.9 ± 0.9% (63 mmol/mol). In multivariable models, higher odds of speech-frequency impairment were significantly associated with older age, higher HbA1c, history of noise exposure, male sex, and higher triglycerides. Higher odds of high-frequency impairment were associated with older age, male sex, history of noise exposure, higher skin intrinsic florescence (SIF) as a marker of tissue glycation, higher HbA1c, nonprofessional/nontechnical occupations, sedentary activity, and lower low-density-lipoprotein cholesterol. Among participants who previously completed computed tomography and carotid ultrasonography, coronary artery calcification (CAC) >0 and carotid intima-medial thickness were significantly associated with high-but not speech-frequency impairment. Conclusion: Consistent with previous reports, male sex, age, several metabolic factors, and noise exposure are independently associated with hearing impairment. The association with SIF further emphasizes the importance of glycemia-as a modifiable risk factor-over time. In addition, the macrovascular contribution of CAC is novel and important. Abbreviations: AER = albumin excretion rate; CAC = coronary artery calcification; CVD = cardiovascular disease; DCCT/EDIC = Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications; eGFR = estimated glomerular filtration rate; ETDRS = Early Treatment Diabetic Retinopathy Study; HbA1c = glycated hemoglobin; HDL = high-density lipoprotein; IMT = intima-media thickness; LDL = low-density lipoprotein; NHANES = National Health and Nutrition Examination Survey; OR = odds ratio; SIF = skin intrinsic fluorescence; T1D = type 1 diabetes.
... 46 Impacts may be different for moderate or light levels of consumption. [46][47][48] Third, comparing health outcomes in drinkers versus non-drinkers may give the false impression that alcohol consumptions is linked to better health outcomes due to the inclusion of people who have given up drinking due to poor health in the non-drinker group ('sick-quitters'). 41 49 The detailed level of analysis in relation to these questions is beyond the scope of the present paper and should be the subject of future investigation. ...
Article
Objective: To assess incidence and changes in tinnitus and bothersome tinnitus as well as associated risk factors in a large sample of UK adults. Design: Prospective cohort study. Setting: UK. Participants: For cross-sectional analysis, a group of 168 348 participants aged between 40 and 69 years with hearing and tinnitus data from the UK Biobank resource. Longitudinal analysis included a subset of 4746 people who attended a 4-year retest assessment. Main outcome measures: Presence and bothersomeness of tinnitus. Results: 17.7% and 5.8% of participants reported tinnitus or bothersome tinnitus, respectively. The 4-year incidence of tinnitus was 8.7%. Multivariate logistic regression models suggested that age, hearing difficulties, work noise exposure, ototoxic medication and neuroticism were all positively associated with both tinnitus and bothersome tinnitus. Reduced odds of tinnitus, but not bothersome tinnitus, was seen in alcohol drinkers versus non-drinkers. Male gender was associated with increased odds of tinnitus, while female gender was associated with increased odds of bothersome tinnitus. At follow-up, of those originally reporting tinnitus, 18.3% reported no tinnitus. Of those still reporting tinnitus, 9% reported improvement and 9% reported tinnitus becoming more bothersome, with the rest unchanged. Male gender and alcohol consumption were associated with tinnitus being reported less bothersome, and hearing difficulties were associated with the odds of tinnitus being reported as more bothersome. Conclusions: This study is one of the few to provide data on the natural history of tinnitus in a non-clinical population, suggesting that resolution is relatively uncommon, with improvement and worsening of symptoms equally likely. There was limited evidence for any modifiable lifestyle factors being associated with changes in tinnitus symptoms. In view of the largely persistent nature of tinnitus, public health strategies should focus on: (1) primary prevention and (2) managing symptoms in people that have tinnitus and monitoring changes in bothersomeness.
... Despite a large decline in smoking consumption, smoking explained only a minor part of the change in hearing. We believe that this nding is plausible, since smoking has been associated with hearing with modest effect sizes [33][34][35][36]. ...
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Background The hearing function at a given age seems to have improved in more recent born cohorts in industrialized countries. But the reasons for the improvement have not yet been explained. Methods We investigated the extent to which better hearing in Norway is attributed to modifiable risk factors by using representative demographic and audiometric data from two cohorts of the Nord-Trøndelag Health Study, HUNT2 (1996-1998) and HUNT4 (2017-2019). We estimated natural indirect effects using causal inference methods in order to assess whether cohort improvement in hearing thresholds (HTs) was mediated by occupational noise exposure, recurrent ear infections, smoking and education. Results The improvement in HTs from HUNT2 to HUNT4 was 2.8 and 3.0 dB at low respectively high frequencies. Together all risk factors mediated this improvement by 0.8 dB (95% CI 0.7-0.9) and 0.8 dB (95% CI 0.7-0.9) respectively, corresponding to mediated proportions of 27 and 28 percent. Substantial mediation was specifically found for occupational noise in men and recurrent ear infections in women (mediated proportions of 11 and 17 percent at high frequencies, respectively). Conclusions Increased education, less occupational noise exposure, ear infections and smoking contributed considerably to better hearing in Norway the last two decades.
... indicated a U-shaped association between alcohol consumption and HI 31,32 or did not find a significant association. 33,34 The present study showed that the prevalence of HI was significantly higher among women who consumed alcohol than among those who never consumed alcohol. ...
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Objective: Hearing impairment (HI) has become one of the most common causes of disability worldwide. To date, few studies have examined the hearing of women in these frequently rural regions. Thus, we explored the HI prevalence and risk factors among low-income, middle-aged, and elderly women in Tianjin, China. Methods: Between October and November 2013, female residents aged ≥45 years of rural Tianjin, China were recruited into the study. The participants completed questionnaire surveys, physical examinations, and hearing tests. The hearing at frequencies of 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz was used to analyze the hearing characteristics of specific frequency bands, and HI was defined as the better ear pure tone averages (PTA) >25 dB HL. Results: Among the 1416 participants, the prevalence of HI was 46.0%. Among those aged 45-54-years, most (65.3%) demonstrated normal hearing; in other age groups, slight HI accounted for the largest proportions of individuals. Compared with women who did not drink, the odds ratio (OR) of HI among women who consumed alcohol was 4.2 (95% confidence interval [CI]: 1.844-9.574; P = 0.001). Compared with pre-menopausal women, the OR of HI among postmenopausal women was 1.8 (95% CI: 1.261-2.667; P = 0.001). Further, each 1-year increase in age in women resulted in a 7.1% increase in HI risk (P < 0.001). Conclusion: The burden of HI among women is heavy in rural northern China, especially among those who experienced menopause. Additionally, the results suggest that to further reduce the risk of developing HI, women in rural areas should stop consuming alcohol. The problem of HI among women in rural areas should be taken seriously; moreover, the measures implemented to prevent HI in high-risk women should be strengthened.
... Several studies have reported that cardiovascular risks factors, including smoking, diabetes, and a history of cardiovascular disease, are also related to hearing loss (5,(7)(8)(9)(10). In addition, the relevance of socioeconomic status (including education status, household incomes, and occupations), history of noise exposure, alcohol consumption, and obesity have also been documented (1,8,11,12). However, there are still controversies regarding the precise impacts of these factors. ...
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We aimed to estimate the effects of various risk factors on hearing level in Korean adults, using data from the Korea National Health and Nutrition Examination Survey. We examined data from 13,369 participants collected between 2009 and 2011. Average hearing thresholds at low (0.5, 1, and 2 kHz) and high frequencies (3, 4, and 6 kHz), were investigated in accordance with various known risk factors via multiple regression analysis featuring complex sampling. We additionally evaluated data from 4,810 participants who completed a questionnaire concerned with different types of noise exposure. Low body mass index, absence of hyperlipidemia, history of diabetes mellitus, low incomes, low educational status, and smoking were associated with elevated low frequency hearing thresholds. In addition, male sex, low body mass index, absence of hyperlipidemia, low income, low educational status, smoking, and heavy alcohol consumption were associated with elevated high frequency hearing thresholds. Participants with a history of earphone use in noisy circumstances demonstrated hearing thresholds which were 1.024 dB (95% CI: 0.176 to 1.871; P = 0.018) higher, at low-frequencies, compared to participants without a history of earphone use. Our study suggests that low BMI, absence of hyperlipidemia, low household income, and low educational status are related with hearing loss in Korean adults. Male sex, smoking, and heavy alcohol use are related with high frequency hearing loss. A history of earphone use in noisy circumstances is also related with hearing loss. Graphical Abstract
... The authors conclude that age-induced hearing loss may be modestly reduced by the same recommended actions as for the prevention of cardiovascular disease. Gopinath et al. (2010) examined hearing in 2815 Australian men and women more than 50 years old in a crosssectional study which was part of the "Blue Mountain Hearing Study". Adjusting for relevant factors, smoking was associated with an increased risk of hearing loss (OR 1.63), and a moderate alcohol consumption led to a slight protective effect (OR 0.75). ...
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To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age.
... One hypothesis is that the association is confounded by factors known to increase the risk of both sensory impairment and mortality. Cardiovascular disease and diabetes have been identified as such factors, although it has been demonstrated that the risk factors (eg, body mass index, smoking, hypertension) and related outcomes (eg, angina, acute myocardial infarction) did not entirely explain the variance in several studies (1)(2)(3)(4)(5). Alternatively, frailty, defined as agerelated higher vulnerability for adverse health outcomes (6), could have confounded the association (1,7,8). ...
Article
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Background: Concurrent vision and hearing impairment, known as dual sensory impairment (DSI), is associated with increased mortality. We aimed to examine individual and joint associations of DSI and involvement in activities with mortality in a large European nursing home study. Methods: In total, 2,851 nursing home residents in 59 facilities in eight countries were followed for 1 year in the Services and Health for Elderly in Long TERm Care study. Vision and hearing impairment and average time of involvement in activities were assessed by trained research staff using the interRAI Long Term Care Facilities. Association between DSI and 1-year all-cause mortality was examined using Cox proportional hazards models adjusted for age, sex, facility, diagnoses of coronary heart disease and diabetes mellitus, self-rated health, end-stage disease, and functional and cognitive status. The modifying effect of involvement in activities on the association was investigated by the additive hazard model. Results: DSI, defined as moderate to severe impairment in both senses, was independently associated with a 35% increased risk of 1-year mortality compared with non-DSI. Residents with DSI who were involved in activities did not have higher mortality, while residents with DSI who were not involved in activities had 51% higher mortality than non-DSI residents who were involved in activities, equivalent to approximately 209 additional deaths per 1,000 person-years (p = .012) due to the interaction between DSI and no involvement in activities. Conclusions: DSI is associated with increased mortality at nursing homes when combined with no involvement in activities.
... This possibility, which emphasises the stability of individual differences in hearing and cognitive abilities, contrasts with the prediction made by the common cause hypothesis (Baltes & Lindenberger, 1997), which predicts that associations between hearing and cognitive abilities will emerge or become stronger in older age. Secondly, childhood cognitive ability could contribute to the risk of hearing loss in adulthood, potentially via its positive association with health literacy (Murray et al., 2011) and relevant health behaviours, such as lower rates of smoking (Wraw et al., 2018), and lower risk of chronic diseases (Batty et al., 2007;Singh-Manoux et al., 2009) including those associated with hearing loss (Fowler & Jones, 1999;Gates et al., 1993;Gopinath et al., 2010;Nomura et al., 2005). We found support for this direction of effect in our previous observational study, using data from the Lothian Birth Cohort 1936; in that study, a higher cognitive ability in childhood was related to a lower risk of hearing impairment at age 76 (Okely et al., 2019). ...
Article
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Previous cross-sectional findings indicate that hearing and cognitive abilities are positively correlated in childhood, adulthood, and older age. We used an unusually valuable longitudinal dataset from a single-year birth cohort study, the National Child Development Study 1958, to test how hearing and cognitive abilities relate to one another across the life course from childhood to middle age. Cognitive ability was assessed with a single test of general cognitive ability at age 11 years and again with multiple tests at age 50. Hearing ability was assessed, using a pure tone audiogram, in childhood at ages 11 and 16 and again at age 44. Associations between childhood and middle-age hearing and cognitive abilities were investigated using structural equation modelling. We found that higher cognitive ability was associated with better hearing (indicated by a lower score on the hearing ability variables); this association was apparent in childhood ( r = -0.120, p <0.001) and middle age ( r = -0.208, p <0.001). There was a reciprocal relationship between hearing and cognitive abilities over time: better hearing in childhood was weakly associated with a higher cognitive ability in middle age ( β = -0.076, p = 0.001), and a higher cognitive ability in childhood was associated with better hearing in middle age ( β = -0.163, p <0.001). This latter, stronger effect was mediated by occupational and health variables in adulthood. Our results point to the discovery of a potentially life-long relationship between hearing and cognitive abilities and demonstrate how these variables may influence one another over time.
... Regional differences in the burden of hearing loss suggested that the governments of countries with high rates of hearing loss need to focus on supporting relevant research to identify the underlying causes and take measures to actively control the occurrence of hearing loss. Healthy lifestyles such as increasing the amount of physical exercise and giving up smoking and drinking should be advocated (Cosiano et al. 2020;Gopinath et al. 2010). Patients with hypertension, diabetes, cancer, and other diseases should be followed up and provided with appropriate medications and improved sensitive range for ototoxicity to prevent the occurrence of hearing loss (Landier 2016). ...
Article
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We aimed to describe the global prevalence and temporal trends of hearing loss. We collected detailed information of hearing loss from the Global Burden of Disease study between 1990 and 2019. Average annual percentage changes (AAPCs) in hearing loss age-standardized prevalence rate (ASPR), by sex, region, and category, were calculated to quantify the temporal prevalence trends. Globally, the prevalent cases of hearing loss increased from 7514.97×10⁵ in 1990 to 14566.62×10⁵ in 2019, and the ASPR increased from 173.33×10² per 100,000 in 1990 to 177.56×10² per 100,000 in 2019. The years lived with disability (YLDs) increased from 220080.97×10² in 1990 to 402353.05×10² in 2019. The AAPC was 83.27 (95% CI 70.66, 95.88) ×10⁻³ in prevalence and −72.87 (95% CI −92.18, −53.56) ×10⁻³ in YLDs. Significant correlations of AAPCs with ASPR (r=−0.60, p<0.001), and age-standardized YLD rate (r=−0.43, p=0.0012 for YLD<455, r=0.32, p<0.001 for YLD≥455) were detected. The YLDs of hearing loss owing to occupational noise (HLOON) increased from 39334.39 (95% UI 26881.04, 55999.67) ×10² in 1990 to 70014.49 (98% UI 47605.62, 100593.43) ×10² in 2019, and the increasing AAPC was observed for females and aged between 15 and 49 years old in global and most regions. The age effect was under zero in 7 age groups, the period effect of hearing loss prevalence was increasing and the birth cohort effect was decreasing with the time advance. The number of cases and ASPR of hearing loss in the world is still growing. Efforts to control hearing loss, especially HLOON, are imminent.
... In literature, there is no consensus whether alcohol and tobacco use influence ARHL. It seems that these factors could accelerate ARHL, however, other factors may play a more crucial role [201][202][203] . A highly reported medical condition possibly influencing ARHL are cardiovascular diseases 182 . ...
... One is the cross-sectional study design, which limits drawing strong conclusions about causation. The few studies that did use a longitudinal approach mostly failed to find significant risk factors (Dubno et al. 2008;Gopinath et al. 2009Gopinath et al. , 2010Mitchell et al. 2009). Another is the study of a certain risk factor in Decline in Older Persons' Ability to Recognize Speech in Noise: The Influence of Demographic, Health-Related, Environmental, and Cognitive Factors isolation. ...
Article
The first aim was to investigate whether the rate of decline in older persons' ability to recognize speech in noise over time differs across age and gender. The second aim was to determine extent demographic, health-related, environmental, and cognitive factors influence the change in speech-in-noise recognition over time. Data covering 3 to 7 years of follow-up (mean: 4.9 years) of a large sample of the Longitudinal Aging Study Amsterdam were used (n = 1298; 3025 observations; baseline ages: 57 to 93 years). Hearing ability was measured by a digit triplet speech-in-noise test (SNT) yielding a speech reception threshold in noise (SRTn). Multilevel analyses were used to model the change in SRTn over time. First, interaction terms were used to test differences in rate of decline across subgroups. Second, for each of the following factors the authors determined the influence on the change in SRTn: age, gender, educational level, cardiovascular conditions, information processing speed, fluid intelligence, global cognitive functioning, smoking, and alcohol use. This was done by calculating the percentage change in Btime after adding the particular factor to the model. On average, respondents' SRTn increased (i.e., deteriorated) significantly over time by 0.18 dB signal-to-noise ratio per annum. Rates were accelerated for older ages (Btime = 0.13, 0.14, 0.25, 0.27 for persons who were 57 to 65, 65 to 75, 75 to 85, and 85 to 93 years of age, respectively). Only information processing speed relevantly influenced the change in SRTn over time (17% decrease in Btime). Decline in older persons' speech-in-noise recognition over time accelerated for older ages. Decline in information processing speed explained a moderate proportion of the SRTn decline. This indicates the relevance of declining cognitive abilities in the ability of older persons to recognize speech in noisy environments.
... Similarly, the findings of a meta-analysis conducted by Nomura et al. also showed the same results [1]. However, the results of our study showed diversity with some of the cohort studies which might be due to the methodological differences [8][9][10][11], but some of them are consistent with our results [12,13]. The mechanism of smoking's effect on hearing loss is unclear. ...
Article
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Introduction: Smoking is a well-recognized risk factor for many health issues; however, its association with hearing loss has been a debate. Some studies have shown a positive association while others did not. In this study, we aim to identify the effect of cigarette smoking on hearing in our population. Methods: This cross-sectional study was conducted in a tertiary care hospital in Pakistan from August 2020 to March 2021. Five hundred male smokers (n = 500), with a history of smoking for more than three years between the ages of 21 and 50, were enrolled in the study via consecutive convenient non-probability sampling after informed consent. Five hundred male non-smokers (n = 500) were enrolled as a reference group. Audiometry was performed in a soundproof room. Results: The hearing levels in audiometry were significantly higher in smokers compared to non-smokers (22.8 ± 8.12 decibels vs 18.7 ± 6.12; p-value < 0.0001). Participants who had been smoking for more than 10 years had higher hearing levels in the audiometry test compared to the participants with less than 10 years of smoking history (24.21 ± 8.91 decibels vs. 21.1 ± 8.01 decibels: p-value < 0.0001). Conclusion: In this study, smokers were associated with greater loss in hearing compared to non-smokers. In addition to other adverse events associated with smoking, smokers should be counselled about hearing loss related to it.
... With consideration of those confounding factors, our results showed that in only female workers, consuming at least 50 g of alcohol per day might be a risk factor for HFHL. There are disparate findings on whether alcohol OR odds ratio, CI 95% confidence interval Variables without statistical significance in the regression models are not shown consumption increases the risk of hearing loss [31]. A large UK population-based study including 164,770 adults reported that those who consumed alcohol were less likely to experience hearing loss than lifetime teetotalers, suggesting that alcohol consumption had a protective effect [32]. ...
Article
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Background Significant sex differences exist in hearing physiology, while few human studies have investigated sex differences in noise-induced hearing loss (NIHL), and the sex bias in previous studies resulted in inadequate female data. The study aims to investigate sex differences in the characteristics of NIHL to provide insight into sex-specific risk factors, prevention strategies and treatment for NIHL. Methods This cross-sectional study included 2280 industrial noise-exposed shipyard workers (1140 males and 1140 females matched for age, job and employment length) in China. Individual noise exposure levels were measured to calculate the cumulative noise exposure (CNE), and an audiometric test was performed by an experienced technician in a soundproof booth. Sex differences in and influencing factors of low-frequency (LFHL) and high-frequency hearing loss (HFHL) were analyzed using logistic regression models stratified by age and CNE. Results At comparable noise exposure levels and ages, the prevalence of HFHL was significantly higher in males (34.4%) than in females (13.8%), and males had a higher prevalence of HFHL (OR = 4.19, 95% CI 3.18 to 5.52) after adjusting for age, CNE, and other covariates. Sex differences were constant and highly remarkable among subjects aged 30 to 40 years and those with a CNE of 80 to 95 dB(A). Alcohol consumption might be a risk factor for HFHL in females (OR = 3.12, 95% CI 1.10 to 8.89). Conclusions This study indicates significant sex differences in NIHL. Males are at higher risk of HFHL than females despite equivalent noise exposure and age. The risk factors for NIHL might be different in males and females.
... Despite a large decline in smoking consumption, smoking explained only a minor part of the change in hearing. We believe that this finding is plausible, since smoking has been associated with hearing with modest effect sizes [19,[39][40][41]. ...
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Background The hearing function at a given age seems to have improved in more recent born cohorts in industrialized countries. But the reasons for the improvement have not yet been explained. Methods We investigated the extent to which better hearing in Norway is attributed to modifiable risk factors by using representative demographic and audiometric data from two cohorts of the Trøndelag Health Study, HUNT2 (1996–1998) and HUNT4 (2017–2019). We estimated natural indirect effects using causal inference methods in order to assess whether cohort improvement in hearing thresholds (HTs) was mediated by occupational noise exposure, recurrent ear infections, smoking and education. Results The improvement in HTs from HUNT2 to HUNT4 was 2.8 and 3.0 dB at low respectively high frequencies. Together all risk factors mediated this improvement by 0.8 dB (95% CI 0.7–0.9) and 0.8 dB (95% CI 0.7–0.9) respectively, corresponding to mediated proportions of 27 and 28%. Substantial mediation was specifically found for occupational noise in men and recurrent ear infections in women (mediated proportions of 11 and 17% at high frequencies, respectively). Conclusions Increased education, less occupational noise exposure, ear infections and smoking contributed considerably to better hearing in Norway the last two decades.
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Millennia have passed since the first medical recognition of acquired hearing loss. Yet, our ears are still afflicted by the same tribulations today, most prominently presbycusis, noise trauma, and drug-induced hearing loss. Despite an increasingly detailed insight into the pathophysiology and underlying molecular pathology, our ability to ameliorate the deafening consequences of environmental insults remains limited. This chapter takes readers from a concise assessment of the current state of knowledge of the death and dying of our auditory sensory cells to questions of otoprotection and to promising targets of future—and perhaps futuristic—scientific exploration. The key to our ears succumbing to outside pressure might not be the fault of an inherited individual sensitivity or an inability of hair cells to muster a valiant defense. Rather than genetics it might be lifelong changes to epigenetics that render us vulnerable; supporting cells might abandon their allegiance under stress and support death in their surroundings instead; and subtle trickeries of 100 trillion gut bacteria might wreak havoc with a few thousand hair cells.
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Age-related hearing loss (ARHL) is an extremely common and disabling condition among older adults. Its detrimental effects on communication can be felt in the emotional, cognitive and functional domains. Epidemiologic studies of age-related hearing loss provide us with knowledge about the prevalence and incidence of hearing loss in older adults, as well as intrinsic and extrinsic factors that may serve as risk factors for the development and/or progression of hearing loss. Overall, the prevalence of hearing loss (including high-frequency hearing loss) increases with age, and ARHL is more prevalent in men than in women and more common among White and Mexican-American individuals than among Black individuals. Risk factors for hearing loss include lower socioeconomic status, the presence of diabetes mellitus or cardiovascular disease, -cigarette smoking, exposure to toxic levels of noise, medication ototoxicity, lead exposure and genetic factors. Prevention methods primarily include limiting one's exposure to risk factors. While much hearing loss is not curable, there are strategies (e.g., conversation techniques, assistive devices) to aid individuals who have ARHL. © 2012 Springer Science+Business Media Dordrecht. All rights reserved.
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Hearing impairment is the most prevalent sensory deficit, affecting approximately 30 million (12.7 %) individuals in the United States in both ears and 48 million (20.3 %) individuals in the United States in at least one ear. Nevertheless, NIH estimates suggest that only 20 % of people who could potentially benefit from a hearing aid seek intervention. Globally, approximately 5.3 % of the world?s population, or 360 million individuals, suffer from hearing impairment that is considered to be disabling by WHO standards. Hearing impairment is a condition that can develop across the life span, and the relations between specific risk factors and hearing impairment may vary with age. The etiology of hearing impairment is complex and multifactorial, representing the cumulative influences of an amalgam of factors, such as aging, genetic, epigenetic, environmental, health comorbidity, diet and lifestyle factors, as well as the complex potential interactions among these factors, that may all contribute to its development. Identification of risk factors for hearing impairment may provide us with a better understanding of the cellular and molecular mechanisms associated with acquired hearing impairment and could aid efforts toward prevention, early detection, and delay of progression. This chapter provides an overview of the epidemiology of hearing impairment in the United States and worldwide, including information on incidence, prevalence, and a discussion of risk factors that have been identified as potential contributors.
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Modifiable risk factors to reduce the incidence of age-related hearing loss remain undetermined. This study was aimed at identifying predictors of hearing loss with aging among middle-aged and elderly Japanese community dwellers. Data were derived from the National Institute for Longevity Sciences-Longitudinal Study of Aging. There were 1374 individuals without hearing loss or any missing data at the baseline, who participated in the follow-up study at least once and were followed for up to 10 years. The hearing impairment criterion was a better-ear pure-tone average of greater than 25dB. Cumulative data were analyzed using generalized estimating equations to investigate the factors contributing to the occurrence of hearing loss during the follow-up period. Among 24 independent variables examined, 7 were identified as being significant. Educational attainment was associated with a reduced incidence of hearing loss (multivariable adjusted odds ratio [OR]= 0.759 per 3-years increase, 95% confidence interval [CI] = 0.639-0.900) while body mass index increase was associated with an increased incidence of hearing loss (OR = 1.287 per 5kg/m² gain, 95% CI = 1.029-1.610), consistent with previous reports. A higher total amount of physical activity was associated with a higher incidence of hearing loss (OR = 1.156 per 50METs∗min/1000/y increase, 95% CI = 1.051-1.272), a result that differed from some previous reports. In this article, we discuss our interpretation of the present results with a review of the literature.
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The purpose of this study was to investigate the influence of work environments and occupational hazards on smoking intensity by occupation type in Korean workers. This study used the data from the Fourth Korea National Health and Nutrition Examination Survey in 2009. The sample of this study included 3,769 adults who were aged 18 years or older and had an occupation of office work, sales, or manufacturing. After controlling for sociodemographic characteristics, the generalized linear models revealed that office workers and the sales force who had smoking co-workers at the workplace were more likely to smoke than those who did not. A dirty workplace and exposure to occupational noise were significant factors increasing the smoking intensity for manufacturers. A smoking cessation program considering physical work environments and co-workers' support should be developed for Korean workers.
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Introduction: Smoking is a common tendency among all social classes around the globe, especially in the working population. Objective: To assess the significant link between tobacco and cigarette smoking and its effect on hearing among smokers as there is limited study on this aspect of the Indian population particularly with a high-frequency hearing threshold. Methodology: Cross-sectional study carried out on patients attending the OPD in ENT and Head & Neck Surgery Department of Rohilkhand Medical College & Hospital. The sample size came to be 90. Results: In smokers, there were 72 (80%) males and 18 (20%) females while in the non-smoker group, there were 53 (58.8%) males and 37 (41.11%) females, and 39 (43.3%) subjects belonging to the rural population while 51 (56.7%) subjects belong to an urban population. out of 90 subjects, 43 (30.3%) had cochlear deafness followed by 40 (28.2%) who had normal hearing and 7 (4.9%) had retrocochlear deafness. Conclusion: Tobacco has the power to reduce the ability to hear, mainly causing a sensorineural hearing loss at higher frequencies.
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Health care professionals including physicians, nurses, and audiologists are charged with providing comprehensive geriatric care for millions of aging adults. As baby boomers mature, prevalence of age-related hearing loss (ARHL) among adults aged 45+ years has risen from 30% to 50%. New findings have emerged regarding risk factors affecting ARHL prevalence. Many aging adults have medical comorbidities, such as diabetes, cardiovascular disease, and hypertension, which substantially increase the risk for ARHL. Recent studies highlighted links between cognitive skills, psychological health, and lifestyle choices like exercise and smoking that also relate to hearing loss. Thus, both intrinsic and extrinsic factors influence risk for ARHL. However, many practitioners are unaware of the relationship between such risk factors and ARHL. Therefore, this tutorial article highlights key research findings and summarizes current knowledge for clinical application. Specific audiologic and interdisciplinary strategies for clinical intervention are recommended within a framework of developing community-specific hearing health promotion programs.
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Background: Reports assessing hearing abnormalities in diabetes are debated. We aimed to evaluated auditory alterations and their possible associations with vascular and neurological dysfunction in 160 Type 2 diabetes mellitus individuals and 100 age and sex-matched healthy controls. Methods: Participants underwent pure tone audiometry (PTA). Associations with demographic, metabolic and neuropathic variables were assessed. Results: Compared with healthy controls, diabetic patients had higher mean hearing thresholds at each frequency, with statistical significance at 2-8 kHz (p <0.05). Prevalence of hearing loss in diabetics was 67.5% (108/160), including high-frequency (72.22%, 78/108), and low/mid- and high-frequency (27.78%, 30/108). The mild hearing loss was predominant in diabetics with high-frequency impairment (52.56%), while the moderate/severe hearing loss was high in individuals with both low-and high-frequency hearing loss (80.00%). Multiple logistic regression analysis of PTA parameters showed that higher Semmes Weinstein Monofilament (OR 1.24, 95% CI 1.02-1.52), Michigan Neuropathy Screening Instrument score (OR 1.38, 95% CI 1.14-1.68), and vibration perception threshold (OR 1.19, 95% CI 1.05-1.34) were independent risk factors for hearing impairment in diabetics after adjusting for potential covariates. Conclusions: These findings suggest that hearing loss is common in T2DM subjects, with predominantly high frequency involved. Diabetic neuropathic factors may explain the underlying mechanism of the association between diabetes and hearing loss.
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Background: With the aging population, the prevalence of age-related hearing loss will increase substantially. Prevention requires more knowledge on modifiable risk factors. Obesity and diet quality have been suggested to play a role in the etiology of age-related hearing loss. We aimed to investigate independent associations of body composition and diet quality with age-related hearing loss. Methods: We performed cross-sectional and longitudinal analyses (follow-up: 4.4 years) in the population-based Rotterdam Study. At baseline (2006-2014), 2,906 participants underwent assessment of body composition, diet, and hearing. Of these 2,906 participants, 636 had hearing assessment at follow-up (2014-2016). Association of body composition and of diet quality with hearing loss were examined using multivariable linear regression models. Results: Cross-sectionally, higher body mass index and fat mass index were associated with increased hearing thresholds. These associations did not remain statistically significant at follow-up. We found no associations between overall diet quality and hearing thresholds. Conclusions: This study shows that a higher body mass index, and in particular a higher fat mass index, is related to age-related hearing loss. However, whether maintaining a healthy body composition may actually reduce the effects of age-related hearing loss in the aging population requires further longitudinal population-based research.
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Objectives/hypothesis: To determine the 10-year incidence of hearing impairment (HI) and associated risk factors in the Beaver Dam Offspring Study (BOSS; 2004-present), a large middle-aged cohort followed for 10 years. Study design: Prospective cohort study. Methods: Hearing thresholds were measured at baseline (2005-2008) and 5- (2010-2013) and 10-year (2015-2017) follow-up examinations. HI was defined as a pure-tone average >25 dB HL in either ear. BOSS participants free of HI at baseline with at least one follow-up examination (N = 2,065) were included. Potential risk factors evaluated included cardiovascular measures, health history, lifestyle factors, inflammatory markers, vitamins D and B12, lead, and cadmium. Results: Participants were 21 to 79 years (mean age = 47.9 years) at baseline. The 10-year cumulative HI incidence was 17.4% (95% confidence interval [CI]: 15.7-19.2) and was twice as likely in men (24.4%, 95% CI: 21.5-27.7) than in women (12.2%, 95% CI: 10.3-14.3). In a multivariable adjusted model, age (hazard ratio [HR] = 1.48, 95% CI: 1.38-1.59, per 5 years), male sex (HR = 2.47, 95% CI: 1.91-3.18), less than a college education (HR = 1.35, 95% CI: 1.02-1.79), body mass index (HR = 1.03, 95% CI: 1.01-1.05, per kg/m2 ), and higher cadmium levels (HR = 1.42, 95% CI: 1.05-1.92, quintile 5 vs. quintiles 1-4) were associated with the 10-year cumulative incidence of HI. There was no association between high lead levels, vitamins D or B12, and 10-year incidence of HI. Conclusions: In addition to age and sex, obesity, education, and blood cadmium levels were associated with increased incidence of HI. These prospective results add to evidence that age-related HI is a multifactorial preventable disorder. Level of evidence: 2b Laryngoscope, 2019.
Chapter
Hearing loss in older adults is a national and global health priority. Fifty percent of adults over the age of 60 years are impacted by a clinically meaningful hearing loss, with that number increasing to every two out of three adults over the age of 70. There is also growing recognition that hearing loss is associated with increased risk for health conditions including dementia and falls. This chapter describes what is known about age-related hearing loss from population-based epidemiologic studies, including the prevalence (burden of existing hearing loss) and incidence (new cases of hearing loss), and describes patterns of severity and trends by demographics and over time. Risk factors for hearing loss are discussed, including those for acquired (and therefore potentially preventable) hearing loss, such as noise exposure, environmental exposures, medications, and cardiovascular-related factors. Also included is epidemiologic evidence for possible consequences of age-related hearing loss, beginning with a framework for understanding how epidemiologic and clinical research is synthesized and evaluated to determine the relationship between an exposure and an outcome. Evidence is then presented for the association between age-related hearing loss and communication and functional geriatric outcomes, including dementia, cognitive impairment and decline, depression, physical function and disability, social engagement, and healthcare utilization. A theoretical biological mechanistic rationale is also provided as to why age-related hearing loss may possibly be related to these important functional outcomes in older adults.
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In traditional geriatrics, the study and treatment of diseases follow the same criteria of general medicine, i.e., the diseases are first of all divided according to the affected anatomical or functional system. For example, in the Broklehurst’s Textbook of Geriatric Medicine and Gerontology (Fillit et al. 2017), the subject is divided into the sections Cardiovascular system, Respiratory system, Nervous system, Musculoskeletal system, Gastroenterology, Urinary tract, Women’s health, Endocrinology, Hematology and Oncology, Skin and Special senses, which mirrors the division of general medicine into various specializations.
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Introduction: Hearing loss and cigarette smoking are major challenges that affect public health in China. Revealing the effect of smoking on hearing loss in the Chinese general population is critical for hearing health protection. We investigated the relationship between smoking status and hearing loss in China, especially in stratified sex and age groups. Methods: A cross-sectional study was conducted on 4685 individuals aged 20- 80 years in Zhejiang province from 2016 to 2018, with audiometric testing for hearing loss and a structured questionnaire for collecting smoking status and covariates. Logistic regression was used to estimate the association between smoking and hearing loss. Results: Cigarette smoking was not significantly associated with hearing loss in females and young males. In middle-aged males, after adjusting for covariates, current smokers and past smokers had a significantly higher prevalence of speech-frequency loss (OR=1.65; 95% CI: 1.17-2.33 and OR=1.88; 95% CI: 1.11-3.17; respectively) and high-frequency hearing loss (OR=2.01; 95% CI: 1.43-2.84 and OR=2.64; 95% CI: 1.50-4.66; respectively). In older males, only past smokers had a significantly higher prevalence of speech-frequency hearing loss than never smokers (OR=2.58; 95% CI: 1.38-4.85). Regarding middle-aged and older current smokers, a dose-dependent relationship between smoking intensity and hearing loss was found. Passive smoking was not significantly associated with an increased hearing loss risk in all the three male groups. Conclusions: The relationship between cigarette smoking and hearing loss varied according to gender and age. Therefore, the interventions for smoking need to be tailored according to age in males.
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Objectives : We examined the association between birthweight and objectively measured hearing loss in older men and women. Study design : 893 community-dwelling participants aged 50+ years with pure-tone audiometry data and self-reported birthweight were included for cross-sectional analysis. Participants were asked how much they weighed at birth either in pounds and ounces or in kilograms and grams. Main outcome measures : The pure-tone average of frequencies 0.5, 1.0, 2.0 and 4.0 kHz (PTA0.5-4kHz) >25 dB HL in the better ear established the presence of hearing loss. Results : Around 31.9% and 50.0% of participants who self-reported low (<2.5 kg) and high birthweight (>4.5 kg), respectively, had hearing loss. The odds of experiencing any level of hearing loss (>25 dB HL) after multivariate adjustment was: OR 2.00 (95% CI 1.13-3.56) for low birthweight and OR 2.43 (95% CI 1.23-4.82) for high birthweight, compared with participants in the reference group who self-reported normal birthweight (3.1-4.0 kg). Additionally, participants with high birthweight had 2.4-fold greater odds of having mild hearing loss (25-40 dB HL), while participants with low birthweight had 2.6-fold greater odds of moderate to severe hearing loss. Conclusions : We observed an independent U-shaped association between birthweight and age-related hearing loss, that is, persons born with low or high birthweight had a greater likelihood of experiencing any level of hearing loss in older age. These findings provide further evidence to address an important gap in the literature regarding the influence of foetal growth on the auditory system in later life.
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Importance: The implications of cigarette smoking and smoking cessation for hearing impairment remain unknown. Many studies on this topic have failed to account for attrition among smokers in their findings. Objective: To assess the association of cigarette smoking patterns with audiometric and speech-in-noise hearing measures among participants of the Atherosclerosis Risk in Communities Study. Design, setting, and participants: This cross-sectional study included participants of the Atherosclerosis Risk in Communities Study from 4 US communities. The analysis includes data from visit 1 (1987-1989) through visit 6 (2016-2017); data were analyzed from March 16 through June 25, 2021. Audiometric hearing and speech-in-noise testing was offered to all participants at visit 6. Participants with incomplete audiometric data or missing data for educational level, body mass index, drinking status, a diabetes or hypertension diagnosis, or occupational noise were excluded. In addition, individuals were excluded if they self-reported as having other than Black or White race and ethnicity, or if they self-reported as having Black race or ethnicity and lived in 2 predominantly White communities. Main outcomes and measures: Smoking behavior was classified from visit 1 (1987-1989) to visit 6 (2016-2017) using group-based trajectory modeling based on self-reported smoking status at each clinic visit. Hearing was assessed at visit 6. An audiometric 4-frequency (0.5, 1, 2, 4 kHz) pure-tone average (PTA) was calculated for the better-hearing ear and modeled as a continuous variable. Speech-in-noise perception was assessed via the Quick Speech-in-Noise Test (QuickSIN) and modeled continuously. Attrition during the 30 years of follow-up was addressed by inverse probability of attrition weighting. Results: A total of 3414 participants aged 72 to 94 years (median [IQR] age, 78.8 [76.0-82.9] years; 2032 [59.5%] women) when hearing was measured at visit 6 (2016-2017) were included in the cohort; 766 (22.4%) self-identified as Black and 2648 (77.6%) as White individuals. Study participants were classified into 3 smoking groups based on smoking behavior: never or former smoking at baseline (n = 2911 [85.3%]), quit smoking during the study period (n = 368 [10.8%]), and persistent smoking (n = 135 [4.0%]). In fully adjusted models, persistent smoking vs never or former smoking was associated with an average 2.69 (95% CI, 0.56-4.81) dB higher PTA (worse hearing) and 1.42 (95% CI, -2.29 to -0.56) lower QuickSIN score (worse performance). Associations were stronger when accounting for informative attrition during the study period (3.53 [95% CI, 1.14-5.93] dB higher PTA; 1.46 [95% CI, -2.52 to -0.41] lower QuickSIN scores). Smoking cessation during the study (vs never or former smoking) was not associated with changes in hearing. Conclusions and relevance: In this cross-sectional study, persistent smoking was associated with worse audiometric hearing and speech-in-noise perception. Hearing measures among participants who quit smoking during the study period did not differ from those for never or former smokers, indicating that smoking cessation (as opposed to persistent smoking) may have benefits for hearing health.
Article
Introduction: A relationship between tobacco smoking and hearing loss has been reported; associations with cannabis smoking are unknown. In this cross-sectional population-based study, we examined relationships between hearing loss and smoking (tobacco, cannabis, or co-drug use). Methods: We explored the relationship between hearing loss and smoking among 2705 participants [mean age = 39.41 (SE: 0.36) years] in the National Health and Nutrition Examination Survey (2011 to 12; 2015 to 16). Smoking status was obtained via questionnaire; four mutually exclusive groups were defined: nonsmokers, current regular cannabis smokers, current regular tobacco smokers, and co-drug users. Hearing sensitivity (0.5 to 8 kHz) was assessed, and two puretone averages (PTAs) computed: low- (PTA0.5,1,2) and high-frequency (PTA3,4,6,8). We defined hearing loss as threshold >15 dB HL. Multivariable logistic regression was used to examine sex-specific associations between smoking and hearing loss in the poorer ear (selected based on PTA0.5,1,2) adjusting for age, sex, race/ethnicity, hypertension, diabetes, education, and noise exposure with sample weights applied. Results: In the age-sex adjusted model, tobacco smokers had increased odds of low- and high-frequency hearing loss compared with non-smokers [odds ratio (OR) = 1.58, 95% confidence ratio (CI): 1.05 to 2.37 and OR = 1.97, 95% CI: 1.58 to 2.45, respectively]. Co-drug users also had greater odds of low- and high-frequency hearing loss [OR = 2.07, 95% CI: 1.10 to 3.91 and OR = 2.24, 95% CI: 1.27 to 3.96, respectively]. In the fully adjusted multivariable model, compared with non-smokers, tobacco smokers had greater odds of high-frequency hearing loss [multivariable adjusted odds ratio = 1.64, 95% CI: 1.28-2.09]. However, in the fully adjusted model, there were no statistically significant relationships between hearing loss (PTA0.5,1,2 or PTA3,4,6,8) and cannabis smoking or co-drug use. Discussion: Cannabis smoking without concomitant tobacco consumption is not associated with hearing loss. However, sole use of cannabis was relatively rare and the prevalence of hearing loss in this population was low, limiting generalizability of the results. This study suggests that tobacco smoking may be a risk factor for hearing loss but does not support an association between hearing loss and cannabis smoking. More definitive evidence could be derived using physiological measures of auditory function in smokers and from longitudinal studies.
Article
Objective: To examine the combined association of five healthy lifestyle behaviors with hearing loss (HL) in the UK Biobank cohort, established between 2006 and 2010 in the United Kingdom. Methods: This longitudinal analysis included 61,958 participants aged 40 to 70 years from April 2007 to December 2016. The healthy behaviors examined were: never smoking, high level of physical activity, high diet quality, moderate alcohol intake, and optimal sleep. Hearing loss was self-reported at baseline and in any physical exam during the follow-up. Results: Over a median follow-up of 3.9�2.5 years, 3072 (5.0%) participants reported incident HL. After adjustment for potential confounders, including age, social factors, exposure to high-intensity noise, ototoxic medication, and comorbidity, the HRs of HL associated with having 1, 2, 3, and 4 to 5 vs 0 behaviors were: 0.85 (95% CI, 0.75 to 0.96), 0.85 (95% CI, 0.75 to 0.96), 0.82 (95% CI, 0.71 to 0.94), and 0.80 (95% CI, 0.67 to 0.97), respectively (P for trend, 0.02). We estimated that the population attributable risk percent for not adhering to any five low-risk lifestyle behaviors was 15.6%. Conclusion: In this large study, an increasing number of healthy behaviors was associated with decreased risk of HL.
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To describe the co-occurrence pattern and determinants of auditory, olfactory, visual, and gustatory impairment across the life spectrum of adults. Cross-sectional analysis. An urban population. In total, 1208 persons from the general adult population (age range, 25-74 years; 46.7% men) were included. Sensory impairments were assessed with validated tests. Alternating logistic regression was applied to characterize (1) the dependence of sensory impairments on selected independent variables and (2) the pairwise association between sensory impairments. The dependence of impairment grade (no to multisensory impairment) on the same set of independent variables was examined using ordinal logistic regression. The prevalence of single sensory impairment was 38.8%, of dual 27.3%, and of multisensory impairment 7.5%. Auditory impairment was the most frequent impairment type (43.9%), followed by olfactory (21.5%), gustatory (20.3%), and visual impairment (14.1%). Besides age and sex, social status (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.80-3.79), smoking status (OR, 1.45; 95% CI, 1.12-1.88), and diabetes (OR, 1.75; 95% CI, 1.16-2.63) were related to an elevated odds of moving from a lower into a higher impairment category. The presence of certain risk factors, such as a low social status, diabetes, and smoking, appears likely to increase the risk of multisensory impairment. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
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Author Contributions:Study concept and design: Gopinath, Schneider, and Mitchell. Acquisition of data: Mitchell. Analysis and interpretation of data: Gopinath, Rochtchina, Leeder, and Mitchell. Drafting of the manuscript: Gopinath. Critical revision of the manuscript for important intellectual content: Rochtchina, Wang, Schneider, Leeder, and Mitchell. Statistical analysis: Rochtchina. Obtained funding: Mitchell. Administrative, technical, and material support: Leeder. Study supervision: Wang, Schneider, and Mitchell.
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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.
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This paper examines the relationship between several risk factors and the development of age-associated hearing loss in the speech frequencies. Hearing loss is defined as an average threshold level of 30 dB HL or greater at the frequencies of 0.5, 1, 2, and 3 kHz. Hearing thresholds from 0.5 to 8 kHz using a pulse-tone tracking procedure were collected on participants of the Baltimore Longitudinal study of Aging since 1965. A proportional hazards regression model was used to study the relationship between several risk factors that have previously been found to be associated with numerous health-related outcomes and the length of follow-up time until the occurrence of unilateral or bilateral hearing loss in a screened group of 531 men. Risk factors considered are age, blood pressure, and alcohol and cigarette consumption. After controlling for age, only systolic blood pressure showed a significant relationship with hearing loss in the speech frequencies (p < .05). Since blood pressure is a modifiable risk factor, these results suggest that preventing hypertension might contribute to an effective program for the prevention of apparent age-associated hearing loss.
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Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults. To evaluate the association between smoking and hearing loss. Population-based, cross-sectional study. Community of Beaver Dam, Wis. Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study. The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear. After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non-age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74). These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.
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Tobacco and alcohol consumption are strongly related to other cardiovascular and cancer risk factors. The aim of the present study was to analyse the association of nutrient intake, blood lipid variables and leisure-time physical activity with tobacco and alcohol consumption status. Participants were recruited in a cross-sectional population-based survey, including cardiovascular risk factor measurements and evaluation of physical activity and diet intake in a Mediterranean population (n 1748). Multiple linear regression analysis, adjusted for several confounders, showed a direct association of saturated fatty acids (g and % total energy intake), dietary cholesterol intakes and serum triacylglycerol with smoking. An inverse association was observed for smoking and unsaturated fatty acids (% energy intake), vitamin C, alpha-tocopherol and beta-carotene intakes, leisure-time physical activity and HDL-cholesterol. These associations were not observed for alcohol drinking. After adjusting for the confounders earlier mentioned, low dietary intakes of vitamin C and dietary fibre were more likely in heavy-smokers as compared with non-smokers (odds ratio 1.74 (95 % CI 1.07, 2.73) and 1.94 (95 % CI 1.29, 2.92) of low vitamin C (<60 mg/d) and dietary fibre intakes (<10 g/d) respectively). Alcohol consumption was directly associated with HDL-cholesterol and triacylglycerol, and attenuated the effects of smoking on HDL-cholesterol. These results suggest that the dietary intake of fibre and several antioxidant components of the Mediterranean diet is reduced in smokers, who also show an adverse lipid profile. However, the worst triacylglycerol levels are associated with the combination of heavy smoking and heavy alcohol drinking. Moderate alcohol consumption was not associated with an unhealthy diet pattern or adverse lipid profile. The health benefits of the Mediterranean diet appear to be strongly counteracted by smoking.
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A multicenter study was set up to elucidate the environmental and medical risk factors contributing to age-related hearing impairment (ARHI). Nine subsamples, collected by nine audiological centers across Europe, added up to a total of 4,083 subjects between 53 and 67 years. Audiometric data (pure-tone average [PTA]) were collected and the participants filled out a questionnaire on environmental risk factors and medical history. People with a history of disease that could affect hearing were excluded. PTAs were adjusted for age and sex and tested for association with exposure to risk factors. Noise exposure was associated with a significant loss of hearing at high sound frequencies (>1 kHz). Smoking significantly increased high-frequency hearing loss, and the effect was dose-dependent. The effect of smoking remained significant when accounting for cardiovascular disease events. Taller people had better hearing on average with a more pronounced effect at low sound frequencies (<2 kHz). A high body mass index (BMI) correlated with hearing loss across the frequency range tested. Moderate alcohol consumption was inversely correlated with hearing loss. Significant associations were found in the high as well as in the low frequencies. The results suggest that a healthy lifestyle can protect against age-related hearing impairment. Electronic supplementary material The online version of this article (doi: 10.1007/s10162-008-0123-1) contains supplementary material, which is available to authorized users.
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Context.— Clinical studies have suggested that cigarette smoking may be associated with hearing loss, a common condition affecting older adults.Objective.— To evaluate the association between smoking and hearing loss.Design.— Population-based, cross-sectional study.Setting.— Community of Beaver Dam, Wis.Participants.— Adults aged 48 to 92 years. Of 4541 eligible subjects, 3753 (83%) participated in the hearing study.Main Outcome Measures.— The examination included otoscopy, screening tympanometry, and pure-tone air-conduction and bone-conduction audiometry. Smoking history was ascertained by self-report. Hearing loss was defined as a pure-tone average (0.5, 1, 2, and 4 kHz) greater than 25-dB hearing level in the worse ear.Results.— After adjusting for other factors, current smokers were 1.69 times as likely to have a hearing loss as nonsmokers (95% confidence interval, 1.31-2.17). This relationship remained for those without a history of occupational noise exposure and in analyses excluding those with non–age-related hearing loss. There was weak evidence of a dose-response effect. Nonsmoking participants who lived with a smoker were more likely to have a hearing loss than those who were not exposed to a household member who smoked (odds ratio, 1.94; 95% confidence interval, 1.01-3.74).Conclusions.— These data suggest that environmental exposures may play a role in age-related hearing loss. If longitudinal studies confirm these findings, modification of smoking habits may prevent or delay age-related declines in hearing sensitivity.
Article
To the Editor.— Vascular insufficiency of the cochlear organ is the predominant cause of progressive hearing loss that occurs with age in our society. Smoking reduces blood supply by (1) vasospasm induced by nicotine, (2) atherosclerotic narrowing of vessels, and (3) thrombotic occlusions.Vasospasm induced by smoking causes enlargement of the normal blind spot and reduced threshold of differential brightness. Visual perception is additionally depressed by the levels of carboxyhemoglobin commonly found in the blood of smokers, a hypoxic effect superimposed on the reduced blood supply.Serum cholesterol, triglyceride, and unesterified fatty acid levels are increased in smokers, predisposing to atherosclerosis. Diabetics who smoke have a 50% greater incidence of detectable leg atherosclerosis than do nonsmoking diabetics. Platelet adhesiveness is increased in smokers, predisposing to thromboses, and decreased platelet survival is demonstrable in vitro after smoking. Arterial thromboses (coronary, cerebral, retinal, peripheral) are up to three times as frequent in
Article
Hearing loss with age (presbycusis) is a substantial problem for the elderly. To investigate the possible relation of presbycusis to cardiovascular disease (CVD), the hearing status of a cohort of 1662 elderly men and women was determined and compared with their 30-year prevalence of cardiovascular disease. Age-adjusted multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) to describe the relation of hearing to cardiovascular disease events, cardiovascular disease risk factors, and both events and risk factors separately for the 676 men and for the 996 women. Cardiovascular disease events were the sum of coronary heart disease, stroke, and intermittent claudication. Five groups of risk factors were studied: hypertension and blood pressure; diabetes, glucose intolerance, and blood glucose level; smoking status and number of pack-years of cigarettes; relative weight; and serum lipid levels, including cholesterol, triglycerides, and lipoprotein fractions. Low-frequency hearing (low pure-tone average, 0.25 to 1.0 kHz) was related to cardiovascular disease events in both genders but more in the women. For women, the OR of having any cardiovascular disease event for a low pure-tone average of 40 dB hearing level was 3.06 (95% CI, 1.84 to 5.10); for a high pure-tone average (average of 4 to 8 kHz) of 40-dB hearing level, the OR for any cardiovascular disease event was 1.75 (95% CI, 1.28 to 2.40). In men with a low pure tone average of 40-dB hearing level, the OR for stroke was 3.46 (95% CI, 1.60 to 7.45) and for coronary heart disease the OR was 1.68 (95% CI, 1.10 to 2.57).(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The Blue Mountains Eye Study is a population-based study of vision and the causes of visual impairment and blindness in a well-defined urban, Australian population 49 years of age and older. The logarithm of the minimum angle of resolution (logMAR) visual acuity was measured before and after refraction in 3647 persons, representing an 88% response rate in two postcode areas in the Blue Mountains area, west of Sydney. Refraction improved visual acuity by one or more lines in 45% of participants and by three or more lines in 13%. Visual impairment (visual acuity 20/40 or worse in the better eye) was found in 170 participants (4.7%). Mild visual impairment (Snellen equivalent 20/40 to 20/60 in the better eye) was found in 3.4% moderate visual impairment (20/80 to 20/160 in the better eye) in 0.6%, and severe visual impairment or blindness (20/200 or worse in the better eye) in 0.7%. Visual impairment increased with age from 0.8% of persons 49 to 54 years of age to 42% of persons 85 years of age or older. Visual impairment was significantly more frequent in females at all ages. Among persons with severe visual impairment, 79% were female. After adjusting for age, females were less likely to achieve 20/20 best-corrected visual acuity than males (odds ratio, 0.57; confidence interval, 0.48-0.66). After adjusting for age and sex, no association was found between visual acuity and socioeconomic status. Age-related macular degeneration was the cause of blindness in 21 of the 24 persons with corrected visual acuity of 20/200 or worse. Increasing age and female sex were independent predictors of visual impairment.
Article
To assess the associations between stage of age-related maculopathy (ARM) and current, past, and passive smoking. A cross-sectional study of 3654 subjects from a defined geographic area west of Sydney, Australia, identified subjects with late age-related macular degeneration (AMD) and early ARM by ocular examination and detailed grading of retinal photographs. Interviewer-administered questionnaires provided data about smoking history for subjects and spouses. Logistic regression, adjusting for age and sex, and 2-way analysis of variance were used to assess associations. Current tobacco smoking was significantly associated with late AMD (odds ratio [OR], 3.92), including neovascular AMD (OR, 3.20) and geographic atrophy (OR, 4.54), and early ARM (OR, 1.75). Having ever smoked was significantly associated with late AMD (OR, 1.83) but not early ARM. Passive smoking was associated with increased but insignificant odds for late AMD. The risk was slightly higher among women compared with men for most exposure categories. These findings provide convincing evidence that smoking may be causally associated with ARM. The strongest risk was found for current smokers, suggesting potential benefits of targeting education to older people who are current smokers and have signs of early ARM.
Article
To estimate the prevalence of hearing loss among community-dwelling older persons according to clinical criteria and to develop a brief self-report screening instrument to detect hearing loss. Survey. National probability sample of noninstitutionalized older persons. A total of 2506 persons aged 55 to 74 who participated in the National Health and Nutrition Examination Survey. Hearing loss as defined by Ventry and Weinstein (VW) criteria and by the High Frequency Pure-Tone Average (HFPTA) scale. Hearing loss by VW criteria was present in 14.2% and by HFPTA criteria in 35.1% of those surveyed. The prevalence increased with advancing age and was higher among men and those with less education. A logistic regression model identified six independent factors for hearing loss by VW criteria: age > or = 70 years (adjusted odds-ratio (AOR) 2.7, 95% confidence interval (95% CI) 1.6, 4.4), male gender (AOR 3.0, 95% CI 1.9, 4.8), < or = 12th grade education (AOR 3.8, 95% CI 1.8, 7.7), having seen a doctor for deafness or hearing loss (AOR 8.9, 95% CI 5.3, 14.9), unable to hear a whisper across a room (AOR 3.2, 95% CI 2.0, 5.1), and unable to hear a normal voice across a room (AOR 6.2, 95% CI 2.6, 14.9). A clinical scale based on the logistic model had 80% sensitivity and 80% specificity in predicting hearing loss using VW criteria and 59% sensitivity and 88% specificity in predicting hearing loss using HFPTA criteria. Hearing loss, as defined by two clinical criteria, is common and can be screened for accurately using simple questions that assess sociodemographic and hearing-related characteristics.
Article
To determine if moderate alcohol consumption is associated inversely with hearing loss in a large population based study of older adults. Cross-sectional population based cohort study. Data are from the 1993-1995 examinations for the population based Epidemiology of Hearing Loss Study (EHLS) (n = 3571) and the Beaver Dam Eye Study (BDES) (n = 3722). Midwestern community of Beaver Dam, Wisconsin. Residents of Beaver Dam aged 43 to 84 in 1987-1988 were eligible for the BDES (examinations in 1988-1990 and 1993-1995). During 1993-1995, this same cohort was eligible to participate in the baseline examination for the EHLS. Hearing thresholds were measured by pure tone air and bone conduction audiometry (250-8000 Hz.). History of alcohol consumption in the past year, heavy drinking (ever), medical history, occupation, noise exposure, and other lifestyle factors were ascertained by a questionnaire that was administered as an interview. In multiple logistic regression analyses controlling for potential confounders, moderate alcohol consumption (>140 grams/week) was inversely associated with hearing loss (PTA(.5,1,2,4 > 25 dB HL); odds ratio [OR] = .71, 95% confidence interval [CI] = .52, .97; where PTA is pure tone average). A similar association was found for moderate hearing loss (PTA(.5,1,2,4 > 40 dB HL); OR = 0.49, 95% CI = 0.32, 0.74). Alcohol consumption was associated inversely with the odds of having a low frequency hearing loss (OR = 0.61) or a high frequency hearing loss (OR = 0.60). These findings did not vary significantly by age or gender. There was an increase in the odds of having a high frequency hearing loss (OR = 1.35, 95% CI = 1.04, 1.75), in those with a history of heavy drinking (> or =4 drinks/day). Including cardiovascular disease or its related factors did not significantly attenuate the protective effect. There is evidence of a modest protective association of alcohol consumption and hearing loss in these cross-sectional data. This finding is in agreement with a small body of evidence suggesting that hearing loss is not an inevitable component of the aging process.
Significant changes in population demographics with respect to age have taken place, and this pattern is expected to continue. The aging of the population underscores the importance of finding ways to improve the quality of life of the elderly. Most of the elderly population, however, suffers from progressive hearing loss: 60% of people older than 70 years have hearing loss of at least 25 dB. Age-related hearing loss affects the quality of life, not only of the elderly but also of their families and loved ones. The research goal in this field is to elucidate the mechanisms involved in age-related hearing loss and the molecular basis of normal and impaired auditory function, with the aim of developing preventative therapies. During the past few years, extraordinary progress has been made in the identification of genes that contribute to deafness. Additionally, inbred strains of mice have proven to be useful models to identify specific factors relevant to age-related hearing loss. A detailed description of the pathology exhibited by inbred mice that exhibit age-related hearing loss is helping to identify the specific structures and cell types affected by age-related hearing loss. A summary of current research efforts is presented. This review focuses on studies using inbred mice. By defining the molecular basis of normal and impaired auditory function, therapies can be developed to ameliorate the effects of aging in the auditory system.
Article
Smoking has been shown to have adverse effects on hearing, but it's unclear whether smoking interacts with known causes of hearing loss such as noise exposure and ageing. To examine the hypothesis that smoking, noise and age jointly affect hearing acuity. This cross-sectional study was carried out in 535 male adult workers of a metal processing factory. Pure-tone audiometric tests were utilized to assess hearing loss. Noise exposure assessment was based on a job exposure matrix constructed with industrial hygienist scoring and job titles. Each participant answered questionnaires about socio-demographic, life-style, occupational and health-related data. Analysis of the possible underlying biological model was undertaken assessing departures from additivity using measures of the size of the interaction present. Age and occupational noise exposures were, separately, positively associated with hearing loss. For all the factors combined the estimated effect on hearing loss was higher than the sum of the effects from each isolated variable, especially for smoking and noise among those 20-40 years of age, and for smoking and age among those non-exposed to occupational noise. The synergistic effect of smoking, noise exposure and age on hearing loss, found in this study, is consistent with the biological interaction. Furthermore, it is possible that distinct ototoxic substances in the chemical composition of mainstream smoke may synergistically affect hearing when in combination with noise exposure, which needs to be examined in future studies.
Article
The effects of smoking on hearing loss within the context of atherosclerosis was assessed, and the statistical interaction of occupational noise evaluated. A cross-sectional study was conducted in 397 Japanese males working at a metal factory, aged 21-66 years, in a periodical health checkup. The following information was obtained: two smoking indices of smoking status and Brinkman index, occupational noise exposures and atherosclerotic risk factors (body mass index, blood pressure, serum cholesterol, hemoglobin A1c, atherosclerosis index). Hearing acuity was measured at 4 kHz using a pure-tone audiometer in a quiet room. Among the total subjects, 55 (13.9%) were identified as having hearing loss at 4 kHz, and 151 (38.0%) were currently exposed to occupational noise. When adjusted for age and occupational noise exposure, odds ratios (95% confidence intervals) of hearing loss were 3.16 (1.04, 9.62) for past smokers and 3.39 (1.05, 11.01) for heavy smokers (Brinkman index >750 cigarettes per day x number of years), compared with never-smokers. Statistical interaction of occupational noise exposure was insignificant with the association between smoking and hearing loss. When including atherosclerotic risk factors in a multiple model, there were no significant associations between hearing loss and either smoking or any other factors (i.e., occupational noise and atherosclerotic factors). Smoking was found to be associated with hearing loss beyond occupational noise exposure, and this association seemed to be masked by atherosclerotic factors, suggesting that the direction of the atherosclerotic effect on the relationship might need to be explored between smoking and hearing impairment.
Article
To analyse the influence of long-term smoking on the hearing threshold of individuals subjected to occupational noise exposure. Prospective observational cohort study. Occupational health examination of noise-exposed employees in the brick manufacturing industry. A study group of long-term smokers (n = 30) and a control group of non-smokers (n = 58) were identified from a population of 227 male noise-exposed employees. Individuals of both groups were employed for 10 years or more at a single brick manufacturing plant. Data on noise exposure, smoking habits, medical and otological history were collected and standard pure tone audiometry was obtained. Exclusion criteria included asymmetrical or conductive hearing loss, uncontrolled systemic illnesses, history of head injury, chronic middle ear pathology or major ear operations. Pure tone audiometry. Both groups had similar mean age and total duration of occupational noise exposure. The median age-corrected hearing thresholds at 3 and 4 kHz in the smokers group were significantly higher (approximately 7dB) than those in the non-smokers group. No statistical difference in the hearing thresholds between both groups was found in any other tested frequency (0.5, 1, 2, 6 and 8 kHz). Long-term smokers with occupational noise exposure may, on the basis of this limited study, have a higher risk of developing permanent hearing loss at 3 and 4 kHz when compared with non-smokers with a similar occupational history.
  • G A Gates
  • D M Caspary
  • W Clark
Gates, G. A., Caspary, D. M., Clark, W., et al. (1989). Presbycusis. Otolaryngol Head Neck Surg, 100, 266 –271.
Australian Guidelines to Reduce Health Risks From Drinking Alcohol
National Health and Medical Research Council. (2009). Australian Guidelines to Reduce Health Risks From Drinking Alcohol. Canberra: Commonwealth of Australia.
The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors
  • G A Gates
  • J L Cobb
  • R B Agostino
Gates, G. A., Cobb, J. L., D'Agostino, R. B., et al. (1993). The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors. Arch Otolaryngol Head Neck Surg, 119, 156 –161.
The relation of hearing in the elderly to the presence of cardiovascular disease and cardiovascular risk factors.
  • Gates