Comparison of Self-reported Measures of Hearing With an Objective Audiometric Measure in Adults in the English Longitudinal Study of Ageing

Tsimpida, Dialechti; Kontopantelis, Evangelos; Ashcroft, Darren M.; Panagioti, Maria

doi:10.1001/jamanetworkopen.2020.15009

Cited by 55 publications

(49 citation statements)

References 31 publications

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“…In addition, we found that tinnitus was associated with the degree of hearing loss rather than the most typical NIHL subtype, while self-reported hearing difficulty was only closely related to the most severe subtype of hearing loss with speech frequencies impairment. These findings are approximately consistent with previous studies that reported that tinnitus is usually accompanied by hearing loss ( 30 ), and self-reported hearing status could not sensitively reflect high-frequency hearing loss ( 31 ).…”

Section: Discussionsupporting

confidence: 92%

Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

et al. 2021

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Background: The definition of notched audiogram for noise-induced hearing loss (NIHL) is presently based on clinical experience, but audiometric phenotypes of NIHL are highly heterogeneous. The data-driven clustering of subtypes could provide refined characteristics of NIHL, and help identify individuals with typical NIHL at diagnosis.Methods: This cross-sectional study initially recruited 12,218 occupational noise-exposed employees aged 18–60 years from two factories of a shipyard in Eastern China. Of these, 10,307 subjects with no history of otological injurie or disease, family history of hearing loss, or history of ototoxic drug use were eventually enrolled. All these subjects completed health behavior questionnaires, cumulative noise exposure (CNE) measurement, and pure-tone audiometry. We did data-driven cluster analysis (k-means clustering) in subjects with hearing loss audiograms (n = 6,599) consist of two independent datasets (n = 4,461 and n = 2,138). Multinomial logistic regression was performed to analyze the relevant characteristics of subjects with different audiometric phenotypes compared to those subjects with normal hearing audiograms (n = 3,708).Results: A total of 10,307 subjects (9,165 males [88.9%], mean age 34.5 [8.8] years, mean CNE 91.2 [22.7] dB[A]) were included, 3,708 (36.0%) of them had completely normal hearing, the other 6,599 (64.0%) with hearing loss audiograms were clustered into four audiometric phenotypes, which were replicable in two distinct datasets. We named the four clusters as the 4–6 kHz sharp-notched, 4–6 kHz flat-notched, 3–8 kHz notched, and 1–8 kHz notched audiogram. Among them, except for the 4–6 kHz flat-notched audiogram which was not significantly related to NIHL, the other three phenotypes with different relevant characteristics were strongly associated with noise exposure. In particular, the 4–6 kHz sharp-notched audiogram might be a typical subtype of NIHL.Conclusions: By data-driven cluster analysis of the large-scale noise-exposed population, we identified three audiometric phenotypes associated with distinct NIHL subtypes. Data-driven sub-stratification of audiograms might eventually contribute to the precise diagnosis and treatment of NIHL.

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Section: Discussionsupporting

confidence: 92%

Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

et al. 2021

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“…We were aware that the self-reported data in the ELSA underestimated objectively measured hearing problems [5]. The sensitivity analysis we run to investigate potential differences in estimates of depression was possible only for ELSA Wave 7; this is the only ELSA Wave that includes both self-reported and objective hearing measures for the same participants [24].…”

Section: Limitationsmentioning

confidence: 99%

“…HL is the leading cause of morbidity among older adults in England [3,4]. However, it is a highly underdiagnosed [5] and untreated chronic health condition [6,7], which is quite alarming, as HL's adverse impact extends beyond auditory impairment and may affect the individuals' mental wellbeing and their full participation in society [2,8] A recent systematic review and meta-analysis [9] found that HL was associated with 1.47 higher odds of depression in older adults (95%CI 1.31-1.65). However, the evidence had large inconsistency and the studies included had substantial heterogeneity (I 2 = 83.26%).…”

Section: Introductionmentioning

confidence: 99%

The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA)

Tsimpida

Kontopantelis

Ashcroft

et al. 2021

Soc Psychiatry Psychiatr Epidemiol

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Purpose The adverse impact of hearing loss (HL) extends beyond auditory impairment and may affect the individuals' psychosocial wellbeing. We aimed to examine whether there exists a causal psychosocial pathway between HL and depression in later life, via socioeconomic factors and quality of life, and whether hearing aids usage alleviates depressive symptoms over time. Methods We examined the longitudinal relationship between HL and depressive symptoms (CES-D) applying dynamic cross-lagged mediation path models. We used the full dataset of participants aged 50–89 years (74,908 person-years), from all eight Waves of the English Longitudinal Study of Ageing (ELSA). Their quality of life (CASP-19) and their wealth were examined as the mediator and moderator of this relationship, respectively. Subgroup analyses investigated differences among those with hearing aids within different models of subjectively and objectively identified HL. All models were adjusted for age, sex, retirement status and social engagement. Results Socioeconomic position (SEP) influenced the strength of the relationship between HL and depression, which was stronger in the lowest versus the highest wealth quintiles. The use of hearing aids was beneficial for alleviating depressive symptoms. Those in the lowest wealth quintiles experienced a lower risk for depression after the use of hearing aids compared to those in the highest wealth quintiles. Conclusion HL poses a substantial risk for depressive symptoms in older adults, especially those who experience socioeconomic inequalities. The early detection of HL and provision of hearing aids may not only promote better-hearing health but could also enhance the psychosocial wellbeing of older adults, particularly those in a lower SEP.

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“…We were aware that the self-reported measures of HL in the ELSA might underestimate the real HL outcomes; for this reason, we conducted additional work to examine the validity of self-reported data through comparisons with the findings of objective HL measures available only in Wave 7 of the ELSA. We found that the self-reported measures correctly classified seven in every ten people with objectively assessed HL [ 16 ]. However, for the scope of our analyses, we assumed the available hearing measure as a suitable indicator of HL.…”

Section: Discussionmentioning

confidence: 99%

“…According to the study’s documentation, self-reported HL was defined as declarations of fair or poor hearing on a five-point Likert scale (excellent, very good, good, fair or poor) or ‘Yes’ responses to the question concerning whether or not the participants find it difficult to follow a conversation if there is background noise (e.g. noise from a TV, a radio or children playing) [ 13 , 16 ].…”

Section: Methodsmentioning

confidence: 99%

Regional patterns and trends of hearing loss in England: evidence from the English longitudinal study of ageing (ELSA) and implications for health policy

et al. 2020

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Background Hearing loss (HL) is a significant public health concern globally and is estimated to affect over nine million people in England. The aim of this research was to explore the regional patterns and trends of HL in a representative longitudinal prospective cohort study of the English population aged 50 and over. Methods We used the full dataset (74,699 person-years) of self-reported hearing data from all eight Waves of the English Longitudinal Study of Ageing (ELSA) (2002–2017). We examined the geographical identifiers of the participants at the Government Office Region (GOR) level and the geographically based Index of Multiple Deprivation (IMD). The primary outcome measure was self-reported HL; it consisted of a merged category of people who rated their hearing as fair or poor on a five-point Likert scale (excellent, very good, good, fair or poor) or responded positively when asked whether they find it difficult to follow a conversation if there is background noise (e.g. noise from a TV, a radio or children playing). Results A marked elevation in HL prevalence (10.2%) independent of the age of the participants was observed in England in 2002–2017. The mean HL prevalence increased from 38.50 (95%CI 37.37–39.14) in Wave 1 to 48.66 (95%CI 47.11–49.54) in Wave 8. We identified three critical patterns of findings concerning regional trends: the highest HL prevalence among samples with equal means of age was observed in GORs with the highest prevalence of participants in the most deprived (IMD) quintile, in routine or manual occupations and misusing alcohol. The adjusted HL predictions at the means (APMs) showed marked regional variability and hearing health inequalities between Northern and Southern England that were previously unknown. Conclusions A sociospatial approach is crucial for planning sustainable models of hearing care based on actual needs and reducing hearing health inequalities. The Clinical Commissioning Groups (CCGs) currently responsible for the NHS audiology services in England should not consider HL an inevitable accompaniment of older age; instead, they should incorporate socio-economic factors and modifiable lifestyle behaviours for HL within their spatial patterning in England.

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Comparison of Self-reported Measures of Hearing With an Objective Audiometric Measure in Adults in the English Longitudinal Study of Ageing

Cited by 55 publications

References 31 publications

Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

Audiometric Phenotypes of Noise-Induced Hearing Loss by Data-Driven Cluster Analysis and Their Relevant Characteristics

The dynamic relationship between hearing loss, quality of life, socioeconomic position and depression and the impact of hearing aids: answers from the English Longitudinal Study of Ageing (ELSA)

Regional patterns and trends of hearing loss in England: evidence from the English longitudinal study of ageing (ELSA) and implications for health policy

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