Compared with the MMSE, the MoCA-P is significantly better for detecting MCI in the elderly, particularly in the oldest old population, and it also displays more effectiveness in detecting dementia.

For the same exposure level, the prevalence of NIHL is greater in workers exposed to non-G noise environments than for workers exposed to G noise. The kurtosis metric may be a reasonable candidate for use in modifying exposure level calculations that are used to estimate the risk of NIHL from any type of noise exposure environment. However, studies involving a large number of workers with well-documented exposures are needed before a relation between a metric such as the kurtosis and the risk of hearing loss can be refined.

Objective To test a kurtosis-adjusted cumulative noise exposure (CNE) metric for use in evaluating the risk of hearing loss among workers exposed to industrial noises. Specifically: to evaluate if the kurtosis-adjusted CNE (1) provides a better association with observed industrial noise-induced hearing loss; (2) provides a single metric applicable to both complex (non-Gaussian) and continuous or steady-state (Gaussian) noise exposures for predicting noise induced hearing loss (dose-response curves). Design Audiometric and noise exposure data were acquired on a population of screened workers (N = 341) from two steel manufacturing plants located in Zhejiang province, and a textile manufacturing plant located in Henan province, China. All the subjects from the two steel manufacturing plants (N=178) were exposed to complex noise while the subjects from textile manufacturing plant (N=163) were exposed to a Gaussian (G) continuous noise. Each subject was given an otologic examination to determine their pure tone hearing threshold levels (HTL); and had their personal 8-hour equivalent A-weighted noise exposure (LAeq) and full shift noise kurtosis statistic (which is sensitive to the peaks and temporal characteristics of noise exposures) measured. For each subject an unadjusted and kurtosis-adjusted cumulative noise exposure (CNE) index for the years worked was created. Multiple linear regression analysis controlling for age was used to determine the relationship between CNE (unadjusted and kurtosis-adjusted) and the mean HTL at 3, 4 and 6 kHz (HTL346) among the complex noise exposed group. In addition, each subjects' HTLs from 0.5 - 8.0 kHz were age and gender adjusted using ANNEX A (ISO-1999) to determine whether they had adjusted high frequency noise induced hearing loss (AHFNIHL), defined as an adjusted HTL shift of 30 dB or greater at 3.0, 4.0 or 6.0 kHz in either ear. Dose-response curves for AHFNIHL were developed separately for workers exposed to G and non-G noise using both unadjusted and adjusted CNE as the exposure matric. Results Multiple linear regression analysis among complex exposed workers demonstrated that the correlation between HTL3,4,6 and CNE controlling for age was improved when using the kurtosis-adjusted CNE compared to the unadjusted CNE (R2=0.386 vs. 0.350), and that noise accounted for a greater proportion of hearing loss. In addition, while dose-response curves for AHFNIHL were distinctly different when using unadjusted CNE, they overlapped when using the kurtosis-adjusted CNE. Conclusions For the same exposure level, the prevalence of NIHL is greater in workers exposed to complex noise environments than for workers exposed to a continuous noise. Kurtosis adjustment of CNE both improved the correlation with NIHL and provides a single metric for dose response effects across different types of noise. The kurtosis-adjusted CNE may be a reasonable candidate for use in NIHL risk assessment across a wide variety of noise environments.

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Job Stress and Coronary Heart Disease: A Case-control Study using a Chinese Population: Weixian XU, et al. Department of Cardiology, Peking University Third Hospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, China-Objectives: This study was to examine the association between job stress and coronary heart disease (CHD) in a Chinese population. Methods: The 388 participants aged 30 to 70 yr who received coronary angiography for suspected or known ischemic heart disease were enrolled in this series, which included 292 CHD cases and 96 controls. The job stress before CHD onset was measured by the effort-reward imbalance (ERI) model. Results: In the results, compared with the baseline, high ERI, high extrinsic effort or high overcommitment increased the risk of CHD with odds ratios (OR) of 2.8, 2.7 and 2.8 respectively after adjustment for the traditional CHD risk factors, such as age, gender, primary hypertension, diabetes mellitus, hyperlipidemia, smoking, body mass index, CHD family history, educational level, and marital status. The combination of high ERI and high overcommitment led to the highest risk of CHD with adjusted OR 5.5. However, high reward reduced the risk of CHD with an adjusted OR of 0.4 in comparison to low reward. Dose-response relationships were also observed. Conclusions: Job stress evaluated by the ERI model significantly increased the risk of CHD, and it may be an important risk factor independent of the traditional risk factors of CHD in the Chinese population. (J Occup Health 2009; 51: 107-113)