Hidden hearing loss: current concepts

Bajin, Münir Demir; Dahm, Valerie; Lin, Vincent

doi:10.1097/moo.0000000000000824

Cited by 16 publications

(11 citation statements)

References 53 publications

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“…Evidence shows that the risk for cognitive decline and all‐cause dementia increases with moderate HL (greater than 40 dB HL) 5,6 ; however, the relationship between HL and cognitive decline could start earlier, including mild HL (in the range between 25 and 40 dB), or even subjects with normal hearing thresholds (<25 dB HL) 7–9 . It is important to note that individuals with mild HL (25–40 dB HL) or normal hearing thresholds (<25 dB HL) can have additional hearing impairments that are not detected by conventional audiometry, such as cochlear dead regions, cochlear synaptopathy or hidden hearing loss, as well as central auditory processing disorders, which have been associated with cognitive decline in elders 10–16 …”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9] It is important to note that individuals with mild HL (25-40 dB HL) or normal hearing thresholds (<25 dB HL) can have additional hearing impairments that are not detected by conventional audiometry, such as cochlear dead regions, cochlear synaptopathy or hidden hearing loss, as well as central auditory processing disorders, which have been associated with cognitive decline in elders. [10][11][12][13][14][15][16] Hearing impairments can be estimated with subjective methods, such as audiometer tests and psychoacoustical tasks, and with objective methods, such as otoacoustic emissions or auditory evoked potentials. 17 Otoacoustic emissions are inaudible low-level sounds that are emitted by the outer hair cells (OHCs) of the cochlea.…”

Section: Introductionmentioning

confidence: 99%

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Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss

Medel,

Delano,

Belkhiria

et al. 2024

Alz & Dem Diag Ass & Dis Mo

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INTRODUCTIONAge‐related hearing loss is an important risk factor for cognitive decline. However, audiogram thresholds are not good estimators of dementia risk in subjects with normal hearing or mild hearing loss. Here we propose to use distortion product otoacoustic emissions (DPOAEs) as an objective and sensitive tool to estimate the risk of cognitive decline in older adults with normal hearing or mild hearing loss.METHODSWe assessed neuropsychological, brain magnetic resonance imaging, and auditory analyses on 94 subjects > 64 years of age.RESULTSWe found that cochlear dysfunction, measured by DPOAEs—and not by conventional audiometry—was associated with Clinical Dementia Rating Sum of Boxes (CDR‐SoB) classification and brain atrophy in the group with mild hearing loss (25 to 40 dB) and normal hearing (<25 dB).DISCUSSIONOur findings suggest that DPOAEs may be a non‐invasive tool for detecting neurodegeneration and cognitive decline in the older adults, potentially allowing for early intervention.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss

Medel,

Delano,

Belkhiria

et al. 2024

Alz & Dem Diag Ass & Dis Mo

View full text Add to dashboard Cite

show abstract

“…Evidence shows that the risk for cognitive decline and all-cause dementia increases with moderate hearing loss (greater than 40 dB HL) (5, 6), however, the relationship between hearing loss and cognitive decline could start earlier, including mild hearing loss (in the range between 25 and 40 dB), or even subjects with normal hearing thresholds (<25 dB HL)(7–9). Importantly, individuals with mild hearing loss (25-40 dB HL) or normal hearing thresholds (<25 dB HL) can have additional hearing impairments that are not detected by conventional audiometry, such as cochlear dead regions, cochlear synaptopathy or hidden hearing loss and central auditory processing disorder (10–12).…”

Section: Introductionmentioning

confidence: 99%

Cochlear dysfunction as an early biomarker for cognitive decline in normal hearing and mild hearing loss

Medel

Délano

Belkhiria³

et al. 2023

Preprint

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Age-related hearing loss (presbycusis) at moderate levels (>40 dB HL) has been recognized as an important risk factor for cognitive decline. However, whether individuals with mild hearing loss (audiogram thresholds between 25 and 40 dB HL) or even those with normal audiograms (<25 dB HL) have a higher risk of dementia is still debated. Importantly, these early stages of presbycusis are the most common among the elderly, indicating the need to screen and identify individuals with early presbycusis that have an increased risk of cognitive decline. Unfortunately, in this group of patients, audiogram thresholds are not sufficiently sensitive to detect all the hearing impairments related to cognitive decline. Consequently, at the individual level, audiogram thresholds are not good estimators of the dementia risk in the group with mild hearing loss or normal hearing thresholds. Here, we propose to use distortion product otoacoustic emissions (DPOAE) as an objective and sensitive tool to estimate the risk of clinically relevant cognitive decline in elders with normal hearing o mild hearing loss. We assessed neuropsychological, brain magnetic resonance imaging, and auditory analyses on 94 subjects aged >64 years old. In addition, cognitive and functional performance was evaluated with the Clinical Dementia Rating Sum of Boxes (CDR SoB), assessed through structured interviews conducted by neurologists blind to the DPOAE results. We found that cochlear dysfunction, measured by DPOAE -and not by conventional audiometry-was associated with CDR SoB classification and brain atrophy in the group with mild hearing loss (25 to 40 dB) and normal hearing (<25 dB). Our findings suggest that DPOAE may be a non-invasive tool for detecting neurodegeneration and cognitive decline in the elderly, potentially allowing for early intervention.

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“…There are multiple theories as to the cause of hidden hearing loss; many focus on pathological changes to the cochlea itself, such as loss of synapses in the auditory nerve pathway, auditory nerve demyelination, and outer hair cell dysfunction, but central causes have also been considered. [6][7][8] Clinically, hidden hearing loss is characterized by difficulty discerning speech in noise and in other complex listening environments. It is also often associated with tinnitus; 7.4%-42.8% of adults with tinnitus demonstrate hearing thresholds within normal limits in conventional pure-tone audiometry.…”

Section: Introductionmentioning

confidence: 99%

Utility of Extended High‐Frequency Audiograms in Clinical Practice

et al. 2023

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ObjectivesExtended high‐frequency (EHF) audiometry elicits pure‐tone thresholds at frequencies above 8 kHz, which are not included in routine clinical testing. This study explores the utility of EHF audiometry in patients with various audiologic symptoms despite normal‐hearing thresholds at ≤8 kHz.MethodsA retrospective review was performed of all patients receiving conventional (250–8 kHz) and EHF (9–20 kHz) audiometry at a tertiary otological referral center between April 2021 and August 2022. Only patients with audiologic symptoms and pure‐tone thresholds ≤25 dB HL at ≤8 kHz bilaterally on routine testing were included in subsequent analysis. EHF‐PTA was defined for each ear as an average of the air conduction thresholds at 9.0, 10.0, 11.2, 12.5, 14.0, 16.0, 18.0, and 20.0 kHz.ResultsOf the 50 patients who received EHF testing, 40 had audiologic symptoms and normal conventional audiograms at ≤8 kHz. Twenty‐five of the 40 (62.5%) were found to have hearing loss in the highest frequencies. Patients with EHF hearing loss (EHF‐HL) were more likely to report subjective hearing loss. Age was significantly greater in those with EHF‐HL compared with those without EHF‐HL, and age was positively correlated with the degree of EHF‐HL.ConclusionEHF testing correlates with audiologic symptoms in patients with normal testing at ≤8 kHz and may be considered when standard audiometry is normal. Additional data are warranted to create an evidenced‐based, clinical algorithm for EHF audiometry that can guide treatment, direct mitigation strategies, and potentially identify those at higher risk of hearing loss over time.Level of Evidence4 Laryngoscope, 2023

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Hidden hearing loss: current concepts

Cited by 16 publications

References 53 publications

Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss

Cochlear dysfunction as an early biomarker of cognitive decline in normal hearing and mild hearing loss

Cochlear dysfunction as an early biomarker for cognitive decline in normal hearing and mild hearing loss

Utility of Extended High‐Frequency Audiograms in Clinical Practice

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