Re: Affordable hearing aids extant? (Cognitive function and (Ben Hornsby )

Subject: Re: Affordable hearing aids extant? (Cognitive function and From: Ben Hornsby <ben.hornsby(at)VANDERBILT.EDU> Date: Mon, 29 Mar 2004 11:43:40 -0600 This is a multi-part message in MIME format. ------=_NextPart_000_0001_01C41583.14DAF710 Content-Type: text/plain; charset="us-ascii" Content-Transfer-Encoding: quoted-printable After just reading the Allen et al., article I think we need to be conservative in our conclusions that the use of hearing aids improves cognitive function. The authors themselves state: =20 "Hearing aids do not improve cognitive function or reduce behavioural or psychiatric symptoms." =20 The PTA of this group was ~60 dB, this is clearly more than a mild = hearing loss. Certainly this article and others like it have shown hearing aids = can improve communication function, in the presence of hearing loss, and = hence reduce the negative effects of hearing loss in a variety of psychosocial realms for many different populations. Tying this improvement to changes = in neurophysiology, however, may difficult and not really necessary as we = see immediate improvements in speech understanding when the speech goes from inaudible to audible.=20 =20 Please note that I am talking about cases of mild-moderate hearing loss. = The situation is vastly different for individuals with severe to profound = loss. In these cases conversational speech is often inaudible and the use of a cochlear implant can drastically change the input that the auditory = system is receiving. In these types of situations bringing in neural plasticity seems, at least intuitively, to make more sense. For individuals with = mild to moderate losses, however, (which is where this thread started) much = of (low frequency) conversational speech is audible without a hearing aid. Adding the aid will help with soft sounds and improve some but not all = high frequency audibility. Acclimatization studies with these types of = patients have shown only minimal (or no) long term improvement in speech understanding, suggesting changes in neural networks due to plasticity = is minimal. =20 Ben =20 -----Original Message----- From: AUDITORY Research in Auditory Perception [mailto:AUDITORY(at)LISTS.MCGILL.CA] On Behalf Of Barbara Reynolds Sent: Sunday, March 28, 2004 6:48 PM To: AUDITORY(at)LISTS.MCGILL.CA Subject: Re: Affordable hearing aids extant? =20 Allen, N.H.; et.al.: The effects of improving hearing in dementia. Age Aging 2003;32: 189-193 This article is the most recent. Dementia patients were fit with one hearing aid (should have been two.) After 24 weeks of wearing the aids, = 30% showed no further cognitive decline and 40% showed cognitive = improvement. Those who wore their aids for 8 hours or more per day were seen by caregivers to have significantly improved compared to those who wore = them less. You can put in a search for an article that is on my updated list that states even mild hearing losses can cause verbal memory problems. This = may be due to a weakening of synaptic density and other neurophysiological changes to those neurons that respond to sound in the hippocampus and = other regions implicated in working memory. On Monday, if you would like, I wrote an article that I'm attempting to = get publish that describes the effect of Alzheimer's disease on the auditory system. Let me know if you would like a copy of this article in the = format that I have it right now. It will probably need to be edited, but there = has been interest in a shortened version of the article. It is referenced. Please let me know. Barb >From: "Ward Drennan" <wdrennan(at)umich.edu>=20 >Reply-To: wdrennan(at)umich.edu=20 >To: "Barbara Reynolds" <br_auditory(at)hotmail.com>=20 >Subject: Re: Affordable hearing aids extant?=20 >Date: Sat, 27 Mar 2004 23:38:57 -0500 (EST)=20 >=20 >Barbara,=20 >=20 >I've found you comments quite interesting and I think there's a lot of=20 >good ideas in them. It's apparent that you've done lots of reading. I=20 >ceratinly could learn much more about these topics. I wrote some=20 >questions, comments and citations requests within your writing (see=20 >attached document). These requests should be quite specific--- I'm = trying=20 >to point to the main or most significant points that should be = addressed=20 >(by someone at least). If this information is true and is to be widely=20 >disseminated and accepted, we would need to be in some tractable form=20 >accessable to scientists and clinicians i.e. a few well-written and=20 >thorough reviews or research studies to verify the accuracy of the=20 >statements. I'm not sure for example what research has been established = >and what reserach still needs to be done.=20 >=20 >If some of your statements can be or have been shown to be true, then = by=20 >golly it should be public knowledge. "Wear hearing aids or you'll lose=20 >your mind" sounds like a pretty good motivation, but then how much do = we=20 >(the research and clinical community) really know about that?=20 >=20 >I have done a number of medline searches, but just haven't yet been = able=20 >to find much on hearing loss and cogntnitive degeneration independent = of=20 >ageing.=20 > >=20 > > I'll try to run a filter on my database for the references. They'll = be=20 > > without the titles, but the author and the reference. I'll try to = limit > > it to the last five years. Another way would be to search on=20 > > www.pubmed.com anything you might be interested in. I search = journals=20 > > from Journal of Neuroscience to Nature Neuroscience, NeuroReport,=20 > > Perceptual and Motor Skills, Dementia and Geriatric Cogntivie = Disorders, > > Age and Ageing, Neurotoxopharmacology, Neuroscience Nursing, PNAS, = etc.=20 > > This accumulation has been over 6 1/2 years. Every 6 months I go to = the > > libraries at McGill (not that I'm in Canada) and the Montreal Neurological=20 > > Institute. I usually come back with anywhere between 250 to 350 = journal > > articles that either directly test the auditory system, or use the=20 > > auditory system to test a disease state such as Alzheimer's or=20 > > Parkinson's, Dyslexia or emotional prosody deficits, stroke, etc. = As!=20 > > an audiologist, if it uses the auditory system to test a disease state,=20 > > it's still a test of the auditory system as well. And since my = patients > > are at risk for some of these conditions (including alcoholism, drug = > > abuse, nutritional deficiencies, etc), I should know if it will = affect=20 > > their perception and recovery through the use of hearing aids.=20 > > By using this information, 1) you'll definitely become a better clinician=20 > > and 2) your patients will try harder to become more compliant with = the use=20 > > of hearing aids because they trust that you know what you're doing = and 3)=20 > > by considering all these conditions (diabetes, MS, etc) you'll be = able to=20 > > counsel the patients more effectively on the benefits and = limitations of > > amplifications.=20 > > I was at a conference of a manufacturer several years ago and one of = the > > representatives actually said "If you fix the hearing aid, you'll = fix the=20 > > hearing loss". I about had a cow. You cannot fix Alzheimer's or = stroke > > damage through a new digital algorithm. No matter what we do, we = are=20 > > still sending information through an impaired system that may or may = not > > recover significantly depending on how severe the loss is and how we = > > counsel the patients.=20 > > I will try to see what I can do though in regards to references. I = have a=20 > > list I used for my Alzheimer's presentation in Vancouver that I can = send > > an attachment when I get back to work.=20 > > Barb=20 > > wdrennan(at)umich.edubr_auditory(at)HOTMAIL.COM Check out MSN PC Safety &=20 > > Security to help ensure your PC is protected and safe.=20 > >=20 >=20 >=20 >Ward R. Drennan, Ph. D.=20 >Kresge Hearing Research Institute=20 >Ann Arbor, MI 48109=20 >Phone: (734)763-5159=20 >Fax: (734)764-0014=20 ><< CommentsandcitationrequestonBRswriting.doc >>=20 _____ =20 All the action. All the <http://g.msn.com/8HMBENUS/2746??PS=3D> drama. = Get NCAA hoops coverage at MSN Sports by ESPN.=20 ------=_NextPart_000_0001_01C41583.14DAF710 Content-Type: text/html; charset="us-ascii" Content-Transfer-Encoding: quoted-printable <html> <head> <META HTTP-EQUIV=3D"Content-Type" CONTENT=3D"text/html; = charset=3Dus-ascii"> <meta name=3DGenerator content=3D"Microsoft Word 10 (filtered)"> <style>  </style> </head> <body lang=3DEN-US link=3Dblue vlink=3Dblue> <div class=3DSection1> After just reading the Allen et = al., article I think we need to be conservative in our conclusions that the = use of hearing aids improves cognitive function. The authors themselves = state:   “Hearing aids do not improve cognitive function or reduce behavioural or psychiatric = symptoms.”   The PTA of this group was ~60 dB, = this is clearly more than a mild hearing loss. Certainly this article and others = like it have shown hearing aids can improve communication function, in the = presence of hearing loss, and hence reduce the negative effects of hearing loss = in a variety of psychosocial realms for many different populations. Tying = this improvement to changes in neurophysiology, however, may difficult and not really = necessary as we see immediate improvements in speech understanding when the speech = goes from inaudible to audible.   Please note that I am talking about = cases of mild-moderate hearing loss. The situation is vastly different for individuals with severe to profound loss. In these cases conversational = speech is often inaudible and the use of a cochlear implant can drastically = change the input that the auditory system is receiving. In these types of = situations bringing in neural plasticity seems, at least intuitively, to make more = sense. For individuals with mild to moderate losses, however, (which is where = this thread started) much of (low frequency) conversational speech is audible = without a hearing aid. Adding the aid will help with soft sounds and improve = some but not all high frequency audibility. Acclimatization studies with these = types of patients have shown only minimal (or no) long term improvement in speech understanding, suggesting changes in neural networks due to plasticity = is minimal.   Ben   -----Original Message----- From: AUDITORY Research = in Auditory Perception [mailto:AUDITORY(at)LISTS.MCGILL.CA] On Behalf Of Barbara Reynolds Sent: Sunday, March 28, = 2004 6:48 PM To: = AUDITORY(at)LISTS.MCGILL.CA Subject: Re: Affordable = hearing aids extant?   <div> <div> Allen, N.H.; et.al.:  The effects of improving hearing in dementia.  = Age Aging 2003;32: 189-193 This article is the most recent.  Dementia patients were fit with one = hearing aid (should have been two.)  After 24 weeks of wearing the aids, = 30% showed no further cognitive decline and 40% showed cognitive = improvement.  Those who wore their aids for 8 hours or more per day were seen by = caregivers to have significantly improved compared to those who wore them = less. You can put in a search for an article that is on my updated list that states = even mild hearing losses can cause verbal memory problems.  This may be due = to a weakening of synaptic density and other neurophysiological changes to = those neurons that respond to sound in the hippocampus and other regions = implicated in working memory. On Monday, if you would like, I wrote an article that I'm attempting to get publish that describes the effect of Alzheimer's disease on the auditory system.  Let me know if you would like a copy of this article in = the format that I have it right now.  It will probably need to be = edited, but there has been interest in a shortened version of the article.  It = is referenced. Please let me know. Barb </div> >From: "Ward Drennan" <wdrennan(at)umich.edu> = >Reply-To: wdrennan(at)umich.edu >To: "Barbara Reynolds" = <br_auditory(at)hotmail.com> >Subject: Re: Affordable hearing aids extant? = >Date: Sat, 27 Mar 2004 23:38:57 -0500 (EST) = > >Barbara, > >I've found you comments quite interesting and I think = there's a lot of >good ideas in them. It's apparent that you've done lots of = reading. I >ceratinly could learn much more about these topics. I wrote = some >questions, comments and citations requests within your = writing (see >attached document). These requests should be quite = specific--- I'm trying >to point to the main or most significant points that should = be addressed >(by someone at least). If this information is true and is to = be widely >disseminated and accepted, we would need to be in some = tractable form >accessable to scientists and clinicians i.e. a few = well-written and >thorough reviews or research studies to verify the accuracy = of the >statements. I'm not sure for example what research has been established >and what reserach still needs to be done. > >If some of your statements can be or have been shown to be = true, then by >golly it should be public knowledge. "Wear hearing aids = or you'll lose >your mind" sounds like a pretty good motivation, but = then how much do we >(the research and clinical community) really know about = that? > >I have done a number of medline searches, but just haven't = yet been able >to find much on hearing loss and cogntnitive degeneration independent of >ageing. > > > > I'll try to run a filter on my database for the references.  They'll be > > without the titles, but the author and the reference.  I'll try to limit > > it to the last five years.  Another way = would be to search on > > www.pubmed.com anything you might be interested in.  I search journals > > from Journal of Neuroscience to Nature Neuroscience, NeuroReport, > > Perceptual and Motor Skills, Dementia and Geriatric = Cogntivie Disorders, > > Age and Ageing, Neurotoxopharmacology, Neuroscience = Nursing, PNAS, etc. > > This accumulation has been over 6 1/2 = years.  Every 6 months I go to the > > libraries at McGill (not that I'm in Canada) and the = Montreal Neurological > > Institute.  I usually come back with = anywhere between 250 to 350 journal > > articles that either directly test the auditory = system, or use the > > auditory system to test a disease state such as = Alzheimer's or > > Parkinson's, Dyslexia or emotional prosody deficits, = stroke, etc.  As! > >   an audiologist, if it uses the auditory = system to test a disease state, > > it's still a test of the auditory system as well.  And since my patients > > are at risk for some of these conditions (including alcoholism, drug > > abuse, nutritional deficiencies, etc), I should know = if it will affect > > their perception and recovery through the use of = hearing aids. > > By using this information, 1) you'll definitely become = a better clinician > > and 2) your patients will try harder to become more = compliant with the use > > of hearing aids because they trust that you know what = you're doing and 3) > > by considering all these conditions (diabetes, MS, = etc) you'll be able to > > counsel the patients more effectively on the benefits = and limitations of > > amplifications. > > I was at a conference of a manufacturer several years = ago and one of the > > representatives actually said "If you fix the = hearing aid, you'll fix the > > hearing loss".  I about had a cow.  You cannot fix Alzheimer's or stroke > > damage through a new digital algorithm.  No = matter what we do, we are > > still sending information through an impaired system = that may or may not > > recover significantly depending on how severe the loss = is and how we > > counsel the patients. > > I will try to see what I can do though in regards to references.  I have a > > list I used for my Alzheimer's presentation in = Vancouver that I can send > > an attachment when I get back to work. = > > Barb > > wdrennan(at)umich.edubr_auditory(at)HOTMAIL.COM Check out = MSN PC Safety & > > Security to help ensure your PC is protected and safe. = > > > > >Ward R. Drennan, Ph. D. >Kresge Hearing Research Institute >Ann Arbor, MI 48109 >Phone: (734)763-5159 >Fax: (734)764-0014 ><< CommentsandcitationrequestonBRswriting.doc >> = </div> <div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'> <hr size=3D2 width=3D"100%" align=3Dcenter> </div> <a href=3D"http://g.msn.com/8HMBENUS/2746??PS=3D">All the = action. All the drama. Get NCAA hoops coverage at MSN Sports by ESPN.</a> = </div> </body> </html> ------=_NextPart_000_0001_01C41583.14DAF710--

This message came from the mail archive
http://www.auditory.org/postings/2004/
maintained by:

DAn Ellis <dpwe@ee.columbia.edu>
Electrical Engineering Dept., Columbia University