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Biomedical subjects

Terry L Wiley

Publications and source records attributed to Terry L Wiley.

8 recordsLinked to original sources

Dichotic word recognition in young and older adults.

Dichotic word recognition was evaluated in free-recall, directed-attention right, and directed-attention left response conditions. All participants were right-handed and included a group of young adults with normal hearing and two groups of older adults with sensorineural hearing loss. Dichotic word recognition performance was best for young adults and decreased for each older group. A right-ear advantage (REA) was observed for all groups. REAs observed in the older groups were larger than those for the young adults, resulting from a greater deficit in dichotic word recognition performance for words presented to the left ear. A subset of older adults exhibited few to no responses (< or = 3/100) for the left ear for all response conditions, which may relate to a compromise in auditory processing. The results support an age-related disadvantage in recognition performance for dichotic stimuli presented to the left ear not entirely accounted for by differences in hearing sensitivity between subject groups.

Adult↗

Five-year changes in middle ear function for older adults.

Longitudinal changes in tympanometric measures of middle ear function over five years were reported for a large population of older adults. Findings were similar for men and women, for right and left ears, and across age groups from 48 to 92 years. Although some of the mean changes reached statistical significance, the vast majority of observed changes were small in magnitude relative to the observed variability and the tolerances of the measuring instrument. Observed mean changes in Peak Ytm for older adults were quite small and were in the positive direction. This is counter to changes that would be predicted on the basis of increases in the stiffness of the middle ear transmission system with advancing age suggested in earlier reports. Overall, the findings suggest little in the way of functional change in middle ear mechanics over a span of five years in older adults.

Acoustic Impedance Tests↗

Continuous versus pulsed tones in audiometry.

The purpose of this study was to compare auditory thresholds obtained for continuous and pulsed tones in listeners with normal hearing. Auditory thresholds, test-retest reliability, false-positive responses, and listener preference were compared for both signals. Hearing thresholds and test-retest reliability were comparable for the 2 signals, and there were no significant differences in the number of false positives or the number of presentations required to reach threshold. Listener preference, however, indicated that pulsed tones were preferred over continuous tones by 67% of the listeners when listening to low-level or high-frequency tones. These findings, coupled with previous reports demonstrating the benefits of using automatically pulsed tones in threshold assessment for listeners with tinnitus, support the general use of pulsed tones in clinical audiometry.

Acoustic Stimulation↗

The 5-year incidence and progression of hearing loss: the epidemiology of hearing loss study.

CONTEXT: Hearing impairment affects many older adults, but the incidence is unknown. OBJECTIVE: To determine the 5-year incidence and progression of hearing impairment. DESIGN: A longitudinal, population-based study of adults aged 48 to 92 years at baseline examination. Hearing sensitivity was measured twice, 5 years apart. SETTING: Testing was conducted at the Beaver Dam Community Hospital, Beaver Dam, Wis. PARTICIPANTS: A total of 1636 participants without hearing loss and 1085 participants with hearing loss at the baseline examination in 1993-1995 were reexamined in 1998-2000. MAIN OUTCOME MEASURES: The examinations included otoscopy, screening tympanometry, and tone air- and bone-conduction audiometry. Incidence of hearing impairment was defined as a pure-tone average (PTA) of thresholds at 500, 1000, 2000, and 4000 Hz (PTA 0.5, 1, 2, and 4 kHz) greater than 25 dB HL (hearing level) in either ear at follow-up among those without hearing loss at baseline. Progression was defined as a change of more than 5 dB in the PTA 0.5, 1, 2, and 4 kHz among those with hearing loss at baseline. RESULTS: The 5-year incidence of hearing impairment was 21%. More than half of those with hearing loss at baseline experienced a decline in hearing. Age was an important risk factor for both incidence and progression. Male sex, occupation, and education were associated with the incidence of hearing loss after adjusting for age. CONCLUSIONS: Older adults have a high risk of developing hearing loss. Among those with hearing loss, most experience further declines in hearing sensitivity over time. These data indicate that hearing impairment is an important public health problem and underscore the need for appropriate hearing screening and treatment.

Acoustic Impedance Tests↗

The impact of hearing loss on quality of life in older adults.

PURPOSE: The authors investigate the impact of hearing loss on quality of life in a large population of older adults. DESIGN AND METHODS: Data are from the 5-year follow-up Epidemiology of Hearing Loss Study, a population-based longitudinal study of age-related hearing impairment conducted in Beaver Dam, WI. Participants (N = 2,688) were 53-97 years old (mean = 69 years) and 42% were male. Difficulties with communication were assessed by using the Hearing Handicap for the Elderly-Screening version (HHIE-S), with additional questions regarding communication difficulties in specific situations. Health-related quality of life was assessed by using measures of activities of daily living (ADLs), instrumental ADLs (IADLs) and the Short Form 36 Health Survey (SF-36). Hearing loss measured by audiometry was categorized on the basis of the pure-tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz. RESULTS: Of participants, 28% had a mild hearing loss and 24% had a moderate to severe hearing loss. Severity of hearing loss was significantly associated with having a hearing handicap and with self-reported communication difficulties. Individuals with moderate to severe hearing loss were more likely than individuals without hearing loss to have impaired ADLs and IADLs. Severity of hearing loss was significantly associated with decreased function in both the Mental Component Summary score and the Physical Component Summary score of the SF-36 as well as with six of the eight individual domain scores. IMPLICATIONS: Severity of hearing loss is associated with reduced quality of life in older adults.

Activities of Daily Living↗

Distortion product otoacoustic emission response characteristics in older adults.

OBJECTIVE: The primary purpose of this study was to determine the distortion product otoacoustic emission (DPOAE) and noise response characteristics in a large sample of older adults. Another purpose was to evaluate how specific absolute DPOAE levels or DPOAE/Noise ratios differentiated hearing status in these individuals. DESIGN: A cross-sectional design was utilized for this study. As a part of the Epidemiology of Hearing Loss Study (EHLS), DPOAEs were measured in 937 of the 3,429 participants aged 48 to 92 yr. The DPOAE and noise response characteristics were evaluated at 1,000, 2,000, 4,000, and 8,000 Hz. Absolute DPOAE level and DPOAE/Noise ratios were measured in the participants. The DPOAE data were compared with individual pure-tone frequencies (1,000, 2,000, 4,000, and 8,000 Hz) in the participants to investigate how DPOAE responses differentiated ears with normal hearing from impaired ears. Sensitivity, specificity, positive and negative predictive values, and accuracies were calculated for various absolute DPOAE levels and DPOAE/Noise ratios. RESULTS: Due to the considerable overlap between DPOAE responses and the noise levels at 1,000 Hz, this frequency was not used for any analyses. Sensitivity and specificity were calculated for various DPOAE responses. Sensitivity and specificity varied by frequency for absolute DPOAE levels and DPOAE/Noise ratios. Receiver operator characteristic (ROC) analyses were used to determine which DPOAE responses differentiated normal hearing from hearing loss. The ROC analyses demonstrated that -6 dB SPL at 2,000 Hz, -14 dB SPL at 4,000 Hz, and -22 dB SPL at 8,000 Hz and a +9 dB DPOAE/Noise ratio at each of these frequencies yielded the highest discrimination. CONCLUSIONS: Sensitivity and specificity varied by DPOAE response characteristics and frequency. The decision as to which DPOAE response criterion used should be based on careful consideration of objectives and the possible consequences of misdiagnosis. The results of this study support the use of DPOAEs as a clinical measure for older adults.

Aged↗

Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study.

Tinnitus (ringing or buzzing in the ear or head) can range from barely noticeable to debilitating. Although a few studies have estimated the prevalence of this condition in adult populations, we know of no population-based estimates of incidence. As part of a population-based study of hearing loss in adults aged 48 to 92 years at baseline in Beaver Dam, Wisconsin, self-reported data on tinnitus were obtained at the baseline examination (1993-1995; N = 3753) and again 5 years later (1998-2000; N = 2800). A person was classified as having tinnitus if their tinnitus was at least moderate in severity or caused difficulty in falling asleep. The prevalence of tinnitus at baseline was 8.2 percent. The 5-year incidence of tinnitus among the 2513 participants at risk was 5.7 percent. Risk factors for prevalent and incident tinnitus were evaluated. The results suggest that tinnitus is a common problem for older adults and is associated with some modifiable risk factors.

Aged↗