Epidemiology of Age-Related Hearing Loss

描述（由申请人提供）：这项拟议的流行病学研究的目的是重新检查一个大型的、基于人群的老年人队列，以确定听力损失的10年发病率和进展，并调查与年龄相关的听力变化的风险因素。基线检查（1993-95）中的参与者（n=3753）年龄为48-92岁。他们将在2003-2005年使用相同的标准化耳镜检查、筛查鼓室测试、听力测试、文字识别测试和畸变产物耳声发射测试方案进行重新检查。将通过访谈完成关于病史、噪声暴露、身体功能和健康相关生活质量的标准化问卷。在五年的随访检查中，增加了嗅觉测试，以确定嗅觉障碍的患病率。将使用相同的嗅觉测试对队列进行重新测试，以确定嗅觉障碍的5年发生率。将从比弗坝眼科研究批准的15年随访中获得视力损害以及心血管疾病风险标志物（C反应蛋白）、亚临床外周血管疾病（踝臂指数）和视网膜微血管变化（动静脉比）的数据。在拟议的资助期间，将获得关于亚临床动脉粥样硬化的存在和严重程度的新数据。将对5年检查时获得的颈动脉存档B型超声扫描进行内膜-中层厚度分级，这是全身性动脉粥样硬化的标志物。 这项研究将提供关于血管因素和其他潜在可改变的风险因素与老年人听力损失发生率和进展之间关系的重要新数据。它将提供第一个基于人群的听力损失10年发病率和进展以及嗅觉障碍5年发病率的估计。由于与正在进行的与年龄相关的眼部疾病的流行病学研究的联系，本研究有机会确定三个感官系统，视觉，听觉和嗅觉的损伤的相对贡献，在老年人的健康相关的生活质量和功能障碍的递减。它将为规划老年人的保健需求提供重要数据，并为延迟或减少感觉障碍对老年人生活质量的影响的干预战略提供可能的目标。

DESCRIPTION (provided by applicant): The purpose of this proposed epidemiologic study is to re-examine a large, population-based cohort of older adults to determine the 10-yr incidence and progression of hearing loss and investigate risk factors for age-related changes in hearing. Participants (n=3753) in the baseline examination (1993-95) were 48-92 years of age. They will be reexamined in 2003-2005 using the same standardized protocols for otoscopy, screening tympanometry, audiometry, word recognition tests, and distortion product otoacoustic emissions. A standardized questionnaire about medical history, noise exposure, physical functioning, and health-related quality of life will be completed as an interview. At the five-yr follow-up examination, olfaction testing was added to determine the prevalence of olfactory impairment. The cohort will be re-tested using the same test of olfaction to determine the 5-yr incidence of olfactory impairment. Data on vision impairment, as well as markers of cardiovascular disease risk (C-reactive protein), subclinical peripheral vascular disease (ankle-brachial index), and retinal microvascular changes (arteriolar-venular ratio) will be available from the approved 15-yr follow-up for the Beaver Dam Eye Study. During the proposed grant period, new data will be obtained on the presence and severity of subclinical atherosclerosis. Archived B-mode ultrasound scans of the carotid arteries obtained at the 5-yr examination will be graded for intima-medial thickness, a marker of generalized atherosclerosis. This study will provide important new data about the associations of vascular factors, and other potentially modifiable risk factors, with the incidence and progression of hearing loss in older adults. It will provide the first population-based estimates of the 10-yr incidence and progression of hearing loss and the 5-yr incidence of olfactory impairments. Because of the links with an on-going epidemiologic study of age-related ocular disorders, this study has the opportunity to determine the relative contributions of impairments in three sensory systems, vision, hearing, and smell, to decrements in health-related quality of life and functional disability in older adults. It will provide data important for planning for the health-care needs of older adults and possible targets for intervention strategies to delay or diminish the impact of sensory impairments on quality of life in older adults.