Epidemiology of Age-Related Hearing Loss

描述(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大批以人群为基础的老年人，以确定10年听力损失的发生率和进展，并调查与年龄相关的听力变化的危险因素。基线检查(1993-95)的受试者(n=3753)年龄为48-92岁。他们将在2003-2005年使用相同的标准化方案进行耳镜检查、筛查鼓室导纳、测听、单词识别测试和失真产物耳声发射。一份关于病史、噪音暴露、身体功能和与健康相关的生活质量的标准化问卷将作为面试完成。在为期五年的随访检查中，增加了嗅觉测试以确定嗅觉障碍的患病率。该队列将使用相同的嗅觉测试进行重新测试，以确定5年内嗅觉障碍的发生率。有关视力损害的数据，以及心血管疾病风险的标记物(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(小动脉-小静脉比率)，将从批准的15年河狸大坝眼科研究的后续行动中获得。在拟议的赠款期间，将获得有关亚临床动脉粥样硬化的存在和严重程度的新数据。在5年检查中获得的颈动脉的B型超声扫描档案将对动脉内膜-中层厚度进行分级，这是泛发性动脉粥样硬化的标志。 这项研究将提供关于血管因素和其他潜在的可改变的危险因素与老年人听力损失的发生率和进展的关系的重要新数据。它将首次提供基于人群的10年听力损失发生率和进展以及5年嗅觉损害发生率的估计。由于与正在进行的年龄相关性眼病的流行病学研究有关，这项研究有机会确定视觉、听力和嗅觉三个感官系统的损伤对老年人健康相关生活质量和功能障碍的相对贡献。它将为规划老年人的卫生保健需求提供重要的数据，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.