Early intervention as a determinant of hearing aid benefit for age-related hearing loss: Results from longitudinal cohort studies

项目摘要/摘要 年龄相关性听力损失(ARHL)是一种非常普遍的慢性疾病，与较差的 心理社会幸福感、沟通和认知功能。使用助听器(HA)缓解症状的证据 急性淋巴细胞性白血病的负面后果是不确定的，因为在一定程度上，基于人群的纵向研究 有足够随访时间的听证会很少见，也很少有人考虑到早期干预的程度 使用HA可改善HA的长期结局，并减少ARHL的广泛后果。长的- 长期目标是通过最大限度地提高HA的整体效益来减少ARHL的影响。具体目标是 全面评估使用HA对心理社会幸福感、沟通和认知结果的好处 获取一般和听力特定的健康状况，并确定ARHL早期干预的程度 房委会受益的决定因素。为了实现这一目标，提出了两个具体目标。AIM 1将使用 来自南卡罗来纳医科大学(MUSC)的ARHL纵向队列研究的纵向数据 确定使用HA的好处，评估早期干预的贡献，并测试a)使用的假设 HA将与更好的心理社会幸福感、认知和一般健康方面相关 沟通，以及b)更早地与医院管理局进行干预将与以下决定的更大的医院管理局利益相关 这些结果。目标2将使用跨期数据来确定使用HA的好处并评估贡献 使用MUSC纵向队列参与者的历史数据和新收集的数据进行早期干预 对ARHL的研究，以检验以下假设：a)使用HA将与更好的听力特异性心理社会相关 幸福感和沟通结果，以及b)更早地与HA进行干预将与更高的HA相关 由这些结果决定的收益。该项目的成果将对公共卫生研究产生积极影响 和临床实践。具体地说，结果可以为未来的流行病学研究和/或临床试验提供信息，目的是 确定早期干预对医管局利益的影响、医管局干预的最佳时机和适当的 开始筛查急性淋巴细胞性白血病的年龄。该项目和研究方向直接面向美国国家科学院 科学、工程和医学部(2016)改善基于预期人群的建议 急性淋巴细胞性白血病及其治疗的影响的证据，并与NIDCD的战略计划相一致 急性淋巴细胞性白血病患者的三级预防和健康促进。也就是说，这项提案旨在确定 早期干预ARHL的重要性(二级预防)和使用HA的好处(三级预防) 关于心理社会幸福感、沟通和认知的一般和与听力相关的测量。这 项目和培训计划将提供以流行病学为重点的新方法的严格指导培训 和公共卫生研究在听力学、教师精神、教学和职业/专业发展方面，以及 将支持申请者成为一名独立的、由NIH资助的临床医生兼研究人员的长期目标。

PROJECT SUMMARY/ABSTRACT Age-related hearing loss (ARHL) is a highly prevalent chronic condition and is associated with poorer psychosocial well-being, communication, and cognitive function. Evidence that hearing aid (HA) use mitigates negative consequences of ARHL is inconclusive because, in part, longitudinal population-based studies of hearing with sufficient follow-up times are rare and few have considered the extent to which earlier intervention with HA improves long-term HA outcomes and reduces the wide-ranging consequences of ARHL. The long- term objective is to reduce impacts of ARHL by maximizing overall HA benefit. The specific objective is to holistically assess benefits of HA use on psychosocial well-being, communication, and cognitive outcomes that capture general and hearing-specific health and determine the extent to which earlier intervention for ARHL is a determinant of HA benefit. To achieve this objective, two specific aims are proposed. Aim 1 will use longitudinal data from the Medical University of South Carolina (MUSC) Longitudinal Cohort Study of ARHL to determine benefits of HA use and assess contributions of early intervention and test hypotheses that a) use of HA will be associated with better general health aspects of psychosocial well-being, cognition, and communication, and b) earlier intervention with HA will be associated with greater HA benefit as determined by these outcomes. Aim 2 will use cross-temporal data to determine benefits of HA use and assess contributions of early intervention using historic and newly collected data from participants in the MUSC Longitudinal Cohort Study of ARHL to test hypotheses that a) use of HA will be associated with better hearing-specific psychosocial well-being and communication outcomes, and b) earlier intervention with HA will be associated with greater HA benefit as determined by these outcomes. Results from this project will positively impact public health research and clinical practice. Specifically, results can inform future epidemiological research and/or clinical trials aiming to determine effects of early intervention on HA benefit, optimal timing of HA interventions, and the appropriate age to begin screening for ARHL. This project and line of research directly addresses the National Academies of Sciences, Engineering, and Medicine (2016) recommendation to improve prospective population-based evidence on impacts of ARHL and its treatment and aligns with NIDCD’s strategic plan on secondary and tertiary prevention and health promotion for individuals with ARHL. That is, this proposal aims to determine importance of early intervention for ARHL (secondary prevention) and benefits of HA use (tertiary prevention) on general and hearing-related measures of psychosocial well-being, communication, and cognition. This project and training plan will provide rigorous mentored training in new methods focused on epidemiological and public health research in audiology, grantsmanship, teaching, and career/professional development, and will support the applicant’s long-term goals of being an independent, NIH-funded clinician-researcher.