Hipoacusia súbita asociada a depresión: síntoma inusual en adultos mayores infectados por Sars-CoV-2 / Sudden hearing loss associated with depression: an unusual symptom in older adults infected with Sars-CoV-2

Se comienza acumular información sobre las alteraciones en pacientes positivos a Covid-19, donde relacionan el virus con el daño del oído medio y oído interno, tanto en la porción vestibular como la auditiva en adultos mayores, generando episodios depresivos. Por tal razón, se propuso como objetivo evaluar la relación hipoacusia súbita asociada a depresión en adultos mayores infectados por Sars-CoV-2 atendidos en el Hospital Básico Pillaros, perteneciente al sector Ciudadela Ciudad Nueva, Ecuador 2020-2021. El estudio fue cuantitavo, descriptivo correlacional de corte transversal con una muestra de 87 pacientes >65 años positivos para Sars-CoV-2. Para la recolección de datos se aplicó el Test audiométrico y la escala de depresión geriátrica de Yesavage. El análisis de los datos fue con estadística descriptiva en base a frecuencias, porcentajes, IC 95% y X2 a través de SPSS. Como resultado 73,6% eran fememnino y 26,4% masculino, 54,0% tenían de 65-75 años, el tipo de presbiacusia más existente fue neural (31,2%) y coclear (31,0%). Así mismo, 81,6% presentaron signos de depresión, mientras que 18,4% no. En el test Vasayage 88,5% expresó no sentirse lleno de energía y 59,8% sienten temor a que algo malo suceda. Como conclusión, la presencia de trastornos auditivos constituye un problema para la comunicación de los adultos mayores que pudiese conllevar a estados depresivos, por ello, incentivar el desarrollo de investigaciones pudieran orientar hacia el desarrollo de alternativas de intervención temprana que favorezcan el mejoramiento de la calidad de vida de este grupo poblacional(AU)

Information is beginning to accumulate on the alterations in patients positive for Covid -19, where they relate the virus to damage to the middle ear and inner ear, both in the vestibular and auditory portions in older adults, generating depressive episodes. For this reason, the objective was to evaluate the relationship between sudden hearing loss associated with depression in older adults infected with Sars-CoV- treated at the Pillaros Basic Hospital, belonging to the Ciudadela Ciudad Nueva sector, Ecuador 2020-2021. The study was quantitative, descriptive correlational cross-sectional with a sample of 87 patients >65 years positive for Sars-CoV-2. For data collection, the audiometric test and the Yesavage geriatric depression scale were applied. The analysis of the data was with descriptive statistics based on frequencies, percentages, CI 95% and X2 through SPSS. As a result, 73.6% were female and 26.4% male, 54.0% were 65-75 years old, the most common type of presbycusis was neural (31.2%) and cochlear (31.0%). Likewise, 81.6% presented signs of depression, while 18.4% did not. In the Vasayage test, 88.5% expressed not feeling full of energy and 59.8% were afraid that something bad would happen. In conclusion, the presence of hearing disorders constitutes a problem for the communication of older adults that could lead to depressive states, therefore, encouraging the development of research could guide the development of early intervention alternatives that favor quality improvement. life of this population group(AU)

Características clínico-epidemiológicas de pacientes ancianos con Hipoacusia atendidos en el Hospital Calixto García / Clinical and epidemiological characteristics of elderly patients with hearing loss treated in Calixto García University Hospital

Introducción: El envejecimiento en Cuba constituye el principal problema demográfico y la Hipoacusia es una de las condiciones crónicas más frecuentes en los adultos mayores. Objetivo: Describir las características clínico-epidemiológicas de los pacientes de la tercera edad con Hipoacusia atendidos en el Hospital Universitario General Calixto García en el período de septiembre de 2015 hasta septiembre de 2016. Material y Método: Se realizó un estudio descriptivo, transversal en el Hospital Universitario General Calixto García durante el período de septiembre de 2015 hasta septiembre de 2016. La población (N) estuvo constituida por 387 pacientes de la tercera edad, quienes asistieron a consulta en el período estudiado. Resultados: Predominó la Hipoacusia en los pacientes con edades entre 65 y 79 años (67,2 por ciento) y el sexo masculino fue el más afectado con esta discapacidad (69,5 por ciento). La Hipoacusia en el anciano se asoció con frecuencia a otras afecciones crónicas como las enfermedades cardiovasculares. La Presbiacusia o Hipoacusia asociada a la edad fue la causa más frecuente de sordera. Conclusiones: La Hipoacusia resultó ser una discapacidad frecuente en los pacientes masculinos de la tercera edad. La misma estuvo asociada a enfermedades crónicas no trasmisibles. Las perdidas auditivas neurosensoriales y mixtas, de moderada y severa intensidad, fueron las más frecuentemente encontradas en la audiometría tonal(AU)

Introduction: Aging constitutes the main demographic problem in Cuba, and hearing loss is one of the most frequent chronic conditions in older adults. Objective: To describe the clinical and epidemiological characteristics of elderly patients with hearing loss, treated in Calixto Gracía University Hospital during the period from September 2015 to September 2016. Material and Method: A descriptive cross-sectional study was conducted in Calixto Garcia University Hospital during the period from September 2015 to September 2016. The population (N) was composed of 387 elderly patients, who went to the doctor´s office during the period under study. Results: Hearing loss predominated in patients aged from 65 to 79 years (67,2 percent), and the male sex was the most affected by this disability (69,5 percent). Hearing loss in the elderly was frequently associated with other chronic conditions such as cardiovascular diseases. Age-related hearing loss (Presbycusis) or hearing loss associated with age was the most frequent cause of deafness. Conclusions: Hearing loss was a frequent disability in male elderly patients. It was associated with non-communicable chronic diseases. Sensorineural and mixed hearing losses of moderate and severe intensity were the most frequent ones found in the tonal audiometry(AU)

Triagem auditiva em idosos: avaliação da acurácia e reprodutibilidade do teste do sussurro / Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test

Resumo Devido à alta prevalência da presbiacusia e as suas consequências, métodos de triagem auditiva são necessários no âmbito da atenção primária. Diante disso, o objetivo do estudo foi verificar a reprodutibilidade e acurácia do teste do sussurro como metodologia de triagem auditiva em idosos. Trata-se de estudo transversal com medidas de acurácia que incluiu 210 idosos, entre 60 e 97 anos, submetidos ao teste do sussurro com dez expressões diferentes e ao exame de referência audiometria tonal limiar. Calculou-se a sensibilidade, a especificidade, o valor preditivo positivo, o valor preditivo negativo e a acurácia do teste, avaliada por meio da área sob a curva Receiver Operating Characteristic (ROC). O teste foi repetido em 20% das orelhas por um segundo examinador com a finalidade de avaliar a reprodutibilidade interexaminador (RIE). As expressões que apresentaram melhor área sob a curva ROC (AUC) e RIE foram: "sapato" (AUC = 0,918; RIE = 0,877), "janela" (AUC = 0,917; RIE = 0,869), "parece que vai chover" (AUC = 0,911; RIE = 0,810) e o "ônibus está atrasado" (AUC = 0,900; RIE = 0,810). Estas são, pois, as expressões propostas para fazerem parte do protocolo do teste do sussurro que mostrou-se como uma ferramenta útil para triagem auditiva em idosos.

Abstract Given the high prevalence of presbycusis and its detrimental effect on quality of life, screening tests can be useful tools for detecting hearing loss in primary care settings. This study therefore aimed to determine the accuracy and reproducibility of the whispered voice test as a screening method for detecting hearing impairment in older people. This cross-sectional study was carried out with 210 older adults aged between 60 and 97 years who underwent the whispered voice test employing ten different phrases and using audiometry as a reference test. Sensitivity, specificity and positive and negative predictive values were calculated and accuracy was measured by calculating the area under the ROC curve. The test was repeated on 20% of the ears by a second examiner to assess inter-examiner reproducibility (IER). The words and phrases that showed the highest area under the curve (AUC) and IER values were: "shoe" (AUC = 0.918; IER = 0.877), "window" (AUC = 0.917; IER = 0.869), "it looks like it's going to rain" (AUC = 0.911; IER = 0.810), and "the bus is late" (AUC = 0.900; IER = 0.810), demonstrating that the whispered voice test is a useful screening tool for detecting hearing loss among older people. It is proposed that these words and phrases should be incorporated into the whispered voice test protocol.

Deficiência auditiva referida por idosos no Município de São Paulo, Brasil: prevalência e fatores associados (Estudo SABE, 2006) / Self-reported hearing loss among elderly individuals in the city of São Paulo, Brazil: prevalence and associated factors (SABE Study, 2006)

O objetivo foi estimar a prevalência de deficiência auditiva referida numa população de idosos de São Paulo, Brasil e verificar os fatores associados, mediante pesquisa transversal, descritiva e quantitativa. A amostra foi composta por sujeitos acima de 65 anos derivada de setores censitários em dois estágios, com reposição e probabilidade proporcional à população para pessoas com 75 anos ou mais. A análise estatística foi realizada no software Stata 10, com dados ponderados, utilizando-se o teste de Rao-Scott e a regressão de Poisson do tipo stepwise backward. Foram entrevistados 1.115 idosos com prevalência de deficiência auditiva referida de 30,4%, maior em idades mais avançadas, no sexo masculino, em sujeitos com doenças osteoarticulares referidas, queixa de vertigem e/ou tontura, deficiência visual referida e com dificuldades para o uso do telefone. O conhecimento da prevalência e dos fatores associados à deficiência auditiva pode auxiliar na elaboração das políticas públicas relacionadas à audição, sendo imprescindível a abordagem deste tema com a população idosa, por conta da importante ocorrência encontrada.

This article describes the prevalence of self-reported hearing loss in an elderly population in the city of São Paulo, Brazil, and associated factors, based on a cross-sectional descriptive and quantitative study. The sample consisted of individuals over 65 years of age selected from census tracts in two stages, with replacement and probability proportional to the population 75 years of age or older. Statistical analysis used Stata 10 with weighted data, Rao-Scott test, and backward stepwise Poisson regression. 1,115 elders were interviewed. Prevalence of self-reported hearing loss was 30.4%, and higher levels were associated with age over 75 years, male gender, self-reported musculoskeletal conditions, dizziness, visual impairment, and difficulty using the telephone. Increased knowledge of factors associated with hearing loss would support public policies on hearing. The high prevalence found in this study underlines the importance of addressing this issue among the elderly.

Comparação entre avaliação audiológica e screening: um estudo sobre presbiacusia / Comparing audiological evaluation and screening: a study on presbycusis

Em virtude da alta prevalência da presbiacusia e dos prejuízos por ela trazidos, uma triagem pode ser útil na identificação da perda auditiva em atenção primária. OBJETIVOS: Estimar a prevalência da perda auditiva em uma população de idosos residentes no Butantã utilizando o método de screening audiológico (questionário) e a avaliação audiológica básica; comparar os resultados do screening audiológico e da avaliação audiológica básica, verificando a validade deste instrumento como forma de triagem auditiva. FORMA DE ESTUDO: Do tipo transversal, descritivo. MATERIAL E MÉTODO: Foram selecionados randomicamente 200 sujeitos de ambos os sexos, com faixa etária a partir de 60 anos, para aplicação do screening audiológico (questionário) e, destes, 100 indivíduos realizaram a avaliação audiológica completa. Em seguida, os resultados dos dois métodos de avaliação foram comparados. RESULTADOS: Verificou-se que não existe associação estatisticamente significante entre a queixa, obtida pelo questionário e o grau de perda auditiva. CONCLUSÕES: A prevalência de perda auditiva encontrada para esta população foi de aproximadamente 56 por cento pelo screening e de 95 por cento pela avaliação audiológica básica. Desta forma, o screening não se mostrou como instrumento válido para uso em triagem auditiva, quando comparado à avaliação audiológica básica.

Given the high prevalence of presbycusis and the damage it brings about, a screening test can be useful in the identification of hearing loss in primary care. AIM: To estimate the prevalence of hearing loss in a representative sample of elderly people living at Butantan using an audiological screening method (questionnaire) and a basic audiological evaluation; to compare the results of the two kinds of evaluations, checking the validity of this tool for hearing loss screening. DESIGN: Cross sectional descriptive study. MATERIALS AND METHODS: 200 individuals (above 60 years old, both genders) were randomly selected to undergo audiological screening (questionnaire). Another randomly selected group encompassed 100 individuals who were submitted to a set of audiological tests. Then, we compared the results from the two methods. RESULTS: There were no statistically significant associations between the questionnaire and the degree of hearing loss of the patients. CONCLUSION: The prevalence of hearing loss in our sample was of 56 percent in the screening and of 95 percent when checked by the audiological evaluation. Therefore, screening was not proven valid to assess hearing when compared to audiological evaluation.

Comparação entre critérios de classificação dos achados audiométricos em idosos / Comparison between classification criteria of audiometric findings in elderly

OBJETIVO: Comparar os resultados audiológicos de idosos com base nas classificações segundo os critérios de Davis e Silverman e da Recomendação 02/1 do Bureau Internacional d'Audiophonologie (BIAP). MÉTODOS: Foram analisados 140 prontuários, pertencentes a 79 mulheres e 61 homens, com média de idade 69,75 anos. Foram coletados dados referentes à história clínica e resultados da audiometria tonal liminar, classificando ocorrências de acordo com: tipo da perda auditiva; curva audiométrica; orelha afetada; grau da perda auditiva de acordo com as propostas de Davis e Silvermane da recomendação 02/1 do BIAP. Os dados foram analisados estatisticamente. RESULTADOS: As queixas audiológicas mais frequentes foram zumbido, prurido, tontura e otalgia. As doenças referidas foram hipertensão arterial e diabetes. Houve relatos de exposição a ruídos. Em relação à configuração audiométrica, 105 orelhas apresentaram curva descendente, 88 horizontal e 24 apresentaram configuração normal bilateralmente. Dos indivíduos com perda, 57 eram do gênero masculino e 59 do gênero feminino, o que indicou 93,44 por cento do número total de homens, e 74,68 por cento do número total de mulheres. Houve predomínio de perda auditiva sensorioneural, de grau leve e moderado, com pequenas diferenças quanto à prevalência de acordo com cada uma das classificações. O grau da perda foi considerado pior e houve menor quantidade de casos de audição normal na classificação BIAP. Na classificação de Davis e Silverman, ocorreram 99 casos de orelhas com limiares normais enquanto pela recomendação do BIAP, apenas 66. CONCLUSÃO: A utilização dos critérios de classificação sugeridos por Davis e Silverman e pela recomendação do BIAP apresentam resultados semelhantes. No entanto, o uso da recomendação do BIAP mostra-se mais sensível para a detecção de perdas auditivas em idosos.

PURPOSE: To compare the audiological results of elderly subjects based on the classifications according to the criteria of Davis and Silverman and of the recommendation 02/1 of the Bureau Internacional d'Audiophonologie (BIAP). METHODS: The records of 140 elderly subjects, 79 female and 61 male, with average age of 69.75 years, were analyzed. Data regarding their clinical history and the results from pure tone audiometry were gathered, and occurrences were classified according to: type of hearing loss; audiometric curve; affected ear; and degree of hearing loss, according to the purposes of Davis and Silverman and the recommendation 02/1 of the BIAP. Data were statistically analyzed. RESULTS: The most frequent audiological complaints were tinnitus, itchiness, dizziness and otalgia. There were reports of noise exposition. Regarding the audiometric configuration, 105 ears showed descending curve, 88 had horizontal curve, and 24 presented normal curve configuration bilaterally. Fifty seven of the individuals with hearing loss were male and 59 were female, corresponding to 93.44 percent of the total number of male subjects and 74.68 percent of the female subjects. Mild and moderate sensorineural hearing losses were predominant, with little prevalence difference according to each of the classifications. The degree of hearing loss was worse and there were lesser cases of normal hearing when the BIAP classification was considered. The classification proposed by Davis and Silverman identified 99 cases of normal hearing, while the BIAP classification identified only 66 cases. CONCLUSION: The classification criteria suggested by Davis and Silverman and by the BIAP recommendation presented similar results. However, the BIAP criteria are more sensible to detect hearing loss in elderly subjects.

Risk factors for presbycusis in a socio-economic middle-class sample / Estudo de fatores de risco para presbiacusia em indivíduos de classe sócio-econômica média

Presbycusis, or the aging ear, involves mainly the inner ear and the cochlear nerve, causing sensorineural hearing loss. Risk factors include systemic diseases and poor habits that cause inner ear damage and lead to presbycusis. Correct identification of these risk factors is relevant for prevention. AIM: To evaluate the prevalence and to identify the risk factors of presbycusis in a sample aged over 40 years. Study design: a retrospective case series. SUBJECTS AND METHODS: medical records of 625 patients were evaluated. Presbycusis was identified using pure tone audiometry, speech audiometry and impedance testing of all patients. RESULTS: The prevalence of presbycusis was 36.1 percent; the mean age was 50.5 years ranging from 40 to 86 years; 85.5 percent were male and 14.5 percent werf female. Age, the male gender, diabetes mellitus, and hereditary hearing loss were identified as risk factors. Cardiovascular diseases, smoking and consumption of alcohol were not confirmed as risk factors, although these have often been mentioned as risk factors for presbycusis. CONCLUSION: Notwithstanding the idea that presbycusis has multiple risk factors, this study identified few risk factors for this disease.

A presbiacusia é consequência de lesões histopatológicas da orelha interna e nervo coclear e leva à deficiência auditiva sensório-neural. Fatores de risco como doenças sistêmicas e hábitos inadequados são agravantes para presbiacusia. A identificação destes fatores é relevante para sua prevenção. OBJETIVO: Avaliar a prevalência da presbiacusia e correlacionar eventuais fatores de risco numa amostra populacional. CASUÍSTICA E MÉTODO: Estudo retrospectivo de série de casos com amostragem aleatória de 625 prontuários de indivíduos sem e com presbiacusia determinada por avaliação audiológica convencional. Foi feita a análise da associação da presbiacusia com fatores de risco pré-estabelecidos. RESULTADOS: A prevalência da presbiacusia foi de 36,1 por cento na amostra, com idade média de 50,5 anos e variou de 40 anos a 86 anos e foi constituída de 85,5 por cento do gênero masculino e 14,5 por cento do gênero feminino. Os fatores de risco associados foram idade, gênero masculino, diabetes melito e história familiar de presbiacusia. Não houve associação entre presbiacusia e profissão, hipertensão arterial sistêmica, dislipidemia, hábitos de fumar e de beber. CONCLUSÃO: Os resultados demonstram que, embora a presbiacusia apresente múltiplos fatores de risco enumerados na literatura, estes fatores na presente amostra foram limitados ao antecedente familiar de presbiacusia, idade, gênero masculino e diabetes melito.

Estudo audiológico de uma população idosa brasileira / Audiological study of an elderly brazilian population

A população idosa brasileira cresce e representa 8,6 por cento do total populacional. Fatores ambientais, hábitos de vida, sexo e fatores genéticos interferem na evolução da presbiacusia que reduz a qualidade de vida. OBJETIVO: Investigar queixas audiológicas e vestibulares em idosos, executar audiometria tonal, verificar se há diferenças entre os sexos. FORMA DE ESTUDO: Clínico prospectivo de corte transversal. MATERIAL E MÉTODO: 320 pacientes idosos (160 homens e 160 mulheres) foram submetidos a anamnese audiológica e audiometria tonal. Análise estatística dos resultados pelos testes ANOVA, Mann-Whitney e Qui-Quadrado. RESULTADO: As queixas audiológicas e vestibulares (perda auditiva, tinnitus, plenitude auricular, tontura) foram similares entre os sexos (exceção, a tontura: p<0,05); audiometria tonal apresentou diferença significante, com perda auditiva nas altas freqüências entre os homens, e entre as mulheres, curvas descendentes e planas. Esses resultados foram estaticamente significantes (p<0,001). CONCLUSÃO: Os resultados permitem concluir que, quando comparados os sexos, a perda auditiva no idoso possui sintomatologia semelhante, mas apresenta diferenças significativas na audiometria tonal.

The Brazilian elderly population is growing, and already represents 8,6 percent of our total population. Environmental factors, lifestyle, gender and genetics impact the development of presbycusis, which reduces quality of life. AIM: investigate audiologic and vestibular complaints in the elderly; perform tonal audiometry and check to see if there are differences between genders. STUDY: Cross-sectional clinical prospective study. MATERIALS AND METHODS: 320 elderly patients (160 men and 160 women) were submitted to audiologic interview and tonal audiometry. The results were statistically analyzed by the following methods: ANOVA, Mann-Whitney and Chi-Squared. RESULTS: audiologic and vestibular complaints (hearing loss, tinnitus, ear fullness, dizziness) were similar between the genders (except for dizziness: p<0,05); tonal audiometry showed a significant difference, with hearing loss in the high frequencies among men; and among women the curves were descending and flat. These results were statistically significant (P<0,001). CONCLUSION: our results lead us to conclude that, when the genders are compared, hearing loss in the elderly has similar symptoms; however, there are significant differences in tonal audiometry.

Incidence of presbycusis of Korean populations in Seoul, Kyunggi and Kangwon provinces

Presbycusis, a bilateral sensorineural hearing loss caused by changes in the inner ear, is related to multiple factors such as noise exposure and otologic disease. In institute-based studies, we tried to determine the incidence of presbycusis in Korean populations living in Seoul, Kyunggi and Kangwon provinces by gender and age groups. The subjects were people who had visited health promotion centers. Pure tone audiometry was done over 20 years on 6,028 subjects. In a community-based study, the subjects were elderly residents of Kanghwa-do area. There were no obvious factors that could cause hearing impairment in the subjects. For the pure tone audiometry, hearing threshold was obtained by using the six-dimension method. The incidence of presbycusis for subjects aged 65 years and older was 37.8% and 8.3% for > or = 27 dB HL criterion and > or = 41 dB HL criterion, respectively. The incidence increased with age. A statistically significant difference in the hearing threshold was found between men and women aged 65 years or older. No differences were found between the community-based study and the institute- based studies. There was a high incidence (about 40%) of presbycusis among Koreans aged 65 years or older (for > or = 27 dB HL criterion). With an aging population, we anticipate that this report could be used to provide a basic data for the study of presbycusis.