Prevalence of Cognitive Impairment and Its Association With Hearing Loss Among Adults Over 50 Years of Age: Results From a Population-Based Survey in Santiago, Chile.

PURPOSE: The purpose of this study was to estimate the prevalence of cognitive impairment and explore its association with hearing loss and other sociodemographic and clinical risk factors, using an objective measurement of hearing levels, in adults over 50 years of age. METHOD: A population-based survey was completed in Santiago, Chile between December 2019 and March 2020. Participants were screened for cognitive impairment using the Short Chilean Mini-Mental State Examination and hearing levels were assessed with tonal audiometry (hearTest). Data on demographic, socioeconomic, and clinical characteristics were collected. RESULTS: A total of 538 persons completed the assessment. The prevalence of cognitive impairment in the 50+ population was 9.3% (95% confidence interval [CI] [5.8, 14.7]). Cognitive impairment was significantly higher in individuals with any level of hearing loss (odds ratio [OR] = 2.19, 95% CI [1.00, 4.80], adjusted for age, sex, education, socioeconomic position [SEP], and head trauma). Subjects with hearing loss and who reported any use of hearing aids (16% of the sample) had a lower risk of cognitive impairment (OR of nonusers 3.64, 95% CI [1.00, 13.28], adjusted for age, sex, education, SEP, and head trauma). CONCLUSION: Strategies for addressing cognitive impairment should further explore the integration of early diagnosis of hearing loss and the regular use of hearing aids.

Prevalence, risk factors and causes of hearing loss among adults 50 years and older in Santiago, Chile: results from a rapid assessment of hearing loss survey.

OBJECTIVE: Among a representative sample of adults aged 50 years and older too (i) determine the prevalence of hearing loss, (ii) evaluate probable causes and risk factors of hearing loss, and (iii) assess the association between hearing loss measured by audiometry and self-report. DESIGN: A population-based survey of adults aged 50 and older in Santiago, Chile using the Rapid Assessment of Hearing Loss (RAHL) survey. STUDY SAMPLE: 538 participants completed a questionnaire, which included questions on socio-demographic and health characteristics and self-reported hearing loss. Hearing and possible cause of hearing loss was assessed using pure tone audiometry (0.5-4.0 kHz), tympanometry, and otoscopy. RESULTS: The prevalence of any level of hearing loss in adults aged 50 years and older was 41% (95% CI 33.2, 49.2). In terms of aetiologies, 89.3% of ears with mild or worse hearing loss were classified as sensorineural. Otoscopy was abnormal in 10.7% of subjects with impacted earwax being the most common finding (4.4%) followed by chronic otitis media (3.5%). Hearing aid usage was 16.6%. Older age, lower socioeconomic position, lack of education, and solvent exposure were significantly associated with hearing loss. CONCLUSION: Hearing loss among individuals aged over 50 years was common in Santiago, Chile.

Timpanoplastias: factores asociados al resultado anatómico y auditivo / Tympanoplasty: factors associated with anatomical and audiometric results

INTRODUCCIÓN: La timpanoplastia es una cirugía frecuente en otorrinolaringología. Su mayor indicación es la perforación timpánica, y con menor frecuencia la otitis adhesiva. Su objetivo primario o anatómico es restaurar la integridad timpánica, previniendo infecciones, y secundario o auditivo es preservar o mejorar la audición. MATERIAL Y MÉTODO: Estudio retrospectivo de los pacientes operados de timpanoplastia en nuestro hospital. Se registraron características biodemográficas, de la patología del oído, de la cirugía y se analizaron los resultados anatómicos y auditivos. RESULTADOS: Se incluyeron 182 pacientes, la mayoría de sexo femenino (57,1%), edad promedio de 36,1 años. La principal indicación fue la perforación timpánica (89,0%), seguida de otitis adhesiva (7,1%). La mayoría de las timpanoplastias correspondió a cirugía primaria (84,1%), tipo I (62,6%), por abordaje endoaural (83,5%) y técnica medial o Austin (90,1%). El injerto más utilizado fue el compuesto de cartílago-pericondrio (87,9%). El éxito anatómico fue 84,6% y el auditivo 66,8%. Los pacientes operados de miringoplastia (sin elevación de colgajo timpanomeatal) presentaron mejor resultado auditivo (p = 0,003). No se identificaron factores asociados a mejor resultado anatómico. CONCLUSIONES: Los resultados anatómicos y auditivos obtenidos son comparables a lo publicado en la literatura. Se requieren más estudios prospectivos para definir factores asociados a un mejor resultado anatómico y auditivo

INTRODUCTION: Tympanoplasty is a frequent surgery in otolaryngology. Its main indication is tympanic perforation, followed by adhesive otopathy. Its main and (or) anatomic objective is to restore the tympanic membrane's integrity, preventing infections, and its secondary or audiometric objective is to preserve or improve hearing. MATERIAL AND METHOD: Retrospective study of all patients submitted to tympanoplasty at our hospital. Biodemographic, ear pathology and surgery characteristics were registered, and anatomic and audiometric success rates were analyzed. RESULTS: A total of 182 patients were included, most female (57.1%), with average age of 36.1 years. The main surgical indication was tympanic perforation (89.0%), followed by adhesive otopathy (7.1%). Most tympanoplasties were primary surgeries (84.1%), type I (62.6%), performed by endoaural approach (83.5%) using medial or Austin technique (90.1%). Compound cartilage-perichondrium grafts were most frequently used (87.9%). The anatomic success rate was 84.6%, and the audiometric success rate was 66.8%. Patients who underwent myringoplasty (without raising of tympanomeatal flap) presented a better audiometric result (p = .003). No factors associated with better anatomical results were identified. CONCLUSIONS: Our anatomic and audiometric results are comparable to those previously published. Further prospective studies are required to define factors associated with improved anatomic and audiometric results

Tympanoplasty: factors associated with anatomical and audiometric results. / Timpanoplastias: factores asociados al resultado anatómico y auditivo.

INTRODUCTION: Tympanoplasty is a frequent surgery in otolaryngology. Its main indication is tympanic perforation, followed by adhesive otopathy. Its main and (or) anatomic objective is to restore the tympanic membrane's integrity, preventing infections, and its secondary or audiometric objective is to preserve or improve hearing. MATERIAL AND METHOD: Retrospective study of all patients submitted to tympanoplasty at our hospital. Biodemographic, ear pathology and surgery characteristics were registered, and anatomic and audiometric success rates were analyzed. RESULTS: A total of 182 patients were included, most female (57.1%), with average age of 36.1 years. The main surgical indication was tympanic perforation (89.0%), followed by adhesive otopathy (7.1%). Most tympanoplasties were primary surgeries (84.1%), type I (62.6%), performed by endoaural approach (83.5%) using medial or Austin technique (90.1%). Compound cartilage-perichondrium grafts were most frequently used (87.9%). The anatomic success rate was 84.6%, and the audiometric success rate was 66.8%. Patients who underwent myringoplasty (without raising of tympanomeatal flap) presented a better audiometric result (p=.003). No factors associated with better anatomical results were identified. CONCLUSIONS: Our anatomic and audiometric results are comparable to those previously published. Further prospective studies are required to define factors associated with improved anatomic and audiometric results.

[Perception of medical students about formative assessments during clinical courses]. / Utilidad de la evaluación formativa en cursos clínicos integrativos en estudiantes de pregrado de medicina.

BACKGROUND: Formative evaluation is a range of formal assessment employed by professors during the teaching process in order to modify curriculum activities, to improve student attainment. For students, it is helpful to evaluate their learning process. Although recommended, it is seldom used. AIM: To evaluate the perception and performance of medical students subjected to formative assessments during an integrative clinical course. MATERIAL AND METHODS: Fourth year medical students that participated in a multiple choice formative assessment, similar to the final exam during 2007 and 2008, responded a survey about the usefulness and quality of such assessment. Student achievement was expressed as the percentage of correct answers of the tests. RESULTS: The formative assessment was answered by 99% of students. In 2007 97% of students considered the experience as excellent or very good and 92% evaluated it as useful or very useful. During 2008 the figures were 89% and 79%. The students outlined that this assessment oriented their study, allowed them to discover their weaknesses and have a perception of the degree of difficulty of the final exam. Over 90% of students that took the formative evaluation, improved their academic achievement. CONCLUSIONS: Formative assessments are well evaluated by medical students and improve their academic achievement.

Utilidad de la evaluación formativa en cursos clínicos integrativos en estudiantes de pregrado de medicina / Perception of medical students about formative assessments during clinical courses

Background: Formative evaluation is a range of formal assessment employed by professors during the teaching process in order to modify curriculum activities, to improve student attainment. For students, it is helpful to evaluate their learning process. Although recommended, it is seldom used. Aim: To evaluate the perception and performance of medical students subjected to formative assessments during an integrative clinical course. Material and Methods: Fourth year medical students that participated in a multiple choice formative assessment, similar to the final exam during 2007 and 2008, responded a survey about the usefulness and quality of such assessment. Student achievement was expressed as the percentage of correct answers of the tests. Results: The formative assessment was answered by 99% of students. In 2007 97% of students considered the experience as excellent or very good and 92% evaluated it as useful or very useful. During 2008 the figures were 89% and 79%. The students outlined that this assessment oriented their study, allowed them to discover their weaknesses and have a perception of the degree of difficulty of the final exam. Over 90% of students that took the formative evaluation, improved their academic achievement. Conclusions: Formative assessments are well evaluated by medical students and improve their academic achievement.