Otological complaints and concerns and communication difficulties of aged individuals

PURPOSE: To investigate the otological complaints and concerns of aged individuals, as well as the communication difficulties they face. METHODS: Fifty elderly subjects (eight men and 42 women) with ages ranging from 61 to 90 years were evaluated. All of them carried out an anamnesis and hearing tests, and presented symmetrical descending audiometric configuration. In this study, anamnesis data and the correlations between otological complaints and the degrees of hearing loss were presented and discussed. RESULTS: Hearing loss complaint was present in 70% of the sample and was associated to the concern about one's own hearing loss, with complaints of communication difficulties and also with the number situations in which the difficulty is observed (presence of background noise was the most cited aspect). Tinnitus complaint (52%) presented an association with concern involving this same aspect, whereas dizziness (38%), besides similar correlation, revealed an association with communication difficulty. There was a significant statistical association among degree of hearing loss in both low and middle frequencies and complaints of hearing loss and dizziness. In high frequencies, these correlations also occurred, along with a significant statistical association between degree of the hearing loss and complaint of communication difficulty. CONCLUSIONS: Of the otological complaints, hearing loss complaint was predominant among the elderly subjects of this study. Age and gender had no influence on the otological complaints and concerns. Degree of hearing loss influenced otological complaints of hearing loss, dizziness and communication difficulty.OBJETIVO: Investigar as queixas e as preocupações otológicas de indivíduos idosos, bem como as dificuldades de comunicação enfrentadas por esta população. MÉTODOS: Foram avaliados 50 idosos (61 a 90 anos de idade), sendo 8 homens e 42 mulheres, que apresentavam configuração audiométrica descendente simétrica. Os pacientes foram submetidos a uma entrevista e testes auditivos. Neste artigo, foram apresentados e discutidos os dados da entrevista e a correlação das queixas otológicas com os graus de perda auditiva. RESULTADOS: A queixa de perda auditiva esteve presente em 70% da amostra e revelou associação com a preocupação quanto à própria perda, com o queixa de dificuldade de comunicação e com a quantidade de situações nas quais a dificuldade é percebida, sendo a presença do ruído de fundo o aspecto mais citado. A queixa de zumbido (52%) apresentou associação com a preocupação envolvendo o próprio zumbido, enquanto que a tontura (38%), além de semelhante correlação, revelou associação com a dificuldade de comunicação. Ocorreu uma associação estatisticamente significante do grau da perda nas freqüências baixas e médias com a queixa de perda auditiva e de zumbido, enquanto que nas freqüências altas, além destas correlações, também ocorreu associação estatisticamente significante da perda auditiva com a queixa de dificuldade de comunicação. CONCLUSÕES: Dentre as queixas otológicas, a queixa de perda auditiva foi predominante entre os idosos. A idade e o gênero não influenciaram as queixas e as preocupações otológicas. O grau de perda auditiva influenciou as queixas otológicas de perda auditiva, de zumbido e a dificuldade de comunicação.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de FonoaudiologiaHospital CEMAsLaboratório Delboni Auriemo Medicina DiagnósticaUNIFESP, Depto. de FonoaudiologiaSciEL

Study of the fundamental frequency in elderly women with hearing loss

SummaryIncreased life expectancy raises demands for special attention for the elderly population; speech, language and hearing science deals with their communication disorders. Hearing loss is a common disorder affecting this age group. It is known that the auditory feedback system is essential to human vocalizing, as it organizes voice production. Aim: To assess and correlate the hearing system and the Fundamental Frequency (F0) of women who have variable degrees of sensorineural hearing loss. Material and Method: a cross-sectional descriptive study. 30 women with a mean age of 75.95 (SD = 7,41) were included. Inclusion criteria were: symmetric sensorineural hearing loss, a high-frequency sloping configuration, and a type A tympanogram. Subjects underwent Pure Tone Audiometry, a Word Recognition Test, Tympanometry, and Voice Assessment. Results: Patients with higher degrees of hearing loss showed an increased fundamental frequency. Conclusion: In aged individuals with hearing loss, audiovocal monitoring is altered, resulting in voice parameter changes

Hearing and voice: its interface in ageing

Introduction: According to data from the Brazilian Institute of Geography and Statistics, the life expectancy estimated at birth in Brazil, for both sex, increased to 71,3 years. The life expectancy increase reflects in special attention necessities to the elderly population, and it falls to the Speech-Language and Hearing Science the parcel that concerns to the communication disorders. The hearing loss, among others, is one of the disorders referred to this age group. It is known that the auditory feedback system is primordial on human vocalizing, organizing the vocal production. Objective: To assess and correlate the hearing and vocal production of elderly who have neurossensorial hearing loss with different degrees and audiometric configurations. Method: Participated in this study 40 subjects from whom 10 were male and 30 were female, whose ages varied from 60 to 93 years old, mean age of 75,95 (SD = 7,41), and who were sent from the Gerontology and Geriatrics Institute of the Federal University of São Paulo. The inclusion criteria considered the ones with symmetric neurossensorial hearing loss, descending configuration and a type A tympanogram. The subjects were submitted to an anamnesis, an auditory assessment (Pure Tone Audiometry, Word Recognition Score and Tympanometry) and vocal assessment. The audiometry were classified into degrees for low frequencies (500Hz, 1 e 2 KHz) and high frequencies (2, 3 e 4 KHz) based on Silman and Silverman (1997). The acoustic analysis of the vocal parameters was done through the CSL Program, from Kay Elemetrics Corporation, 1993/1994 version, MVDP module. Results: In the higher hearing loss degrees, an increase of the fundamental frequency. The maximum phonatory extension, in semitones, and maximum phonation time decreased in hearing losses with higher degrees, while the mean speech loudness increased. Conclusion: In an elderly individual with hearing loss, in whom it is expected an altered auditory-vocal monitoring, the higher hearing loss degree, the greater modifications observed on vocal parameters.Introdução: De acordo com dados do Instituto Brasileiro de Geografia e Estatística (IBGE), a esperança de vida estimada ao nascer no Brasil, para ambos os sexos, subiu para 71,3 anos. O aumento da expectativa de vida reflete em necessidades especiais de atenção à população idosa, cabendo à fonoaudiologia a parcela de cuidado aos distúrbios da comunicação. A deficiência auditiva, dentre outros, é um dos distúrbios referidos para esta faixa etária. Sabe-se que o sistema de feedback auditivo é primordial na vocalização humana, organizando a produção vocal. Objetivo: Avaliar e correlacionar a audição e a produção vocal de indivíduos idosos, portadores de perda auditiva neurossensorial de diferentes graus e configurações audiométricas. Método: participaram deste trabalho 40 sujeitos, sendo 10 do sexo masculino e 30 do sexo feminino, com idades de 60 a 93 anos, média de 75,95 (DP = 7,41) encaminhados pelo Instituto de Geriatria e Gerontologia da Universidade Federal de São Paulo. O critério de inclusão considerou portadores de perda auditiva neurossensorial simétrica de configuração descendente e curva timpanométrica do tipo A. Os sujeitos foram submetidos à anamnese, avaliação auditiva (audiometria tonal limiar, IPRF e imitanciometria) e avaliação vocal. As audiometrias foram classificadas em graus para as freqüências baixas (500Hz, 1 e 2 KHz) e para as freqüências altas (2, 3 e 4 KHz) de acordo com Silman e Silverman (1997). A análise acústica dos parâmetros vocais foi feita através do programa CSL da Kay Elemetrics Corporation versão 1993/1994, módulo MVDP. Resultados: Em graus de perda auditiva mais elevados, ocorreu aumento da freqüência fundamental. A extensão fonatória máxima, em semitons, e o tempo máximo de fonação diminuíram em graus mais elevados de perda auditiva, enquanto que a média da intensidade de fala aumentou. Conclusão: No indivíduo idoso com deficiência auditiva, no qual se espera um monitoramento auditivo-vocal alterado, observou-se que quanto mais elevado o grau da perda auditiva, maiores as modificações observadas nos parâmetros vocais.TEDEBV UNIFESP: Teses e dissertaçõe

Study of the fundamental frequency in elderly women with hearing loss Summary

Increased life expectancy raises demands for special attention for the elderly population; speech, language and hearing science deals with their communication disorders. Hearing loss is a common disorder affecting this age group. It is known that the auditory feedback system is essential to human vocalizing, as it organizes voice production. Aim: To assess and correlate the hearing system and the Fundamental Frequency (F0) of women who have variable degrees of sensorineural hearing loss. Material and Method: a crosssectional descriptive study. 30 women with a mean age of 75.95 (SD = 7,41) were included. Inclusion criteria were: symmetric sensorineural hearing loss, a high-frequency sloping configuration, and a type A tympanogram. Subjects underwent Pure Tone Audiometry, a Word Recognition Test, Tympanometry, and Voice Assessment. Results: Patients with higher degrees of hearing loss showed an increased fundamental frequency. Conclusion: In aged individuals with hearing loss, audiovocal monitoring is altered, resulting in voice parameter changes

Evolução da perda auditiva no decorrer do envelhecimento Hearing loss in aging

A perda auditiva associada ao envelhecimento refere-se à soma de perdas auditivas resultantes da degeneração fisiológica causada por exposição ao ruído, agentes ototóxicos e prejuízos causados por desordens e tratamentos médicos. Afeta cerca de 60% de todas as pessoas com idade acima de 65 anos. OBJETIVO: Verificar a degeneração do sistema auditivo no decorrer da idade através de medidas supraliminares e de sensibilidade auditiva. MATERIAL E MÉTODO: Estudo de coorte contemporânea com corte transversal. Foram avaliados 211 idosos, com idade média de 75,24 anos, sendo 61 do sexo masculino e 150 do sexo feminino. Os indivíduos foram submetidos a uma anamnese e à avaliação audiológica básica e divididos em quatro grupos, de acordo com a faixa etária. RESULTADOS: Declínio significativo do limiar nas 4 faixas etárias estabelecidas, diminuição do índice percentual de reconhecimento de fala, diferença significante com relação ao gênero. CONCLUSÃO: Com o avanço da idade, ocorreu um aumento gradual no grau da perda auditiva, os homens apresentaram limiares mais rebaixados na freqüência de 4000Hz em comparação com as mulheres e na inteligibilidade de fala observou-se decréscimo gradativo com o aumento da idade.<br>Aging is a natural consequence of a society developing process. The city of São Paulo has almost one million people who are above sixty years of age. Age-related hearing loss equals the total hearing loss resulted from cell degeneration caused by noise exposure, ototoxic agents and the loss caused by disorders and medical treatments. AIM: To study age-related hearing degeneration by means of higher thresholds and hearing sensitivity measures. MATERIALS AND METHODS: Cross-sectional contemporary cohort study in which we assessed 211 elderly patients with mean age of 75.24 years, of whom 61 were females and 150 were males. The subjects were submitted to an interview and a conventional audiometric assessment; and later divided into four groups according to age range. RESULTS: Significant threshold drop in the four established age groups, decrease in speech recognition ratio, and a significant difference regarding gender. CONCLUSION: As age advanced there was a gradual increase in hearing loss, men showed a lower threshold in the 4000Hz frequency when compared to women, and in the speech intelligibility test thre was also a gradual decrease with aging