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Coping with dual sensory impairment or deafblindness can be a challenging task for an individual and for the caregiver. Currently limited information is available hence the objective of this study is to determine the profile and quality of life for children with dual sensory impairment or deafblindness. It is hoped that with this information, better rehabilitation programs can be designed for children with deafblindness in Malaysia. A purposive sampling was adopted. Children with dual sensory impairment were invited to participate in the study. Demographic and hearing loss information was extracted from the children’s medical records. Face to face interviews with parents were conducted using the SF-36 quality of life questionnaire. Vision assessment comprising visual acuity, refraction, cover test, external ocular examination and children’s behaviour observations was conducted. Four children were identified based on sample size calculation and fulfilled the dual sensory impairment criteria out of the 44 children screened. The mean age was 9.3 ± 2.9 years old. Majority of the children were of Indian ethnicity. The category of deafblindness was congenital deafblindness with rubella as the main cause. All the children were premature babies but had a normal birth weight. The hearing profile showed the majority of them had bilateral profound hearing loss with mean pure tone average ranging between 50 dBHL and 120 dBHL. The main type of hearing problem was sensorineural and the majority of children owned hearing aids. The visual profile of the deafblindness children revealed either light perception (LP) and categorised as blind or low to moderate myopia. A majority had esotropia. All the children used braille as a visual aids and children with residual vision used closed circuit television (CCTV). Tactile methods were the main means for communication and majority of the children used a white cane. Behaviour and external observation assessments concurred with the hearing and vision impairment manifested. Quality of life in these subjects was lower in 7 out of 8 SF-36 dimensions as compared to normative values. Congenital deafblindness is the main category found among the children in this study and they had profound vision and hearing losses. Tactile methods are the main means of communication for these children. Their quality of life was affected and introducing deafblindness rehabilitation, which includes a combination of hearing and low vision rehabilitation, will be able to assist them in coping with their daily activities. DOI : http://dx.doi.org./10.17576/JSKM-2019-1702-18

The present study aimed to examine the prevalence of dual sensory impairment, and to identify its risk factors among community-dwelling older adults in Selangor. Methods Secondary analysis was carried out on data collected by the Grand Challenge Project among older adults aged ≥65 years from Selangor. Data on sociodemographic information, medical history, cognitive function and functional performance were obtained through face-to-face interviews using standardized questionnaires. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while hearing was assessed using pure-tone audiometry. Descriptive analysis was used to measure the prevalence of the impairments, and logistic regression analysis was used to identify the risk factors. Results The prevalence of dual sensory impairment and hearing impairment were at 10.5% and 76.2% respectively. Multivariate logistic regression analysis revealed that participants with lower cognitive scores were associated with dual sensory impairment (odds ratio, 0.90; 95% confidence interval, 0.83-0.98), while smoking was found associated with hearing impairment (odds ratio, 6.58; 95% confidence interval, 1.51-28.65). Conclusion Dual sensory impairment is common among older adults in Selangor. The association between dual sensory impairment and cognitive function suggests the need to have visual and hearing screening on older adults for early detection particularly those at risk of cognitive impairment. The prevalence of hearing impairment was reported high among older adults and smokers appeared to be at higher risk of the impairment. Geriatr Gerontol Int 2020; ••: ••-••.

(1) Background: Cognitive frailty (CF) is the simultaneous presence of physical frailty and cognitive impairment with an increased risk of dementia. Considering that the risk factors of CF are mostly elucidated from cross-sectional studies, we conducted a community-based longitudinal study to determine the incidence and the predictors of CF among Malaysian older adults., (2) Methods: Out of 490 older adults participating in the Malaysian Towards Useful Aging (TUA) study, 282 were successfully followed-up at five-years for an analysis of the CF incidence. CF was defined as a comorbid physical frailty (&gt, 1 Fried criteria) and mild cognitive impairment (Petersen criteria). A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, physical function, dietary intake, psychosocial, and biochemical indices. Univariate analyses were performed for each variable, followed by a regression analysis to identify the predictors of CF that accounted for confounding effects between the studied factors, (3) Results: The incidence rate of CF was 7.1 per 100 person-years. Advancing age (OR=1.12, 95% CI:1.04-1.21, p &lt, 0.05), depression (OR=1.20, 95% CI:1.05-1.37, p &lt, 0.05), decreased processing speed, assessed by a lower digit symbol score (OR=0.67, 95%CI:0.0.56-0.80, p &lt, 0.05), decreased functional mobility measured using Timed-Up-and-Go (TUG) (OR=1.23, 95% CI:1.04-1.46, p &lt, 0.05), low vitamin D intake (OR:0.36, 95% CI:0.14-0.93, p &lt, 0.05) and physical frailty (OR=2.16, 95% CI:1.02-4.58, p &lt, 0.05) were predictors for CF incidence, and (4) Conclusions: Our study results could be used as an initial reference for future studies to formulate effective preventive management and intervention strategies to decelerate CF development among older adults.

Objectives: Studies in cognitive aging demonstrated inconsistent association between hearing and cognition in older adults. Furthermore, it is still unclear if hearing loss at high frequencies, which is the earliest to be affected, is associated with cognitive functioning. This study aimed to determine the association between global cognitive status and pure tone average (PTA) at 0.5, 1, and 2 kHz (PTA low) and PTA at 4 and 8 kHz (PTA high). Methods: This study involved 307 adults aged 60 years and older. Participants had their hearing and cognition measured using pure tone audiometry and Mini Mental State Examination (MMSE), respectively. Results: Pure tone average (low) accounted for significant but minimal amount of variance in measure of MMSE. Multiple regression analyses were also performed on normal and impaired hearing cohorts and cohorts with younger (60-69 years) and older (≥70 years) groups. The results revealed a significant relationship between PTA (low) and MMSE only in the younger age group. In contrast, no significant relationship was found between PTA (high) and cognition in any of the cohorts. Conclusion: Pure tone average (low) is significantly but minimally related to measure of general cognitive status. Similar relationship is not observed between high-frequency hearing and cognition. Further research using a more comprehensive cognitive test battery is needed to confirm the lack of association between high-frequency hearing and cognition.

The aims of the present study were to determine the effects of language background on the performance of the pitch pattern sequence test (PPST) and duration pattern sequence test (DPST). As temporal order sequencing may be affected by age and working memory, these factors were also studied.Performance of tonal and non-tonal language speakers on PPST and DPST were compared.Twenty-eight native Mandarin (tonal language) speakers and twenty-nine native Malay (non-tonal language) speakers between seven to nine years old participated in this study.The results revealed that relative to native Malay speakers, native Mandarin speakers demonstrated better scores on the PPST in both humming and verbal labeling responses. However, a similar language effect was not apparent in the DPST. An age effect was only significant in the PPST (verbal labeling). Finally, no significant effect of working memory was found on the PPST and the DPST.These findings suggest that the PPST is affected by tonal language background, and highlight the importance of developing different normative values for tonal and non-tonal language speakers.

Introduction: Little is known about the prevalence of hearing loss and the usefulness of self-reported hearing loss among older adults in Malaysia. Aim: We conducted a population-based study to investigate the prevalence of self-reported hearing problem and its relationship with audiometric hearing thresholds in older adults in Selangor, Malaysia. We also investigated demographic factors that were associated with the self-reported hearing loss. Materials and Methods: The participants were recruited from Selangor using multi-stage clustered sampling involving 324 participants aged between 60 to 88 years (68.3±5.9 years). All participants underwent a face-to-face interview and pure tone audiometry. Self-reported hearing loss was obtained using three questions. Results: The prevalence of self-reported hearing problems was 53.4%. This prevalence did not differ significantly among age group, gender, race and education level (p>0.05). Univariate and logistic regression analyses found that tinnitus and Pure Tone Average (PTA) of at least moderate hearing loss at 0.5 kHz to 4 kHz contributed significantly to the likelihood of self-reported hearing problem. Participants with tinnitus and participants with PTA of at least moderate hearing loss at 0.5 kHz to 4 kHz were twice as likely to report hearing problem than their counterparts. The questions yielded poor sensitivity in identifying at least mild loss and moderate sensitivity for at least moderate hearing loss. Conclusion: The present study highlights the need for a more effective self-report inventory or audiometry instrument that is less sensitive to background noise to better estimate hearing loss prevalence among adults in Malaysia.

Objective: This study was conducted to evaluate the speech perception of Malaysian Chinese adults using the Taiwanese Mandarin HINT (MHINT-T) and the Malay HINT (MyHINT). Design: The MHINT-T and the MyHINT were presented in quiet and noise (front, right and left) conditions under headphones. Results for the two tests were compared with each other and with the norms for each test. Study sample: Malaysian Chinese native speakers of Mandarin (N = 58), 18–31 years of age with normal hearing. Results: On average, subjects demonstrated poorer speech perception ability than the normative samples for these tests. Repeated measures ANOVA showed that speech reception thresholds (SRTs) were slightly poorer on the MHINT-T than on the MyHINT for all test conditions. However, normalized SRTs were poorer by 0.6 standard deviations for MyHINT as compared with MHINT-T. Conclusions: MyHINT and MHINT-T can be used as norm-referenced speech perception measures for Mandarin-speaking Chinese in Malaysia.

Objective: With the development of more sophisticated and sensitive measures of auditory dysfunction, both the Audioscan test and Bekesy audiometry can provide detailed information on hearing status between the octaves, which has clinical importance. This study investigated the reliability and validity of Audioscan and Bekesy audiometry. Method: Audioscan and Bekesy audiometry were undertaken at a comparable sweep rate in 21 subjects with normal hearing. Each subject underwent conventional pure tone audiometry, Audioscan and Bekesy audiometry. Test sessions were conducted on four consecutive days. Results: The results indicate that more than 90% of participants had variability of hearing threshold of less than 10dB at all frequencies. Median variances for thresholds obtained from Audioscan were less than 10dB2 for all frequencies except 4.0 kHz. In contrast, thresholds obtained from Bekesy showed greater variance, more than 15dB2 at all frequencies when it was undertaken at the same sweep rate. Audioscan results were in excellent agreement with the PTA at all frequencies except at 0.25, 6 and 8 kHz, whereas Bekesy results differed significantly from PTA at all frequencies except at 6 kHz. Conclusion: Data from the present study indicate that the Audioscan can provide reliable and valid hearing thresholds. However, a slow sweep rate appears to be more desirable for Bekesy audiometry to improve its reliability and validity in detecting hearing sensitivity.

To investigate auditory dysfunction in patients with tinnitus and normal hearing thresholds using two sensitive audiological measures.The study was designed to investigate the characteristics of Audioscan and DPOAE tests in tinnitus patients with normal hearing thresholds. Audioscan and DPOAE notches were analysed and compared. All tests were performed in a sound-treated chamber or in a sound-treated room.Forty-five tinnitus patients with normal hearing thresholds were examined following a written clinical protocol.The averaged hearing levels obtained from tinnitus participants were significantly worse at high frequencies than those derived from the normative data. There was a significantly higher prevalence of Audioscan and DPOAE notches, whose central frequencies matched tinnitus frequencies in the mid-frequency regions, but not in the low- and high-frequency regions. A significant correlation was found between the centre frequencies of the Audioscan notches and the DPOAE notches from 500 to 4000 Hz.Tinnitus in different frequency regions may be associated with different underlying mechanisms of tinnitus generation. Some negative results on the Audioscan and DPOAE notches matching tinnitus pitches may be due to a limited set of discrete frequencies used for the tinnitus pitch matching test.

INTRODUCTION: The general consensus on the roles of hearing loss in triggering tinnitus seems not applicable in patients with normal hearing thresholds. The absence of hearing loss on the audiogram in this group of patients poses a serious challenge to the cochlear theories in explaining tinnitus generation in this group of patients. OBJECTIVE: To scrutinize auditory functioning in a sample of tinnitus subjects with normal hearing thresholds and non-tinnitus normally hearing control participants using transient evoked and distortion product otoacoustic emission (TEOAE and DPOAE) and Threshold Equalising Noise (TEN) test. METHODS: Twenty-seven tinnitus adult patients with normal hearing thresholds and 27 normally hearing volunteers were tested with TEOAE, DPOAE and TEN test. RESULTS: Abnormal TEOAE was significantly more in tinnitus group than in controls. No significant difference was observed in DPOAE and TEN test. Only one patient was found with a positive TEN test result, who was confirmed by Magnetic Resonance Imaging to have acoustic neuroma on the affected ear. CONCLUSION: These results suggest the possible existence of subtle auditory deficit in normally hearing tinnitus patients, which may be an early sign of diseases that are only diagnosed after the onset of hearing loss.