Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal

Susan D. Emmett; Jane Schmitz; Joseph Pillion; Lee Wu; Subarna K. Khatry; Sureshwar L. Karna; Steven C. LeClerq; Keith P. West

doi:10.1097/MAO.0000000000000619

Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal

Susan D. Emmett, Jane Schmitz, Joseph Pillion, Lee Wu, Subarna K. Khatry, Sureshwar L. Karna, Steven C. LeClerq, Keith P. West

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Objective: To evaluate the association between adolescent and young-adult hearing loss and nonverbal intelligence in rural Nepal. Study design: Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults. Setting: Sarlahi District, southern Nepal. Patients: Seven hundred sixty-four individuals aged 14 to 23 years. Intervention: Evaluation of hearing loss, defined by World Health Organization criteria of pure-tone average greater than 25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally. Main outcome measure: Nonverbal intelligence, as measured by the Test of Nonverbal Intelligence, 3rd Edition standardized score (mean, 100; standard deviation, 15). Results: Nonverbal intelligence scores differed between participants with normal hearing and those with bilateral (p = 0.04) but not unilateral (p = 0.74) hearing loss. Demographic and socioeconomic factors including male sex; higher caste; literacy; education level; occupation reported as student; and ownership of a bicycle, watch, and latrine were strongly associated with higher nonverbal intelligence scores (all p G 0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% confidence interval, j5.56 to j0.75; p = 0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal intelligence score based on unilateral hearing loss (0.97; 95% confidence interval, j1.67 to 3.61; p = 0.47). Conclusion: Nonverbal intelligence is adversely affected by bilateral hearing loss even at mild hearing loss levels. Socio economic well-being appears compromised in individuals with lower nonverbal intelligence test scores.

Original language	English (US)
Pages (from-to)	86-92
Number of pages	7
Journal	Otology and Neurotology
Volume	36
Issue number	1
DOIs	https://doi.org/10.1097/MAO.0000000000000619
State	Published - Jan 1 2015

Keywords

Cognition
Hearing loss
Nepal
Nonverbal intelligence

ASJC Scopus subject areas

Otorhinolaryngology
Sensory Systems
Clinical Neurology

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10.1097/MAO.0000000000000619

Cite this

@article{98f4efe34acd47f39c975dd749ec9872,

title = "Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal",

abstract = "Objective: To evaluate the association between adolescent and young-adult hearing loss and nonverbal intelligence in rural Nepal. Study design: Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults. Setting: Sarlahi District, southern Nepal. Patients: Seven hundred sixty-four individuals aged 14 to 23 years. Intervention: Evaluation of hearing loss, defined by World Health Organization criteria of pure-tone average greater than 25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally. Main outcome measure: Nonverbal intelligence, as measured by the Test of Nonverbal Intelligence, 3rd Edition standardized score (mean, 100; standard deviation, 15). Results: Nonverbal intelligence scores differed between participants with normal hearing and those with bilateral (p = 0.04) but not unilateral (p = 0.74) hearing loss. Demographic and socioeconomic factors including male sex; higher caste; literacy; education level; occupation reported as student; and ownership of a bicycle, watch, and latrine were strongly associated with higher nonverbal intelligence scores (all p G 0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% confidence interval, j5.56 to j0.75; p = 0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal intelligence score based on unilateral hearing loss (0.97; 95% confidence interval, j1.67 to 3.61; p = 0.47). Conclusion: Nonverbal intelligence is adversely affected by bilateral hearing loss even at mild hearing loss levels. Socio economic well-being appears compromised in individuals with lower nonverbal intelligence test scores.",

keywords = "Cognition, Hearing loss, Nepal, Nonverbal intelligence",

author = "Emmett, {Susan D.} and Jane Schmitz and Joseph Pillion and Lee Wu and Khatry, {Subarna K.} and Karna, {Sureshwar L.} and LeClerq, {Steven C.} and West, {Keith P.}",

note = "Funding Information: Address correspondence and reprint requests to Susan D. Emmett, M.D., Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD 21205, U.S.A.; E-mail: semmett2@jhmi.edu This study was supported by the Bill and Melinda Gates Foundation (grant OPPGH 614, Global Control of Micronutrient Deficiency), Seattle, WA, U.S.A., the National Institutes of Health (grant 5T32DC000027-25), Bethesda, MD, U.S.A., and the Sight and Life Global Nutrition Research Institute, Baltimore, MD, U.S.A. The original vitamin A supplementation field trial in 1989 to 1991 was supported by Cooperative Agreement No. DAN 0045-A-5094 between the Office of Nutrition, U.S. Agency for International Development, Washington, and the Johns Hopkins University. This work was presented at the International Federation of Otorhinolaryngological Societies 20th World Congress, Seoul, Korea, June 1 to 5, 2013, and the World Health Organization Symposium on Primary Ear and Hearing Care, Seoul, Korea, June 4, 2013. Publisher Copyright: {\textcopyright} 2015 Lippincott Williams and Wilkins. All rights reserved.",

year = "2015",

month = jan,

day = "1",

doi = "10.1097/MAO.0000000000000619",

language = "English (US)",

volume = "36",

pages = "86--92",

journal = "Otology and Neurotology",

issn = "1531-7129",

publisher = "Lippincott Williams and Wilkins",

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TY - JOUR

T1 - Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal

AU - Emmett, Susan D.

AU - Schmitz, Jane

AU - Pillion, Joseph

AU - Wu, Lee

AU - Khatry, Subarna K.

AU - Karna, Sureshwar L.

AU - LeClerq, Steven C.

AU - West, Keith P.

N1 - Funding Information: Address correspondence and reprint requests to Susan D. Emmett, M.D., Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St., Room E2519, Baltimore, MD 21205, U.S.A.; E-mail: semmett2@jhmi.edu This study was supported by the Bill and Melinda Gates Foundation (grant OPPGH 614, Global Control of Micronutrient Deficiency), Seattle, WA, U.S.A., the National Institutes of Health (grant 5T32DC000027-25), Bethesda, MD, U.S.A., and the Sight and Life Global Nutrition Research Institute, Baltimore, MD, U.S.A. The original vitamin A supplementation field trial in 1989 to 1991 was supported by Cooperative Agreement No. DAN 0045-A-5094 between the Office of Nutrition, U.S. Agency for International Development, Washington, and the Johns Hopkins University. This work was presented at the International Federation of Otorhinolaryngological Societies 20th World Congress, Seoul, Korea, June 1 to 5, 2013, and the World Health Organization Symposium on Primary Ear and Hearing Care, Seoul, Korea, June 4, 2013. Publisher Copyright: © 2015 Lippincott Williams and Wilkins. All rights reserved.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: To evaluate the association between adolescent and young-adult hearing loss and nonverbal intelligence in rural Nepal. Study design: Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults. Setting: Sarlahi District, southern Nepal. Patients: Seven hundred sixty-four individuals aged 14 to 23 years. Intervention: Evaluation of hearing loss, defined by World Health Organization criteria of pure-tone average greater than 25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally. Main outcome measure: Nonverbal intelligence, as measured by the Test of Nonverbal Intelligence, 3rd Edition standardized score (mean, 100; standard deviation, 15). Results: Nonverbal intelligence scores differed between participants with normal hearing and those with bilateral (p = 0.04) but not unilateral (p = 0.74) hearing loss. Demographic and socioeconomic factors including male sex; higher caste; literacy; education level; occupation reported as student; and ownership of a bicycle, watch, and latrine were strongly associated with higher nonverbal intelligence scores (all p G 0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% confidence interval, j5.56 to j0.75; p = 0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal intelligence score based on unilateral hearing loss (0.97; 95% confidence interval, j1.67 to 3.61; p = 0.47). Conclusion: Nonverbal intelligence is adversely affected by bilateral hearing loss even at mild hearing loss levels. Socio economic well-being appears compromised in individuals with lower nonverbal intelligence test scores.

AB - Objective: To evaluate the association between adolescent and young-adult hearing loss and nonverbal intelligence in rural Nepal. Study design: Cross-sectional assessment of hearing loss among a population cohort of adolescents and young adults. Setting: Sarlahi District, southern Nepal. Patients: Seven hundred sixty-four individuals aged 14 to 23 years. Intervention: Evaluation of hearing loss, defined by World Health Organization criteria of pure-tone average greater than 25 decibels (0.5, 1, 2, 4 kHz), unilaterally and bilaterally. Main outcome measure: Nonverbal intelligence, as measured by the Test of Nonverbal Intelligence, 3rd Edition standardized score (mean, 100; standard deviation, 15). Results: Nonverbal intelligence scores differed between participants with normal hearing and those with bilateral (p = 0.04) but not unilateral (p = 0.74) hearing loss. Demographic and socioeconomic factors including male sex; higher caste; literacy; education level; occupation reported as student; and ownership of a bicycle, watch, and latrine were strongly associated with higher nonverbal intelligence scores (all p G 0.001). Subjects with bilateral hearing loss scored an average of 3.16 points lower (95% confidence interval, j5.56 to j0.75; p = 0.01) than subjects with normal hearing after controlling for socioeconomic factors. There was no difference in nonverbal intelligence score based on unilateral hearing loss (0.97; 95% confidence interval, j1.67 to 3.61; p = 0.47). Conclusion: Nonverbal intelligence is adversely affected by bilateral hearing loss even at mild hearing loss levels. Socio economic well-being appears compromised in individuals with lower nonverbal intelligence test scores.

KW - Cognition

KW - Hearing loss

KW - Nepal

KW - Nonverbal intelligence

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SN - 1531-7129

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JO - Otology and Neurotology

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IS - 1

ER -

Hearing Loss Is Associated With Decreased Nonverbal Intelligence in Rural Nepal

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