Published on May 20th, 20210
Research on Hearing and Aging in the Canadian Longitudinal Study of Aging
Written By: M. Kathleen Pichora-Fuller
Recent Funding Announcement and Background
In 2021, the Government of Canada announced an investment of $9.6M for the infrastructure needed to renew and extend the Canadian Longitudinal Study on Aging (CLSA). Planning for the CLSA started in 2001 and the research platform was launched in 2010. The over-arching goal of the CLSA is to generate knowledge that promotes the health and well-being of older adults and informs the development of programs and policies for Canada’s aging population. Just over 50,000 Canadians, who were between 45 and 85 years of age at the time of recruitment, are being followed for 20 years, with data collected from each individual every three years until 2033 or their death. Of these 50,000 participants, 20,000 living across Canada provide data by telephone and another 30,000 provide data at test sites in 10 different cities across the country. The CLSA is led by Dr. Parminder Raina, the lead principal investigator at McMaster University, and co-principal investigators Dr. Christina Wolfson of McGill University and Dr. Susan Kirkland of Dalhousie University, along with a national team of researchers who lead CLSA sites at Memorial University, Université de Sherbrooke, Bruyère Research Institute/University of Ottawa, University of Manitoba, University of Calgary, Simon Fraser University, University of British Columbia and the University of Victoria. The Canadian Foundation for Innovation funds awarded in 2021 will be used to renew infrastructure, including the development of a new remote data analysis platform and new infrastructure for linking the CLSA data with provincial health data, the integration of new equipment to assess mobility, vision and brain health, well as new equipment for proteomics and metabolomic analyses of biospecimens and upgrades to existing CLSA equipment and software.
The data being collected include more than 4,000 variables covering a wide range of physical, mental and social measures. Research using the CLSA platform is being conducted by more than 160 researchers from 26 universities across Canada. Notably, since the inception of CLSA in 2001, Kathy Pichora-Fuller has served as the audiology expert for CLSA. As a member of the Clinical Working Group, she worked with the CLSA staff to develop and monitor the protocol for pure-tone audiometry. Since the beginning of the CLSA, pure-tone audiometry has been conducted every three years on the 30,000 participants who provide data at the CLSA test sites. The Hearing Handicap for the Elderly (Weinstein, 1986) screening questionnaire was added to the CLSA self-report questions on hearing loss in the second cycle of data collection. In the most recent cycle, hearing is also measured using the Canadian Digit Triplet Test (CDTT) in Canadian English and French (Giguère et al., 2020); Kathy Pichora-Fuller and Christian Giguère have worked with the CLSA staff on implementing the test protocol for the CDTT speech-in-noise test in the CLSA. In the next cycle, tinnitus questions will be added.
Hearing and Aging Research
The inclusion of hearing measures in the CLSA makes it possible to do unprecedented, complex cross-sectional and longitudinal statistical analyses in a very large sample of older Canadians to examine the connections among hearing measures and between hearing measures and other health measures. To date, an inter-professional team of researchers have published several peer-reviewed papers from studies funded by the Canadian Institutes of Health Research. The first publication examined associations between self-reported hearing and vision abilities, as well as various social factors such as social network size, availability of social support, social participation and loneliness; results showing that those with self-reported hearing problems had lower availability of social support and more loneliness than peers without hearing problems were presented with a discussion of clinical implications and recommendations for family practice physicians (Mick et al., 2018). Subsequent publications found weak evidence that social factors mediated significant associations between sensory and cognitive measures (Hämäläinen et al., 2019). This year, we have published a comprehensive report on the prevalence of hearing and vision loss in older Canadians (Mick et al., 2021) and also an analysis showing how demographic and social factors help to explain discrepancies between self-reported hearing ability and hearing measured using pure-tone audiometry (Hämäläinen et al., 2021). Currently, using CLSA longitudinal data, we are collaborating with experts in genetics and endocrinology to investigate how genetic and social factors are related to hearing loss and the associations of hearing loss with cognition and other physical health conditions (e.g., diabetes, cardiovascular disease).
Importance of CLSA Research on Hearing and Aging
Past, present and future research using CLSA data will enable us to answer a wide range of population and public health questions concerning the causes and consequences of age-related changes in hearing loss in older Canadians. In addition to publications and conference presentations, webinars on our research have raised awareness of sensory aging and its relevance to health and aging across the CLSA network of researchers and participants.
- CLSA Webinar Series: Hearing loss and healthy aging
- Combined Vision and Hearing Loss in the CLSA
- The cross-sectional relationship between sensory status and cognitive function in CLSA participants
This research is already shaping directions for practice and policy in hearing care, as well as in aging health care more broadly.
Giguère, C., Lagacé, J., Ellaham, N., Pichora-Fuller, M.K., Goy, H., Bégin, C., Alary, E., & Bowman, R. (2020). Development of the Canadian Digit Triplet Test in English and French. Journal of the Acoustical Society of America Express Letters. 147, EL252. https://doi.org/10.1121/10.0000825
Hämäläinen, A., Phillips, N. A., Wittich, W., Pichora-Fuller, M. K., & Mick, P. T. (2019). Sensory-cognitive associations are only weakly mediated by social factors in the Canadian Longitudinal Study of Aging. Scientific Reports, 9(1), 19660. doi: 10.1038/s41598-019-55696-5
Hämäläinen, A., Pichora-Fuller, M. K., Wittich, W., Phillips, N. A., & Mick, P. T. (2021). Self-report measures of hearing and vision in older adults participating in the Canadian Longitudinal Study of Aging are explained by behavioral sensory measures, demographic, and social factors, Ear and Hearing: March 19, 2021 PAP doi: 10.1097/AUD.0000000000000992
Mick, P. T., Hämäläinen, A., Kolisang, L., Pichora-Fuller, M.K., Phillips, N. A., Guthrie, D. M., & Wittich, W. (2021). The prevalence of hearing, vision, and dual sensory loss in older Canadians: An analysis of data from the Canadian Longitudinal Study on Aging. Canadian Journal on Aging, 40(1), 1-22. DOI: https://doi.org/10.1017/S0714980820000070
Mick, P. T., Parfyonov, M., Wittich, W., Phillips, N. A., & Pichora-Fuller, M.K. (2018). The association between sensory loss and social networks, participation, support and loneliness. Canadian Family Physician, 64, e33-41. https://pubmed.ncbi.nlm.nih.gov/29358266/
Weinstein, B. (1986) Validity of a screening protocol for identifying elderly people with hearing problems. ASHA, 28(5), 41–45.