Browsing by Person "Johnson, Christine"

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ALLIANCE report for the CPG on Deafness - Dementia Assessments for people with Deafness, Deafblindness or Visual Impairment
(Health and Social Care Alliance Scotland, 2025-04-07) Johnson, Christine
A working group of the Cross-party Group on Deafness aims to improve care pathways and support for people with dementia who also experience Deafness, Deafblindness or Visual Impairment, including BSL users. This working group, also supported by the Cross-party Group on Visual Impairment, is developing the first framework of sensory care standards for Scotland. The framework of sensory care standards will centre around several core areas, one of which will be sensory assessment. Identifying Deafness, Deafblindness or Visual Impairment before people are assessment for dementia is important, because it enables tailored communication which meets people’s needs. This fosters informed decision making and independence. It also enables GPs and other health and medical professionals to select different memory/dementia assessment tools – rather than using standard tools that require people to see and hear. Not identifying or considering Deafness, Deafblindness or Visual Impairment means that assessments and support planning are unlikely to be appropriately tailored to the needs and rights of individuals. The working group wanted to know if or how sensory assessments feature as part of any dementia assessment pathway in Scotland, or during post-diagnostic support. We explored the practices of health and medical professionals who carry out memory/dementia assessments for people who are Deaf, Deafblind or who have a Visual Impairment, including BSL users, and the eye and hearing care specialists who assess sight and hearing. From August to October 2024 the ALLIANCE collected responses to four online surveys, each one targeted at a specific group of health and medical professionals in Scotland. The major findings from this research are that there are large variations in practice in the assessment of dementia for people with Deafness, Deafblindness and Visual Impairment, including BSL users. There is also a lack of integrated care pathways between dementia assessments performed by GPs and other health and medical professionals, and sensory assessments from eye and hearing care services. Our findings include: Only 6% of GPs and 12% of other health and medical professionals specified that they would assess both sight and hearing as an integrated part of assessing memory/dementia. Methods used to assess dementia risked missing Deafness, Deafblindness or Visual Impairment. GPs and other Health and Medical Professionals were largely unaware of memory/dementia assessments specifically design for people who are Deaf, Deafblind or have a Visual Impairment, and this included assessments for BSL users. A respondent who is also a professional with lived experience of supporting a relative with Deafness and now advanced dementia through diagnosis and post-diagnostic support, stated that if appropriate assessment tools had been used much earlier in the process, poor outcomes could have been avoided: “Provision is drastically lacking for deaf/blind dementia patients […] deafblind manual [users] are not considered – the hearing community typically thinks that it’s all the same language.” Based on the research findings, the ALLIANCE has published a report for the Cross-party Group on Deafness containing 26 recommendations to improve care pathways and support for people with dementia who also experience Deafness, Deafblindness or Visual Impairment, including BSL users. These recommendations will inform future work by the sensory care and dementia working group on developing the first framework of sensory care standards for Scotland.
Assessing the Joint Prevalence of Dementia and Hearing Loss in Scotland: An Epidemiological Model for Public Health Planning
(Springer, 2023-08-03) Koesters, Nils Bernd; McMenemy, Andrena; Johnson, Christine
Aim: Data in Public Health studies often comes in mismatched age groups. This study investigated how mathematical modeling techniques could be used to estimate the number of individuals with dementia and hearing loss in Scotland given heterogeneous age group data. Subject and Methods: Using established criteria for modeling hearing loss, current population level estimates from the Scottish National Records office were employed to calculate general estimates of the number of individuals with hearing loss in Scotland. Additionally, age group models developed by the European Collaboration on Dementia were used to generate estimates of the number of people with dementia in Scotland. To estimate the number of individuals with both conditions, the two models were combined in a single formula. Parameter optimization was performed on various growth models to determine the best fit to the data. Results: The Stannard growth model was found to be the best fit to the data. Conclusion: The prevalence of hearing loss, dementia, and their co-occurrence exhibit a sigmoidal pattern, which is well-captured by the Stannard growth model, a logistic, sigmoidal type model. This study demonstrates the potential of mathematical modeling to provide nuanced and robust estimates of the prevalence of hearing loss, dementia, and their co-occurrence given heterogeneous data sources. A lookup table is provided.
THE AUDITORY BRAINSTEM RESPONSE IN HEALTHY ADULTS AND ADULTS WITH ALCOHOL DEPENDENCE SYNDROME
(Queen Margaret University, Edinburgh, 2018) Johnson, Christine
The Auditory Brainstem Response (ABR) assesses brainstem function. This thesis explores the click and speech ABR in both healthy adults and adults with alcohol dependence syndrome (ADS). Experiment One undertook auditory-cognitive assessment including ABRs, of 60 healthy adults (30 women), aged 18-30 years. For waves III and V of the click ABR, women’s responses were earlier than men’s by 0.14ms and 0.19ms. For the speech ABR, onset and offset measures were earlier in women by at least 0.43ms. No effect for left vs. right ear was found in either case. Inter-rater reliability was found to be high (ICC2,1 ≥0.89) for the click ABR and good (ICC2,1 ≥0.75) for six of the seven peaks of the speech ABR. A comparison of ABRs to those from an older group of 12 adults aged 31-49 years (six women, matched control group for Experiment Two) found the stimulus to response lag for the speech ABR, was earlier (0.78ms) in the older women but within the expected range. Click and speech ABRs were repeated after 12 weeks and the representation of F0 for women was greater by 4.8 μV at the second recording. Experiment Two assessed the auditory-cognitive profile and ABRs of 16 adults (six women) aged 29-49 years, undergoing a treatment and rehabilitation programme for people with ADS. All participants had hearing thresholds within normal limits, but exhibited deficits in auditory-cognitive profiles compared to matched, healthy adults, including their click and speech ABRs. For the click ABR, men had significant delays in wave III (0.18ms) and wave V (0.22ms). For women there were significant delays for wave I (0.11ms) and wave V (0.22ms). For the speech ABR, men had significant delays in the onset measures of waves V (0.40ms) and A (0.36ms). Women had significant delays in waves V (0.45ms), A (0.48ms) E (0.66ms) and O (0.42ms). Testing was repeated after 12 weeks of abstinence and significant improvements in the click and speech ABR were observed. For men, average click ABR latencies improved for wave III (0.12ms) and wave V (0.22ms) and for women, wave V (0.08ms) improved. Significant improvements were also found for discrete peak and onset measures of the speech ABRs for both men and women. For men, average speech ABR latencies improved for wave A (0.23ms) and the duration of the VA complex (0.15ms). For women there were improvements in wave V (0.10ms), A (0.12ms) and E (0.33ms). These results add to the body of knowledge about the ABR and support its value as a clinical tool. They also provide new information about auditory-cognitive function in adults with ADS, for whom beneficial effects of abstinence are demonstrated. The ABR has a potential role in identifying people most at risk of alcohol related brain damage and in monitoring recovery with abstinence. Keywords Auditory Brainstem Response, Frequency Following Response, Speech ABR, Reliability, Alcohol Dependence Syndrome, Abstinence.
Can older people remember medication reminders presented using synthetic speech?
(BMJ, 2014-07-30) Wolters, M.; Johnson, Christine; Campbell, P.; DePlacido, Christine; McKinstry, B.
Reminders are often part of interventions to help older people adhere to complicated medication regimes. Computer-generated (synthetic) speech is ideal for tailoring reminders to different medication regimes. Since synthetic speech may be less intelligible than human speech, in particular under difficult listening conditions, we assessed how well older people can recall synthetic speech reminders for medications. 44 participants aged 50-80 with no cognitive impairment recalled reminders for one or four medications after a short distraction. We varied background noise, speech quality, and message design. Reminders were presented using a human voice and two synthetic voices. Data were analyzed using generalized linear mixed models. Reminder recall was satisfactory if reminders were restricted to one familiar medication, regardless of the voice used. Repeating medication names supported recall of lists of medications. We conclude that spoken reminders should build on familiar information and be integrated with other adherence support measures. The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.comFor numbered affiliations see end of article.
Deafness and Dementia: Predicting the future for Scotland
(deafscotland, 2020-07-17) McMenemy, Andrena; Johnson, Christine
Deafness: Predicting the future for Scotland
(deafscotland, 2020) McMenemy, Andrena; Koesters, Nils; Johnson, Christine
The exact numbers of deaf people in Scotland varies depending upon which source is consulted. This lack of clarity is problematic when it comes to planning for delivery of future services and it is widely recognised that there is a need to establish better reporting procedures in order to capture relevant statistics. To this end, this research has sought to investigate the source with which the Scottish Government makes policy decisions; the source that is used to ‘allocate resources and plan services’ in Scotland: The 2011 Census for Scotland (Office for National Statistics 2011). As the next Census will be taken in 2021, it would seem timely to look at what information this source currently offers on the prevalence of hearing loss in Scotland and how far it relates to the wider picture. How far does the above definition of the aims and objectives of the Census fit to enable precise data to be captured and recorded and as a result ensure optimum service planning and provision for those with hearing loss in Scotland?
A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank
(Oxford University Press, 2024-12-16) Mur, J; Klee, M; Wright, H R; Solomon, A; Johnson, Christine; Littlejohns, T J; Muniz-Terrera, G; Leist, A K
Observational studies have reported that hearing aid (HA) use is associated with a reduced risk of dementia diagnosis, suggesting a possible protective effect. However, extant observational studies do not explicitly model causal effects, while randomised controlled trials on the effect of HA on dementia exhibit short follow-up. Here we used self-report, hearing tests, and healthcare records in UK Biobank to design a hypothetical intervention for the effect of HA use on the risk of dementia diagnosis in people with incident hearing loss (HL). HA users exhibited a higher risk of dementia diagnosis than non-users (RR=1.43, 95%CI=1.08-1.88). Associations between HA use and dementia diagnosis were robust across sensitivity analyses (RRs: 1.34-1.59) but adjustment for primary healthcare utilisation (0.77, 0.44-1.33) or primary and secondary care utilisation (0.68, 0.39-1.18) substantially decreased the observed effect. The decrease in effect estimates upon adjustment for primary (1.30, 0.95-1.78) and primary and secondary healthcare utilisation (1.30, 0.94-1.78) was smaller when participants with relatively early diagnoses of HL were included in the sample compared to when they were not. While the findings are not conclusive, they suggest residual confounding by healthcare utilisation and dating of HL diagnosis in participants without primary care data in UK Biobank.
Inequality in access to hearing care for older adults in residential homes
(Oxford University Press, 2019-07-31) White, Joanna D.; Johnson, Christine; DePlacido, Christine; Matthews, Ben; Steenkamp, Lizanne
Background The population of older people in residential homes is projected to rise. There are unrecognized hearing difficulties among residents and prevalence of hearing loss in this population is underreported. This can result in an overestimation of levels of cognitive impairment. Untreated hearing loss is associated with social isolation, depression, disruptive behaviour and cognitive decline. This study aimed to explore the provision of hearing care (hearing assessment, rehabilitation and staff training) in Scottish care homes for older people.
Inter-Rater Reliability of Auditory Brainstem Response Waveforms Elicited by Complex Stimuli
(Medknow Publications, 2024-06-20) Johnson, Christine; White, Joanna D.
Objective: The objective of this study was to assess the inter-rater reliability of peak marking for the frequency following the response portion of auditory brainstem response (ABR) waveforms elicited by complex stimuli. Materials and Methods: ABR testing was carried out on 30 adult participants with normal hearing, which generated a data set of 60 click-evoked waveforms and 60/da/-evoked waveforms. Three audiologists marked peaks for both click and/da/evoked ABR waveform data, derived from 30 participants aged 18–30 years. To assess inter-rater reliability, a two-way, random effects, single-measure model was used to calculate the intraclass correlation coefficients (ICCs). Results: The ICCs were ≥0.89 for peaks I, III, and V of the click-evoked waveforms. For the/da/evoked waveforms, the ICCs were rated good to high (≥0.83) for peaks V, A, E, F, and O, fair (0.75) for peak D but poor (≥0.45) for peak C. Conclusion: Investigations of reliability of waveform marking should be undertaken before using complex stimuli for ABR testing to prevent premature adoption of screening or diagnostic tools.
Mental health and deafness in Scotland: Exploring the data
(deafscotland, 2021-06-09) McMenemy, Andrena; Johnson, Christine; Koesters, Nils
Prevalence rates for those with dual sensory loss and dementia in Scotland
(Datafakts Ltd, 2022-05-22) Kösters, Nils; McMenemy, Andrena; Johnson, Christine
Visualizing Worldwide Prevalence of Age-Related Dual Sensory Loss
(SAGE Publications, 2024-06-23) Koesters, Nils; Minhas, R; Wittich, Walter; McMenemy, Andrena; Johnson, Christine
Objectives: This study aims to create a first visualization of global prevalence of age-related dual sensory loss (DSL), significantly affecting older people’s quality of life. Methods: Data from World Health Organization (WHO) regions, particularly African, American, and European, were analyzed. The study focused on DSL onset and prevalence, using adjusted life expectancy for regional comparison. Results: There were notable regional variations in DSL onset and prevalence. The African region showed consistent data, thanks to standardized methods from the World Federation of the Deafblind. However, global patterns varied when adjusted for life expectancy, hinting at possible DSL prevalence stabilization at older ages. Discussion: The study identifies a lack of standardization in DSL prevalence research regarding definitions, methodologies, and reporting. It calls for more uniform and thorough research methods for accurate global DSL understanding. The research highlights the complexity and challenges in determining DSL prevalence worldwide.
Young Adults’ Knowledge and Perceptions of Permanent Noise-Induced Tinnitus and its Influence on Behavioural Intentions
(Medknow Publications, 2023-12-28) Runciman, Lucy; Johnson, Christine
Objective: Young adults’ music-listening behaviours may put them at risk of developing permanent hearing loss and tinnitus. This study aimed to assess knowledge of permanent tinnitus and whether this knowledge may influence listening behaviours to a greater degree than knowledge of hearing loss. Materials and Methods: A two-group (between subjects), randomised post-test only, single-factor experimental design was used to determine the effects of health message focus (permanent tinnitus vs. permanent hearing loss) on the main outcome measure of protective behavioural intention. The sample included 109 male and 287 female adults, aged 18 to 25 years, living in the United Kingdom. The young adults’ existing knowledge of either permanent hearing loss or permanent tinnitus was measured, and after exposure to a health message, their perceptions and resultant behavioural intentions were assessed and compared. The pooled data were used to test a proposed model of factors influencing hearing protective behavioural intention using path analysis. Results: Whilst 83% knew about the link with hearing loss, only 75% knew that loud music may cause permanent tinnitus. The participants viewed tinnitus as closer temporally than hearing loss, perceived themselves as equally susceptible to both, but perceived hearing loss as more severe. There was no significant difference in behavioural intention between the groups. Conclusion: Perceived susceptibility and severity have a positive effect on behavioural intentions. In light of these results, recommendations for future noise-damage prevention campaigns are made.