Aging and Hearing Health: The Life-course Approach (original) (raw)
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Advances in Clinical Audiology, 2017
Background Age related hearing impairment is a risk factor for functional decline, reduced social participation and accidents. Aims To obtain knowledge about the characteristics of age related hearing impairments and to help elderly optimize their hearing function. Design and method Study 1; Baseline description of data on hearing impairments. Study 2; ROC curve to compare self-assessments with a gold standard test. Study 3; RCT to test whether removal of earwax, and referral to a specialist can improve functional hearing. Results More than 90% had hearing impairments. Mean PTAV was 40,4 dB. Self-assessment of hearing function with a single global question correlated only weakly with the PTAV measurements. Comparison yielded 18 false negatives, indicating many reported their hearing as good when the standardized test indicated that it was not. Conclusion Elderly people live with hearing impairments not sufficiently attended to. Asking about their hearing with a single global question will not provide accurate information. It is necessary to use standardized tests in addition. When asking more detailed questions about communication abilities, the elderly reported having difficulties. Many elderly could not be expected to do all the self-care activities necessary to improve their functional hearing. Close monitoring and assistance is recommended.
Increases in the Rate of Age-Related Hearing Loss in the Older Old
JAMA Otolaryngology–Head & Neck Surgery, 2017
resbycusis, or age-related hearing loss (ARHL), affects approximately two-thirds of adults older than 70 years and four-fifths of adults older than 85. 1 It is a major public health concern that is associated with numerous deleterious effects. Although ARHL increases social isolation because of impaired communication, it decreases one's ability to perform activities of daily living and instrumental activities of daily life without assistance from others. 2 Poor hearing is also associated with an increased incidence of cognitive impairment and rate of cognitive decrease. 3,4 Finally, ARHL increases overall mortality in older adults because of injuries from falls and motor vehicle crashes and is notably associated with poor self-rated health. 5 Despite the high prevalence and negative health consequences of ARHL, hearing aids are underused in the older adult population regardless of being shown to improve the social, functional, and emotional effects of hearing loss. 6-8 Currently, there is a global demographic change that has resulted in an increase in the number of older adults. In the United States, the population of individuals older than 80 years is expected to double in the next 40 years. 9 To better serve this growing population, it is important to consider persons 60 years and older as a continuum of age rather than a single group. The majority of research in ARHL, however, groups participants older than 70 years into a single category, thus obscuring changes in the severity of hearing loss as individuals live to 80 years or older. Here, we characterize the hearing loss of individuals between the ages of 80 and 106 as it relates to age, sex, and hearing aid use. IMPORTANCE There is a critical disparity in knowledge regarding the rate and nature of hearing loss in the older old (80 years and older). OBJECTIVE To determine if the rate of age-related hearing loss is constant in the older old. DESIGN, SETTING, AND PARTICIPANTS We performed a retrospective review that began on August 1, 2014, with audiometric evaluations at an academic medical center of 647 patients aged between 80 and 106 years, of whom 141 had multiple audiograms. MAIN OUTCOMES AND MEASURES From a population perspective, the degree of hearing loss was compared across the following age brackets: 80 to 84 years, 85 to 89 years, 90 to 94 years, and 95 years and older. From an individual perspective, the rate of hearing decrease between 2 audiograms was compared with age. RESULTS Changes in hearing among age brackets were higher during the 10th decade of life than the 9th decade at all frequencies (5.4-11.9 dB hearing level [dB HL]) for the 647 patients (mean [SD] age, 90 [5.5] years). Correspondingly, the annual rate of low-frequency hearing loss was faster during the 10th decade by the 3.8 dB HL per year at 0.25 kHz, 3.8 dB HL per year at 0.5 kHz, and 3.2 dB HL per year at 1 kHz. Despite the universal presence of hearing loss in our sample, 382 patients (59%) used hearing aids. CONCLUSIONS AND RELEVANCE There is a significant increase in the rate of hearing loss in patients during the 10th decade of life compared with the 9th decade that represents a fundamental change in the mechanistic process of presbycusis. Despite the potential benefit of hearing aids, they remain underused in the older old. Use may be improved by changing the method of hearing rehabilitation counseling from a patient-initiated model to a chronic disease example.
Canadian Medical Association Journal, 2007
C linically significant hearing loss is the third most common condition among older adults. It is present in about 25%-40% of people over 65 years of age, 50% of those over 75, and 80% of those over 85 years 1-becoming, with aging, the rule rather than the exception. Of all our sensory modalities, hearing is the most integral to communication; hearing impairment therefore affects just about the entirety of human experience. Loss of hearing can damage one's mental processing, emotional and mental health, and educational and occupational prospects. Hearing loss, especially in older adults, also tends to lead to social isolation, depression, withdrawal from daily activities, and frustration with and among family members and friends.
Age related hearing loss and cognitive impairment -a current perspective
Age related hearing loss (ARHL) is one of the commonest health conditions of the elderly people which have an important relation with the cognition. Long standing hearing deprivation leads to decline of the cognitive performance. This has impact on quality of communication and result in social isolation, depression and enhances the dementia. Cognitive decline may be misdiagnosed or over-diagnosed when the sensory abilities of the patients are not properly evaluated. Adequate intervention by use of hearing aid or cochlear implant improves the communication, cognitive function, social, emotion function and positively impact on the quality of life. With rise of the elderly population and concomitant increase of ARHL with associated cognitive impairment, it is imperative to discuss this morbid clinical entity in present scenario. Cognitive decline in elderly age have a profound impact on the affected person, on caregivers and society. The financial costs for cognitive impairment in ARHL are also major source of concern for the society. In this review article, we focus on the epidemiology, pathophysiology, hypotheses of etiological mechanisms between the ARHL and cognitive decline or impairment, impact of cognitive impairment on quality of life and prevention.
Causes and Consequences of Age-Related Hearing Loss
Aging and Hearing, 2020
Hearing loss in older adults is a national and global health priority. Fifty percent of adults over the age of 60 years are impacted by a clinically meaningful hearing loss, with that number increasing to every two out of three adults over the age of 70. There is also growing recognition that hearing loss is associated with increased risk for health conditions including dementia and falls. This chapter describes what is known about age-related hearing loss from population-based epidemiologic studies, including the prevalence (burden of existing hearing loss) and incidence (new cases of hearing loss), and describes patterns of severity and trends
Negative Consequences of Hearing Impairment in Old Age: A Longitudinal Analysis
The Gerontologist, 2000
To determine whether functional and psychosocial outcomes associated with hearing impairment are a direct result or stem from prevalent comorbidity, we analyzed the impact of two levels of reported hearing impairment on health and psychosocial functioning one year later with adjustments for baseline chronic conditions. Physical functioning, mental health, and social functioning decreased in a dose-response pattern for those with progressive levels of hearing impairment compared with those reporting no impairment. Our results demonstrate an independent impact of hearing impairment on functional outcomes, reveal increasing problems with higher levels of impairment, and support the importance of preventing and treating this highly prevalent condition.
Impact of hearing loss in the lives of geriatric individuals
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2019
Background: Hearing loss in old age is a vexing problem and millions of people worldwide are suffering from it. The aim of this study is to identify the problems which geriatric individuals with hearing loss experience and to help them to overcome their disability and its effects on social engagement and interpersonal relationship.Methods: The study was conducted in a tertiary care hospital and is based on prospective study. The data collection was done in the form of confrontational interview. Results: According to our study individuals suffering from moderate hearing loss have difficulty in communicating with friends, relatives and even strangers. They even face problems in travelling. They feel disoriented during conversation and tend to miss out parts of conversation. They tend to use their visual signals more than hearing for example while watching television they try to focus and interpret more by the video than by listening to the audio. People suffering from mild to moderat...
The Impact of Hearing Loss on Quality of Life in Older Adults
The Gerontologist, 2003
The authors investigate the impact of hearing loss on quality of life in a large population of older adults. Design and Methods: Data are from the 5-year follow-up Epidemiology of Hearing Loss Study, a population-based longitudinal study of agerelated hearing impairment conducted in Beaver Dam, WI. Participants (N ¼ 2,688) were 53-97 years old (mean ¼ 69 years) and 42% were male. Difficulties with communication were assessed by using the Hearing Handicap for the Elderly-Screening version (HHIE-S), with additional questions regarding communication difficulties in specific situations. Health-related quality of life was assessed by using measures of activities of daily living (ADLs), instrumental ADLs (IADLs) and the Short Form 36 Health Survey (SF-36). Hearing loss measured by audiometry was categorized on the basis of the puretone average of hearing thresholds at 0.5, 1, 2, and 4 kHz. Results: Of participants, 28% had a mild hearing loss and 24% had a moderate to severe hearing loss. Severity of hearing loss was significantly associated with having a hearing handicap and with self-reported communication difficulties. Individuals with moderate to severe hearing loss were more likely than individuals without hearing loss to have impaired ADLs and IADLs. Severity of hearing loss was significantly associated with decreased function in both the Mental Component Summary score and the Physical Component Summary score of the SF-36 as well as with six of the eight individual domain scores. Implications: Severity of hearing loss is associated with reduced quality of life in older adults.
Evaluation of elderly patients with hearing impairment
The Professional Medical Journal
Hearing is decreased in later age is due to aging and is normally seen in most of the elderly people all over the world. Objectives: To ascertain the degree of hearing in elders in relation to age, pattern and extent of hearing weakness in old age so that interventional strategies can be planned to improve their wellbeing. Study Design: Cross Sectional Study. Setting: ENT Outdoor Clinic of Akbar Niazi Teaching Hospital of Islamabad Medical and Dental College, Bhara Kahu, Islamabad. Period: December 2017 to October 2018. Material & Methods: 200 patients were part of the study with age > 50 years and no past history of drug therapy. Data was gathered by detailed clinical history, clinical examination and audiometric findings. Result: 57% patients were found with normal hearing and 43% had variable degree of hearing deterioration. Highest number of hearing weakness was found in 9th decade. Most of hearing deterioration was found in both the ears and that of sensorineural in type. Co...
Hearing Loss Health Care for Older Adults
Journal of the American Board of Family Medicine : JABFM
Hearing deficits are highly prevalent among older adults and are associated with declines in cognitive, physical, and mental health. However, hearing loss in the geriatric population often goes untreated and generally receives little clinical emphasis in primary care practice. This article reviews hearing health care for older adults, focusing on what is most relevant for family physicians. The objective of hearing loss treatment is to ensure that a patient can communicate effectively in all settings. We present the 5 major obstacles to obtaining effective hearing and rehabilitative care: awareness, access, treatment options, cost, and device effectiveness. Hearing technologies are discussed, along with recommendations on when it is appropriate to screen, refer, or counsel a patient. The purpose of this article is to provide pragmatic recommendations for the clinical management of the older adult with hearing loss that can be conducted in family medicine practices.