Functional status of elderly people with hearing loss
Primary Care Head Office. Marqués de Villores 6, 02001 Albacete, Spain. Archives of gerontology and geriatrics
(Impact Factor: 1.85).
07/2008; 49(1):88-92. DOI: 10.1016/j.archger.2008.05.006
The objective is to determine the prevalence of hearing loss in people over 65 years of age, to describe the functional status of people with hearing loss and to identify the need for hearing aid use. In a cross-sectional study, a random sample of 1387 people aged 65 years and over was selected. The primary study variables were: hearing level by audiometric assessment, self-perceived hearing loss, screening for hypoacusia using the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) and physical, cognitive and emotional functional status. Using the HHIE-S it was determined that 11.3% of the subjects had severe hearing handicap. According to the Ventry/Weinstein criteria 43.6% had hearing handicap. When asked about the use of hearing aids, 4.5% of the study subjects said they used them, although 41.9% had hearing loss of 35 dB or more in their better ear. The variables associated with the need for a hearing aid were age >75 years (odds ratio=OR=3.2), ADL dependence (OR=2.7), cognitive impairment (OR=2.0), multiple health problems (OR=1.8), male sex (OR=1.6) and single/widowed (OR=1.5). In conclusion, there is a high prevalence of hearing loss associated with other functional limitations. Of those people who would benefit from a hearing aid (more than a third of people over 65 years old), 89.3% do not own one. The screening of hearing loss needs to be improved.
Available from: Dane J Genther
- "These inconsistencies may be explained in part by differences in how HI has been measured across studies. While some studies have used audiometric measures of hearing (Bess et al., 1989; Chia et al., 2007; Gopinath et al., 2012; M. Y. Lin et al., 2004; Viljanen et al., 2009), others have relied on self-reported measures of hearing (Dargent-Molina et al., 1996; Laforge et al., 1992; Lopez-Torres Hidalgo et al., 2009; Reuben et al., 1999; Rudberg et al., 1993; Strawbridge et al., 2000). However, the agreement between self-reported assessments of hearing and gold-standard audiometric assessments varies substantively by demographic factors such as age, sex, race, and education. "
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The aim was to investigate whether associations of hearing impairment (HI) with functional outcomes in older adults differ when using self-report versus pure-tone audiometry.
We examined 1,669 participants ≥70 years in National Health and Examination Survey from 2005-2006 and 2009-2010 whose hearing was assessed by self-report and pure-tone audiometry. We explored functional outcomes associated with audiometric HI (low physical activity, poor physical functioning, and hospitalization).
In adjusted models, we found significant associations of audiometric HI with both subjective and objective outcomes (e.g., dichotomous HI with self-reported difficulty in activities of daily living [ADLs], odds ratio [OR] = 1.47, 95% confidence interval [CI] [1.05, 2.06], and low accelerometer-measured physical activity, OR = 2.19, 95% CI [1.11, 4.34]). In contrast, self-reported HI was only associated with subjective outcomes and not with objective outcomes (e.g., dichotomous HI with difficulty in ADLs, OR = 1.63, 95% CI [1.12, 2.38], and low accelerometer-measured physical activity, OR = 0.95, 95% CI [0.66, 1.35]).
Results using self-reported hearing should not be considered representative of results using audiometry and may provide distinct aspects of HI in older adults.
Available from: jn.physiology.org
- "Presbycusis (age-related hearing loss) affects 35% of humans older than 65 yr (Gates and Mills 2005). It is the most prevalent form of hearing impairment, contributes to speech processing deficits and social isolation, and may lead to cognitive impairment (Frisina 2009; Gates and Mills 2005; Lopez-Torres Hidalgo et al. 2009; Weinstein and Ventry 1982). "
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ABSTRACT: Presbycusis (age-related hearing loss) is a prevalent disability associated with aging that impairs spectrotemporal processing, but the mechanisms of such changes remain unclear. The goal of this study was to quantify cortical responses to frequency modulated (FM) sweeps in a mouse model of presbycusis. Previous studies showed that cortical neurons in young mice are selective for the rate of frequency change in FM sweeps. Here, single unit data on cortical selectivity and response variability to FM sweeps of either direction and different rates (0.08-20 kHz/msec) were compared across young (1-3 month), middle age (6-8 month) and old (14-20 month) groups. Three main findings are reported. First, there is a reduction in FM rate selectivity in the old group. Second, there is a slowing of the sweep rates at which neurons likely provide best detection and discrimination of sweep rates. Third, there is an increase in trial-to-trial variability in the magnitude and timing of spikes in response to sweeps. These changes were only observed in neurons that were selective for fast or intermediate range of sweep rates, and not in neurons that preferred slow sweeps or were non-selective. Increased variability of response magnitude, but not changes in temporal fidelity or selectivity, was seen even in the middle aged group. The results show that spectrotemporal processing becomes slow and noisy with presbycusis in specific types of neurons suggesting receptive field mechanisms that are altered. These data suggest neural correlates of presbycusis-related reduction in the ability of humans to process rapid spectrotemporal changes.
Available from: Debbie Tolson
- "Given the low response rate the eight respondents who were approaching 60 were included in the statistical analyses. This is not unreasonable given the association of age-related hearing problems as a manifestation of physiological ageing and a likely predictor of other geriatric syndromes (Gates & Mills 2005, Lopez-Torres et al. 2009). The mean length of time participants reported being hard of hearing was approximately 14 years, though the time ranged from 1 to 76 years. "
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ABSTRACT: This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit.
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