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Epidemiology and Importance of Hearing Screening

Introduction

Most people over the age of 60 develop some degree of hearing impairment. It exists when there is decrease ability to hear and diminish sensitivity to the sounds normally heard. It can vary from mild to total loss of hearing and occur in one or both ears.

Epidemiology

More than 33% of elderly have hearing loss. The incidence of hearing loss is estimated to double per decade, beginning with 16% at 60 years of age and proceeding to 32% at 70 years and 64% at 80 years. When matched for age, males tend to have worse hearing than females.

The most common pattern or hearing loss in older adult is presbycusis, a bilateral high frequency sensorineural hearing loss that occurs with advancing age.

Mechanism of hearing impairment

Hearing is made possible by tiny hair cells located inside the inner ear compartment. Noise caused vibration to the air molecules. The vibration is then picked up by the hair cells inside the ears and converts it into nerve signals. The signals are channelled to the brain which interprates it as sound. These hair cells can be damaged as a person gets older or when exposed to long term adverse condition to the ear. Damaged hair cells causes hearing loss. As the hair cells cannot regenerate, most hearing loss due to hair cell damage is permanent.

Even though many elderly retain good hearing with age, age related hearing loss is common among elderly.

Impact of hearing impairment in the elderly

Hearing loss can affect social functioning and quality of life in the affected elderly.
It causes:

  • inability to interpret speech sounds

  • reduce the ability to communicate

  • produces miscommunication

  • social isolation

  • social withdrawal

  • stigmatisation

  • confusion

  • depression

  • deterioration in functional status

  • difficult to understand and follow doctor’s advice

  • difficult to respond to warnings, may be dangerous

  • embarrassment ad frustrations

Benefits of screening for hearing impairment in the elderly

Screening for hearing impairment in the elderly provides avenue for earlier detection of hearing impairment.  This will assist in providing appropriate intervention like hearing aid to improve hearing thus minimising the negative impact of hearing impairment and improve the quality of life for the elderly. They can take part in social gathering, communicate better, express their need better, reduce social isolation and improve their functional status.

References

  1. Walling ADDickson GM. Hearing loss in older adults,  Am Fam Physician. 2012 Jun 15;85 (12):1150-6. http://www.ncbi.nlm.nih.gov/pubmed/22962895.

  2. http://www.mayoclinic.com/health/hearing-loss/DS00172

Last Review : 20 January 2014
Writer : Dr. Ruziatun binti Hasim