Addressing Hearing Loss in Old Age Psychiatry

Abstract

Rationale, aims and objectives: The United Kingdom has an increasingly ageing population. With age, hearing declines and the risk of dementia rises. Sensory impairment such as hearing loss is strongly correlated with cognitive decline, mental illness and dementia. Hearing loss has a negative association with quality of life. Addressing hearing impairment, with early recognition and treatment, is a significant public health issue. The main aims of this study were to: (1) evaluate current practice in Old Age Psychiatry in addressing hearing impairment in older adults in contact with mental health services; (2) evaluate the accessibility of Audiology and/or Ear, Nose and Throat (ENT) services and (3) evaluate the level of awareness among clinicians routinely shared with patients and families or carers regarding relevant associations with hearing loss. Method: A national cross-sectional study of the Royal College of Psychiatrists Faculty of Old Age Psychiatry members in England was conducted over 8 weeks. Results: The majority of respondents routinely established a history of hearing impairment in their patients, as well as the possession and regular use of hearing aids. However, a significant proportion did not advise patients of potential links between hearing loss and cognitive impairment (26%) or mental illness (40%). Most respondents reported that their awareness of these links was primarily based on professional experience, rather than published evidence or clinical guidelines. Additionally, 20% reported the experience of referring patients to Audiology and ENT services, was ‘difficult’ or ‘very difficult’. Conclusions: There is a need for further research into hearing loss and its impact on mental health and cognitive impairment, as well as scope to improve dissemination of existing evidence. The identified difficulty in referring to Audiology and ENT should be explored and addressed. Clinicians in Old Age Psychiatry have an important role in identifying hearing impairment and promoting use of hearing aids as part of the person-centered healthcare of this vulnerable population.