Abstract
Key Points: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? Findings: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. Purpose: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). Methods: A total of 1696 elderly people underwent the government’s annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. Results: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5–4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach’s alpha = 0.901), and the test-retest reliability was also excellent (Spearman’s correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5–4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. Conclusions: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.
Highlights
Hearing loss is very common among people aged 65 or older worldwide, but it is not fully understood or treated
hearing handicap inventory for elderly screening (HHIE-S) score has been verified with respect to a hearing test for hearing loss, and the results show that it has sufficient sensitivity and specificity in identifying individuals with hearing loss [33,34]
We found that 43.1% of the subjects with normal hearing felt that their hearing was impaired according to the TC-HHIE-S results
Summary
Hearing loss is very common among people aged 65 or older worldwide, but it is not fully understood or treated. In Taiwan and other countries, the increasing number of age-related hearing loss (ARHL) cases among elderly people is becoming an increasingly important public health problem. There is evidence that patients with hearing loss have more tinnitus and balance problems and a worse long-term quality of life [4,5] These findings raise serious concerns about other negative health consequences, including [6] walking difficulties [7], driving ability [8], social isolation [9], cognition [9,10], dementia [11,12], functional decline [13,14], falls [15], increasing disability-adjusted life years (DALYs) [16], and mortality [13]. Prior studies have used subjective measures, such as a manual audiometry, test to detect ARHL [17,18]
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