Hearing loss in the aged: Status and interventions in China

Abstract

Hearing loss is now one of the chronic diseases with the most impact on quality of life of aged Chinese people. According to the second China National Sample Survey on Disability there are 15,400,000 people over 60 years of age suffering from a hearing disorder. Among these, 2,788,600 have more than a severe hearing loss. The main causes of hearing loss in Chinese elderly people are presbycusis, long-term exposure to noise, otitis media and systematic diseases. Hearing thresholds increase approximately 10dB per decade for subjects aged 60 years and above, and remain stable from 50 to 70 years of age. A dramatic increase occurs after 70 years of age. Speech recognition showed a poor correlation with pure tone thresholds in patients older than 80 years, suggesting that the age factor should be taken into account when considering hearing amplification. The auditory brainstem response (ABR) and mismatch negativity (MMN) response have demonstrated both peripheral and central deterioration of hearing pathways in elderly people. Use of a hearing aid is the main approach for helping elderly people overcome difficulties in communication. In the past 10 years, digital hearing aids have gradually replaced analogue ones in China and have been shown to have a better effect. However, compared with the proportion of aged people with hearing loss in China, the number of those who use hearing aids is very small. This may be related to the following factors: 1) a traditional attitude towards hearing loss in the elderly; 2) financial reasons; 3) some worries due to the unfamiliarity of hearing aids; and 4) inability to manipulate hearing aids. The main complaints in elderly hearing aid users include self-hearing being too loud, a muffled feeling, excessive gain in the higher frequencies and poor speech recognition. Cochlear implants have also been used in pre-elderly and elderly patients in China. At present there is a long way to go in developing hearing healthcare services for elderly people in China. It is necessary to provide more hearing training and rehabilitation for elderly people with hearing loss using various means.