The Need for Improved Detection and Management of Adult-Onset Hearing Loss in Australia

Catherine M Mcmahon,Stephen R Leeder,Louise Hickson,Jennifer Reath,Julie Schneider,Bamini Gopinath,Paul Mitchell,Robert Cowan

doi:10.1155/2013/308509

Abstract

Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being) is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1) early identification of persons with chronic hearing impairment; (2) appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss.

Highlights

Adult-onset hearing loss is a highly prevalent yet relatively underrecognised health problem in the older adult Australian population [1, 2]
We identified that a 33.0% prevalence of bilateral hearing loss existed in persons aged 50+ years (51% showed hearing loss in the worse ear) consistent with that measured in the US-based Epidemiology of Hearing Loss Study (EHLS) [27]
Blue Mountains Hearing Study (BMHS)-I data showed that bilateral hearing loss was associated with poorer SF-36 scores in both physical and mental domains (decrease in physical component score (PCS) of 1.4 points, P = 0.025; decrease in mental component score (MCS) of 1.0 point, P = 0.13); with poorer scores associated with more severe levels of impairment (PCS Ptrend = 0.04, MCS Ptrend = 0.003) [3]

Summary

Introduction

Adult-onset hearing loss is a highly prevalent yet relatively underrecognised health problem in the older adult Australian population [1, 2]. Because hearing loss is often progressive and gradual in its onset in most individuals, it is typically diagnosed and managed several years after its onset, often only after having led to multiple negative consequences including effects on employment, poor quality of life, social isolation, depressive symptoms, increased mortality risk, and reduced independence [3,4,5,6,7,8,9]. It is one of the leading causes of burden of disease prior to older age, for ages 45–64 years, in men and women [9].

Poor Recognition and Uptake of Hearing Services

GP Hearing Screening Strategies

Speech-in-Noise Tests

Findings

Conclusions