Self-perceived Hearing Research Articles

Hearing and hearing conservation practices among Australia's professional orchestral musicians.

Orchestral musicians are an at-risk population for noise-induced hearing loss. Following strategic approaches to mitigate exposure, many must use earplugs to safeguard their hearing, although reported usage rates are poor. Australia has progressive hearing conservation programs within many of its orchestras, yet little is known of earplug usage rates, abilities with earplugs or self-perceived hearing loss in this population. To help direct and inform future approaches to hearing conservation in Australia's orchestras a questionnaire assessing hearing conservation behaviors and the prevalence of self-perceived hearing loss was distributed. A total of 580 musicians across eight professional orchestras were surveyed, with 367 completed surveys (63%) returned. Eighty percent of respondents reported a risk of hearing damage in the orchestra, 64% used earplugs of some type at least some of the time and 83% found this use difficult/impossible. Forty-three percent reported a hearing loss, including 54% in pit orchestras and 46% of those ≤50 years of age. Brass players were least likely to use earplugs, most likely to report usage difficulties and most likely of those ≤50 years of age to report a hearing loss. While earplug usage rates in Australia are encouraging and may be linked to hearing conservation measures in the orchestras, the widespread difficulty reported with the use of these earplugs, the prevalence of self-reported hearing loss and the continued vulnerability of those most at-risk indicate improvements in both earplug design and further education for musicians are required to progress hearing conservation options for this population.

Relationship between the Pure-tone Thresholds and Self-perceived Hearing Problems among the Community-Frail Elderly

Relationship between the Pure-tone Thresholds and Self-perceived Hearing Problems among the Community-Frail Elderly

Development of a test of suprathreshold acuity in noise in Brazilian Portuguese: a new method for hearing screening and surveillance.

This paper describes the development of a speech-in-noise test for hearing screening and surveillance in Brazilian Portuguese based on the evaluation of suprathreshold acuity performances. The SUN test (Speech Understanding in Noise) consists of a list of intervocalic consonants in noise presented in a multiple-choice paradigm by means of a touch screen. The test provides one out of three possible results: “a hearing check is recommended” (red light), “a hearing check would be advisable” (yellow light), and “no hearing difficulties” (green light) (Paglialonga et al., Comput. Biol. Med. 2014). This novel test was developed in a population of 30 normal hearing young adults and 101 adults with varying degrees of hearing impairment and handicap, including normal hearing. The test had 84% sensitivity and 76% specificity compared to conventional pure-tone screening and 83% sensitivity and 86% specificity to detect disabling hearing impairment. The test outcomes were in line with the degree of self-perceived hearing handicap. The results found here paralleled those reported in the literature for the SUN test and for conventional speech-in-noise measures. This study showed that the proposed test might be a viable method to identify individuals with hearing problems to be referred to further audiological assessment and intervention.

Quality of life, effort and disturbance perceived in noise: A comparison between employees with aided hearing impairment and normal hearing

Objectives: The aims were to compare health-related quality of life (HRQOL) and hearing handicap between two groups of employees with normal hearing and aided hearing impairment (HI). HRQOL was also compared to a normative population. The second aim was to compare perceived effort (PE) and disturbance after completing a task in office noise between the two study groups. Design: A Swedish version of the short form-36 (SF-36) and the hearing handicap inventory for adults (HHIA) was used to determine HRQOL and hearing handicap. The Borg-CR 10 scale was used to measure PE and disturbance. Study sample: Hearing impaired (n = 20) and normally hearing (n = 20) participants. The normative sample comprised of 597 matched respondents. Results: Hearing-impaired employees report relatively good HRQOL in relation to the normative population, but significantly lower physical functioning and higher PE than their normally-hearing peers in noise. Results from the HHIA showed mild self-perceived hearing handicap. Conclusions: The current results demonstrate that physical health status can be negatively affected even at a mild-moderate severity of HI, and that a higher PE is reported from this group when performing a task in noise, despite the regular use of hearing aids.

Evaluating the Use of an Assistive Listening Device for Communication Efficiency Using the Diapix Task: A Pilot Study

Objective: The present study aimed to investigate the effects of assistive listening device (ALD) use on communication efficiency in groups of elderly adults with and without hearing impairment during a structured language sampling task. The relationship between self-perceived hearing handicap and communication efficiency was also explored. Method: Twenty-two subjects completed measures of hearing sensitivity, perceived hearing handicap, cognition, and a language sample. One half of the hearing-impaired participants and one half of the normal-hearing group were randomly assigned to use an ALD during a structured conversation task with a naïve partner. Results: The Hearing Loss/No ALD group had significantly more breakdowns than the Hearing Loss/With ALD group. Further, the Hearing Loss/With ALD group performed statistically similar to the two groups without hearing loss. For the normal-hearing groups as well as the Hearing Loss/No ALD group, self-perceived hearing handicap was significantly correlated with the number of communication breakdowns. Conclusion: The results lent preliminary support for the use of ALDs in the management of hearing loss. A case for functional assessment of communication was made to better illuminate causes of perceived communication handicap in the aural rehabilitation of elderly persons with hearing impairment.

Origins and Pawns Scales: A Pilot Study Assessing Perception of Control in Adults with Hearing Problems

Purpose: The main purpose of this pilot study was to determine if a content analysis of locus of control (Origins and Pawns Scales) can be used reliably with a population of older adults with hearing impairment. A second purpose of this pilot study was to determine the relationship between locus of control using this content analysis and audiologic variables such as hearing aid adoption and self-perceived hearing handicap. Finally, the third purpose of this pilot study was to determine if there were any differences between older men’s and women’s perception of locus of control as measured by this content analysis. Methods: A total of 30 adults with hearing impairment between the ages of 52 and 71 years participated in this study. Information regarding hearing ability, participant demographics, hearing aid adoption, and self-perceived hearing handicap were obtained. To obtain data for the content analysis, participants were required to respond to a single prompting question, which was transcribed verbatim and coded according to the refined Origins and Pawns scoring guidelines. Results: The content analysis of locus of control (Origins and Pawns Scales) had high internal consistency and intra-class correlations. Additionally, participants who adopted hearing aids had significantly higher origins scores than those who did not adopt. Conversely, participants who did not adopt hearing aids had higher pawns scores, however this finding was not statistically significant. There was no significant relationship between Origins and Pawns Scales and self-perceived hearing handicap nor were any gender differences found. Conclusions: Results of this study indicate that the Origins and Pawns Scales can be used reliably to assess the perception of locus of control for older adults with hearing impairment who present for clinical services. Both the Origins and Pawns Scales differentiated older adults who adopted hearing aids from those who did not. The Origins and Pawns Scales may prove to assist clinicians in addressing hearing aid adoption rates through targeting perceptions of control.

Initial-Fit Approach Versus Verified Prescription: Comparing Self-Perceived Hearing Aid Benefit

Despite evidence suggesting inaccuracy in the default fittings provided by hearing aid manufacturers, the use of probe-microphone measures for the verification of fitting accuracy is routinely used by fewer than half of practicing audiologists. The present study examined whether self-perception of hearing aid benefit, as measured through the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox and Alexander, 1995), differed as a function of hearing aid fitting method, specifically, manufacturer's initial-fit approach versus a verified prescription. The prescriptive fit began at NAL-NL1 targets, with adjustments based on participant request. Each of the two fittings included probe-microphone measurement. A counterbalanced, cross-over, repeated-measures, single-blinded design was utilized to address the research objectives. Twenty-two experienced hearing aid users from the general Bay Pines VA Healthcare System audiology clinic population were randomized into one of two intervention groups. At the first visit, half of the participants were fit with new hearing aids via the manufacturer's initial fit while the second half were fit to a verified prescription using probe-microphone measurement. After a wear period of 4-6 wk, the participants' hearing aids were refit via the alternate method and worn for an additional 4-6 wk. Participants were blinded to the method of fitting by utilizing probe-microphone measures with both approaches. The APHAB was administered at baseline and at the end of each intervention trial. At the end of the second trial period, the participants were asked to identify which hearing aid fitting was "preferred." The APHAB data were subjected to a general linear model repeated-measures analysis of variance. For the three APHAB communication subscales (i.e., Ease of Communication, Reverberation, and Background Noise) mean scores obtained with the verified prescription were higher than those obtained with the initial-fit approach, indicating greater benefit with the former. The main effect of hearing aid fitting method was statistically significant [F (1, 21) = 4.69, p = 0.042] and accounted for 18% of the variance in the data (partial eta squared = 0.183). Although the mean benefit score for the APHAB Aversiveness subscale was also better (i.e., lower) for the verified prescription than the initial-fit approach, the difference was not statistically significant. Of the 22 participants, 7 preferred their hearing aids programmed to initial-fit settings and 15 preferred their hearing aids programmed to the verified prescription. The data support the conclusion that hearing aids fit to experienced hearing aid wearers using a verified prescription are more likely to yield better self-perceived benefit as measured by the APHAB than if fit using the manufacturer's initial-fit approach.

Subjective and Objective Outcomes from New BiCROS Technology in a Veteran Sample

Patients with single-sided deafness (SSD), where one ear has an unaidable hearing loss and the other ear has normal or aidable hearing, often complain of difficulties understanding speech and localizing sound sources, and report a higher self-perceived hearing disability. Patients with SSD may benefit from using contralateral routing of signal (CROS) or bilateral contralateral routing of the signal (BiCROS) amplification. Dissatisfaction of previously available (Bi)CROS devices has been reported, such as, interfering transmissions, low-fidelity sound quality, poor "user-friendly" set-up, and a bulky and cosmetically cumbersome appearance. Recent advances in hearing aid technology have improved (Bi)CROS hearing aids; however, these devices have not been experimentally evaluated. We hypothesized that newer technology with reports of improved digital signal processing, wireless transmission, and physical design would be as good, or better than, our participants' previous-generation BiCROS systems. A within-subjects, pretest-posttest design was executed. Thirty-nine veterans (one female, 38 males; mean age = 74 yr, range = 49-85 yr) from the Audiology Section of the Bay Pines Veterans Affair Healthcare System participated. All participants were previously experienced BiCROS hearing aid users with varying degrees of sensorinerual hearing impairment in their better ear. Participants were provided at least 4 wk of consistent use with the new BiCROS. DATA COLLECTION AND ANALYSES: Participants completed three research visits. At Visit 1, with their previous BiCROS, and at Visit 3, with their new BiCROS, the following objective and subjective measures were obtained: (1) soundfield speech-in-noise testing using the Words-In-Noise (WIN) test; (2) speech, spatial, and qualities of the hearing scale (SSQ) questionnaire; (3) selected questions from the MarkeTrak questionnaire; and, (4) three open-ended questions. Data were analyzed using parametric and nonparametric statistics. Overall, the objective (WIN) and subjective (SSQ, MarkeTrak, and open-ended questions) measures indicated that the new BiCROS provided better outcomes than the previous BiCROS system. In addition, an overlap of favorable results was seen across measures. Of the 39 participants, 95% reported improvements with the new BiCROS and chose to utilize the device regularly. The favorable objective and subjective outcomes indicate that the new BiCROS system is as good, or better than, what was previously utilized by our sample of veterans.

Musical background not associated with self-perceived hearing performance or speech perception in postlingual cochlear-implant users

In normal-hearing listeners, musical background has been observed to change the sound representation in the auditory system and produce enhanced performance in some speech perception tests. Based on these observations, it has been hypothesized that musical background can influence sound and speech perception, and as an extension also the quality of life, by cochlear-implant users. To test this hypothesis, this study explored musical background [using the Dutch Musical Background Questionnaire (DMBQ)], and self-perceived sound and speech perception and quality of life [using the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the Speech Spatial and Qualities of Hearing Scale (SSQ)] in 98 postlingually deafened adult cochlear-implant recipients. In addition to self-perceived measures, speech perception scores (percentage of phonemes recognized in words presented in quiet) were obtained from patient records. The self-perceived hearing performance was associated with the objective speech perception. Forty-one respondents (44% of 94 respondents) indicated some form of formal musical training. Fifteen respondents (18% of 83 respondents) judged themselves as having musical training, experience, and knowledge. No association was observed between musical background (quantified by DMBQ), and self-perceived hearing-related performance or quality of life (quantified by NCIQ and SSQ), or speech perception in quiet.

Hearing-impaired adults are at increased risk of experiencing emotional distress and social engagement restrictions five years later

we aimed to assess both cross-sectional and temporal links between measured hearing impairment and self-perceived hearing handicap, and health outcomes. in total, 811 Blue Mountains Hearing Study participants (Sydney, Australia) aged ≥55 years were examined twice (1997-99 and 2002-04). Hearing levels were measured with pure-tone audiometry. The shortened version of the hearing handicap inventory (HHIE-S) was administered, scores ≥8 defined hearing handicap. baseline hearing impairment was strongly associated with 7 of the 10 HHIE-S questions, 5 years later. Individuals with and without hearing impairment at baseline reported that they felt embarrassed and/or frustrated by their hearing problem, and that it hampered their personal/social life, multivariable-adjusted OR: 11.5 (CI: 3.5-38.1), OR: 6.3 (CI: 2.5-15.7) and OR: 6.0 (CI: 2.1-17.5), respectively, 5 years later. Hearing-impaired, compared with non-hearing-impaired adults had a significantly higher risk of developing moderate or severe hearing handicap, OR: 3.35 (CI: 1.91-5.90) and OR: 6.60 (CI: 1.45-30.00), respectively. Cross-sectionally (at wave 2), hearing handicap increased the odds of depressive symptoms and low self-rated health by 80 and 46%, respectively. older, hearing-impaired adults were significantly more likely to experience emotional distress and social engagement restrictions (self-perceived hearing handicap) directly due to their hearing impairment.

Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults

BackgroundWe aimed to determine the prospective association between measured hearing impairment, self-reported hearing handicap and hearing aid use with quality of life. Study design829 Blue Mountains Hearing Study participants (≥55 years) were examined between 1997–1999 and 2007–2009. The shortened version of the hearing handicap inventory was administered. Hearing levels were measured using pure-tone audiometry. Quality of life was assessed using the 36-Item Short-Form Survey (SF-36); higher scores reflect better quality of life. ResultsHearing impairment at baseline compared with no impairment was associated with lower mean SF-36 mental composite score 10 years later (multivariable-adjusted p=0.03). Physical composite score and mean scores for seven of the eight SF-36 domains after 10-year follow-up were significantly lower among participants who self-reported hearing handicap at baseline. Differences in the adjusted means between participants with and without hearing handicap ranged from 2.7 (physical composite score) to 10.4 units (‘role limitations due to physical problems’ domain). Individuals who developed incident hearing impairment compared to those who did not, had adjusted mean scores 9.5- and 7.7-units lower in the ‘role limitation due to physical problems’, and ‘bodily pain’ domains, respectively, at the 10-year follow-up. Hearing aid users versus non-users at baseline showed a 1.82-point (p=0.03) and 3.32-point (p=0.01) increase in SF-36 mental composite score and mental health domain over the 10-year follow-up, respectively. ConclusionOlder adults with self-perceived hearing handicap constitute a potential risk group for overall deterioration in quality of life, while hearing aid use could help improve the well-being of hearing impaired adults.

Temporal Processing in Low-Frequency Channels: Effects of Age and Hearing Loss in Middle-Aged Listeners

Hearing loss and age interfere with the auditory system's ability to process temporal changes in the acoustic signal. A key unresolved question is whether high-frequency sensorineural hearing loss (HFSNHL) affects temporal processing in the low-frequency region where hearing loss is minimal or nonexistent. A second unresolved question is whether changes in hearing occur in middle-aged subjects in the absence of HFSNHL. The purpose of this study was twofold: (1) to examine the influence of HFSNHL and aging on the auditory temporal processing abilities of low-frequency auditory channels with normal hearing sensitivity and (2) to examine the relations among gap detection measures, self-assessment reports of understanding speech, and functional measures of speech perception in middle-aged individuals with and without HFSNHL. The subject groups were matched for either age (middle age) or pure-tone sensitivity (with or without hearing loss) to study the effects of age and HFSNHL on behavioral and functional measures of temporal processing and word recognition performance. These effects were analyzed by individual repeated-measures analyses of variance. Post hoc analyses were performed for each significant main effect and interaction. The relationships among the measures were analyzed with Pearson correlations. Eleven normal-hearing young adults (YNH), eight normal-hearing middle-aged adults (MANH), and nine middle-aged adults with HFSNHL were recruited for this study. Normal hearing sensitivity was defined as pure-tone thresholds ≤25 dB HL for octave frequencies from 250 to 8000 Hz. HFSNHL was defined as pure-tone thresholds ≤25 dB HL from 250 to 2000 Hz and ≥35 dB HL from 3000 to 8000 Hz. Gap detection thresholds (GDTs) were measured under within-channel and between-channel conditions with the stimulus spectrum limited to regions of normal hearing sensitivity for the HFSNHL group (i.e., <2000 Hz). Self-perceived hearing problems were measured by a questionnaire (Abbreviated Profile of Hearing Aid Benefit), and word recognition performance was assessed under four conditions: quiet and babble, with and without low-pass filtering (cutoff frequency = 2000 Hz). The effects of HFSNHL and age were found for gap detection, self-perceived hearing problems, and word recognition in noise. The presence of HFSNHL significantly increased GDTs for stimuli presented in regions of normal pure-tone sensitivity. In addition, middle-aged subjects with normal hearing sensitivity reported significantly more problems hearing in background noise than the young normal-hearing subjects. Significant relationships between self-report measures of hearing ability in background noise and word recognition in babble were found. The conclusions from the present study are twofold: (1) HFSNHL may have an off-channel impact on auditory temporal processing, and (2) presenescent changes in the auditory system of MANH subjects increased self-perceived problems hearing in background noise and decreased functional performance in background noise compared with YNH subjects.

Pilot Initiatives of Adult Hearing Screening in Italy.

A series of pilot initiatives of adult hearing screening programs were organized in eight large and small-size cities in Italy in the past two years. The screening initiatives were held in public places, supermarkets, drugstores, and in some universities of the third age, and involved an overall population of 2,278 screened subjects with age ranging from 13 to 93 years. Three different screening tests were used to assess hearing ability in the participants, i.e.: screening pure tone audiometry (PTA), an automated speech-in-noise screening test (the SUN-test), and a screening questionnaire of self-perceived hearing handicap (the HHIE-S). This paper describes the organization and management of these screening initiatives and reviews the main results obtained in the screened population, using the three different screening tests. Results obtained in these pilot initiatives showed that screening adults for hearing problems might be feasible, on a local level, in non clinical settings and can be performed quite easily with the support of local coordinators and partners, such as associations or local authorities. It is recognized that further initiatives and studies will have to be performed to better define the key aspects related to the organization and management of adult hearing screening programs, either at a local, regional, or national level.

Hearing disability in patients with Fuchs&amp;rsquo; endothelial corneal dystrophy: unrecognized co-pathology?

PurposeTo investigate a possible association between Fuchs’ endothelial corneal dystrophy (FECD) and hearing disability.MethodsA cross-sectional observational study was performed at the University Medical Center Utrecht. Cases and controls were patients who were treated by a cornea specialist between 2004 and 2008. FECD patients had either already undergone or were planned for a keratoplasty procedure. All controls were patients treated for cataract without any corneal pathology. Cases and controls were matched by age group and gender. A structured telephone interview combined with a validated self-perceived hearing function test (the Hearing Handicap Inventory for the Elderly, screening version; HHIE-S) was used for data collection.ResultsHearing disability was reported in 33 patients (45.8%) in the FECD-group (n = 72, average age: 73 years) versus 50 patients (34.7%) in the control group (n = 144, average age: 73 years). Hearing disability was significantly associated with FECD after adjustment for age, noise exposure, and diabetes mellitus (odds ratio 1.97 95% confidence interval 1.04–3.75).ConclusionThis case–control study reports a significant association between FECD and hearing disability. The causal relation was not evaluated in this study, though mutations in the SLC4A11 gene could have played an important role. This gene encodes for an ion transporter, which has been found in the cornea and inner ear. With the lack of examination with a pure tone or speech audiometry in this study, further studies need to be performed in order to support the association and should include a complete ENT examination with audiometry and genetic research.

Use of Hearing Aids and Assistive Listening Devices in an Older Australian Population

Hearing loss is a common sensory impairment experienced by older persons. Evidence shows that the use of hearing aids and/or assistive listening devices (ALDs) can benefit those with a hearing loss but that historically the uptake and use of these technologies has remained relatively low compared with the number of people who report a hearing loss. The aim of this study was to determine the prevalence, usage, and factors associated with the use of hearing aids and ALDs in an older representative Australian population. A population-based survey. A total of 2956 persons out of 3914 eligible people between the ages of 49 and 99 yr (mean age 67.4 yr), living in the Blue Mountains, west of Sydney, completed a hearing study conducted from 1997 to 2003. Hearing levels were assessed using pure tone audiometry, and subjects were administered a comprehensive hearing survey by audiologists, which included questions about hearing aid and ALD usage. Logistic regression analysis was used to identify factors associated with hearing aid and ALD usage. Of the surveyed population, 33% had a hearing loss as measured in the better ear. 4.4% had used an ALD in the past 12 mo, and 11% owned a hearing aid. Of current hearing aid owners, 24% never used their aids. ALD and hearing aid usage were found to be associated with increasing age, hearing loss, and self-perceived hearing disability. These results indicate that hearing aid ownership and ALD usage remains low in the older population. Given the significant proportion of older people who self-report and have a measured hearing loss, it is possible that more could be helped through the increased use of hearing aid and/or ALD technology. Greater efforts are needed to promote the benefits of these technologies and to support their use among older people with hearing loss.

Correlações audiométricas do questionário de handicap auditivo para adultos

OBJETIVO: verificar as relações entre a autopercepção do handicap auditivo (restrição de participação), os achados audiométricos e dados sócio-demográficos em adultos deficientes auditivos. Comparar os resultados da percepção do handicap entre homens e mulheres. MÉTODOS: participaram deste estudo, 113 adultos jovens portadores de deficiência auditiva pós-lingual, neurossenssorial bilateral de graus variados. O questionário de Handicap Auditivo para Adultos (HHIA) foi aplicado no formato de entrevista. A pontuação total e das subescalas "social" e "emocional", do questionário foram correlacionadas com as médias dos limiares audiométricos (ISO, baixa, média e alta frequência) e limiar de reconhecimento de fala (LRF). Também foi obtida correlação entre as pontuações do questionário e tempo de surdez, escolaridade e nível sócio-econômico. A comparação dos resultados do HHIA entre homens e mulheres foi realizada pelo teste t de Student. RESULTADOS: correlações fracas, porém significantes, foram obtidas entre os dados audiométricos e a pontuação do HHIA. Não houve correlação entre o tempo de surdez, escolaridade e nível sócio-econômico com a pontuação do questionário. Não houve diferença significativa da pontuação entre homens e mulheres. CONCLUSÃO: os dados deste estudo reforçam a necessidade de utilização de um instrumento de avaliação da restrição de participação, já que esta não pode ser inferida a partir dos dados audiológicos e/ou sócio-demográficos.

Loneliness in old age: Psychosocial and health predictors

Study objectives Design Main results 17% (CI 12.5–23.0) of the respondents answered yes. A significant correlation was demonstratedbetween a feeling of loneliness and low self-perceived health, low vision and poor hearing, low activity of dailylife (ADL) function, loss of a spouse, low social network, no hobbies and possession of a safety alarm. After amultiple regression analysis of the significant variables, the remaining variables as predictors for lonelinessincluded: number of social contacts, self-perceived health, using hearing aid and having a safety alarm.: : The information is obtained from a survey conducted among 232 inhabitants in this age group in the municipalityof Tønsberg, its Northern District. The interview data are composed of the responses from 202 elderlypeople living in a house or apartment (non-institutionalized) to the question «do you generally feel lonely?».The purpose of this article is to study the prevalence of loneliness in a group of elderly peopleover 80 years old and the sociodemographic, health-related and social predictors for experiencing loneliness.ABSTRACT:

The Factors Associated with a Self-Perceived Hearing Handicap in Elderly People with Hearing Impairment—Results from a Community-Based Study

Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. There was a moderate association (gamma(s) = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score >or=10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 >or=41 dB HL), 5.0% of those with HHIE-S <10 and 45.4% of those with HHIE-S >or=10 used or felt that they required hearing aids (chi2 test, p < 0.001). These data suggested that a self-perceived hearing handicap (HHIE-S >or=10) is an important indicator for referral of elderly persons for hearing-aid fitting. Our study findings, consistent with those of previous studies, demonstrated that not all elderly persons with impaired hearing function (hearing impairment) perceived a hearing deficit socially or emotionally in everyday life (hearing handicap). Marital status (widowed) and bad/neutral general health were nonaudiologically associated factors with a hearing handicap in the present study. Further, those with a self-perceived hearing handicap reported a higher rate of the use of, or requirement for, hearing aids. Because hearing deterioration is a common biologic process of aging, the results of this study can be used to identify the groups among elderly people with a greater need for hearing screening and hearing rehabilitation services.

Self-Perception of Hearing Ability as a Strong Predictor of Hearing Aid Purchase

Hearing threshold data are not particularly predictive of self-perceived hearing handicap or readiness to pursue amplification. Poor correlations between these measures have been reported repeatedly. When a patient is evaluated for hearing loss, it is common to collect both threshold data and the individual's self-perception of hearing ability. This is done to help the patient make an appropriate choice related to the pursuit of amplification or other communication strategies. It would be valuable, though, for the audiologist to be able to predict which patients are ready for amplification, which patients require more extensive counseling before pursuing amplification, and which patients simply are not ready for amplification regardless of the audiometric data. The purpose of this study was to evaluate the following question for its potential usefulness as a determinant of patient readiness for amplification: "On a scale from 1 to 10, 1 being the worst and 10 being the best, how would you rate your overall hearing ability?" The test-retest reliability and the predictive value of the question, based on final hearing aid purchase, were evaluated in a private practice setting. Eight hundred forty hearing-impaired adults in the age range from 18 to 95 years. COLLECTION AND ANALYSIS: Data were collected retrospectively from patient files. Results were repeatable and supported the use of this question in similar clinical settings.

Functional status of elderly people with hearing loss

The objective is to determine the prevalence of hearing loss in people over 65 years of age, to describe the functional status of people with hearing loss and to identify the need for hearing aid use. In a cross-sectional study, a random sample of 1387 people aged 65 years and over was selected. The primary study variables were: hearing level by audiometric assessment, self-perceived hearing loss, screening for hypoacusia using the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) and physical, cognitive and emotional functional status. Using the HHIE-S it was determined that 11.3% of the subjects had severe hearing handicap. According to the Ventry/Weinstein criteria 43.6% had hearing handicap. When asked about the use of hearing aids, 4.5% of the study subjects said they used them, although 41.9% had hearing loss of 35 dB or more in their better ear. The variables associated with the need for a hearing aid were age >75 years (odds ratio = OR = 3.2), ADL dependence (OR = 2.7), cognitive impairment (OR = 2.0), multiple health problems (OR = 1.8), male sex (OR = 1.6) and single/widowed (OR = 1.5). In conclusion, there is a high prevalence of hearing loss associated with other functional limitations. Of those people who would benefit from a hearing aid (more than a third of people over 65 years old), 89.3% do not own one. The screening of hearing loss needs to be improved.