Recent initiatives of the President’s Council of Advisors on Science & Technology (PCAST) and the National Academy of Sciences (NAS) have raised awareness of the possible public health consequences resulting from untreated sensorineural hearing loss in adults. The PCAST and NAS recommendations have also renewed interest in updating hearing loss prevalence data in order to better understand the magnitude of this challenge, especially in light of the rapidly aging American population.
Two recent studies — each examining different aspects of hearing loss prevalence — may facilitate changes in how services are delivered to our aging population.
Observing the Data
The first study, published online in the American Journal of Public Health on August 23, analyzed data over a 9-year period in order to update hearing loss prevalence. The researchers, Adele Goman and Frank Lin at Johns Hopkins University School of Medicine, determined hearing loss directly impacts 23% of Americans 12 years of age and older.
Specifically, they found that 25.4 million Americans have mild bilateral hearing loss, 10.7 million have moderate bilateral hearing loss, 1.8 million have severe bilateral hearing loss, and 0.4 million have profound hearing loss bilaterally.
When hearing loss is categorized as “hearing loss in at least one ear,” the total number of American with hearing loss rises to 60.73 million individuals. When hearing loss is categorized this way, 37.1 million have a mild loss in at least one ear, while 17 million have a moderate loss in at least one ear, 4.6 million have a severe loss in at least one ear, and 2.0 million have a profound loss in at least one ear.
Evaluating Hearing Loss in the Elderly
In a separate study, published online in JAMA-Otolaryngology , a group of Columbia University researchers analyzed the rate of hearing loss in the “older old.” Researchers investigated the rates of hearing loss and hearing aid use among a group of adults 80 years and older. Study participants were sub-divided into four age brackets: 80 to 84, 85 to 89, 90 to 94 and 95 years and older.
As expected, hearing thresholds declined with each older age bracket, as individuals in the 95 years and older category had the worst thresholds. Interestingly, the most decline in hearing relative to the other age groups occurred at lower frequencies (250, 500 & 1000 Hz).
Although all 647 study participants had hearing loss, 59% of the patients reported they used hearing aids regularly. The percentage of hearing aid users increased with age, as 100% of the 95 years old and above group reported they used hearing aids. When compared to participants who were non-users, the hearing aids users in this study were older, had poorer hearing thresholds and a faster decrease in word recognition scores.
In what may be a bold move to address the low uptake of hearing aids among this group, the researchers proposed that age-related hearing loss, rather than being viewed as a medical condition, needs to be treated as a chronic disease in which hearing aid use can be thought of as a lifestyle modification.
Additionally, the authors suggested patients with age-related hearing loss would benefit from a longitudinal approach, similar to other chronic condition like diabetes, smoking cessation and hypertension – that employ motivational interviewing techniques to improve outcomes in this population.
*title image courtesy sureymonkey