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April 16, 2003

Speak into my good ear …

From: News24, South Africa - Apr 16, 2003

Most seniors don't undergo simple screening tests, even though effective treatments could dramatically improve their hearing, new research indicates.

According to the researchers, at least one in four Americans of 65 and over suffers from hearing impairment, but it's often undiagnosed and untreated. It can be safely assumed that the same goes for South African seniors.

The study, appearing in the April 16 issue of the Journal of the American Medical Association, is based on an analysis of nearly 1 600 research studies published between 1985 and 2001. Researchers concluded the number of Americans over 65 with hearing loss could be as high as 40 percent.

Hearing loss just accepted
"A lot of people have come to accept hearing loss as a part of aging," says Dr Bevan Yueh, the study's lead author. "What shouldn't be accepted is the resulting loss of quality of life. There's effective treatment available for hearing loss."

Yueh, a staff surgeon and research associate at the Veterans Affairs Puget Sound Health System in Seattle, says many cases of hearing loss among the elderly could be easily detected by a primary-care physician with one of two quick, simple screening methods.

A hand-held audioscope emits tones to test hearing and can also be used to examine the eardrum. And a short questionnaire can often reveal hearing difficulties.

Few GPs screen their patients
Less than 10 percent of primary-care physicians, however, screen elderly patients for hearing loss, the study says, and only 25 percent of patients who could benefit from hearing aids receive them.

"It's kind of sad to think that there's a major disorder out there and that it's under-treated and under-recognised," says Yueh, who also is an associate professor at the University of Washington's medical school and school of public health.

He noted that primary-care physicians routinely do eye examinations and blood pressure tests, and they could easily perform hearing tests as well. The audioscope test, for example, takes just one or two minutes, less time than a blood-pressure examination, and a patient could easily complete the hearing questionnaire in the waiting room.

Elders socially isolated, depressed
The researchers found strong links between hearing loss in the elderly and social isolation, depression, low self-esteem and difficulty functioning. Depression, for instance, is twice as prevalent in the hearing-impaired, Yueh says.

"A lot of people with even mild to moderate hearing loss are socially isolated, stay home and turn up the TV and don't realise how bad it is," Yueh says. "Some of them who come didn't talk to the grandkids anymore, didn't have any social life. Then they got the hearing aids, and now they live life fully again."

Patients often in denial
Screening is vitally important because often the patients themselves fail to realise they have hearing loss, Yueh says. Gradual hearing loss, he says, is often imperceptible even to the sufferer and requires tests to detect.

"The classic thing is for a patient to come in and say, 'You know, I don't have a problem, but my wife told me to come in because she thinks I have a problem,'" Yueh says. "The patients are not even acknowledging the possibility because it happens so gradually, they think, 'How could I have hearing loss?'"

Nerve deafness often the case
More than 90 percent of hearing loss is sensorineural, or nerve deafness, which typically results from damage to the hair cells of the cochlea, and nerve deafness due to aging is the most common form of hearing loss in the United States, the study says.

Nerve deafness is characterised by the loss of ability to hear high-frequency sounds and difficulty filtering out background noise. There is no treatment, but hearing aids can greatly improve hearing and, in severe cases of hearing loss, a cochlear implant, an electronic device implanted behind the ear, can bypass the hair cells to stimulate auditory nerve fibres directly.

Unlike nerve deafness, conductive hearing loss results from abnormalities of the middle and external ear and generally requires surgery, the study says. – (HealthScout News)

Read more:
A-Z of Deafness and Hearing
How do we hear?

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