With 78 million baby boomers approaching senior adulthood, the total number of people with hearing loss will grow substantially in the next few years. Noise-induced hearing loss is also affecting younger people. Fortunately, the hearing aid technology that is available today is immensely improved from only a few years ago and is able to meet the needs of this growing and diverse group of individuals.
Hearing loss is among America’s leading chronic health problems, with about 1 out of 10 people, or approximately 38 million people affected. It is especially common in people that are 60 years of age or older. Hearing loss is the third most common chronic health condition affecting the aging population, and the numbers are increasing in younger populations as well.
In some cases, hearing loss is a symptom of a more serious problem necessitating medical intervention. In most of your patients, however, hearing loss is a chronic and degenerative process that can be properly managed with hearing aids.
Recent research has demonstrated that hearing loss can have dramatic adverse effects on both emotional well-being and on interpersonal and marital relationships. According to the National Council on the Aging (1999), untreated hearing loss can result in negative emotional consequences including depression and paranoia. Newer studies have shown a link between hearing loss and cognitive decline.
The site of lesion for about 95% of all hearing losses is the cochlea, resulting in “sensorineural hearing loss.” In sensorineural hearing loss, damage occurs to the cilia in the inner ear, resulting in irreversible hearing loss. The most common causes of sensorineural hearing loss are noise exposure, aging, and hereditary predisposition. Fortunately, the vast majority of people with this sensorineural hearing loss respond very well to the use of hearing aids.
Only 5% of hearing losses are “conductive,” resulting from structural or mechanical damage to the outer ear and/or middle ear. In many of these patients, medical or surgical treatment can result in partial or complete reversal of the hearing loss. Some common causes of conductive hearing loss are wax impaction, eardrum perforation, middle ear fluid, cholesteatoma and congenital problems.
Aside from the embarrassment caused by the inability to hear and to maintain communication, research reveals that hearing loss also adversely affects the hearing-impaired persons’ quality of life. Negative effects on relationships, enjoyment of social activities, and work performance have all been carefully documented. Danger from failure to hear warning signals and even doctor’s instructions regarding medications have also been reported.
The 1999 National Council on Aging report showed that individuals with untreated hearing loss experience feelings of depression, paranoia, anger and frustration at a significantly greater rate than do hearing aid users. Those who use hearing aids also report significantly higher social involvement, less worry, and more positive interpersonal relationships.
Additionally, Untreated Hearing Loss Can:
Ideally, all patients should be screened annually. We can provide self-assessment forms for your patients to complete in the waiting room, and those patients who report hearing problems can be referred for a complete audiological evaluation. Additionally, patients who are at risk for hearing loss– including those over age 50 and those who present observable symptoms– should be checked.
A few simple questions regarding the common early warning signs of hearing loss can help you determine whether your patient needs a hearing screening:
• Does he or she ask others to repeat?
• Does he or she complain that others mumble or don’t speak clearly?
• Do others complain that he or she turns the TV or radio volume too loud?
• Does he or she have difficulty understanding speech in groups and/or noisy places?
• Does he or she have trouble hearing at a distance?
• Does he or she complain of ringing in either or both ears?
• Does he or she hear better in one ear than the other?
Hearing plays an imperative role in the mental, emotional and physical well-being of your patients. You are a vital resource for your patients who are hearing impaired. As a physician, your role starts by asking hearing-related questions as part of the case history interview and by screening your patients’ hearing.
Hearing screening tools, such as the Hearing Handicap Inventory Screening Questionnaire, is available upon request.
Hearing loss has a profound impact on quality of life and functional capabilities (Research studies: NCOA-1999 and VA/NIDCD-2000). Solid clinical data correlates hearing loss to the occurrence of depression, anxiety, and social isolation. Hearing aids were shown to be highly effective in treating these.