Falling on Deaf Ears: Hearing loss in older adults may be an undertreated condition

Most people will experience some degree of hearing loss as they age. Statistics from the National Institute on Deafness and Other Communication Disorders at the National institutes of Health (NIH) indicate that 30 percent of adults ages 65 to 74, and 47 percent of adults 75 years or older, have hearing loss.

Besides these findings, there is a paucity of data on the effects of hearing loss on older adults. Much that is known about the psychosocial effects of hearing loss on older adults comes from a 1999 report by the National Council on Aging (NCOA), which found that untreated hearing loss is a prevalent and serious problem among hearing-impaired older adults.

Compared to older adults with corrected hearing impairment, the NCOA study found that older adults with untreated hearing impairment were more likely to experience sadness and depression, worry and anxiety, paranoia, less social activity and emotional turmoil and insecurity. The percentages of patients with mild hearing loss reporting these outcomes are shown in table 1 (p. 5), while those with more severe hearing loss are shown in table 2 (p. 5).

Despite evidence of the detrimental effects of even mild hearing loss on older patients, the numbers of older people correcting hearing loss remain woefully low. This is true even though studies clearly show the benefits of hearing aids for people who wear them, as reported more recently in 2007 in the American Academy of Audiology’s systematic review of the literature on the effects of hearing aids on health-related quality of life outcomes. The report found that hearing aids improved quality of life in hearing-impaired adults by reducing the psychological, social and emotional effects of hearing loss (J Am Acad Audiol. 2007;18(2):151-183).

The reason for the lack of better hearing loss correction appears to be multifold. According to the NCOA report, denial on the part of the hearing-impaired person is a primary reason. Additionally, cost issues and the difficulty involved in getting used to wearing a device can be major challenges. A more subtle problem may be the perception by many physicians, as well as older hearing-impaired adults themselves, that hearing loss, and even the psychosocial problems associated with hearing loss, are simply a part of aging.

Recent research on a possible connection between hearing loss and cognitive decline may provide a stronger impetus for both physicians and patients to seek help for hearing loss.