title: Auditory rehabilitation of older people from the general population--the Leiden 85-plus study.
abstract: BACKGROUND
  Very few older people with severe hearing loss use hearing aids to reduce the negative consequences of reduced hearing in daily functioning.
  
  
  OBJECTIVE
  Assessment of a screening test and a standardised auditory rehabilitation programme for older people from the general population with untreated severe hearing loss.
  
  
  METHODS
  Intervention study and qualitative exploration.
  
  
  METHODS
  Leiden 85-Plus Study, a prospective population-based study of 85-year-old inhabitants of Leiden, the Netherlands.
  
  
  METHODS
  Hearing loss was measured by pure-tone audiometry in 454 subjects aged 85 years. Subjects with hearing loss above 35 dB at 1, 2, and 4 kHz who did not use hearing aids were invited to participate in a standardised programme for auditory rehabilitation. In-depth interviews were held with participants to explore arguments for participating in this programme.
  
  
  RESULTS
  Of the 367 participants with severe hearing loss (prevalence = 81%), 66% (241/367) did not use a hearing aid. Three out of four of these participants (n = 185) declined participation in the auditory rehabilitation programme. The most common reason given for not participating was the subjects' feeling that their current hearing loss did not warrant the use of a hearing aid. Subjects who participated in the programme were found to suffer from more severe hearing loss and experienced more hearing disability. Those who did not participate in the programme felt they could cope with their disabilities and considered a hearing aid unnecessary.
  
  
  CONCLUSIONS
  Untreated hearing loss is prevalent among older people from the general population. The majority of older people decline auditory rehabilitation. For these people the use of a hearing aid is not perceived as necessary in order to function on a daily basis. Older people who have expected benefits from a hearing aid have already obtained them, marginalising the benefits of a rehabilitation (and screening) programme.
authors.affiliation: Section of Gerontology and Geriatrics, Department of General Internal Medicine, Leiden University Medical Centre, C-2-R, PO Box 9600, 2300 RC Leiden, The Netherlands. JGussekloo@LUMC.nl
authors.forename: Jacobijn
authors.initials: J
authors.lastname: Gussekloo
authors.forename: L E
authors.initials: LE
authors.lastname: de Bont
authors.forename: M
authors.initials: M
authors.lastname: von Faber
authors.forename: J A
authors.initials: JA
authors.lastname: Eekhof
authors.forename: J A
authors.initials: JA
authors.lastname: de Laat
authors.forename: J H
authors.initials: JH
authors.lastname: Hulshof
authors.forename: E
authors.initials: E
authors.lastname: van Dongen
authors.forename: R G
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D012048:Correction of Hearing Impairment / Q000295:instrumentation / Q000523:psychology; D005260:Female; D006310:Hearing Aids / Q000706:statistics & numerical data*; D034381:Hearing Loss / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009426:Netherlands; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology; D011446:Prospective Studies