Screening for hearing impairment in a cohort of elderly patients attending a hospital geriatric medicine service.
BACKGROUND
This study sets out to determine the usefulness of a questionnaire to screen for hearing impairment, assess the psychosocial impact of hearing handicap and survey older persons' attitudes towards hearing aid usage.


METHODS
Subjects were recruited from a Geriatric Medicine unit over a six-month period. A questionnaire was administered, followed by an otoscopic examination and audiometric testing.


RESULTS
Sixty-three patients were included in the study. Fifty-two (83%) patients had hearing impairment, of which 34 were moderately severe and 18 were mild. Of the six questions used in hearing screening, the question on self-perception was the most specific (91%). Administering the remaining five questions on activities of daily living improved the questionnaire's sensitivity from 58% to 73%, although the specificity was reduced from 91% to 64%. Of the 30 patients with self-perceived and audiometrically-confirmed hearing impairment, about 40% reported negative psychosocial impact as a result of the handicap. 66.7% were not keen to consider using hearing aid, even if recommended. The willingness to use hearing aids was correlated to patients' functional status (p=0.002) but not to the severity of hearing impairment (p=0.157).


CONCLUSIONS
Self-perception of hearing problems in the elderly is a strong indicator of hearing impairment. Introducing additional culturally-relevant questions based on activities of daily living improves the detection rate of hearing impairment. Although hearing loss impacts negatively on psychosocial well-being, most elderly subjects are unwilling to consider the use of hearing aids. There is a need to educate the elderly on the importance of intervention in order to reduce their handicap and improve their quality of life.
Wu
H Y
HY
Department of Geriatric Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433. huei_yaw_wu@ttsh.com.sg
Chin
J J
JJ
Tong
H M H
HM
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015331:Cohort Studies; D005260:Female; D006310:Hearing Aids / Q000523:psychology; D006311:Hearing Disorders / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012846:Singapore; D011795:Surveys and Questionnaires