[Hearing aids in the elderly. Why is the accommodation so difficult?].
PRELIMINARY REMARKS: The acceptance of hearing-aids by elderly people is generally poor. Hearing loss on the other hand increases with age, and the ability to communicate,especially in random noise, diminishes.


METHODS
Audiometric data on 331 individuals older than 60 years were collected. Sixty people between 15 and 30 and 86 people between 31 and 60 years acted as controls. Tympanograms, hearing thresholds, speech audiometry and dichotic hearing as well as binaural masking level differences and otoacustic emissions for eight frequencies were measured. Hearing aid status was also determined.


RESULTS
Our data show more hearing deficits at low frequencies as indicated in the literature. Presbycusis is present solely in the internal ear in 11.5-27.7%, in central hearing structures in 3.8-21.4%, but mainly in all parts of the auditory pathway 50.9-84.6% of cases. Only 15.3% of patients needing hearing aids were actually provided with them.


CONCLUSIONS
Hearing decreases with age but some older people have completely normal hearing. Therefore, a physiological presbycusis does not exist. There are deficits in the inner ear as well as in the central auditory structures which should be determined by audiometric diagnosis. Hearing aid supply should be carefully regulated and audiotherapy carried out.
Hesse
G
G
Tinnitus-Klinik Arolsen, Bad Arolsen. ghesse@tinnitus-klinik.de
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001299:Audiometry; D005858:Germany / Q000453:epidemiology; D006310:Hearing Aids / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011304:Presbycusis / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D018570:Risk Assessment / Q000379:methods*