By Linda Carroll
NEW YORK (Reuters Health) - Seniors with hearing loss as well as another sensory impairment are less likely to use a hearing aid than those with hearing loss alone, a new study finds.
An analysis of data from approximately 10 million Americans 70 and older revealed that the prevalence of regular hearing-aid use among those with hearing loss only was more than twice that of those with dual sensory impairments, researchers report in JAMA Otolaryngology-Head & Neck Surgery. Hearing checks also appeared less common in seniors with dual sensory impairment, although the finding was not statistically significant.
"We know sensory impairment is common as we age and that addressing sensory impairments is critical to healthy aging," said Dr. Carrie Nieman of the Johns Hopkins University School of Medicine and the Johns Hopkins Cochlear Center for Hearing and Public Health in Baltimore, Maryland. "However, hearing-care access is unequal and older adults with both hearing and vision impairments may be at particular risk for going without the services they need to age well."
"Hearing care, including testing and the provision of hearing aids, can be challenging to access, often requiring multiple visits to specialized clinicians and high out-of-pocket costs," Dr. Nieman told Reuters Health by email. "These barriers can disproportionately affect individuals who are already managing multiple conditions, including vision impairment. Furthermore, hearing aids and some of the strategies we recommend to compensate for hearing loss can be challenging for individuals with vision impairment, from manipulating a small device, like hearing aids, or changing batteries to speech reading."
To take a closer look at the impact of dual sensory impairment on hearing testing, Dr. Nieman and her colleagues turned to data from the 2005 to 2006 cycle of the National Health and Nutrition Examination Survey (NHANES), an ongoing cross-sectional study of a representative sample of the non-institutionalized U.S. population.
Compared with those with hearing loss alone, a smaller percentage of seniors with dual sensory impairments had had their hearing tested more than four years earlier (41% vs. 49%; difference, -0.08; 95% CI, -0.26 to 0.10).
Moreover, compared with those with hearing loss alone, a smaller percentage said they had ever worn a hearing aid, amplifier or had an implant (15.9% vs. 27.0%; difference, -0.11; 95% CI, -0.22 to 0.002) or wore a hearing aid regularly (6.5% vs. 17.8%; difference, -0.11; 95% CI, -0.17 to -0.06).
"Vision care and hearing care often exist in silos and we need a more holistic approach to the identification and care of sensory impairments, particularly among older adults," Dr. Nieman said. "We need to prioritize sensory health as fundamental to healthy aging. We can identify and take action on both vision and hearing impairments in order to improve outcomes and lives."
Hearing healthcare is important for everyone, said Dr. Justin Golub, an associate professor of otolaryngology-head and neck surgery at Columbia University Vagelos College of Physicians and Surgeons, in New York City, and a hearing-loss researcher at NewYork-Presbyterian/Columbia University Irving Medical Center.
But "good utilization of hearing healthcare is even more critical for those with dual sensory (both vision and hearing) impairment than for those with only hearing impairment," Dr. Golub, who was not involved in the research, told Reuters Health by email. "Yet this study showed the reverse of what we hope to see. Those with dual sensory impairment had the same or worse utilization of hearing healthcare. Broad societal recognition of the importance of sensory impairments is needed to improve diagnosis and treatment levels."
The new study is a "great example of how powerful NHANES and other ongoing data collection efforts can be in addressing important healthcare questions," said Dr. Catherine Palmer, director of the Center for Audiology and Hearing Aids in the Department of Otolaryngology at the Eye & Ear Institute at UPMC and an associate professor of communications science and disorders at the University of Pittsburgh's School of Health and Rehabilitation Sciences.
"Clinicians will not be surprised by the finding that there are disparities between adults with dual sensory impairment and individuals with hearing loss alone in terms of uptake in hearing evaluation and hearing aid use," Dr. Palmer told Reuters Health by email. "The important question is, how do we make hearing healthcare accessible?"
"The authors mention possible barriers to care including finances and manipulating small devices, but they do not highlight the barrier created by needing to access yet another healthcare appointment," Dr. Palmer said.
"At UPMC we approach this problem through interventional audiology which brings hearing services to the individual," she added. "We have extended our services by integrating into the clinics and locations where seniors likely to have hearing and vision loss can be found. This includes embedding audiology services into our geriatric clinics and providing hearing screening and the provision of simple amplifiers (large and easy to see) to support communication in the perioperative clinic, post-trauma outpatient clinic, survivorship clinic, and inpatient units as well as bringing audiology and hearing support services into our Senior Living communities."
SOURCE: https://bit.ly/3tjUQTS JAMA Otolaryngology-Head & Neck Surgery, online June 2, 2022.
