Hearing impairment in older people: a review
- Arrowe Park Hospital, Upton Road, Wirral, Merseyside L69 5PE, UK
- Dr Morgan
- Received 21 September 1999
- Accepted 7 December 1999
As we age we are increasingly likely to suffer from chronic conditions. Hearing impairment is among the top three such conditions along with arthritis and hypertension.1 It may have become a problem for the first time in old age or may have been acquired when younger or at birth. Prevalence figures illustrate the size of the condition. The prevalence of 45 decibels (dB) (moderate whisper) or greater hearing loss in the better ear in the UK population has been estimated as 3.8%. In those aged 61–80 years old the prevalence of conductive hearing loss of 45 dB or greater in the better ear is 3.1% and the prevalence of sensorineural hearing loss of at least 45 dB in the better ear is 14.3%.2 Looked at another way 90% of those with a hearing loss of 45 dB average in the better ear are over 52 years old, and for milder degrees of hearing loss a staggering 35% of those over 50 are afflicted.3 Not only is hearing impairment common,4 but also frequently disabling and it is essential that all clinicians who care for elderly patients are familiar with its recognition and methods of amelioration.
Aetiology
There are two main types of hearing loss: conductive and sensorineural. Any impediment to the transmission of sound waves through the external ear canal and middle ear as far as the footplate of the stapes results in conductive hearing loss—for example, perforation of the ear drum and fixation of the ossicular chain (otosclerosis). Sensorineural hearing impairment results from a defect in the cochlea, the cochlear nerve or more rarely in the central neural pathways. Within these two broad categories there are numerous conditions which may contribute to hearing impairment in the older adult, some of which may also affect younger adults (box …
