Article Figures & Data
Figures
- Figure 1.
Conceptual model of the association of hearing impairment with impaired cognitive and physical functioning in older adults. QoL, quality of life.
- Figure 2.
Suggested pathway for the evaluation and management of hearing loss in primary care. *Medical issues include, but are not limited to, pain, sudden onset of hearing loss, dizziness, abnormal ear examination, unremitting tinnitus, ear drainage, or single-sided/asymmetric deafness.
- Figure 3.
Communication strategies for patients with hearing loss.
Tables
- Table 1.
Epidemiologic Studies of the Association of Audiometric Hearing Impairment with Outcomes in Older Adults
Outcomes by Category Odds/Hazard Ratio (95% CI)* Measure Authors Cognition Cognitive decline 1.2 (1.1–1.5) Increased risk of cognitive impairment Lin et al.6 Dementia 3.0 (1.4–6.3) Increased risk of dementia for moderate HI Lin et al.,9 Gallacher et al.10 Mental health Depression 3.9 (1.3–11.3) Greater odds of depression in women with moderate HI Li et al.,11 Mener et al.12 Anxiety 1.5 (1.3–1.7) Greater odds of anxiety disorder Chung et al.,17 Tambs et al.18 Social isolation 3.5 (1.9–6.4) Greater odds in women per 10 dB of HI Mick et al.19 Physical function Mortality 1.5 (1.1–2.2) Increased risk of mortality for moderate HI Contrera et al.,5 Fisher et al.20 Falls 1.6 (1.2–1.9) Greater odds of falls per 10 dB of HI Lin et al.,21 Viljanen et al.22 Physical activity 1.6 (1.1–2.2) Greater odds of lower physical activity for moderate HI Gispen et al.,23 Loprinzi24 Disability 1.3 (1.1–1.9) Increased risk of disability for moderate HI Chen et al.25 Gait speed 2.0 (1.2–3.3) Greater odds of low gait speed per 25 dB of HI Li et al.,26 Viljanen et al.27 Cost Hospitalizations 1.4 (1.1–1.7) Greater odds of hospitalization Genther et al.28 Unemployment 2.0 (1.4–2.9) Greater odds of unemployment Emmett and Francis,29 Lin et al.30 CI, confidence interval; dB, decibel; HI, hearing impairment.
↵* Compared with individuals without hearing impairment, taken from the first citation in column 4.
Option Training Services Limitations Best Clinical Utility Audiologist AuD or PhD Gold-standard aural rehabilitation and HA fitting High cost, access Mild to severe HL Hearing aid specialist High school, apprenticeship HA testing and fitting Limited rehabilitation and customization Mild to moderate HL Otolaryngologist MD Medical and surgical evaluation/treatment — Severe HL, medical management Primary care physician MD Hearing screening, referral, and care coordination — Selective screening, education, referral Internet sales None Direct-to-consumer sale of HAs, PSAPs, and ALDs No aural rehabilitation, fitting, or customization Mild to moderate HL with existing care Over-the-counter sales None Direct sale of PSAPs and ALDs only No aural rehabilitation, fitting, or customization No to mild HL ALD, assistive listening device; HA, hearing aid; HL, hearing loss; PSAP, personal sound amplification product.
