STRUCTURED ABSTRACT:BACKGROUND: Poor hearing is common in older adults and it may have negative consequences which extend beyond communication. OBJECTIVES:To explore the associations of self-reported hearing problems with physical performance and self-reported difficulties in mobility and activities of daily living (ADL) in community-dwelling older adults. DESIGN:Cross-sectional cohort study SETTING: Community PARTICIPANTS: 848 men and women aged 75-90 years MEASUREMENTS:Structured face-to-face interviews to assess perceived hearing problems in the presence of noise, mobility difficulties (moving indoors, stair-climbing, 0.5 km walk and 2 km walk) and difficulties in ADLs and instrumental ADLs. The Short Physical Performance Battery (SPPB) test was administered. Age, years of education, cognitive functioning, and self-reported cardiac, circulatory, and locomotor diseases were used as covariates. RESULTS:Compared to persons who reported good hearing, persons who reported major hearing problems had a lower SPPB total score indicating poorer performance (mean 9.8 vs.10.9, p=0.009) and more difficulties in ADLs (mean 1.8 vs. 1.4, p=0.002) and IADLs (mean 4.6 vs. 3.4, p=0.002) after controlling for covariates. They also had higher odds for more difficulty in stair-climbing (OR 2.8, p<0.001) and walking 2 km (OR 2.1, p=0.003) and tended to have more difficulty in walking 0.5 km (OR 1.7, p=0.050) but not in moving indoors (p=0.177). Persons who reported only some hearing problems did not differ from those who reported good hearing in any of the variables studied. CONCLUSION:Perceived major hearing problems among older adults may contribute to 4 poorer lower limb performance, and difficulties in mobility and ADL. Longitudinal studies are needed in order to disentangle whether poor hearing is a risk factor for decline in physical performance. Given the growing prevalence of hearing problems with increasing age, it is vitally important to study the correlates of hearing difficulties in old adults. The primary purpose of the present study was to explore the associations between self-reported hearing problems and physical performance in community-dwelling older adults. We also studied the association of self-reported hearing problems with perceived mobility difficulties and difficulties in activities of daily living.7 METHODS Design and sampleThe analyses made use of cross-sectional data gathered for the Life-Space Mobility in Old Age (LISPE) project, which is a study of community-dwelling older adults. The project has been described in detail elsewhere. 20 Briefly, a sample of 2 550 older persons between 75and 90 years of age and living in the municipalities of Muurame and Jyväskylä, both located in Central Finland, was drawn from the population register. A telephone interview was used to screen eligible participants based on the inclusion criteria, which were: living independently, residing in the recruitment area, being able to communicate, and willingness to participate in the study. The final data set comprised 848 ind...

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BackgroundLife-space mobility reflects individuals’ actual mobility and engagement with society. Difficulty in hearing is common among older adults and can complicate participation in everyday activities, thus restricting life-space mobility. The aim of this study was to examine whether self-reported hearing predicts changes in life-space mobility among older adults.MethodsWe conducted a prospective cohort study of community-dwelling older adults aged 75–90 years (n = 848). At-home face-to-face interviews at baseline and telephone follow-up were used. Participants responded to standardized questions on perceived hearing at baseline. Life-space mobility (the University of Alabama at Birmingham Life-Space Assessment, LSA, range 0–120) was assessed at baseline and one and two years thereafter. Generalized estimating equations were used to analyze the effect of hearing difficulties on changes in LSA scores.ResultsAt baseline, participants with major hearing difficulties had a significantly lower life-space mobility score than those without hearing difficulties (mean 54, 95 % CI 50–58 vs. 57, 95 % CI 53–61, p = .040). Over the 2-year follow-up, the life-space mobility score declined in all hearing categories in a similar rate (main effect of time p < .001, group x time p = .164). Participants with mild or major hearing difficulties at baseline had significantly higher odds for restricted life-space (LSA score < 60) at two years (OR 1.8, 95 % CI 1.0–3.2 and 2.0, 95 % CI 1.0–3.9, respectively) compared to those without hearing difficulties. The analyses were adjusted for chronic conditions, age, sex and cognitive functioning.ConclusionsPeople with major hearing difficulties had lower life-space mobility scores at baseline but did not exhibit accelerated decline over the follow-up compared to those without hearing difficulties. Life-space mobility describes older people’s possibilities for participating in out-of-home activities and access to community amenities, which are important building blocks of quality of life in old age. Early recognition of hearing difficulties may help prevent life-space restriction.

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Perceived hearing difficulties in various everyday life situations are more strongly associated with older adults' QoL than audiometrically assessed hearing impairment.

BackgroundOlder adults with hearing difficulties face problems of communication which may lead to underuse of health services. This study investigated the association of hearing loss and self-reported hearing difficulty with the use of health services and unmet health care needs in older adults.MethodsData on persons aged 65 and older (n = 2144) drawn from a population-based study, Health 2000, were analyzed. Hearing loss was determined with screening audiometry (n = 1680). Structured face-to-face interviews were used to assess self-reported hearing difficulty (n = 1962), use of health services (physician and nurse visits, health examinations, mental health services, physical therapy, health promotion groups, vision test, hearing test, mammography, PSA test) and perceived unmet health care needs. Multivariable logistic regression analyses were used.ResultsAfter adjusting for socio-economic and health-related confounders, persons with hearing loss (hearing level of better ear 0.5–2 kHz > 40 dB) were more likely to have used mental health services than those with non-impaired hearing (OR = 3.2, 95 % CI 1.3–7.9). Self-reported hearing difficulty was also associated with higher odds for mental health service use (OR = 2.1 95 % CI 1.2–3.5). Hearing was not associated with use of the other health services studied, except presenting for a hearing test. Persons with self-reported hearing difficulty were more likely to perceive unmet health care needs than those without hearing difficulty (OR = 1.7, 95 % CI 1.4–2.1).ConclusionsOlder adults with hearing loss or self-reported hearing difficulty are as likely to use most health services as those without hearing loss. However, self-reported hearing difficulty is associated with experiencing unmet health care needs. Adequate health services should be ensured for older adults with hearing difficulties.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-016-0356-5) contains supplementary material, which is available to authorized users.

Perceived benefit from HA use is associated with higher life-space mobility among community-dwelling older adults. Future studies are needed to examine whether use of an appropriate HA promotes life-space mobility among those with difficulties in hearing.

Using the COSMIN guidelines, the authors show that the HERE is a valid, reliable, and stable questionnaire for the assessment of self-reported speech perception, sound localization, and the socio-emotional consequences of hearing impairment in the context of social functioning. The authors also show that cross-cultural data collected using different data collection strategies can be combined with a range of statistical methods to validate a questionnaire.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.