Objectives Self-reported hearing impairment is often used to gauge objective hearing loss in both clinical settings and research studies. The aim of this study was to examine whether demographic factors affect the accuracy of subjective, self-reported hearing in older adults. Design We examined 3,557 participants aged 50 and older in the National Health and Nutrition Examination Survey (NHANES) cycles 1999-2006 and 2009-10. We examined the relationship between objective and subjective hearing impairment using percent correct classification and misclassification bias in analyses stratified by gender, age group, race/ethnicity, and education. Results We found that younger participants tended to overestimate and older participants underestimate their hearing impairment. Older women, blacks, and Hispanics were less accurate in self-reporting than their respective younger age groups. Conclusions The association between subjective and objective hearing differs across gender, age, race/ ethnicity, and education and this observation should be considered by clinicians and researchers employing self-reported hearing.

Objective We aimed to determine whether hearing impairment (HI) in older adults is associated with the development of frailty and falls. Method Longitudinal analysis of observational data from the Health, Aging and Body Composition study of 2,000 participants aged 70 to 79 was conducted. Hearing was defined by the pure-tone-average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better hearing ear. Frailty was defined as a gait speed of <0.60 m/s and/or inability to rise from a chair without using arms. Falls were assessed annually by self-report. Results Older adults with moderate-or-greater HI had a 63% increased risk of developing frailty (adjusted hazard ratio [HR] = 1.63, 95% confidence interval [CI] = [1.26, 2.12]) compared with normal-hearing individuals. Moderate-or-greater HI was significantly associated with a greater annual percent increase in odds of falling over time (9.7%, 95% CI = [7.0, 12.4] compared with normal hearing, 4.4%, 95% CI = [2.6, 6.2]). Discussion HI is independently associated with the risk of frailty in older adults and with greater odds of falling over time.

This review highlights the broad effects of hearing impairment and the importance of involving CPs in hearing loss treatment decisions.

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Objectives Given reported age and sex disparities in access to kidney transplantation (KT), we sought to explore whether these disparities originate at the time of pre-referral discussions about KT. Design Cross-sectional survey Setting 26 outpatient dialysis centers in Maryland Participants 416 patients who had recently initiated hemodialysis treatment Measurements Participants reported whether medical professionals (nephrologist, primary medical doctor, dialysis staff) and social group members (significant other, family member, friend) discussed KT with them and, when applicable, rated the tone of discussions. Relative risks were estimated using modified Poisson regression. Results Participants aged ≥65 years were much less likely to have had discussions with medical professionals (44.5% vs. 74.8%, p<0.001) or social group members (47.3% vs. 63.1%, p=0.005). Irrespective of sex, and independent of race, health-related factors, and dialysis-related characteristics, older adults were less likely to have had discussions with medical professionals (1.13-fold, 95% CI:1.03-1.24, less likely for each 5-year increase in age through 65 and 1.28-fold, 95% CI: 1.14-1.42, for each 5-year increase in age beyond 65). Irrespective of age, females were 1.45-fold (95% CI: 1.12-1.89) less likely to have had discussions with medical professionals. Males were 1.04-fold (95% CI: 0.99-1.10) less likely and females 1.17-fold less likely (95% CI: 1.10-1.24), for each 5-year increase in age, to have discussions with social group members. Among those who actually had discussions with medical professionals or social group members, older participants described these discussions as less encouraging (p<0.01). Conclusion Older adults and females undergoing hemodialysis are less likely to have discussions about KT as a treatment option, supporting a need for better clinical guidelines and education for these patients, their social network, and their providers.