Aging and Hearing Health: The Life-course Approach

Abstract

Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice.

A Review and Classification of Widely used Offline Brain Datasets

“… Sound: Detecting vibrations along some medium, such as air or water that is in contact with your ear drums [57].  Proprioception: This sense gives you the ability to tell where your body parts are, relative to other body parts.…”

Increasing access to hearing rehabilitation for older adults

“…24 Self-efficacy is a commonly targeted component in improving the uptake of a given health behavior, particularly when the behavior includes use of technology by an older adult, such as hearing aids, and can be enhanced through training. 25,26 Beyond self-efficacy, social support is associated with increased help-seeking, where significant others can act as a cue to action, and has also been associated with greater hearing aid satisfaction. 27,28 Self-reported hearing disability is another consistently cited factor closely associated with help-seeking behavior, which questions the importance of objective versus subjective measures of hearing loss.…”

“…27,28 Self-reported hearing disability is another consistently cited factor closely associated with help-seeking behavior, which questions the importance of objective versus subjective measures of hearing loss. 25,29 …”

A Life Course Approach to Hearing Health

“…The relative contributions of delayed diagnosis of congenital losses, progression of existing losses, and acquisition of new losses to the rising prevalence of hearing loss with age are uncertain. Improvements to the prevention, diagnosis, and management of hearing loss across all age groups are public health priorities (Reavis et al 2016;Davis et al 2016). Although there have been considerable advances in understanding the etiology of hearing loss, with genetic causes now thought to account for up to 50% of congenital losses (Mitchell 2005), in many individual cases, the cause of hearing loss remains unknown.…”

“…Adults with hearing loss are reported to have higher levels of unemployment (Parving and Christensen 1993) and lower quality of life than their hearing peers (Appollonio et al 1996). For older individuals, hearing disability is associated with accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality (for a review, see Davis et al 2016). In addition to these medical consequences, there are also social functioning implications including social isolation due to reduced communication, loss of autonomy, and financial decline.…”