Hearing Loss and Your Patients: Information For the Physician and Primary Care Practitioner
Untreated hearing loss will affect your patient's ability to comprehend your conversations and recommendations.
There is now ample evidence indicating age-related hearing loss has serious consequences that require early intervention. Early intervention of age-related hearing loss has great potential to allow individuals to maintain active and participatory life as they age.
Hearing Loss and Comorbidities
1. Cognitive decline and Healthy aging (The ability to maintain optimal cognitive and physical functioning throughout an individual's lifespan)
a. Individuals with hearing loss have a 40% greater risk of subsequently developing dementia than do individuals without hearing loss
b. A mere 25 dB hearing loss (just outside the normal range) equates to a 7 year cognitive decline
i. 20.1% of all Americans, children and adults, cannot pass a 25 dB hearing screening
c. Individuals with hearing loss have accelerated cognitive decline. If hearing loss is appropriately treated, a lower incidence of dementia is expected.
d. Individuals with hearing loss have accelerated brain volume changes, predominantly in the right temporal lobe, but also whole brain volume decline.
a. Hearing loss is twice as common in adults with diabetes as compared to non-diabetic adults
b. Diabetic patients should have their hearing screened annually.
a. Smokers have a 2.0 increased risk of having hearing loss
b. Exposure to second hand smoke increases risk of hearing loss by 1.83
4. Falls Risk
a. For every 10 dB increase in hearing loss, there is a 1.4 fold increase in odds of having a fall in preceding 12 months.
5. Depression and Social Isolation
a. Individuals with hearing loss are more vulnerable to depression than those without hearing loss
b. Hearing loss magnifies the maladaptive coping strategies associated with anxiety and depression
c. Greater amounts of hearing loss is associated with greater amounts of social isolation, particularly in the 6th decade of life
6. Aging in Place (The ability to live in one's own home)
a. Treating hearing loss may allow the individual with hearing loss to age in place.
Assessment of the beneficiary's functional ability and level of safety by assessing hearing status is a requirement for both the Welcome to Medicare visit and Medicare Annual Wellness Visit.
Hearing screening options:
a. Portable audiometer
b. Hearing screening online: The National Hearing Test: $5.00 or free for AARP members: https://www.nationalhearingtest.org/wordpress/
c. Paper and pencil screening questionnaires
Conclusions and Recommendations:
1. Screen your patients for hearing loss. Hearing loss of gradual onset is imperceptible, and only 28% of individuals can correctly self-identify a hearing loss. All individuals over the age of 50 should have a baseline hearing screening. Patients with a history of depression, cardiovascular disease, diabetes, and dementia should have their hearing screened annually.
2. Audiology can improve quality of life for patients at risk for hearing loss as well as reduce overall costs to the health care system.
In summary, hearing loss creates a "triple threat" to the Individual:
1. The hearing loss itself as a disability
2. Hearing loss interferes with the patient's ability to be treated for other medical conditions because it hinders the individual's ability to engage with the practitioner and understand treatment advice and conditions
3. Hearing loss may actually accelerate disabilities such as cognitive dysfunction and vestibular impairment