Hearing Aids: Needed but Shunned

Only 14% of older adults with hearing loss use hearing aids, according to estimates from a nationwide survey.

The proportion dropped to fewer than 4% of people with mild hearing loss across all age decades and to fewer than 5% of adults ages 50 to 59, irrespective of the severity of hearing loss.

The results suggest that almost 23 million older Americans with audiometry-confirmed hearing loss do not use hearing aids, wrote Frank R. Lin, MD, PhD, and Wade Chien, MD, of Johns Hopkins School of Medicine in Baltimore, in a brief clinical correspondence in the Archives of Internal Medicine.

"Recent research demonstrating strong associations between hearing loss and domains critical to aging (dementia, cognitive functioning, and falls) highlights the need for further intervention studies to determine the possible role of hearing rehabilitative modalities in helping to mitigate these adverse outcomes," the authors concluded.

The findings came from a study aimed at describing the current state of hearing-loss treatment, as well as the extent to which hearing loss goes untreated.

Lin and Chien analyzed data from the 1999 to 2006 National Health and Nutritional Examination Surveys (NHANES), which included questions about hearing-aid use. Additionally, 1,888 participants, ages 50 to 69, and 717 people 70 and older had air-conduction, pure-tone audiometric hearing evaluations.

The authors defined hearing loss as an average hearing level of 25 dB or greater in both ears. They separated the participants into four age groups: 50 to 59, 60 to 69, 70 to 79, and ≥80.

The analysis indicated that 3.8 million (14.2%) of older Americans with hearing loss used hearing aids. The prevalence of hearing-aid use increased with age from 4.3% of participants 50 to 59 to 22.1% of the 80+ age group.

Among individuals with mild (25 to 40 dB) hearing loss, the prevalence of hearing-aid use by age group ranged from 2.6% to 3.4%.

The NHANES data suggested that 26.7 million older Americans had impaired hearing and that 3.8 million (14.2%) of them used hearing aids.

"The low observed rate of hearing-aid use in the United States likely has various causes, including a general perception of hearing loss as being an inconsequential part of the aging process, the absence of health insurance reimbursement for hearing rehabilitative services, and the lack of research on the impact of hearing-loss treatment," the authors wrote.

They added that the only adequately sized randomized trial of hearing aids showed that use of the devices had positive effects on cognition and function (Ann Intern Med 1990; 113: 188-194).