Download hearing loss in older adults

HEARING LOSS IN OLDER ADULTS
It is estimated that over 6 million people 65 and over have hearing loss. 30 – 60% of the population 65
and older have hearing impairment. Hearing loss is the 3rd most prevalent chronic condition behind HTN and
OA. Only 25% of patients who would benefit from hearing aids after testing actually get them.
KEY MESSAGES
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Identify if hearing loss is a problem for our patients 65 and up.
Treat any immediately reversible causes (cerumen or effusion). These are usually CONDUCTIVE causes.
Refer to Audiology for audiometric testing for hearing aids or to ENT for treatment if any surgical
intervention is warranted and feasible for patient.
There are some auditory assistance devices we can suggest to patients if they can’t afford hearing aids.
TYPES OF HEARING LOSS
Sensorineural
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Due to damage to neurons or hair cells transmitting
auditory signals to the brain for interpretation.
Loud environments, neural tumors, viral insults
(acoustic neuritis)
Most common form in aging for hearing decline
over time.
Sensorineural hearing loss due to aging is known as
“presbycusis”
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Conductive
Due to mechanical damage or obstruction of the middle
ear or external auditory canal
Examples of middle ear issues would be effusions
(purulent – otitis media, serous – eustachian tube
dysfunction) , trauma to the boney structures or
tympanic membrane (scarring –tympanosclerosis), or
growths such as cholesteotomas or otosclerosis.
Examples of external auditory canal issues would be
foreign body (cerumen, insect, crayon), inflammation
(otitis externa), or growth (polyp, malignancy)
EVALUATION OF HEARING LOSS
Rinne Test: Place the base of struck tuning fork on the mastoid
Weber Test: Place the base of struck tuning fork on bridge of
bone behind the ear. Have patient indicate when sound is no longer
heard. Move fork (held at base) beside ear and ask if now audible.
o Normal: AC > BC; patient can hear fork at ear.
o Conductive Loss: BC > AC; patient will not hear
fork at ear
AC = Air Conduction; BC = Bone Conduction
forehead, nose or teeth.
o Normal: No lateralization of sound
o Unilateral Conductive Loss : Sound lateralizes
towards affected ear.
o Unilateral Sensorineural Loss: Sound lateralizes
to normal or better-hearing side
Funded by D.W. Reynolds Foundation