ORLANDO — Elderly persons with hearing loss are more likely to describe themselves as aging unsuccessfully, compared with their peers who hear well, despite the absence of any other chronic conditions, according to a study presented as a poster at the annual meeting of the Gerontological Society of America.
But this impairment to healthy aging is often underappreciated by physicians, said the lead investigator, Margaret Wallhagen, Ph.D., R.N.
“Hearing loss is strongly linked to depression,” she said in an interview. “It makes people feel isolated and left out, and they may feel bad or embarrassed because they can misinterpret things.”
The study used data from the Alameda County (Calif.) Study, a longitudinal study on aging that began in 1965.
A total of 899 subjects aged at least 65 years were identified and asked to evaluate their own aging as successful or unsuccessful. The presence and number of chronic conditions was recorded, and hearing capability was also assessed with questions about hearing difficulties—even with hearing aids—in three settings: normal conversation, over the telephone, and in a noisy room.
Half the subjects described themselves as aging “successfully,” and half deemed their aging “unsuccessful.” But although the number of chronic conditions was a significant predictor of successful aging, one-third of those with no chronic conditions still described themselves as not aging successfully. Conversely, one-third of subjects with two or more chronic conditions described themselves as aging well.
This inconsistency between subjects' physical health and their self-rated successful aging can be partly explained by their hearing, said Dr. Wallhagen, a professor in the department of physiological nursing at the University of California, San Francisco.
Subjects rating themselves as not aging successfully had significantly more hearing loss (a score of 2.26 on the hearing loss scale) than did subjects who said they were aging well (a score of 1.57), even in the absence of any chronic conditions.
And even among those with two or more chronic conditions, subjects who described themselves as aging successfully had less hearing loss (score of 2.13), compared with those who said they were not aging well (score of 3.22).
“Our data support the importance of hearing in the aging experience,” Dr. Wallhagen said. “I wish physicians would pay more attention to hearing loss in their patients, and if they find it, they can send them for an evaluation.” Other research by her group has shown that more than 80% of elderly people never have their hearing impairment addressed by their primary care practitioner. “[Physicians] have a time limitation, so they focus on things they think are critical. And [hearing loss is] not something people die of, so that's why it is often ignored,” she said.
Additionally, another of her studies has found that spousal hearing loss is a significant predictor of unsuccessful aging in the partner.
Dr. Wallhagen said that while it is often assumed the adjustment to hearing aids may be too difficult for many aging adults, most can be coached through the transition period.
“In truth, I think we as primary care practitioners can help people with their expectations. In other words, they need to know that they have to work at wearing hearing aids. You can't just put them on like glasses. But many people—if they are given the coaching and if they are instructed to understand that their brain has to relearn how to listen—they can get used to them.”
In another study she is doing, many subjects with newly acquired hearing aids are surprised at the number of sounds they did not even know they were missing.