老年人主观性耳鸣的临床特征分析

目的探讨老年人主观性耳鸣的临床特征及其关联因素。方法采集门诊就诊的老年主观性耳鸣患者一般情况、病史临床表现,并进行相关听力学检测,分析耳鸣临床特征及与各因素的关系。结果老年人主观性耳鸣男女比例相当。单耳发病明显低于双耳,左耳与右耳无明显差异。耳鸣与听力损失显著相关。耳鸣的匹配音调与听力损失的性质相关。失代偿耳鸣患病率为11.3%,年龄组间差异不显著。结论主观性耳鸣在老年人群中较为常见,加强防治干预非常重要。     

扬州地区老年人、中年人及青年人听力情况调查分析

目的 调查分析目前扬州地区老年人群（≥60岁）、中年人群（≥45岁且＜60岁）和青年人群（≥30岁且＜45岁）听力状况,着重了解老年性聋的分布和严重程度的相关情况,为老年性聋的预防、治疗提供科学可靠的依据。方法 用随机抽样的方法调查扬州市区、江都、仪征、宝应、高邮、安徽天长的听力情况。总共选取2 116人,运用纯音测听、声导抗、听力筛选等方法进行统计分析。结果 首先进行耳部检查,去除耵聍及异物等,确诊传导性听力损失人群（外耳或中耳疾病患者）,给予治疗指导意见,并在研究中予以排除,老年组人群听力减退比例为65.57%,其中轻度听力损失为46.78%,中度听力损失为13.31%,中重度听力损失为4.25%,重度听力损失为1.23%。中年组人群听力减退比例为48.12%,其中轻度、中度、中重度和重度听力损失分别为41.76%、4.34%、1.45%和0.58%。青年组人群听力减退比例为47.05%,其中各度听力损失分别为37.12%、6.76%、2.73%和0.43%,老年人、中年人及青年人听力损失的差异有统计学意义。结论 随着年龄增长,听力损失情况逐步加重。听阈随着年龄的增长而提高,并且在高频处,听力损失尤为明显。重视老年性疾病（如高血压、糖尿病、冠心病、脑供血不足等）的预防与治疗,避免噪声环境,拒绝烟酒等,对于防治老年患者的听力损失,有积极作用。     

老年隐匿性高血压伴听力损失的影响因素分析及相关性研究

目的 探究老年隐匿性高血压患者发生听力损失的影响因素及相关性。方法 选取2020年9月至2021年12月首都医科大学附属北京同仁医院老年医学科接诊的老年隐匿性高血压患者215例，根据患者是否出现听力损失分为不伴听力损失组(109例)和听力损失组(106例),比较2组患者一般临床资料，通过多因素logistic回归分析筛选影响老年隐匿性高血压患者发生听力损失的因素。结果 不伴听力损失组降压药物种类、昼间收缩压、昼间舒张压、夜间收缩压、24 h收缩压、昼间收缩压变异系数、24 h收缩压变异系数明显低于听力损失组(P<0.05,P<0.01)。logistic回归模型分析显示，昼间收缩压、夜间收缩压、24 h收缩压、昼间收缩压变异系数、24 h收缩压变异系数和降压药物种类是老年隐匿性高血压患者发生听力损失的影响因素(P<0.05,P<0.01)。列线图模型校正后的ROC曲线下面积为0.802,敏感性为83.75%,特异性为61.50%。结论 老年隐匿性高血压患者的收缩压和收缩压变异性与其发生听力损失存在密切联系，应重视老年隐匿性高血压的筛查。     

老年性耳聋听力损失程度调查及中医辨证分型与治疗

目的 通过对老年人不同年龄段听力损失程度的调查,探讨有效地干预方法.方法 将三个不同年龄段老年人采用相同的检测方法统计听力损失调查结果,并进行比较.结果 老年性耳聋随着年龄增长,听力损失呈渐进性增高,中医各证型比较发现肾虚血瘀窍闭是老年性耳聋的主要病机.结论 老年性听力下降是不可逆的退行性变.根据耳聋的证治分型,对老年性耳聋患者进行辨证施治及干预指导,可减缓老年人听力损失渐进速度.     

老年听神经瘤患者听力损失的临床特征

目的探讨老年听神经瘤患者听力损失的临床症状。方法 82例老年听神经瘤患者按照肿瘤大小分为A、B两组。A组肿瘤直径2.1~5.4 cm,40例,B组肿瘤直径0.5~2.0 cm,42例。分析两组的临床资料且进行听力学检查、听性脑干反应检查、声反射检查以及影像学检查,比较两组听神经瘤临床特征、听力损失程度以及影像学资料的差异性。结果 A组发生听力丧失、耳鸣、患耳疼痛、三叉神经功能障碍、面部麻木与疼痛、眩晕与头痛均显著多于B组(P<0.05);两组听力损失状况比较差异有统计学意义(P<0.05);A组发生ABR异常、声反射阈消失或升高以及影像学特征的例数均显著高于B组(P<0.05)。结论肿瘤直径较大的老年听神经瘤患者的临床症状表现多样,侵犯的区域越广,听力损失状况越严重,且听性脑干反应检查、声反射检查以及影像学检查等检测率越高。     

北京市区老年人听力障碍状况及其神经心理因素调查

目的探讨老年人群中听力障碍的患病情况，为制定老年人听力康复对策提供依据。方法采用集体听力测试、全身体格检查及与国际接轨的入户调查问卷３种形式进行调查。结果实查北京市区老年人３７４例，听力障碍患者１９４例，标准化总听力障碍患病率为４１．９％，样本患病率在性别间的差异无显著性。仅有１３例（６．７％）患者曾接受听力康复，其在心理感受、调控信念等方面明显低于非听力障碍组。结论老年人听力障碍康复率极低的原因在于：传统观念的束缚、听力学门诊不健全、无正规的听力学教育体系以及助听器价格较高等因素。神经心理因素分析表明，听力障碍会造成患者心理上的创伤，对此应受到人们的重视，以实现患者听力的全面康复     

386例老年人耳疾与听力障碍状况

目的 调查来我院以耳部疾患就诊的386例老年人的听力残疾状况与耳疾的病因分布,为本地区老年人群耳聋、耳疾的防治提供科学依据. 方法 对来我院以耳部疾患就诊的386例65岁以上的老年人分别进行电耳镜、声导抗、纯音测听、畸变产物耳声发射检查,根据听力检查及诊断结果对386例老年人进行听力损失评定及病因分析.结果 386例(772耳)老年人中,无听力损失为67耳,占8.68%;轻度听力损失为228耳,占29.53%;中度听力损失为288耳,占37.31%;重度听力损失为117耳,占15.16%;极重度听力损失为72耳,占9.33%.就诊患者听力损失的发生率为91.32%,其中以中耳炎和老年性聋为主要病因.结论 以耳部疾患就诊的老年人中都有不同程度地听力损失,其中中耳炎和老年性聋致残占相当大的比例,有效防治中耳炎和老年性聋是防聋治聋的关键.     

老年2型糖尿病患者听力改变与老年单纯性耳聋的比较研究

目的探讨老年2型糖尿病患者与老年单纯性耳聋患者的听力损害状况。方法对85例老年2型糖尿病患者和76例健康老年人进行纯音测听、鼓室(声导抗)、脑干听觉诱发电位及耳声发射测试,观察脑干听觉诱发电位(BAEP)Ⅰ~Ⅲ峰间潜伏期和Ⅰ-Ⅴ峰间潜伏期两耳差值改变,记录畸变产物耳声发射(DPOAE)听力图上不同测试频率时的幅值。结果老年2型糖尿病患者听力损害主要是Ⅰ~Ⅲ峰间潜伏期延长和Ⅰ-Ⅴ峰间潜伏期两耳差值增大,DPOAE的幅值部分降低,甚至完全消失。结论脑干听觉诱发电位及耳声发射检测可作为观察老年糖尿病患者听力改变的客观指标。     

老年听力损失的影像研究进展

近年来,随着人口老龄化的加速,越来越多的人正在或即将遭受年龄相关性听力损失带来的困扰,这对人们的工作和生活造成了极大不便。因此,精准快速诊断老年人群听力损失相关疾病的重要性不言而喻。以电子计算机断层扫描、磁共振多模态成像和分子影像为主的影像技术的构建和发展,正为老年人群听力损失相关疾病的诊断和疗效预测提供着重要客观依据。本文对年龄相关性听力损失方面的影像学研究进展进行了综述。     

2020年我国社区老年人听力损失状况调查

目的调查我国社区60岁及以上老年人群听力损失状况, 比较主观报告听力下降与客观听力测量之间的差异。方法调查对象来自老年期重点疾病预防和干预项目, 该项目采用多阶段分层整群随机抽样的方法, 于2020年在辽宁、河南和广东三省12个县区完成对10 347例60岁及以上老年人的耳镜检查、纯音测听和问卷调查。客观听力损失评估采用世界卫生组织推荐标准。主观报告听力下降通过询问调查对象是否存在听力不好来获取。不同特征老年人听力损失现患率的差异检验采用χ2检验和Cochran-Armitage趋势检验, 影响听力损失的因素采用多因素Logistic回归分析。结果 2020年我国辽宁、河南和广东三省60岁及以上老年人听力损失现患率为69.8%(95%CI:68.9%～70.7%), 男高于女, 随年龄增加而逐步上升。轻度听力损失现患率为47.2%, 中度、重度和极重度听力损失现患率分别为18.0%、3.6%和0.9%。多因素Logistic回归分析显示, 与听力损失正相关的因素有:增龄、男性、居住在农村以及从事体力劳动, 而受教育程度与听力损失呈负相关。在7223例客观测量存在轻度及以上听力损失的人群...     

Over-the-counter hearing aids: What will it mean for older Americans?

In October 2021 the Food and Drug Administration released draft rules creating a new class of hearing aids to be sold over the counter. Since Medicare does not cover hearing aids, the ready availability of low-cost aids is potentially good news for the millions of older Americans with hearing loss, a disorder that is associated with isolation, depression and poor health. However, better financial access to hearing aids will not necessarily translate into better hearing: many older people will need assistance in fitting, using and maintaining their aids. Policymakers, managers, and clinicians need to consider how to structure, fund and deliver these vital adjunctive services.     

Hearing loss and depressive symptoms in elderly patients

Aims: Hearing loss is a common disability that has a profound impact on communication and daily functioning in the elderly. The present study assesses the effects of hearing aids on mood, quality of life and caregiver burden when hearing loss, comorbidity and depressive symptoms coexist in the elderly. Methods: A total of 15 patients aged older than 70 years suffering from hearing loss and depressive mood were recruited. Comorbidity was evaluated by the Cumulative Illness Rating Scale, functional ability by the Activities of Daily Living scale and the Lawton Instrumental Activities of Daily Living scale, cognitive capacity by the Mini‐mental State Examination and the Clock Drawing Test, psychological status by the Center for Epidemiological Studies‐Depression scale, and quality of life by the Short Form (36) Health Survey. Caregiver burden was appraised by the Caregiver Burden Inventory. Testing was carried out at baseline and at 1‐, 3‐ and 6‐month intervals, assessing the use of binaural digital and programmable hearing aids. Results: Reduction in depressive symptoms and improved quality of life at statistically significant levels were observed early on with the use of hearing aids. In particular, general health (P < 0.02), vitality (P < 0.03), social functioning (P < 0.05), emotional stability (P < 0.05) and mental health (P < 0.03) all changed for the better, and were maintained for the study duration. The degree of caregiver burden also declined, remaining low throughout the study. Conclusions: The benefits of digital hearing aids in relation to depressive symptoms, general health and social interactivity, but also in the caregiver – patient relationship, were clearly shown in the study. The elderly without cognitive decline and no substantial functional deficits should be encouraged to use hearing aids to improve their quality of life. Geriatr Gerontol Int 2012; 12: 440–445.     

Effects of hearing aids on cognitive functions and depressive signs in elderly people

With the physical, emotional and cognitive effects of senility, elderly people, especially those with impaired hearing, need rehabilitation for improving their life conditions. Hearing aids are frequently used to improve their daily life communications and activities. The aim of this study was to report the cognitive and psychological benefits of using hearing aids by the elderly people, over the age of 65. This was a prospective, single-arm interventional study in 34 elderly subjects with hearing impairment who answered the geriatric depression scale-short form (GDS) questionnaire and the mini mental state examination (MMSE) test, prior to, and 3 months following the use of hearing aid, after obtaining the patients’ consent to participate in study. Patients with evidence of focal neurological loss with clinical examination, a confusional state, sudden hear loss and severe tinnitus were not included in the study. Scores of the effects of hearing aids on mood and cognitive functions were compared for each subject, before and after, and between males and females. After 3 months of using a hearing aid, all patients showed a significant improvement of the psychosocial and cognitive conditions, and all of them showed betterment of their problems, i.e., the social communication and exchanging information. In conclusion, for the elderly people with the effects of hearing aids in presbycusis and due to the significant improvement in psychological state and mental functions, using and being adaptable to hearing aids is a good solution.     

老年性耳聋患者助听器佩戴效果的影响因素

目的 观察老年性耳聋患者助听器的佩戴效果,并分析影响助听器佩戴效果的相关因素。方法 回顾性分析2021年5月至2023年5月琼海市中医院收治的102例因老年性耳聋佩戴助听器患者的临床资料,患者入院后均行助听器效果国际性调查问卷(IOI-HA)评估,比较不同临床特征患者IOI-HA总分的差异。采用SPSS 22.0统计软件进行数据分析。根据数据类型,分别采用t检验或方差分析进行组间比较。采用多因素logistic回归分析影响老年性耳聋患者助听器佩戴效果的相关因素。结果 102例老年性耳聋患者IOI-HA总分为(24.18±7.84)分。文化程度、助听器佩戴时长、耳聋严重程度及助听器佩戴耳侧不同的患者IOI-HA总分比较,差异均有统计学意义(P＜0.05)。多因素logistic回归分析显示,初中文化程度(OR=3.245,95%CI 1.337～7.876)、单耳佩戴助听器(OR=2.195,95%CI 1.032～4.669)、助听器佩戴时长＜4个月(OR=4.513,95%CI 1.395～14.600)及轻度聋(OR=2.447,95%CI 1.208～4.957)为影响老年性耳聋患者助听器佩戴效果的相关因素。结论 老年性耳聋患者助听器佩戴效果受文化程度、助听器佩戴耳侧、助听器佩戴时长及耳聋严重程度的影响,临床治疗时应当予以相应关注。     

Quality of life determinants and hearing function in an elderly population: Osservatorio Geriatrico Campano Study Group

BACKGROUND: Hearing impairment (HI) is a very common condition in elderly people and the epidemiology together with hearing-related problems is still poorly investigated. Moreover, the cognitive status may be impaired in relation to hearing function. OBJECTIVE: The goal of the study was to evaluate: (a) the prevalence of HI in a random sample of elderly people aged 65 and over (n = 1,750) living in Campania, a region of southern Italy; (b) the cross-sectional relationship between hearing function and cognitive status and also depressive symptomatology and disability, and (c) to assess the role of hearing aids on depressive symptomatology. METHODS: Cross-sectional study on a random sample of elderly population. RESULTS: The overall participation rate in the study was 74.8% (n = 1,332, mean age was 74.2 +/- 6.4 years). The prevalence rate of HI (evaluated by questionnaire) was 27.2%, cognitive impairment prevalence (evaluated by the Mini-Mental State Examination (MMSE)) was 27.9%, mean depressive symptomatology score (evaluated by Geriatric Depression Scale (GDS)) was 11.4 +/- 6.6, while disability assessed by Activity of Daily Living (ADL) was present in 7.0% of the whole population. A strong relationship was found between both decreasing hearing function and MMSE decline, independently by the effect of age and education (r = 0.97; p < 0.01). A positive relationship (r = 0.85; p < 0.01) between GDS score and hearing function was also found. Moreover, at an increased level of hearing loss, a lower ADL score was recorded (r = 0.98; p < 0.01). Finally, the use of hearing aids reduced GDS score. In logistic regression analysis, gender, age and educational level indicate that hearing loss risk increased with age (odds ratio 1.60; 95% confidence interval 1.53-1.71), whereas education plays a protective role (odds ratio 0.75; 95% confidence interval 0.72-0.80). CONCLUSION: HI is very prevalent among elderly people and is associated with either cognitive impairment and/or depression and reduction of functional status. This study suggests that hearing aids may protect against cognitive impairment and disability, improving quality of life of aged people. Copyrightz1999S.KargerAG,Basel     

Hearing impairment in elderly persons

Hearing impairment is a common problem in elderly people that produces significant personal morbidity and isolation. Hearing impairment in elderly people often has a treatable cause. Presbycusis is only one cause of hearing loss, and may coexist with other causes. The clinical examination, if performed correctly and corroborated by caregivers, is probably adequate screening for hearing loss. However, formal testing should be administered if doubt remains. Hearing aids, although expensive, are helpful for most patients, but they are only part of a total program of aural rehabilitation. Patients, family, and health care provides can all benefit from improvement of communication skills.     

Geriatric hearing loss: myths, realities, resources for physicians

The recommended protocol for receiving a hearing aid is: a hearing evaluation to determine candidacy for a hearing aid and/or ALD; an examination by a physician to rule out medical contraindication to hearing aid use; hearing aid selection and fitting by a dispensing audiologist or a hearing aid dealer; hearing aid orientation/counseling. It is well accepted that sensorineural hearing loss is one of the most frequent by-products of the aging process, with prevalence ranging from 30 to 50%. The hearing loss and resulting difficulty understanding speech can have a negative effect on the quality of one's daily activities and, hence, can interfere with the enjoyment of an elderly individual's remaining years. The myths of "hearing loss as an inevitable part of aging" no longer prevail, however. Advances in biomedical technology have enabled the development of smaller hearing aids with wide fitting ranges, making hearing aids a realistic option for the majority of elderly hearing-impaired individuals. To maximize benefit from hearing aids, the elderly must be identified early via routine hearing screening and referred to an audiologist for evaluation and management.     

Physical, mental and social factors affecting self-rated verbal communication among elderly individuals

Background:   Satisfactory verbal communication is necessary to improve the quality of life in elderly individuals. However, few studies have directly analyzed the factors that influence the ability to achieve satisfactory verbal communication. The purpose of the present study was to identify the physical, mental and social factors that affect self-rated verbal communication.
Methods:   A cross-sectional survey was used to obtain the required data from 197 elderly (75.5 ± 8.3 years of age) individuals in the southern area of Japan who independently carried out basic activities of daily living. Subjective evaluation on verbal communication, general health status, oral function and hearing ability were assessed using a self-administered questionnaire. Age, sex, instrumental activities of daily living, intellectual activity, social activity, cognitive status, the number of present teeth, maximum phonetic time and status regarding the use of dentures and hearing aids were also evaluated.
Results:   In bivariate analyses, self-rated verbal communication ability was significantly related to age, instrumental activities of daily living, intellectual activity, social activity, cognitive function, maximum phonation time, the number of present teeth, the wearing of dentures, self-rated general health and oral function. However, self-rated hearing ability and the wearing of hearing aids were not significantly related to self-rated verbal communication. The backward logistic regression analysis was refined until it included only two independent variables: social activity and self-rated general health status.
Conclusion:   These results suggest that social activity and self-rated general health status are the most influential factors of satisfactory verbal communication in the present model, and that self-rated verbal communication is not related to hearing factors.     

Long‐Term Effectiveness of Screening for Hearing Loss: The Screening for Auditory Impairment—Which Hearing Assessment Test (SAI‐WHAT) Randomized Trial

OBJECTIVES: To evaluate the effect of hearing screening on long‐term hearing outcomes in a general population of older veterans. DESIGN: Hearing loss in the elderly is underdetected and undertreated. Routine hearing screening has been proposed, but it is not clear whether screening identifies patients who are sufficiently motivated to adhere to treatment. A four‐arm randomized clinical trial was conducted to compare three screening strategies with no screening in 2,305 older veterans seeking general medical care. SETTING: Veterans Affairs Puget Sound Health Care System. INTERVENTIONS: The screening strategies were a tone‐emitting otoscope, a widely used questionnaire about hearing handicap, and a combination of both tools. MEASUREMENTS: Hearing aid use 1 year after screening. RESULTS: Of participants who underwent screening with the tone‐emitting otoscope, questionnaire, and combined testing, 18.6%, 59.2%, and 63.6%, respectively, screened positive for hearing loss (P<.01 for test of equality across three arms). Patients proceeded to formal audiology evaluation 14.7%, 23.0%, and 26.6% of the time in the same screening arms, compared with 10.8% in the control arm (P<.01 for test of equality across four arms). Hearing aid use 1 year after screening was 6.3%, 4.1%, and 7.4% in the same arms, compared with 3.3% in the control arm (P<.01). Hearing aid users experienced significant improvements in hearing‐related function and communication ability. CONCLUSION: In older veterans, screening for hearing loss led to significantly more hearing aid use. Screening with the tone‐emitting otoscope was more efficient. The results are most applicable to older populations with few cost barriers to hearing aids.