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Hearing Loss Goes Untreated Among Elderly , Study Finds

The Wall Street Journal, April 17 2003

CHICAGO -- Hearing loss in the elderly is easily treated but often underdiagnosed by doctors who in some cases wrongly consider it an inevitable part of aging, a study found.

The most common cause of deafness in older adults is nerve damage, which isn't reversible but can be substantially improved with hearing aids and surgery for some severe cases, said Dr. Bevan Yueh, an ear specialist with a Seattle-area Veterans Affairs center and the University of Washington.

But reversible hearing loss also occurs in older adults, caused by commonly treatable conditions, including infections. Many patients and primary-care doctors are ill-informed about both types of hearing loss and incorrectly consider all cases an untreatable result of aging, Dr. Yueh said.

In a report in Wednesday's Journal of the American Medical Association, Dr. Yueh and colleagues reviewed previous studies on methods to detect hearing loss and the efficacy of treatments.

They said research indicates that hearing loss affects up to 40% of adults aged 65 and older. It is strongly linked to depression and decreased quality of life, but the researchers said fewer than 10% of internists offer routine testing to older patients.

Some types of hearing loss, including gradual nerve-related impairment, might not be obvious in a quiet doctor's examination room -- and patients might not bring it up.

"Because it's so gradual, people say, 'It's OK, I'll get used to it.' In the meantime, they're getting depressed, losing all their friends and becoming socially isolated," Dr. Yueh said.

Dr. Munsey Wheby, president of the American College of Physicians, which represents 115,000 internists and medical students, agreed that hearing loss is underdetected in older adults, partly because of lack of awareness among some primary-care doctors.

Dr. Wheby said mild hearing loss might be missed in routine exams because "there are subtle changes that people are able to compensate for or fake it a little."

Only 25% of patients with treatable nerve-related hearing loss receive hearing aids, the study found.

Simple tests to detect hearing loss include a 10-item questionnaire and a $500 tone-producing hand-held device called an audioscope, the researchers said. Audioscopes also can also detect wax buildup and a middle-ear condition called serous otitis that might follow colds or other respiratory illnesses. It can impair hearing, is more common than thought in older adults and can sometimes lead to deafness if ignored. Treatments can include antibiotics, but patients with persistent conditions should be referred to specialists for other treatment.