[Early management of presbycusis: recommendations from the French Society of Otorhinolaryngology and Head and Neck Surgery, the French Society of Audiology, and the French Society of Geriatrics and Gerontology]. / Recommandations de la Société française d'otorhinolaryngologie et de chirurgie de la face et du cou, la Société française d'audiologie et la Société française de gériatrie et gérontologie pour la prise en charge précoce de la presbyacousie.

INTRODUCTION: Presbycusis is the physiological decrease in hearing due to advancing age and begins well before the sixth decade. These recommendations recall the principles of early diagnosis of presbycusis and the means of optimal rehabilitation as soon as the first symptoms appear. MATERIAL AND METHODS: The recommendations are based on a systematic analysis of the literature carried out by a multidisciplinary group of doctors and audioprosthetists from all over France. They are graded A, B, C or expert opinion according to decreasing level of scientific evidence. RESULTS: The diagnosis of presbycusis is more difficult at the beginning of its evolution but a certain number of tools are available for its early diagnosis and its management in face-to-face or even distance learning. CONCLUSION: In case of a clinical profile suggestive of presbycusis in a young subject, especially if there are several family cases, it is recommended to propose a genetic investigation. It is recommended to perform free-field speech audiometry in noise to measure intelligibility in an environment as close as possible to reality. Questionnaires can be used in addition to audiometry to best assess the patient's disability. It is recommended that hearing rehabilitation with a hearing aid or cochlear implant may slow or prevent cognitive decline. Combined auditory and cognitive rehabilitation should be offered regardless of the time elapsed since the fitting. It is recommended to integrate programs accessible via smartphones, tablets or the Internet, integrating different training domains in addition to face-to-face sessions.

Adherencia y caracterización de la población de adultos mayores usuarios de audífonos atendidos en el Servicio de Otorrinolaringología del Hospital Regional de Talca / Adherence and characterization of elderly adults users of hearing aids attended in the Otorhinolaryngology Department at the Regional Hospital of Talca

Introducción: En Chile se ha descrito una baja adherencia al uso de audífonos en la población de adultos mayores, sin embargo, existe escasa información acerca de la realidad actual en regiones. Objetivo: Determinar la adherencia al uso de audífonos y caracterizar a la población de adultos mayores beneficiarios de éstos mediante GES (Garantías Explícitas en Salud) del Hospital Regional de Talca (HRT). Asimismo, determinar las principales variables que se relacionan con la adherencia en este grupo. Material y método: Estudio descriptivo, transversal, correlacional y analítico. Se evaluó a 78 usuarios con CIRUA presencialmente, índice de Barthel y cuestionario complementario. Además, se realizó una visita domiciliaria. Para el análisis de los datos se utilizó estadística descriptiva y pruebas de proporciones. El programa estadístico empleado fue STATA versión 11. Resultados: La adherencia fue del 75%. La edad tuvo una correlación significativa in-versa con la adherencia, las demás variables estudiadas no estarían asociadas. No existe diferencia significativa entre la adherencia arrojada en el HRT versus la visita domiciliaria. Conclusiones: Se sugiere reformular el abordaje al grupo de beneficiarios que tienen mayor edad, enfatizando el rol evaluativo y terapéutico del fonoaudiólogo. Se proponen futuras investigaciones en otras regiones, utilizando metodologías similares e instrumentos validados.

Introduction: In Chile, a low adherence to the use of hearing aids in the elderly population has been described, however, there is a lack of information regarding the current situation in locations outside the capital city. Aim: To determine the adherence to the use of hearing aids, and to characterize the population of elderly people that benefit from the use of the same through the Explicit Guarantees in Health (GES), in the Regional Hospital of Talca (HRT). Furthermore, evaluate the main variables related to adherence in this group. Material and method: Descriptive, cross-sectional, correlational and analytical study. 78 users were evaluated with CIRUA, Barthel Index and a complementary questionnaire in person. Furthermore, a home visit was carried out. For the data analysis, descriptive statistics and proportions tests. Statistical software used was STATA 11. Results: The adherence described was 75%. Age had a significant inverse correlation with adherence, without an association of the other variables studied. There is no significant difference between adherences in the HRT compared with home visits. Conclusions: It is suggested that the approach to elderly beneficiaries be reformulated, emphasizing the evaluative and therapeutic role of the speech therapist. Future research is proposed in other regions of the country, using similar methodologies and instruments validated.

Avaliação dos benefícios auditivos, quanto ao uso de prótese auditiva em indivíduos idosos / Evaluation of hearing benefits as to the use of hearing prosthesis in elderly individuals / Evaluación de los beneficios auditivos en cuanto al uso de prótesis auditivas en personas mayores

A presbiacusia é um processo natural do envelhecimento. O uso de próteses auditivas permite a reabilitação do idoso, de modo a diminuir os impactos psicossociais. Participaram do estudo 27 idosos, que responderam ao questionário Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) ao receberem a prótese, e após três meses de uso. A diferença entre os escores pré- e pós-adaptação foi significante. Houve uma redução significativa do handicap auditivo após o uso da prótese por três meses.

Presbycusis is a natural aging process. The use of hearing aids allows the rehabilitation of the elderly, in order to reduce the psychosocial impacts. The study included 27 elderly people who responded to the hearing handicap inventory for the elderly screening version (HHIE-S) when they received the prosthesis and after three months of use. The difference between the pre- and post-adjustment scores was significant. There was a significant reduction of the auditory handicap after the use of the prosthesis for three months.

La presbiacusia es un proceso natural del envejecimiento. El uso de prótesis auditivas permite la rehabilitación del anciano, para disminuir los impactos psicosociales. En el estudio participaron 27 ancianos, que respondieron al cuestionario Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) al recibir la prótesis, y después de tres meses de uso. La diferencia entre los puntajes pre y postadaptación fue significativa. Hubo una reducción significativa del handicap auditivo después del uso de la prótesis por tres meses.

[Benefit of Bimodal Stimulation with Cochlear Implant and Hearing Aid in Elderly Patients]. / Cochlea-Implantation ab dem 70. Lebensjahr ­ Nutzen der bimodalen Versorgung mit Hörgerät und CI.

Cochlear implant (CI) surgery is the standard of care for postlingual deafness in adults. A hearing aid (HA) for the non-implanted ear is normally used if residual hearing is available. There is limited data on bimodal stimulation in elderly patients. We compare the outcome of bimodal stimulation and analyzed the correlation of bimodal benefit and residual hearing in elderly patients. 22 patients≥70 years were implanted with a single-sided CI from 2002 till 2014. 17 patients use a HA on the non-implanted ear (bimodal). In a retrospective chart review we analyzed the audiological benefit (pure tone average, speech recognition). Time to follow-up was 6 month to 12 years. The subjective benefit was assessed using a structured questionnaire. The speech recognition (monosyllabic word testing in quiet @ 65 dB SPL) showed a score of 61% in bimodal condition vs. 53% with CI alone (p=0.35). There was no statistically significant correlation between residual hearing in the lower frequencies (250 Hz, 500 Hz and 1 kHz) and bimodal benefit. Most elderly patients benefit from bimodal stimulation. In quiet and in comparison with CI alone, most patients showed some improvement in word recognition scores using bimodal fitting, and all of them were using the contralateral hearing aid all day long. Postlingual deafened elderly patients fitted with a unilateral CI require a short rehabilitation period. In case of contralateral hearing aid fitting, regular control of the hearing aid should not be overlooked.

Implicações do uso do Aparelho de Amplificação Sonora Individual na qualidade de vida de idosos / Implications of using the Hearing Aids on quality of life of elderly

RESUMO Objetivo Avaliar, por meio de questionários padronizados, a qualidade de vida de idosos com deficiência auditiva diagnosticada que utilizam ou não a prótese auditiva (AASI) e de idosos sem queixa auditiva. Método Trata-se de um estudo transversal, com amostra não probabilística, distribuída em três grupos divididos da seguinte forma: 30 idosos com perda auditiva diagnosticada e com indicação para uso do aparelho de amplificação sonora individual (AASI), mas que ainda não faziam uso da prótese; 30 idosos com deficiência auditiva que usavam o AASI; e 30 idosos sem queixa auditiva. Os participantes completaram um questionário que investigava dados sociodemográficos e familiares, o Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) e o World Health Organization Quality of Life - versão breve (WHOQOL-Breve). Além das análises descritivas dos dados, foram realizados testes para comparação dos três grupos, aplicando-se a análise de variância (ANOVA) e o teste post hoc de Bonferroni. Resultados Os três grupos se diferenciaram significativamente em todos os domínios de qualidade de vida. O grupo de idosos com perda auditiva diagnosticada e com indicação para uso do AASI apresentou menores escores que o grupo de idosos com deficiência auditiva que usavam o AASI e que o grupo de referência. O grupo com AASI apresentou os melhores resultados de qualidade de vida. Conclusão A perda auditiva afeta a qualidade de vida do idoso. O uso efetivo da prótese auditiva é benéfico a esta população, melhorando suas condições de vida e saúde.

ABSTRACT Purpose To evaluate through standardized questionnaires the quality of life of elderly people with hearing loss diagnosed with and without the use of hearing aids (HA) and elderly without hearing complaints. Methods This is a cross-sectional study with non probabilistic sample, divided into three groups divided as follows: 30 elderly people with diagnosed hearing loss and indication for use of individual sound amplification devices (hearing aids), but have not yet made use of the prosthesis; 30 individuals with hearing impairment who used hearing aids and 30 elderly without hearing complaints. Participants completed a questionnaire investigating sociodemographic and family data, the Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S) and the World Health Organization Quality of Life - Short version (WHOQOL-BREF). In addition to the descriptive analysis of the data were performed tests to compare the three groups by applying analysis of variance (ANOVA) and the Bonferroni post hoc test. Results The three groups differed significantly in all domains of quality of life. The group of the elderly people with hearing loss diagnosed and with indication for the use of hearing aids presented lower scores and the group of the elderly with hearing disabilities that used the hearing aid and that the reference group. The AASI group presented the best quality of life results. Conclusion The hearing loss affects the quality of life of the elderly. The effective use of hearing aid is beneficial to this population, improving their living and health conditions.

[Hearing disorders in aphasia]. / Hörstörungen bei Aphasie.

Aphasia is an acquired communication disorder that often involves receptive language abilities. After clinical assessment it is often not clear if this is partially due to a hearing loss, which can be compensated by hearing aids facilitating the rehabilitative process.In the present study the hearing ability of 88 male and female patients with aphasia after stroke, all of whom suffered from a left-hemispheric ischemia was assessed in the rehabilitative setting.We found that a majority of patients (72, 82%) was able to perform pure tone audiometry. 15 aphasic patients (21%) showed a hearing loss and were not fitted with hearing aids.Patients with aphasia are due to their central speech disorders in their communication skills limited, so that the therapeutic success is further reduced by an existing hearing loss. Due to the demographic development of our people and with the age increasing prevalence of hearing impairment hearing screening in the post-acute phase in aphasic patients is justified by pure tone audiometry.

Comprehensive management of presbycusis: central and peripheral.

The prevailing otolaryngologic approach to treatment of age-related hearing loss (ARHL), presbycusis, emphasizes compensation of peripheral functional deficits (ie, hearing aids and cochlear implants). This approach does not address adequately the needs of the geriatric population, 1 in 5 of whom is expected to consist of the "old old" in the coming decades. Aging affects both the peripheral and central auditory systems, and disorders of executive function become more prevalent with advancing age. Growing evidence supports an association between age-related hearing loss and cognitive decline. Thus, to facilitate optimal functional capacity in our geriatric patients, a more comprehensive management strategy of ARHL is needed. Diagnostic evaluation should go beyond standard audiometric testing and include measures of central auditory function, including dichotic tasks and speech-in-noise testing. Treatment should include not only appropriate means of peripheral compensation but also auditory rehabilitative training and counseling.

Cochlear implantation in the elderly.

OBJECTIVES: To analyse complications and outcome of cochlear implant (CI) treatment in seniors receiving CIs during a 10-year period. METHODS: A total of 28 patients, 79 years or older (mean age 81.6 years), were evaluated and compared with a younger group of 76 patients, 20-60 years old (mean age 48.9 years). A retrospective study of the patients' records was performed. Data on per- and post-operative complications, pre- and post-operative speech perception, estimated cognitive skills, and social situation was extracted. A subjective score was assessed and correlated with post-operative performance. RESULTS: No severe per- or post-operative surgical complications were noted. Speech perception improved significantly after surgery (P < 0.001). The younger age group showed better results post-operatively for monosyllabic words (P < 0.01) compared with the older group with no difference seen for bi-syllabic words. In both the groups, there were no significant differences between patients living with or without social support. DISCUSSION: CI surgery for patients 79 years or older was well tolerated. Patients benefited greatly from the device with improved hearing. CI should not be denied older individuals who are otherwise in good health. Non-use in the elderly was associated with post-operative vertigo and tinnitus, severe disease and limited social support.

Qualidade de vida em idosos antes e após a adaptação do AASI / Quality of life in elderly adults before and after hearing aid fitting

A presbiacusia é um dos distúrbios comum nos idosos, que causa perda auditiva, podendo contribuir para o desenvolvimento de alguns distúrbios psiquiátricos, favorecendo o isolamento, devido à dificuldade de comunicação com o meio social. OBJETIVO: Verificar por meio do instrumento WHOQOL (World Health Organization of Life Questionnaire), a qualidade de vida do indivíduo deficiente auditivo antes e após a adaptação do aparelho de amplificação sonora individual (AASI). MÉTODO: Participaram da pesquisa 30 indivíduos portadores de perda auditiva, com mais de 60 anos, atendidos em uma Clínica de Fonoaudiologia. O paciente respondeu às questões do instrumento WHOQOL, sem o uso do AASI e após uso efetivo da amplificação por um período de três meses responderam novamente o questionário. O WHOQOL - Bref é formado por 26 questões, duas gerais, associadas à qualidade de vida e 24 que discriminam quatro aspectos: físico, psicológico, meio ambiente e relações sociais. RESULTADOS: Houve melhora significativa na qualidade de vida em geral quanto às oportunidades de atividades de lazer; não houve grandes mudanças quanto à frequência de sentimentos negativos; mesmo após a adaptação do AASI, os pacientes continuam apresentando tais sentimentos. CONCLUSÃO:O uso do AASI favoreceu a qualidade de vida geral dos indivíduos avaliados.

Presbycusis is a common disorder in the elderly, which causes hearing loss and may contribute to the development of some psychiatric disorders, leading to isolation due to communication difficulties in the social environment. OBJECTIVE: To identify through the WHOQOL (World Health Organization Quality of Life Questionnaire), the quality of life of hearing impaired individuals before and after hearing aid fittings. METHOD: We had 30 individuals with hearing loss, all over 60 years of age - patients from a Speech Therapy Clinic. The patients answered the WHOQOL questions without the use of hearing aids; and after the effective use of a sound amplification device for a period of three months they answered it again. The WHOQOL - Bref consists of 26 questions, two general quality-of-life questions and 24 associated with four aspects: physical, psychological, environmental and social relations. RESULTS: There was a significant improvement in quality of life in general, as far as leisure activities were concerned, there were no major changes regarding the frequency of negative feelings; even after the hearing aid fitting, the patients continue to have such feelings. CONCLUSION: The use of hearing aids favored the overall quality of life of the individuals evaluated.

[Hearing aid application performance evaluation questionnaire to presbycusis].

OBJECTIVE: By matching patients with presbycusis hearing aids,hearing aid performance assessment questionnaire to fill out to assess the effect of its use and targeted to solve problems encountered in its use and improve the quality of life of older persons. METHOD: Through face to face way to investigate and analyse patients with hearing aids fitting, totally 30 subjects accepted the analysis, preliminary assessment of the use of hearing aids in patient with presbycusis results and solve problems encountered in its use by using SPSS software to analyze the collecting data. RESULT: HHIE questionnaire on statistical analysis, obtained in patients with hearing loss use hearing aids after the problem is a significant improvement statistical analysis of the SADL questionnaire, the conclusion is relatively satisfied with the overall satisfaction. CONCLUSION: Effects Assessment Questionnaire in patients with hearing aids hearing impairment can be epitomized the disabled after use to improve the situation and understand the satisfaction of patients with hearing aids can be an initial effect as the rehabilitation of a reliable subjective assessment of the impact assessment indicators.

Challenges and opportunities in presbycusis.

The population aged 65 years and older is increasing at a faster rate than the total population, with predictions that by 2030, 20% of the population will be 65 years or older. In 2006, between 35% and 50% of those aged 65 years or older reportedly had presbycusis, a sensory impairment that contributes to social isolation and loss of autonomy and is associated with anxiety, depression, and cognitive decline. To address these concerns, the Geriatric Committee of the American Academy of Otolaryngology, in conjunction with the Hearing Committee, focused on 3 challenges and opportunities in the management of presbycusis: (1) the financial burden of caring for patients with presbycusis in the face of increasing costs and declining reimbursements; (2) future treatment options arising from improved understanding of the molecular mechanisms underlying presbycusis, and (3) recognition of central presbycusis as a condition commonly superimposed on peripheral age-related hearing loss whose diagnosis and management can improve outcomes.

Age-related hearing loss or presbycusis.

Aging is a natural consequence of a society developing process. Although many adults retain good hearing as they aging, hearing loss related with age-presbycusis which can vary in severity from mild to substantial is common among elderly persons. There are a number of pathophysiological processes underlying age-related changes in the auditory system as well as in the central nervous systems. Many studies have been dedicated to the illustration of risk factors accumulating presbycusis such as heritability, environment factors, medical conditions, free radical (reactive oxygen species, ROS) and damage of mitochondrial DNA. Left untreated, presbycusis can not only lead sufferers to reduced quality of life, isolation, dependence and frustration, but also affect the healthy people around. These can be partly corrected using hearing aids, but it is not enough, more and more strategies of treatment based on the findings associating with presbycusis should be added rather than using single hearing aids. We review here the pathophysiology; heritability, susceptibility genes and other risk factors including environmental, medical, especially free radical (ROS) and damage of mitochondrial DNA; and some strategies of treatment, as well as promising rehabilitations associating with presbycusis.

Non-verbal visual reinforcement affects speech audiometry in the elderly.

The purpose of this study was to investigate how non-verbal visual reinforcement provided by the audiologist during speech testing influences performance in the elderly. Thirty-two volunteers with age-related hearing loss with or without dual sensory-impairment (DSI), were administered a speech audiometry test in which they repeated lists of ten disyllabic words in two different conditions, namely with and without visual reinforcement. In the conditions of "with visual reinforcement", the tester provided non-verbal cues to acknowledge the response of each participant. The "visual reinforcement" condition did not apparently provide any significant variation in the results. However, when we considered the group of patients without DSI, the non-verbal "visual reinforcement" resulted in better scores (p < 0.001). Non-verbal visual reinforcement may influence speech audiometry results in the elderly. During speech testing of elderly people with age-related hearing loss, audiologists should always remember to administer visual reinforcement to the patients in order to remove a possible confounding factor from audiological evaluation.

Cochlear implant surgery in patients more than seventy-nine years old.

OBJECTIVES/HYPOTHESIS: To evaluate the surgical complications, auditory performance, and hearing handicap following cochlear implantation in patients greater than 79 years of age. STUDY DESIGN: Retrospective trial, tertiary referral center. METHODS: The study group was comprised of 21 patients implanted after 79 years of age from 1996 through 2006 with follow-ups past their 8th decade. Pre-op evaluation consisted of pure-tone audiometry and speech discrimination scores (Hearing in Noise Test and City University of New York sentence test). The results of these tests were compared to similar tests taken post-op. A validated hearing handicap questionnaire was used to evaluate the outcome. RESULTS: There were no permanent medical or surgical complications. However, two patients developed exacerbations of previous comorbid conditions (i.e., urinary retention and acute delirium). Implanted patients experienced a significant improvement in audiologic performance, post-op pure tone average, and post-op speech scores (P < .001). A majority of them were able to use the phone and reported that the cochlear implant was of great benefit to them. The post-op hearing handicap inventory for the elderly demonstrated a significant decrease of hearing handicap scores. CONCLUSIONS: This is the first study to focus on a patient group this advanced in age. With increasing life expectancy, we should begin to stratify risk versus benefit of cochlear implantation in this age group. Cochlear implantation improved audiologic performance and the quality of life in patients older than 79 years old. There were no permanent medical or surgical complications. Chronic pain and temporary vertigo were the most common complications reported in this elderly group. Laryngoscope, 2009.

Reabilitação audiológica em pacientes idosos / Auditory rehabilitation in elderly patients

OBJETIVO: O objetivo deste trabalho é comparar o perfil dos idosos que participaram de sessões de aconselhamento após a aquisição da prótese auditiva em um centro auditivo de Curitiba (PR), com aqueles que não retornaram após a primeira ou segunda sessão de aconselhamento. MÉTODOS: Fizeram parte deste estudo 45 idosos com presbiacusia que adquiriram prótese auditiva em um centro auditivo de Curitiba (PR). A amostra foi dividida em dois grupos: o Grupo 1, Controle, composto por 30 idosos que participaram de cinco sessões de aconselhamento após o recebimento da prótese, e o Grupo 2, Experimental, formado por 15 idosos que participaram somente da primeira e/ou segunda reunião de aconselhamento. Foram utilizadas as perguntas do protocolo de entrevista inicial, para o levantamento dos dados. RESULTADOS: Foram encontradas diferenças entre o perfil do Grupo 1 e do 2. Dos 11 aspectos levantados, houve diferenças em oito deles, no que se refere a: antecedentes familiares de perda auditiva, usuários antigos de aparelhos auditivos, grau da perda, estado emocional, relacionamento familiar, vida social, privações decorrentes da deficiência e habilidades de manuseio da prótese auditiva. CONCLUSÕES: O estudo mostra que o grupo que participou de todas as sessões tem um perfil diferente daquele que só participou do primeiro e/ou segundo encontro, sendo que os aspectos levantados parecem ter influenciado na decisão dos integrantes do segundo grupo de continuar as sessões de aconselhamento.

PURPOSE: The aim of this study was to compare the profile of elderly people who participated in five counseling sessions after the purchase of hearing aids in an auditory center of Curitiba (PR), to that of those who did not return after the first or second session. METHODS: Forty five elderly subjects with presbycusis from an auditoy center of Curitiba (PR) participated in this study. The sample was divided into two groups: Group 1, Control, composed by 30 individuals who participated in the five counseling sessions; and Group 2, Experimental, constituted by 15 individuals who participated only in the first and/or second session. The questions of the initial interview were used for gathering these data. RESULTS: Differences were found between the profiles of both groups. From the eleven aspects raised, there were differences in eight of them, regarding: family history of hearing loss, former users of hearing aids, degree of hearing loss, emotional state, family relations, social life, deprivations arising from the hearing loss, and abilities in handling the hearing aids. CONCLUSIONS: The study showed that the group that participated in all counseling sessions presented a different profile from that who only participated in the first and/or second meeting, and that the issues raised seem to have influenced the decision of the members of the second group to continue participating in the sessions.

The contribution of family history to hearing loss in an older population.

OBJECTIVES: Although it has been well established that the prevalence of and severity of hearing loss increase with age, the contribution of familial factors to age-related hearing loss cannot be quantified. This is largely because hearing loss in older people has both genetic and environmental contributions. As environmental factors play an increasing role with age, it is difficult to delineate the separate contribution of genetic factors to age-related hearing loss. In a population-based survey of hearing loss in a representative older Australian community, we attempted to overcome this using logistic regression analysis, accounting for known factors associated with hearing loss including age, sex, noise exposure at work, diabetes, and current smoking. DESIGN: We tested hearing thresholds using pure tone audiometry and used a forced choice questionnaire to determine the nature of family history in a population of individuals aged 50 yrs or older in a defined region, west of Sydney, Australia (N = 2669). We compared the characteristics of participants with and without family history of hearing loss. Of those reporting a positive family history, we compared subgroups for age, gender and severity of hearing loss, and trends by the severity of hearing loss. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence intervals (CIs) that compared the chances of having hearing loss in participants with and without family history, after adjusting for other factors known associated with hearing loss. RESULTS: Our findings indicate that family history was most strongly associated with moderate to severe age-related hearing loss. We found a strong association between maternal family history of hearing loss and moderate to severe hearing loss in women (adjusted OR 3.0; 95% CI 1.6-5.6 in women with without a maternal history). Paternal family history of hearing loss was also significantly, though less strongly, associated with moderate-severe hearing loss in men (adjusted OR 2.0; CI 1.01-3.9 in men with than without a paternal history). CONCLUSIONS: Findings from this study are important in the identification of individuals whose auditory system may be genetically susceptible to aging and environmental insult. Genetic counseling may assist in ameliorating the effects of hearing loss.

Impacto social del uso de audífonos en adultos mayores / Social impact of hearing aid use among the elderly

Introducción: La prevalencia de la hipoacusia en adultos mayores alcanza al 40 por ciento. De éstos, hasta 30 por ciento no utiliza audífono. El HHIE-S (Shortened Hearing Handicap Inventory for the Elderly) es un cuestionario validado que permite medir el impacto emocional y social de la hipoacusia. Objetivos: Estimar el porcentaje de adultos mayores que usan audífonos, determinar las razones que esgrimen para no usarlos, y evaluar el impacto emocional y social que la hipoacusia provoca en los pacientes con esta discapacidad, distinguiendo si usan o no audífono Material y método: Se realizó un estudio retrospectivo en pacientes mayores de 65 años, quienes habían recibido audífonos en el Complejo Asistencial Barros Luco (CABL) y en el Complejo de Salud San Borja Arriarán (CSSBA). Fueron interrogados acerca de si usaban o no su audífono, las razones para no usarlo, y se les aplicó el cuestionario HHIE-S. Resultados: Este estudio incluyó 179 pacientes, de los cuales sólo el 80 por ciento utilizaba el audífono al año de su entrega. Las razones para no usarlo fueron: la pérdida o robo del aparato (40 por ciento), el ruido que emite (14 por ciento), la postración del paciente (13 por ciento) y problemas con el molde (11 por ciento). El 48 por ciento de los usuarios de audífonos presentó un cuestionario HHIE-S >10, en tanto que el porcentaje se eleva al 77 por ciento en los no usuarios de audífonos, diferencia que alcanzó a poseer significado estadístico (p =0,0021). Conclusión: Los pacientes que usan audífono mejoran su condición emocional y social, lo cual coincide con la literatura

Introduction: Prevalence of hearing problems among elderly people is around 40 percent. Of these, up to a 30 percent does not use hearing aids. The HHIE-S (shortened hearing handicap inventory for the elderly) is a validated questionnaire that provides a measure of the emotional and social impact of hearing impairment. Aim: To estímate the percentage of elderly people that uses hearing aids, to find out their arguments for not using them, and to evaluate the emotional and social impact that hearing loss causes in patients suffering from it, according to whether or not they use hearing aid. Material and Method: A retrospective study was carried out on patients over 65 years old, who had received hearing aids at either the Barros Luco or San Borja Arriaran Hospitals. They were questioned about the use of their hearing aids, their reasons for not using them and were asked to complete the HHIE-S questionnaire. Results: 179 patients were included in this study, of which only 80 percent used their hearing aid a year after receiving it. Reasons for not-using them were: Hearing aid loss or theft (40 percent), noise coming out from it (14 percent), patient was bedridden (13 percent), and problems with the mold (11 percent). 48 percent of hearing aid users had a HHIE-S score - 10, whereas the percentage goes up to 77 percent in those that did not use a hearing aid, a significant difference (p=0,0021). Discussion: In agreement with the literature, patients using their hearing devices improve their emotional and social condition

Satisfação de idosos com aparelhos auditivos concedidos no estado do Tocantins / Satisfaction of elderly with hearing aid conceded in Tocantins State

A deficiência auditiva afeta milhares de brasileiros, o que levou o Ministério da Saúde a criar políticas de atenção à saúde auditiva, que incluem a concessão de aparelhos de amplificação sonora individual...

Hearing loss affects thousands of Brazilians. This fact has forced the Department of Health (Ministério da Saúde) to create policies about the problem, which includes the concession of hearing loss...

Audiologia do envelhecimento: revisão da literatura e perspectivas atuais / Audiology and aging: literature review and current horizons

OBJETIVO: Revisar a literatura sobre a perda auditiva associada ao envelhecimento e suas implicações, numa perspectiva atual. REVISÃO DA LITERATURA: Nos estudos realizados no Brasil, a presbiacusia vem sendo apontada como causa mais freqüente da deficiência auditiva em pessoas idosas, implicando em uma dificuldade de compreensão durante a comunicação verbal. Estudos internacionais também mostram alta prevalência da perda auditiva em pessoas idosas. DISCUSSÃO: Segundo pesquisas recentes, à medida que o quantitativo da população idosa vem aumentando, também aumenta a prevalência da presbiacusia que interfere na qualidade de vida do idoso. Mesmo entre os profissionais de saúde, ainda é grande o desconhecimento em relação às vantagens e ganhos que a reeducação auditiva específica para idosos com perda auditiva pode oferecer. CONCLUSÃO: Os artigos aqui analisados mostraram que os serviços de saúde da rede pública, que envolvem médicos e fonoaudiólogos, devem estabelecer diretrizes para o desenvolvimento de programas de diagnóstico, aquisição de aparelhos de amplificação sonora individual e, principalmente, de reeducação auditiva para os idosos portadores de presbiacusia, para que eles possam participar e desfrutar das relações sociais, mantendo uma boa qualidade de vida. Entretanto, no Brasil, os estudos e pesquisas nesta área estão apenas começando.

AIM: to review the literature on aging-related hearing loss and its current impacts. LITERATURE REVIEW: In studies carried out in Brazil, presbycusis has been blamed for being the most frequent cause of hearing loss in the elderly, causing verbal communication impairment. International studies also show the high prevalence of hearing loss in the elderly. DISCUSSION: According to recent investigations, as the number of elderly people increase, the prevalence of presbycusis interfering in the life quality of this population also increases. Even among health care professionals, there is a huge lack of knowledge about the advantages and gains a specific hearing reeducation can bring about for the elderly with hearing impairment. CONCLUSIONS: the papers hereby analyzed showed that the public health care centers with physicians and speech and hearing therapists, should establish the guidelines for the development of diagnostic programs, purchase of hearing aids and, most specially, hearing reeducation for the elderly with presbycusis, so that they may enjoy their social relations, and thus enhance their life quality. However, in Brazil, studies and research in this area only beginning.