Age‐Related Disparities in the Treatment of Borderline/Mild Hearing Loss in the United States

Grewal, Maeher; Dragon, Jacqueline; Golub, Justin S.

doi:10.1177/2473974x221083092

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…The observation that older adults were disproportionally affected requires particular attention, as these patients may be less likely to seek care in the COVID-19 era (9). Moreover, these findings compound findings from other groups who have demonstrated that Medicare-aged adults experience greater delays in referral for cochlear implantation (10,11), receive less overall treatment (12,13), and display less awareness of CIs as a treatment option-all despite the greater prevalence of more significant hearing loss in this demographic (14). Finally, the observation that elderly adults were disproportionally affected is also compounded by the sequelae of social isolation and difficulty communicating when masks are worn.…”

Section: Discussionmentioning

confidence: 70%

Effect of a Global Pandemic on Adult and Pediatric Cochlear Implantation across the United States

et al. 2022

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ObjectiveTo characterize the effect of the COVID-19 pandemic on national cochlear implantation utilization by age using inclusive cochlear implantation data from two manufacturers between 2015 and 2020.Study DesignAnalysis of prospectively registered consecutive patient data from two major cochlear implant (CI) manufacturers in the United States.PatientsChildren or adults who received CIs.InterventionsCochlear implantation.Main Outcome MeasuresAnnual implantation utilization by age.ResultsA total of 46,804 patients received CIs from the two participating manufacturers between 2015 and 2020. The annual number of implant recipients increased significantly during the first 5 years of the study period for both children and adults, from a total of 6,203 in 2015 to 9,213 in 2019 (p < 0.001). During 2020, there was a 13.1% drop in national cochlear implantation utilization across all ages compared with 2019, including a drop of 2.2% for those ≤3 years old, 3.8% for those 4–17 years old, 10.1% for those 18–64 years old, 16.6% for those 65–79 years old, and 22.5% for those ≥80 years old. In a multivariable linear regression model, the percent drop in CIs differed significantly by age-group (p = 0.005).ConclusionsEspecially in light of the prepandemic projected CI counts for 2020, the COVID-19 pandemic reduced national cochlear implantation utilization by over 15% among Medicare-aged patients and by almost 25% among those ≥80 years old, resulting in more than a 3-year setback in total annual CIs. Children were less affected, with those ≤3 years old experiencing minimal interruption during 2020.

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Section: Discussionmentioning

confidence: 70%

Effect of a Global Pandemic on Adult and Pediatric Cochlear Implantation across the United States

et al. 2022

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“…The cognitive relationship is present even for a minimal level of HL 30,40‐42 . Disturbingly, even though older adults are at risk for many of these disorders, their HL may be less likely to be treated than younger individuals 4 . These data contribute to the growing field of the potential impact of HL beyond audition and the importance of equitable treatment in often overlooked groups.…”

Section: Discussionmentioning

confidence: 95%

“…Hearing loss (HL) is the third most common chronic physical condition in US adults, 1 and yet only 11% who have at least unilateral HL and subjective moderate difficulty hearing use hearing aids 2,3 . This represents a significant proportion of the population at risk for the negative sequelae associated with HL 4 . Many studies have recently shown strong associations between HL and numerous deleterious medical comorbidities, including depression, cognitive decline, dementia, and most recently, serious mental illness 5‐13 .…”

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confidence: 99%

Association Between Hearing Loss and Multiple Negative Emotional States in the US Hispanic Population

Grewal

Golub

2023

Otolaryngol.--head neck surg.

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Objective Hearing loss (HL) has been linked to commonly studied detrimental mood states, such as loneliness and depression. However, its relationship with other negative emotions remained largely unstudied. We explore the association between HL and anxiety, anger, hostility, poor self‐esteem, and pessimism in a national cohort of US Hispanic adults. Study Design Cross‐sectional study. Setting Multicentered US national epidemiologic study (Hispanic Community Health Study). Methods Subjects were ages 18 to 75 with completed audiometric and emotional survey data. Multivariable regressions controlling for age, gender, and education were conducted to analyze the association between HL, measured by 4‐frequency pure‐tone average (PTA), and emotional states. States included anxiety (Spielberger Trait Anxiety Scale‐10), anger (Spielberger Trait Anger Scale), hostility (Cook Medley Cynicism Scale‐13), poor self‐esteem (Self‐Esteem Scale‐10), and pessimism (Revised Life Orientation Test). Results A total of 4120 to 4341 participants met inclusion criteria, depending on the specific survey; the average age was 46.7 years (standard deviation [SD] = 13.7), and the average PTA was 13.8 dB (SD = 10.1). Controlling for age, gender, and education, HL was associated with all outcomes. Specifically, for every 10 dB worsening in HL, the anxiety score worsened by 0.41 (0.23‐0.60), the anger score worsened by 0.40 (0.22‐0.58), the hostility score worsened by 0.16 (0.04‐0.27), the self‐esteem score worsened by 0.25 (0.12‐0.38), and the pessimism score worsened by 0.17 (0.04‐0.30) (all p < .01). Conclusion HL is related to numerous negative mood states beyond loneliness and depression. This includes worse anxiety, anger, hostility, self‐esteem, and pessimism. Future studies should investigate whether treating HL improves negative emotional states.

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“…Some organizations, such as the American Speech-Language-Hearing Association, include a slight HL category of 16 to 25 dB (36). It has been proposed that implicit ageism, rather than rational biological evidence, underlies the reason for different definitions of HL in children versus adults (37). For example, in both children and adults, minimal levels of HL are similarly associated with worse cognition (20,38).…”

Section: Discussionmentioning

confidence: 99%

Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss

et al. 2022

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ObjectiveSubclinical hearing loss (SCHL) (previously defined by our group as a four-frequency pure tone average [PTA4] >0 to ≤25 dB) has recently been associated with depressive symptoms and cognitive decline. This suggests that the common 25 dB adult cutpoint in the United States for normal hearing may not be sensitive enough. We aim to characterize real-world hearing difficulties, as measured by hearing aid use and self-reported hearing difficulty, among individuals with SCHL.Study DesignAnalysis of biennial cross-sectional epidemiologic survey (National Health and Nutrition Examination Survey, 1999–2012, 2015–2016).SettingCommunity, multicentered, national.SubjectsNoninstitutionalized US citizens ≥12 years old, n = 19,246.MeasuresPTA4 (500, 1,000, 2,000, 4,000 Hz), high-frequency pure tone average (PTAhf) (6,000, 8,000 Hz), reported hearing aid use, subjective difficulty hearing.ResultsThere were 806,705 Americans with SCHL who wore hearing aids (or 0.35% of the 227,324,096 Americans with SCHL; 95% confidence interval = 0.23%–0.54%). Among those with SCHL, 14.6% (33.1 million Americans) perceived a little trouble hearing and 2.29% (5.21 million Americans) perceived moderate/a lot of trouble hearing. When restricted to the borderline subcategory (>20 to ≤25 dB), 42.43% (6.64 million Americans) had at least a little trouble hearing. Among those with SCHL who wore hearing aids, 81% had a PTAhf >25 dB.ConclusionDespite hearing loss traditionally being defined by PTA4 ≤ 25 dB in the United States, nearly 1 million adults and adolescents with SCHL wore hearing aids, and nearly half with borderline HL had subjective difficulty hearing. To better reflect real-world difficulties, stricter definitions of hearing loss should be explored, including a lower cutpoint for the PTA4 or by using the more sensitive PTAhf.

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Age‐Related Disparities in the Treatment of Borderline/Mild Hearing Loss in the United States

Cited by 6 publications

References 24 publications

Effect of a Global Pandemic on Adult and Pediatric Cochlear Implantation across the United States

Effect of a Global Pandemic on Adult and Pediatric Cochlear Implantation across the United States

Association Between Hearing Loss and Multiple Negative Emotional States in the US Hispanic Population

Hearing Aid Usage and Reported Hearing Difficulty in Americans With Subclinical Hearing Loss

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