Self-reported disability and handicap in the population in relation to pure-tone threshold, age, sex and type of hearing loss

Abstract

A self-administered questionnaire concerning auditory disability and handicap was completed by 1691 subjects who were part of a two-stage random sample of the UK adult population. A principal components analysis of questionnaire replies identified four components. They were interpreted as (a) disability for everyday speech, (b) disability for speech-in-quiet, (c) localisation, and (d) hearing handicap. Components (a) and (d) were the strongest, accounting for 68% of the variance. Subjects also performed pure-tone audiometry amongst other tests. Audiometric information was well described by a two-parameter model characterised by low-to-mid-frequency loss and high-frequency slope. All four components increased progressively with increasing low-to-mid-frequency loss, independent of high-frequency slope. They were best correlated with a binaural average over 0.5, 1 and 2 kHz weighted 4:1 in favour of the better ear, out of several audiometric descriptors examined. Sex and socio-economic group did not generally affect disability or handicap, but people of similar hearing impairment reported less disability and handicap as age increased. This is interpreted as over-compensation for the effects of age in self-report. There were three unexpected findings which may entail some changes in current thinking on the relationship between auditory impairment and self-perceived disability/handicap. Hearing losses incorporating a conductive component in the better ear were more disabling and handicapping than sensorineural losses of equal magnitude. Localisation ability and, to a lesser extent, general hearing handicap were more highly correlated with measures of impairment in the worse ear than in the better ear. There was little evidence for the concept of a 'low fence' in the relationship between impairment and either disability or handicap.

The Contribution of Symptoms of Posttraumatic Stress Disorder, Health Anxiety and Intolerance of Uncertainty to Distress in Ménière's Disease

“…Tinnitus and fullness in the ear were assessed using the Tinnitus Severity Index and the Aural Pressure Index (Cass, 1999;Stahle et al, 1981). Hearing disability was assessed using the Hearing Disability Questionnaire (Lutman et al, 1987).…”

Adults with mild hearing impairment: Measuring real-world hearing performance

“…56; Lutman, Brown, & Coles, 1987). This may not be the case for all individuals with mild hearing impairment.…”

“…While a mild HI can have significant impact on everyday speech understanding for some individuals (Lutman, Brown, & Coles, 1987), if left unaddressed it may also affect other daily functioning, such as walking and preparing meals (Dalton et al, 2003), mental health (Gopinath et al, 2009), cognition (Lin et al, 2013) and psychosocial health (Pronk et al, 2014). It is therefore vital to encourage help-seeking and intervention, such as the provision of hearing aids (HA) even for mild degrees of HI to maintain or improve quality of life for older adults.…”

“…A recent systematized review of the research literature concerned with adults with acquired mild hearing impairment (HI) showed a dearth of evidence, in particular regarding the hearing disability of this clinical group show only a weak correlation with real-world hearing activity limitations and participation restrictions (John, Kreisman, & Pallett, 2012;Lutman, Brown, & Coles, 1987), and this is particularly evident for adults with mild HI ).…”

“…Lastly, EMA researchers report that the approach provides insight into the individual variability within a cohort, and allows for analysis of both group and individual data Ramsey, Wetherell, Depp, Dixon, & Lenze, 2016). This last benefit of EMA suggested the approach could be suitable when investigating the hearing disability of adults with mild HI, as it has been shown that individual variability in activity limitations and participation restrictions in this clinical group is large (Lutman et al, 1987;. Furthermore, standard self-report measures have been shown to have limited sensitivity with this population as the impact associated with a mild HI may be less obvious than for individuals with greater degrees of HI .…”