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Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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[Hearing Loss and Speech Recognition in the Elderly].

Petra von Gablenz, Inga Holube

    Laryngo- Rhino- Otologie
    |November 14, 2017
    PubMed
    Summary

    Many older adults experience hearing difficulties in noise, even with normal pure-tone audiometry. Speech recognition thresholds in noise often exceed normal ranges, indicating a need for better hearing assessments in the elderly population.

    Area of Science:

    • Audiology
    • Gerontology
    • Speech Science

    Background:

    • Elderly individuals frequently report challenges with speech understanding in noisy environments.
    • Clinical audiological assessments often include speech tests under noise conditions to evaluate hearing ability.

    Purpose of the Study:

    • To investigate the relationship between pure-tone audiometry, speech recognition thresholds in noise, and self-reported hearing difficulties in an elderly population.
    • To compare objective hearing measures with subjective hearing ability in older adults.

    Main Methods:

    • The HÖRSTAT study utilized the Goettingen Sentence Test (GÖSA) and pure-tone audiometry on a population-based sample of 1903 adults.
    • Analysis focused on 553 adults aged 60-85 with specific pure-tone average (PTA-4) and speech recognition threshold (SRT) criteria.

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  • Hearing impairment was defined using the WHO criterion (PTA-4 > 25 dB HL).

    • Main Results:

    • Pure-tone thresholds and SRTs in noise progressively worsened with age.
    • A significant percentage of elderly individuals with normal pure-tone hearing (WHO criterion) exhibited elevated SRTs, falling outside the reference range of younger adults.
    • Correlation analysis revealed moderate to good agreement between PTA-4 and SRTGÖSA.
    • Over half of the subjects reported hearing difficulties when PTA-4 was ≥ 30 dB HL or SRTGÖSA was ≥ -2 dB SNR.

    Conclusions:

    • Objective hearing measures like SRTs in noise are crucial for identifying hearing difficulties in the elderly, even when pure-tone audiometry appears normal.
    • A substantial proportion of older adults with normal pure-tone hearing experience speech recognition deficits in noise.
    • Elderly individuals, particularly those over 70, may overestimate their hearing abilities and underestimate their hearing difficulties.