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Original Investigation
September 15, 2016

Increases in the Rate of Age-Related Hearing Loss in the Older Old

Author Affiliations
  • 1Department of Otolaryngology–Head & Neck Surgery, Columbia University College of Physicians and Surgeons, New York, New York
  • 2Robert Wood Johnson Medical School, New Brunswick, New York
  • 3Columbia University College of Physicians and Surgeons, New York, New York
  • 4Department of Otolaryngology–Head & Neck Surgery, Stanford University, Stanford, California
  • 5Department of Emergency Medicine, Temple University, Philadelphia, Pennsylvania
  • 6Boston Consulting Group, New York, New York
JAMA Otolaryngol Head Neck Surg. Published online September 15, 2016. doi:10.1001/jamaoto.2016.2661
Abstract

Importance  There is a critical disparity in knowledge regarding the rate and nature of hearing loss in the older old (80 years and older).

Objective  To determine if the rate of age-related hearing loss is constant in the older old.

Design, Setting, and Participants  We performed a retrospective review that began on August 1, 2014, with audiometric evaluations at an academic medical center of 647 patients aged between 80 and 106 years, of whom 141 had multiple audiograms.

Main Outcomes and Measures  From a population perspective, the degree of hearing loss was compared across the following age brackets: 80 to 84 years, 85 to 89 years, 90 to 94 years, and 95 years and older. From an individual perspective, the rate of hearing decrease between 2 audiograms was compared with age.

Results  Changes in hearing among age brackets were higher during the 10th decade of life than the 9th decade at all frequencies (5.4-11.9 dB hearing level [dB HL]) for the 647 patients (mean [SD] age, 90 [5.5] years). Correspondingly, the annual rate of low-frequency hearing loss was faster during the 10th decade by the 3.8 dB HL per year at 0.25 kHz, 3.8 dB HL per year at 0.5 kHz, and 3.2 dB HL per year at 1 kHz. Despite the universal presence of hearing loss in our sample, 382 patients (59%) used hearing aids.

Conclusions and Relevance  There is a significant increase in the rate of hearing loss in patients during the 10th decade of life compared with the 9th decade that represents a fundamental change in the mechanistic process of presbycusis. Despite the potential benefit of hearing aids, they remain underused in the older old. Use may be improved by changing the method of hearing rehabilitation counseling from a patient-initiated model to a chronic disease example.

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