Journal of the American Geriatrics Society 9/4/19
More than 27 million Americans, aged 65 years and older, live with hearing loss (HL). Prevalence of HL is estimated to grow due to our growing geriatric population. Prior literature indicates strong associations between HL and adverse conditions, such as social isolation, depression, cognitive decline, injuries associated with falls, and reduced quality of life. Despite these findings, use of hearing aids (HAs) as a potential treatment intervention for those with HL remains low. This has been attributed to multiple factors, including lack of perceived need, limited apparent benefit, uncomfortable fit, a complex system of hearing care with multiple points of contact, stigma, and cost (exacerbated by no or low insurance coverage in the United States).
There is a paucity of research on the impact of HAs on medical outcomes. Further, the results of these studies are often inconsistent. For example, Dawes et al found no significant differences in cognitive and mental health outcomes between HA users and nonusers. A cross‐sectional analysis of 164 770 adults, aged 40 to 69 years, with HL in the United Kingdom found better cognitive function among those who used HAs compared with those who did not. A recent review of the literature by Hubbard et al showed that hearing interventions have been successful in slowing the progression of cognitive decline among aging adults without dementia. Despite contradictory findings and lack of literature studying this population, evidence‐based research on hearing interventions among older adults with HL is gaining momentum. More longitudinal research on this topic is warranted.
Although routine HL examinations and HA‐related expenditures are not covered by Medicare fee‐for‐service plans, many managed care plans cover a portion of HA costs. Thus, we used nationwide claims data from a private managed care payer to examine the association between HA use and time to diagnosis of three common conditions among adults, aged 66 years and older, who were diagnosed with HL: (1) Alzheimer disease (AD) or dementia; (2) depression or anxiety; and (3) injuries related to falls. We hypothesized that HAs are associated with a delay in diagnosis of the above age‐related conditions.
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