UF study: elderly admit hearing loss but not necessarily its effects

December 17, 2003

GAINESVILLE, Fla. — The elderly aren’t as stubborn as stereotyped in their unwillingness to admit hearing loss, although they may still deny the strain it creates for themselves and others, a new University of Florida study finds.

“Audiologists have thought for years that older people deny their hearing loss by saying kids today don’t speak clearly or people mumble, in short blaming their inability to hear on everybody else,” said Patricia Kricos, a UF professor of communication sciences and disorders who led the research. “But our study found that a majority do acknowledge they have a hearing loss.”

While many of the study’s participants acknowledged the loss, however, they reported it had no other effect on them, including in their relationships with friends or family, she said.

“There’s an expression by a famous audiologist, Mark Ross, that when someone in the family has a hearing loss, the entire family has a hearing problem,” Kricos said. “That is so true, because it affects every member of the family, not just the person who’s hard of hearing.”

Hearing loss is the third most common chronic condition experienced by older Americans today, affecting about one-third of people over 65, and half in their 80s, she said.

Untreated hearing loss is a serious problem for older people because it contributes to their sense of anxiety, depression and social isolation, Kricos said. Seniors with hearing loss may no longer want to attend social get-togethers they once enjoyed because they tire of trying to read lips, or they may be afraid to take their dogs out for walks because they couldn’t hear an approaching car, she said.

“If you’re 83 years old and have a significant hearing loss, you might even worry about being able to hear someone break into your house or apartment at night,” she said.

For their study, Kricos and Sherri Smith, a former UF graduate student in communication sciences and disorders who is now an audiologist at the James H. Quillen Veterans Affairs Medical Center in Mountain Home, Tenn., administered questionnaires asking respondents if they thought they had a hearing loss. All of the participants were 65 or older and had never worn hearing aids. They were recruited with flyers posted at retirement communities in North Central Florida seeking anyone who met these criteria, whether they considered their hearing good, average or poor, she said.

Kricos and Smith followed the questionnaire with hearing tests using an Audioscope in each ear and a 10-question survey about the effects hearing loss had on their lives, such as whether it caused them to stop going to church or to have arguments with their families. The scale was designed to determine whether hearing loss affected the person socially or emotionally. A sample “social effects” question was: “Does a hearing loss cause you difficulty when visiting friends, relatives or neighbors?” A sample “emotional effects” question was: “Does a hearing problem cause you to feel frustrated when talking to members of your family?”

Of 91 participants in the UF study, 62 percent admitted having a hearing loss. Of the remaining 35 participants who denied having the problem, 30 – 33 percent of the total participant sample – had normal hearing in on-site hearing screening tests. Only 5 people – 5 percent – had a hearing loss and denied it.

“Dr. Kricos is one of the leading audiologists in this country conducting research on the impact of a hearing loss upon the affected person and his or her family,” said Mark Ross, a professor emeritus of audiology at the University of Connecticut who writes a regular column for Hearing Loss – The Journal of Self Help for Hard of Hearing People. “In this study, she finds, unlike conventional wisdom, that people with a hearing loss do know that their hearing is impaired. They are not so much denying the hearing loss as denying the impact of the loss upon themselves and their families.”

Hearing loss carries a stigma, but this may be less true than in the past among some elderly people, many of whom would rather acknowledge and treat the problem than have it interfere with the wide range of activities in which they are involved, Kricos said.

“There’s a whole different attitude about aging today, and we’re going to see it even more with this new generation of baby boomers coming up,” she said. “They are not going to be content to sit on the front porch rocker and watch the world go by.”

In addition, hearing aid fitting has become more reputable and professional, said Kricos, who also is director of UF’s Center for Gerontological Studies.

Other studies have shown that as many as 80 percent of elderly people who might benefit from hearing aids don’t wear them, probably because they are expensive and initially difficult to learn how to use, Kricos said.

The latest highly digital programmable hearing aids cost about $5,000 for both ears, and even if people can afford them, about 18 percent of all hearing aids purchased are returned before the end of the 30-day trial period, she said. This doesn’t include those that are never worn – as many as one out of four hearing aids may end up in the dresser drawer, she said.

Although today’s hearing aids are vastly superior to versions made 10 or 15 years ago in their ability to amplify sound, the technology is so advanced that people often are daunted by all the different memory programs they must learn in order to use them properly, she said.