Arlinger Stig
Department of Audiology, University Hospital, Linköping, Sweden.
Int J Audiol. 2003 Jul;42 Suppl 2:2S17-20.
Hearing loss gives rise to a number of disabilities. Problems in recognizing speech, especially in difficult environments, give rise to the largest number of complaints. Other kinds of disabilities may concern the reduced ability to detect, identify and localize sounds quickly and reliably. Such sounds may be warning or alarm signals, as well as music and birds singing. The communicative disability affects both hearing-impaired people and other people in their environment--family members, fellow workers, etc. Hearing-impaired people are not always aware of all the consequences of the impairment; they do not always know what they are missing. Several studies have shown that uncorrected hearing loss gives rise to poorer quality of life, related to isolation, reduced social activity, and a feeling of being excluded, leading to an increased prevalence of symptoms of depression. These findings indicate the importance of early identification of hearing loss and offers of rehabilitative support, where the fitting of hearing aids is usually an important component. Several studies also point to a significant correlation between hearing loss and loss of cognitive functions. Most of these studies show such a correlation without being able to show whether the hearing loss caused the reduction in cognitive performance or if both the hearing loss and the cognitive decline are parts of a common, general age-related degeneration. A couple of these studies, however, indicate that the uncorrected hearing loss may be the cause of cognitive decline. Whichever alternative is true, the correlation should be seen as a clear indication for early hearing aid fitting for those needing it. Monaural hearing aid fitting in subjects with bilateral hearing loss may give rise to a reduced ability to recognize speech presented to the unaided ear, the so-called late-onset auditory deprivation effect. This functional decline is reversible in some but not all subjects after fitting of a hearing aid also on the previously unaided ear.
听力损失会引发多种残疾问题。识别语音存在困难，尤其是在嘈杂环境中，这是引发最多抱怨的原因。其他类型的残疾可能涉及快速、可靠地检测、识别和定位声音的能力下降。这些声音可能是警告或警报信号，也可能是音乐和鸟鸣声。这种交流障碍会影响听力受损者及其周围环境中的其他人，如家庭成员、同事等。听力受损者并不总是意识到这种损伤的所有后果，他们并不总是知道自己错过了什么。多项研究表明，未经矫正的听力损失会导致生活质量下降，这与孤独、社交活动减少以及被排斥感有关，进而导致抑郁症症状的患病率增加。这些发现表明早期识别听力损失并提供康复支持的重要性，其中佩戴助听器通常是一个重要组成部分。多项研究还指出听力损失与认知功能丧失之间存在显著相关性。这些研究大多显示了这种相关性，但无法表明是听力损失导致了认知能力下降，还是听力损失和认知衰退都是与年龄相关的常见全身性退化的一部分。然而，有几项研究表明，未经矫正的听力损失可能是认知衰退的原因。无论哪种情况属实，这种相关性都应被视为需要佩戴助听器者尽早佩戴助听器的明确指征。对于双侧听力损失的患者，单耳佩戴助听器可能会导致识别未佩戴助听器耳朵接收到的语音的能力下降，即所谓的迟发性听觉剥夺效应。在之前未佩戴助听器的耳朵也佩戴助听器后，这种功能衰退在一些但并非所有患者中是可逆的。
