Sangster J F, Gerace T M, Seewald R C
Department of Family Medicine, University of Western Ontario, London.
CMAJ. 1991 Apr 15;144(8):981-4.
To investigate hearing loss in elderly patients.
Cohort study.
Family practice.
All ambulatory patients 65 years of age or older who attended the practice from June to August 1989.
The Hearing Handicap Inventory for the Elderly--Screening Version (HHIE-S) and the Welch-Allyn Audioscope. Patients who failed one or both of the screening tests were referred to a speech and hearing clinic for audiologic assessment and treatment recommendations. Those with hearing aids were excluded from the main study but were given the opportunity to have them assessed at the clinic.
Of 157 eligible patients 42 were excluded: 16 refused to participate, 13 already had hearing aids, and 13 could not be contacted. Of the remaining 115, 34 failed one or both of the tests (14 failed the HHIE-S, 9 failed the audioscope test, and 11 failed both). Of the 34, 25 completed the audiologic assessment at the clinic. Fifteen were found to have severe hearing impairment; the recommendation was hearing aids for 12, further assessment for 2 and no treatment for 1. Of the remaining 10 patients it was thought that 6 would benefit from hearing aids. Ten of the 11 patients with hearing aids who agreed to undergo testing at the clinic were found to need an adjustment or replacement of their devices.
Hearing loss is a significant problem in elderly patients in primary practice. Further study is required to determine which of the two screening tools is most effective. Most elderly patients with hearing aids may require modification or replacement of their devices.
调查老年患者的听力损失情况。
队列研究。
家庭医疗诊所。
1989年6月至8月在该诊所就诊的所有65岁及以上的门诊患者。
老年听力障碍筛查量表（HHIE-S）和Welch-Allyn听力计。一项或两项筛查测试未通过的患者被转介至言语和听力诊所进行听力评估并获取治疗建议。佩戴助听器的患者被排除在主要研究之外，但有机会在诊所对其助听器进行评估。
157名符合条件的患者中，42名被排除：16名拒绝参与，13名已佩戴助听器，13名无法联系到。其余115名患者中，34名一项或两项测试未通过（14名HHIE-S测试未通过，9名听力计测试未通过，11名两项测试均未通过）。这34名患者中，25名在诊所完成了听力评估。发现15名有严重听力障碍；建议12名佩戴助听器，2名进一步评估，1名无需治疗。其余10名患者中，认为6名将从佩戴助听器中受益。同意在诊所接受测试的11名佩戴助听器的患者中，10名被发现需要调整或更换其设备。
在基层医疗中，听力损失是老年患者的一个重要问题。需要进一步研究以确定两种筛查工具中哪一种最有效。大多数佩戴助听器的老年患者可能需要对其设备进行调整或更换。
