McMahon Catherine M, Gopinath Bamini, Schneider Julie, Reath Jennifer, Hickson Louise, Leeder Stephen R, Mitchell Paul, Cowan Robert
Centre for Language Sciences, Australian Hearing Hub, 16 University Dve, Macquarie University, North Ryde, NSW 2109, Australia ; HEARing Cooperative Research Centre, 550 Swanston St, Audiology, Hearing and Speech Sciences University of Melbourne, VIC 3010, Australia.
Int J Otolaryngol. 2013;2013:308509. doi: 10.1155/2013/308509. Epub 2013 Apr 28.
Adult-onset hearing loss is insidious and typically diagnosed and managed several years after onset. Often, this is after the loss having led to multiple negative consequences including effects on employment, depressive symptoms, and increased risk of mortality. In contrast, the use of hearing aids is associated with reduced depression, longer life expectancy, and retention in the workplace. Despite this, several studies indicate high levels of unmet need for hearing health services in older adults and poor use of prescribed hearing aids, often leading to their abandonment. In Australia, the largest component of financial cost of hearing loss (excluding the loss of well-being) is due to lost workplace productivity. Nonetheless, the Australian public health system does not have an effective and sustainable hearing screening strategy to tackle the problem of poor detection of adult-onset hearing loss. Given the increasing prevalence and disease burden of hearing impairment in adults, two key areas are not adequately met in the Australian healthcare system: (1) early identification of persons with chronic hearing impairment; (2) appropriate and targeted referral of these patients to hearing health service providers. This paper reviews the current literature, including population-based data from the Blue Mountains Hearing Study, and suggests different models for early detection of adult-onset hearing loss.
成人后天性听力损失具有隐匿性，通常在发病数年之后才得以诊断和治疗。通常情况下，此时听力损失已引发了多种负面后果，包括对就业的影响、抑郁症状以及死亡风险增加等。相比之下，使用助听器与降低抑郁程度、延长预期寿命以及在职场留任相关。尽管如此，多项研究表明，老年人对听力健康服务的需求远未得到满足，而且所开具的助听器使用情况不佳，常常导致其被弃用。在澳大利亚，听力损失的经济成本（不包括幸福感丧失）中最大的一部分是由于职场生产力损失。尽管如此，澳大利亚公共卫生系统并没有一个有效且可持续的听力筛查策略来解决成人后天性听力损失检测不力的问题。鉴于成人听力障碍的患病率和疾病负担不断增加，澳大利亚医疗保健系统在两个关键领域未得到充分满足：（1）早期识别慢性听力障碍患者；（2）将这些患者适当地、有针对性地转介给听力健康服务提供者。本文回顾了当前的文献，包括来自蓝山听力研究的基于人群的数据，并提出了成人后天性听力损失早期检测的不同模式。
