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年龄相关性听力损失:早期检测与管理的循证策略

Age-Related Hearing Loss: Evidence-Based Strategies for Early Detection and Management.

作者信息

Hughes Sarah E, Brenner Clinton R, Pandian Alwyn T, Ross Erin J, Nieman Carrie L, McKee Michael M, McCaslin Devin L, Tunkel David E, Manojlovich Milisa, Wallhagen Margaret I, Brenner Michael J

机构信息

University of Michigan Medical School, Ann Arbor, MI.

Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI.

出版信息

ORL Head Neck Nurs. 2025 Spring;43(2):26-39.

Abstract

Age-related hearing loss (ARHL) is common in older adults and has been linked to significant health and social challenges. These challenges include cognitive decline, depression, falls, and overall decreased quality of life. Despite its high prevalence, ARHL remains underdiagnosed and undertreated, partly due to its gradual onset, stigma, and lack of standardized screening and management protocols. This article provides a comprehensive overview of evidence-based strategies for the early detection and management of ARHL, with an emphasis on recent clinical practice guidelines where nurses are instrumental in leading quality improvement efforts. The multifactorial etiology of ARHL, encompassing genetic predispositions, environmental exposures, and physiological aging, is discussed alongside the health and socioeconomic impacts of untreated hearing loss, including cognitive decline and increased healthcare utilization. Routine screening and hearing assessments can be integrated into patient care visits for individuals aged 50 and above to improve early detection and opportunities for hearing loss management. Effective patient education involves individualized, culturally sensitive counseling that addresses the implications of untreated hearing loss and the benefits of early intervention, which can mitigate stigma and encourage proactive management. Assistive technologies such as consumer devices, hearing aids, and cochlear implants play a vital role in promoting hearing health in personalized care plans developed in collaboration with audiologists. Regular monitoring and follow-up are essential to assess adherence, address challenges, and adjust interventions. By adopting these evidence-based strategies, healthcare professionals can improve identification and management of age-related hearing loss, enhancing the overall health and quality of life for the aging population.

摘要

年龄相关性听力损失(ARHL)在老年人中很常见,并与重大的健康和社会挑战相关联。这些挑战包括认知能力下降、抑郁、跌倒以及总体生活质量下降。尽管其患病率很高,但ARHL仍未得到充分诊断和治疗,部分原因是其发病缓慢、存在污名化现象以及缺乏标准化的筛查和管理方案。本文全面概述了基于证据的ARHL早期检测和管理策略,重点介绍了近期的临床实践指南,其中护士在引领质量改进工作中发挥着重要作用。文中讨论了ARHL的多因素病因,包括遗传易感性、环境暴露和生理衰老,同时还探讨了未经治疗的听力损失对健康和社会经济的影响,包括认知能力下降和医疗保健利用率增加。对于50岁及以上的人群,可将常规筛查和听力评估纳入患者就诊过程中,以改善听力损失的早期检测和管理机会。有效的患者教育包括个性化的、具有文化敏感性的咨询,解决未经治疗的听力损失的影响以及早期干预的益处,这可以减轻污名化并鼓励积极管理。诸如消费设备、助听器和人工耳蜗等辅助技术在与听力学家合作制定的个性化护理计划中,对促进听力健康起着至关重要的作用。定期监测和随访对于评估依从性、解决问题和调整干预措施至关重要。通过采用这些基于证据的策略,医疗保健专业人员可以改善对年龄相关性听力损失的识别和管理,提高老年人群的整体健康和生活质量。

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本文引用的文献

1
Toward Alleviating the Stigma of Hearing Aids: A Review.减轻助听器污名化:综述
Audiol Res. 2024 Dec 4;14(6):1058-1074. doi: 10.3390/audiolres14060087.
2
A qualitative systematic review of the impact of hearing on quality of life.关于听力对生活质量影响的定性系统评价
Qual Life Res. 2025 Apr;34(4):879-892. doi: 10.1007/s11136-024-03851-5. Epub 2024 Nov 23.

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