The Factors Associated with a Self-Perceived Hearing Handicap in Elderly People with Hearing Impairment—Results from a Community-Based Study

In Brief Objectives: Elderly persons with a physiologic hearing deficit (hearing impairment) are not necessarily socially or emotionally disturbed by the deficit in everyday life (hearing handicap). The self-perception of a hearing handicap in elderly people is a key element in seeking consultation for a hearing impairment or using hearing aids. Thus, it is important to determine the factors associated with the self-perception of a hearing handicap. The aims of the present study were to report the relation between a hearing impairment and the self-perception of a hearing handicap, and the factors associated with a self-perceived hearing handicap among a group of randomly recruited, community-dwelling elderly persons, aged 65 yr and older, in Taipei, Taiwan. Design: A cross-sectional survey of community-dwelling elderly persons aged 65 yr and older (N = 1220) participating in an annual general purpose geriatric health examination in 2005 in Taipei. Pure-tone audiometry and a questionnaire including the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) were administered, after obtaining the subject's consent to participate in the study. Demographic information, lifestyle, self-report health status, and biochemical data were also collected. Results: There was a moderate association (γs = 0.52) between hearing impairment and self-perceived handicap. Only 21.4% of the study subjects with moderate to profound hearing impairment (M4 ≥41 dB HL, N = 555) perceived themselves as hearing-handicapped (HHIE-S total score ≥10). Besides hearing level, marital status (widowed) and self-perceived general health (bad or neutral) were factors that are significantly associated with a self-perceived hearing handicap among elderly subjects with moderate to profound hearing impairment. For study subjects with moderate to profound hearing impairment (M4 ≥41 dB HL), 5.0% of those with HHIE-S <10 and 45.4% of those with HHIE-S ≥10 used or felt that they required hearing aids (χ2 test, p < 0.001). These data suggested that a self-perceived hearing handicap (HHIE-S ≥10) is an important indicator for referral of elderly persons for hearing-aid fitting. Conclusions: Our study findings, consistent with those of previous studies, demonstrated that not all elderly persons with impaired hearing function (hearing impairment) perceived a hearing deficit socially or emotionally in everyday life (hearing handicap). Marital status (widowed) and bad/neutral general health were nonaudiologically associated factors with a hearing handicap in the present study. Further, those with a self-perceived hearing handicap reported a higher rate of the use of, or requirement for, hearing aids. Because hearing deterioration is a common biologic process of aging, the results of this study can be used to identify the groups among elderly people with a greater need for hearing screening and hearing rehabilitation services. Hearing impairment might not be perceived as a hearing handicap, which is a key element in the decision to seek treatment for hearing impairment. Only 21.4% of a group of community-dwelling elderly persons in Taipei with a moderate-to-profound hearing impairment perceived themselves as hearing-handicapped. Besides hearing level, marital status and self-perceived general health were factors significantly associated with self-perception of a hearing handicap among elderly subjects with moderate-to-profound hearing impairment. These findings helped to identify the high-risk groups with self-perceived hearing handicap among elderly persons that have a greater need for hearing rehabilitation.