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Title: [Hearing Loss and Speech Recognition in the Elderly].
Author: von Gablenz P, Holube I.
Journal: Laryngorhinootologie; 2017 Nov; 96(11):759-764. PubMed ID: 29132188.
Abstract:
Elderly people often complain about poor speech understanding in noisy environments. In clinical practice, speech tests under noise conditions are used to examine hearing ability. The HÖRSTAT study, conducted on a population-based random sample consisting of 1903 adults, used the Goettingen Sentence Test (GÖSA) under noise conditions along with pure-tone audiometry. Hearing impairment was defined as pure-tone average at 0.5, 1, 2 and 4 kHz (PTA-4) greater than 25 dB HL in the better ear (WHO criterion). As expected, pure-tone thresholds and speech recognition thresholds (SRT) in GÖSA worsened steadily with age. For a comparison of PTA-4, SRTGÖSA and self-reported hearing, analysis was limited to 553 adults aged 60-85 years with PTA-4 below 50 dB HL and SRTs measured with a constant 65 dB SPL noise level. The percentage of hearing-impaired increased from 13 % in the 60-65 year-old people to 60 % in those aged 80-85 years. Overall, 68 % of the 60-85 years adults showed normal hearing in terms of unimpaired hearing according to the WHO criterion. The SRTGÖSA of 66 % of the elderly adults with normal hearing, however, did not lie within the reference range established with young normal hearing subjects in the HÖRSTAT study (4.8 ± 1.8 dB SNR, mean±2 * standard deviation). Among the 553 elderly, only 24 % reached this reference range. PTA-4 and SRTGÖSA results showed moderate to good correlations (Pearson r = 0.562, within 5-years bands: 0.372-0.514). From PTA-4 ≥ 30 dB HL and SRTGÖSA ≥- 2 dB SNR, respectively, more than half of the subjects reported hearing difficulties. Despite the continuous decline of PTA-4 and SRTGÖSA with age, the proportion of self-reported hearing difficulties as well as the self-rated hearing ability score stagnated. From the age of 70 years onwards, the elderly in the HÖRSTAT sample tend to overestimate their hearing abilities and to underestimate their difficulties. Das Verstehen von Sprache bei Hintergrundgeräuschen bereitet vielen älteren Menschen Probleme. In der klinischen Praxis wird diese Qualität des Hörvermögens durch Sprachtests im Störgeräusch untersucht. Die Studie HÖRSTAT setzte den Göttinger Satztest (GÖSA) im Störgeräusch zusätzlich zur Tonaudiometrie und einer Befragung bei einer Zufallsstichprobe aus der Allgemeinbevölkerung ein. Wie erwartet nahm der Anteil Schwerhörender ab ca. 60 Jahren stark zu. Bei Ausschluss sehr hoher Hörverluste waren im Alter von 60–85 Jahren jedoch 68 % von 553 Probanden nach dem WHO-Kriterium als normalhörend einzustufen. Von diesen erreichte im GÖSA allerdings nur jeder Dritte annähernd das Sprachverstehen im Störgeräusch junger Normalhörender. Die Selbsteinschätzung des Hörvermögens folgte dabei nur eingeschränkt der messbaren Verschlechterung. Ab einem Alter von ca. 70 Jahren wurden die eigenen Hör-Fähigkeiten eher über- und die Defizite unterschätzt.

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