Up to a-third of older adults with hearing loss in England could be undetected and untreated, according to a new study by University of Manchester researchers. An article summarizing the results was published on the University’s website.

The study, published in JAMA Network Open, might mean millions of people are not seeing ear specialists or given hearing aids, when their hearing has considerably deteriorated.

Women and older people, with fewer qualifications and living in more deprived areas were the at higher risk of not recognizing their hearing had deteriorated and, thus, were less likely to seek help, found the researchers.

The findings reveal many hearing loss cases remain undiagnosed in primary care, since people very often cannot recognize their hearing has been affected, and highlight gaps in the continuity of hearing care pathways.

PhD Researcher Dalia Tsimpida, who led the study, said untreated hearing difficulty can have a negative impact on mental and physical health, and despite that, hearing loss among older people is under-diagnosed and under-treated.

The team examined patterns of health pathways among older adults in England, using hearing data of 8,529 participants aged 50-89 years old from the English Longitudinal Study of Ageing (ELSA).

The researchers said that as the survey is representative of the English older population, the findings provide a good representation for England as a whole.

Although participants had objectively been identified as having hearing loss, they did not self-identify their own difficulties correctly and reported themselves as having normal hearing.

Action on Hearing Loss estimates that hearing loss affects over 12 million people in the UK.

There is no accurate figure for England because of the absence of a screening program.

By 2035, it is estimated that there will be more than 15 million people with hearing loss in the UK—a fifth of the population.

Diagnosis of hearing loss starts in primary care, where traditionally, people with hearing difficulties present to their GP to seek advice and investigation.

Tsimpida, who is based at the University’s Institute for Health Policy and Organization (IHPO) said: “It is crucial that those with hearing loss are detected in a timely way, referred to ear specialists, and given access to hearing aids. The early identification of hearing difficulties in primary care may be the key to tackling this major public health issue.

“However, more research is needed to understand why so many people are undiagnosed, though we feel making hearing loss part of a routine primary care examination among older adults would be beneficial.”

The study was carried out during Tsimpida’s NIHR Manchester Biomedical Research Centre PhD Studentship, co-authored by her supervisors Dr Maria Panagioti, Professor Evangelos Kontopantelis, and Professor Darren Ashcroft.

She added: “This lack of self awareness of hearing loss is a problem for many people.”

Clinical research often relies on a self-report measure of hearing loss. Our study showed that self-report measurement of hearing loss had limited accuracy and was not sufficiently sensitive to detect hearing loss.

“These findings may inform public health policies relevant to selection of appropriate and validated tools for detecting hearing problems among middle-aged and older adults, ” said Tsimpida. “The study also provides novel insights into the clinical practice and reinforces the importance of an effective and sustainable hearing loss screening strategy in primary care.”

Original Paper: Tsimpida D, Kontopantelis E, Ashcroft D, Panagioti M. Comparison of self-reported measures of hearing with an objective audiometric measure in adults in the English longitudinal study of ageing. JAMA Network Open. 2020;3(8):e2015009.

Source: University of Manchester, JAMA Network Open