An Approach to Self-Assessed Auditory Wellness in Older Adults

Abstract

Editor’s Note: The following article is based on the 2020 American Auditory Society Carhart Memorial Lecture and is categorized as a “Point of View” article. As originally described (Jerger 2000): “Our second type of new publication, the Point of View article, is a publication with a slant or opinion. This type of article should have a fresh point of view, a clear logic to its propositions, and a clarity of presentation. The article must have a well-reasoned point of view, but the view does not have to be balanced. Our long-term goal for the Point of View article is to stimulate the field’s interest in and to enhance the appreciation of the author’s area of expertise.” In 2008, under Amy Donahue’s leadership, the National Institute on Deafness and other Communication Disorders (NIDCD) convened the Working Group on Accessibility and Affordability of Hearing Healthcare. A summary of that group’s deliberations and recommendations appeared in this journal a decade ago (Donahue et al. 2010). The purpose of the working group was to address a long-standing problem: most adults with mild-to-moderate hearing loss who could potentially benefit from hearing aids were not obtaining them. Before the meeting of the NIDCD Working Group, both industry surveys and epidemiological studies had documented that only about 15 to 30% of adults with mild-to-moderate hearing loss were obtaining hearing aids (Sangster et al. 1991; Kochkin 1993a,b,c; Ward et al. 1993; Popelka et al. 1998; Kochkin 2000; Smeeth et al. 2002; Dalton et al. 2003; Chia et al. 2007; Kochkin 2009) and this has remained the case since (Wilson et al. 2010; Chien & Lin 2012; Dawes et al. 2014; Bisgaard & Ruf 2017). The general problem underlying the limited uptake of hearing aids was believed to be the poor affordability and accessibility of hearing healthcare, especially treatment via hearing aids (Donahue et al. 2010). Moreover, the failure of the prevailing service-delivery model at the time meant that millions of adults with untreated hearing loss would continue to suffer broader consequences. It is well-known, for example, that the loss of audibility alone causes many difficulties for everyday speech communication, including poor speech perception (e.g., Humes & Dubno 2010) and increased listening effort (e.g., Pichora-Fuller et al. 2016), among others. Furthermore, it has been long established that untreated hearing loss to a of with most studies on (e.g., et al. is that untreated hearing loss have a on and that hearing aids to that (e.g., & In the poor uptake of hearing aids was a problem with on everyday and The NIDCD Working and the summary of et al. the for a of to with accessibility and affordability of hearing to this was the of the with mild-to-moderate hearing loss to hearing difficulties and to the of a The of on and a this to hearing for the of hearing aids in This was a in a the National of and this to the Hearing of was in The and is to and for hearing aids in to the Hearing especially to be for to hearing in is for to the of a hearing it on the perception of hearing the that for of hearing be but not a new is for the in hearing aids be to many adults with mild-to-moderate hearing It is to that this new is not the Hearing the is a of a broader to from a model of it to a model of to and (e.g., et al. 2017). many have been that to hearing loss that it to be a (e.g., et al. 2010; et al. of and its the to hearing loss is not and following is and for hearing healthcare, including the of hearing as in the of adults to to for as as for the of is for the of a Moreover, the of must not be to the of alone but should recommendations for other as (e.g., et al. the group of adults with documented mild-to-moderate hearing loss is the of (e.g., et al. 2010; Lin et al. not in the Hearing it be that it was with this group in this was the in to the of the this in that be to the in and that have hearing difficulties that of hearing In the that it is that the Hearing for the the or & & the & could be to adults in the and of from a as the is to on in the of the model of established the This of and to the of and It is not the that is of interest as this has been is it the of this model to as this has been in et al. Humes et al. and to enhance this (e.g., et al. the is on the of the model of and in the In the the and the of the and and in the them. has on and on in the in to as and from in or it is in the model that is not but in a and the of in the of and the have a or on and other with it as only of the of of or on the other have the to in and the and In the in would be and of or and in and as as of or a or of is as or to and on to poor and in from the other in this poor is to poor or is to be to or As a of or of The a of and for It was to be to the of hearing loss hearing difficulties and in to The has a on and & & The to as the of that of hearing difficulties (e.g., a hearing problem to would and that the to hearing difficulties (e.g., a hearing problem to meeting new and point and This in a of of to the have been as and does not (e.g., et al. et al. 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Chia et al. with a to the to the hearing it is that in the from hearing aids had the on the of hearing in the that it was a who of in the to the for it is the was difficulties or other The of hearing among the is but to be that of the In to as in the is Furthermore, for the in only of the adults were in were should be in to the The the of as the group in the of The in the the and for the were for of the in was not to to the for the for and were not as a The as a of et al. in the of the to to to to to to to to to and to hearing to be of as the with the of the hearing loss in both and as the in the of is a of hearing difficulties for a the to the in the example, the case of the the for the most with a of have of to many with that have from to As in the of the the and the for the was is to the of with of only about of the in of as of the is and of the is The and for this was and the was with as a both alone only for to to or to of the in the that the the of but is other of the hearing difficulties not to hearing The for the and et al. the The the as the but as a with in the The the of with Hearing for the and in were to of in of The the of hearing difficulties in the general of adults of and The on the other the of for who to have that difficulties were to at the In the of the of the from to for the a of from to the a with of the or difficulties from to The the of the and the who had of the The of for the not from based on of the example, for of the and in the from other in a Group The the from the in the the and or the and Hearing for the of the and in the of that the This in of the described about the in hearing difficulties the and many in the hearing most in the hearing difficulties as the of were to the for a to the for other from to this of of with in the of and in the of with for both the of example, the for the of from other and this the group the for the of in the from other and the second of the for the of and not from but from other and of is to the the for of and not from but from other were via the of the as in the of from the of for the in the of were in of the from the or the The in the of in who of it is that this from the general who hearing The that with a of of with other the other the in the it is that a of or on the is from a of to have at the In as in the with of with on the in the and the of in the of of were and or hearing of or and in of the and of with other with hearing of or and in of the and with other of to with for the and and with of to and in of the and with and from to and in of the and of with other the of was of the of in the and of the of the of was example, the of would at both of the with as many as the and the other could that is among the and that only of from is for the of the from the and were a of the to 15 were but the as the and it was a based on the was to the of the example, to the of or for of the to or to of to the for this to the of the and or This from to at or 30% was a for to be the from to 30% to a of from to to with the a of from to to a of of the of for the to be in difficulties to the but the of this is In it is that a is a for the of In the that the be this does not that other of from the or would be is to the most of including the of or of as as the for the of the the goal was to have a that to the hearing loss but the alone & and that of to to to and to have since the of for in other (e.g., et al. et al. et al. 2010; et al. for of the as a for hearing to at the and In the were the in the as the was the for of hearing In the case of the is not to with as was the case in of the the is for and to that of In that it should be that the is as a of hearing difficulties or of As a difficulties in to or of be for In the the of for the a of is to the of in of the from the for the and with or most from the with or from the in the it is that from the or of a the and of the in that the of the and for the In of the for of the a of on and a of the for from other Furthermore, were on the for the in with of to to to and to were the that in a or of the based on the to be a of hearing difficulties the and in the of or were and the of in type is the from in the of were to with group and and and as and as a the of group and were for both the and the The group and was only for the It should be that the not from to the to the In were in both to group for in The were to in and this was the Furthermore, as in the of the described for group and were was a in with for both and that the as a the of and on the be to in hearing the was not in the group and were in et al. the was on the of failure on the be the of on as et al. the of in both with is et al. that other from the for the of a hearing that in in in the of other or have on or have The for of the group and on the of and of were of on would be for and of The that and and this is not a of of and on hearing should the of or of as It would be the of based on the could be as a of epidemiological studies with to and limited time to only and of but this is for of that for epidemiological for the that for other the for from of adults to a based on a must be The the for the for It was to both and from and the of a of The is the for of the The in the of a the and the In this to the the and at the most of the the the The of the were of this but the to have to & of the and the from The from the with the and the in the a the The from the The for the and the from the both in the Hearing for the of a of from the for the and As the has from adults who both and a and The for the adults with and from the is as a in the of the of and in adults it is not that is the in the and the from the in the The was from and As a this be to the of based on the to based on the The the the of the based on the or the is the for adults from the with most of the the This is a This a of the of the the The of the with the is for the Hearing for the of the of based on the for the and a from The that would be from the of the based on the the of is not as clear as that for the based on the in This most has to with the a of and in the and the of the with of hearing loss in the broader for the of the in a the and of the the at of the The had a on the with a that the for was from of other Furthermore, for the for from point to point the the of the from the The of based on the for a and a Hearing for the of to of the of the based on the hearing for from the and who to a about hearing at the time the was the of the or were hearing The in the that the hearing aids increased with the in with were hearing aids of with poor hearing The of hearing for the and the In the were both for hearing and the had hearing The the that were in the to for with Hearing for the of the in the of were about hearing at the time the was were had hearing aids and were hearing The the in who had hearing The in who were and hearing This of hearing was as hearing for at and for at the had hearing aids and were and hearing of hearing as with of with or hearing aids and about of with poor or hearing were with in the and this was It is to that the for the in for the of hearing in the studies hearing in the studies to for in studies of hearing aids and were with hearing aids in the hearing difficulties and via in hearing but 15 to and hearing aids the to et The on hearing uptake and in in the the was and the hearing ago for many of This in the of or hearing that hearing Hearing and has in the is that the to of hearing aids was and was the it is only with and of who would have been to be for hearing from Humes et al. were based on the of hearing loss as categorized the The based on the was both and for adults in the and the in were most of in the and would not have been for hearing the for hearing with and to this of the of hearing in in the to hearing aids is of was for of the and The Communication for the Hearing & was from adults with in the and in the The the most and of hearing difficulties and to The is of and is to As and the Communication of the or and not a of the the to and Furthermore, of Communication for and for a of the other Communication and to the and This of the that were in the of the and The from of the were to were and for of the was and with most In the a of In of the were as and were and with others. 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Humes & as have hearing that is of or for it has been of its has been with as the American of Hearing of or the NIDCD would be to its to in the about the of a or for with mild-to-moderate hearing In the was on adults with mild-to-moderate hearing difficulties for the is to the of a and of to the of In many in could in adults to hearing The of to the in is A case has been for based on of the a and that be The is that to be as the of hearing aids is in the The that could and affordability of hearing healthcare, would be to the of and that adults from It is to that this is not as model with a to be The as in the Hearing is on adults with mild-to-moderate hearing the of of under the of with of or adults with hearing the model has In for many of adults with mild-to-moderate be or to As is to to the benefit of This article that it is and to from of hearing loss as a and to model the The should be to and to to or A of that on the for the was The were to and of hearing to from the and in following with hearing of be in the but in the based on the to and to of and is as a to adults on to The is to the following who to the in this for the for the Dubno for the and for the

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