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This article is part of an epidemiological study on hearing in an urban population > or = 80 years of age, and concentrates on the prevalence of hearing problems and hearing sensitivity as a function of age and gender. Prior to the study, 2915 residents aged 80+ from the Valby area in Copenhagen were selected for investigation and subdivided into two groups. The first group, comprising n = 859 subjects previously provided with HA, and the second group, resulting from an invitation mailed to n = 565 subjects, were matched according to the age and gender distribution of the population, i.e. 24% males and 76% females. Among these, only 41% at a median age of 84 years, range 80-96, accepted the invitation, being significantly younger than the non-attenders. The estimated prevalence of self, reported hearing problems ranged between 33 and 66%, increasing with increasing age. Significant differences were found in the hearing sensitivity as a function of gender, i.e. the hearing in the low-frequency area < 1 kHz is better, whereas the hearing sensitivity at > 2 kHz is significantly worse in males compared with females. The speech recognition score (SRS) was significantly higher in females compared with males, and a comparison between ears supports the finding that the right ear speech recognition score is better than the left. The study demonstrates the difficulties in obtaining reliable epidemiological data on the hearing in the elderly > or = 80 years, which represents an obstacle for the planning of appropriate hearing health services directed towards this age group, and collaborative studies are suggested in order to accumulate more knowledge.

This contribution forms part of an epidemiological study of hearing in the elderly > or = 80 years of age, living in an urban area. The study concentrates on the prevalence of self-reported hearing problems in a sample of subjects not provided with hearing aids (HAs), hearing level, and knowledge of and attitudes to HAs. Among the total population of 2915 > or = 80 years of age, an age- and sex-matched sample of 565 subjects was invited to attend an extensive audiological evaluation, including a questionnaire, giving information on knowledge about and attitudes to HAs. Forty-one percent (n = 231) attended, and dividing the attenders into 5 or 10 year age bands showed that the better and worse ear hearing levels, averaged across 0.5-4 kHz (BEHL/ WEHL0.5-4 kHz), deteriorate significantly with increasing age, and that no differences as a function of gender could be found. The prevalence of self-reported hearing problems was 44% (n = 101), and among these 30% (n = 30) indicated the potential need for a HA. A significantly poorer BEHL0.5-4 kHz was found in these subjects compared to those without hearing problems and/or need of a HA. In the total sample, 63% reported that a HA can ameliorate a hearing problem; however, 62% indicated that the HA should be invisible, and 28% that a HA 'makes you old'.

This contribution compares a currently worn hearing instrument (i.e. R-HI) with a programmable multiband full-dynamic range compression behind-the-ear HI (i.e. T-HI), based on subject preference for HI, and, in addition, compares the preference for a linear/ non-linear amplification-mode (i.e. L-mode/C-mode). Finally, it evaluates some health technology aspects related to the devices. N = 34 experienced HI-users at a median age of 72 years (range 22-84) completed the trial, n = 5 being monaurally, and n = 29 being binaurally fitted. The trial comprises an unblinded comparative study of the R-HI and T-HI, in either C-mode or L-mode amplification, and a double-blind crossover study evaluating the C-mode versus the L-mode amplification. The results of the unblinded study showed that 94% (n = 32/34) preferred the T-HI, whereas two subjects preferred their current HI. The double-blind crossover study concerning the preference for the C-mode and L-mode, respectively, in the T-HI, showed that 72% (n = 23/32) had a significant preference for the non-linear amplification, whereas 28% (n = 9/32) preferred the linear amplification. Provided that the price of the T-HI is kept unchanged, a health technology evaluation may imply an estimate of 30 mill. DKR added costs on a national basis, which should be taken into account within the national hearing services.

This study was undertaken in the Valby health district in Copenhagen in order to evaluate the activities and attitudes of GPs concerning hearing problems in their elderly patients. Among 55 GPs offering health services to the 2915 residents > or = 80 years of age in the district, 76% (n = 42) responded to a structured questionnaire or personal interview, evaluating their line of action concerning hearing problems, and their knowledge and attitudes towards hearing aids (HAs). Among the responding GPs, 7% always seek information on the hearing ability of their elderly patients at the defined age, whereas 14% never focus on the hearing; 45% of the GPs always refer to an ENT specialist when hearing problems are present, which causes further delay in the rehabilitation process and increases costs within the primary health care sector. GPs' attitudes to HAs seem to be changing in a positive way, 91% of them revealing a positive attitude to HAs, and 86% indicating that a HA is capable of ameliorating a hearing problem in the elderly. Irrespective of this positive attitude, the knowledge of types of HAs among GPs seems limited. The study cannot support the idea of making HAs prescribable by GPs unless they are first offered intensive courses on audiology.