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Abstract #160601

Eva Blozik, MD, MPH¹, Gerhard Gillmann², Danielle Harari, MD³, Wolfgang von Renteln-Kruse, MD⁴, John C. Beck, MD⁵, and Andreas E. Stuck, MD¹. (1) Department of Geriatrics, University of Bern, Morillonstr. 75-91, Bern, CH-3001, Switzerland, +41 31 970 73 29, eva.blozik@gmx.ch, (2) Department of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern, Switzerland, (3) Department of Aging and Health, St Thomas' Hospital, North Wing Lambeth Palace Road, London, United Kingdom, (4) Zentrum für Geriatrie und Gerontologie, Albertinen-Haus, Sellhopsweg 18-22, Hamburg, D-22459, Germany, (5) School of Medicine, University of California Los Angeles, 10945 Le Conte, Los Angeles, CA 90095-1687

Background: Based on current evidence (Bagai A. et al., JAMA 2006) annual hearing checks should be performed in all older people. Methods: This secondary analysis of the PRO-AGE trial (BMC Medical Research Methodology 2007, 7:1, 2) includes 7314 community-dwelling persons aged ≥65 years from Hamburg (Germany), Solothurn (Switzerland), and London (UK). Subjects completed a self-administered multidimensional questionnaire, questions on preventive care use, hearing (Hearing Handicap Inventory for the Elderly), function, comorbidity, and socio-demographics. Results: Prevalence of underuse (no hearing checks within preceding 12 months by self-report) was 64% in Hamburg, 71% in Solothurn, and 90% in London. Significant (p<0.01 in multivariate logistic analyses) determinants of under-use differed between sites. In Hamburg and London, in persons aged 65 to 74 underuse was higher than in older persons (Hamburg, OR 1.6, 95% CI 1.2-2.2; London, OR 2.2, 95% CI 1.4-3.4). In Solothurn, in women underuse was higher than in men (OR 1.5, 95 % CI 1.2-1.8). In London, in persons without hearing impairment underuse was more prevalent than in persons with hearing impairment (OR 2.9, 95% CI 1.8-4.6). Functional ability, comorbidity, and education were not significantly associated with underuse. Conclusion: Underuse differed between sites, and in part between subgroups according to age, gender, or presence of hearing impairment. Surprisingly, comorbidity, social network or functional ability played no role in underuse. The lack of guidelines and other system factors seem to be more relevant than individual factors for explaining underuse of recommended hearing checks in older persons.

Learning Objectives:

• Describe the evidence for recommending annual hearing checks in older persons.
• List the determinants of underuse of hearing checks in older persons.
• Recognize potentially modifiable factors for improving utilization of hearing checks.

Keywords: Hearing Protection, Preventive Medicine

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.