Hearing, Vision, Communication, and Older People

ABSTRACT

The auditory thresholds of 248 older adults with normal vision were compared with ratings of their conversational fluency (4-point scale, unaided, face-to-face at 1m in quiet). Participants were placed into one of two general groups on the basis of conversational performance: a low group (conversational fluency rated 1 or 2) or a high group (conversational fluency rated 3 or 4). Hearing thresholds of the two groups differed in the lower frequencies, but overlapped considerably in the higher frequencies (i.e., high frequency thresholds were not closely related to communicative handicap). Most people with low unaided face-to-face conversational fluency reported regular use of hearing aids. Selected cases illustrated the combined effects of impaired hearing and impaired vision on conversational fluency and the need for amplification.

There are implications for predicting hearing aid benefit: (1) during face-to-face interaction, many people with adequate vision can compensate for a high-frequency hearing loss through lip reading, precluding the need for hearing aids; (2) many people with poor vision cannot compensate for a high-frequency hearing loss through lip reading, and may require hearing aids; (3) people with poor low-frequency hearing cannot compensate through lip reading unless the sounds of speech are made audible; (4) in general, people with low unaided face-to-face conversational fluency are most likely to become reliable hearing aid users. It is recommended that clinicians assess each client's vision and conversational performance along with hearing thresholds before considering directions for rehabilitation.

KEYWORD

Hearing - vision - audiogram - conversational fluency - hearing aids

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