Predictors of Hearing Help-Seeking among Older Adults in England and Implications for Health Policy Strategies in Primary Care

Background Hearing loss is a major public health issue that affects over 9 million people in England. Traditionally, people with hearing difficulties will present to their GP to seek advice and investigation. Many of these people will be referred to Secondary Care Audiology or ENT for assessment and management. However, as hearing loss almost always develops gradually, people do not see it as a dramatic health problem requiring urgent intervention. In the absence of a HL screening program in England, It is therefore important to examine whether the self-identification of hearing problems is accurate, as it affects the initiation of hearing help-seeking. Method Cross-sectional analysis of participants aged 50-89 years old from a representative sample of adults aged 50 years and over living in England (the English Longitudinal Study of Ageing, Wave 7). Our cohort was composed of 8,529 individuals that had assessment in their hearing by both self-reported measures and consented for assessment by a qualified nurse via a hearing screening device (HearCheck™ Screener). Hearing loss was defined as >35dB HL at 3.0 kHz, in the better-hearing ear. Multiple logistic regression models examined whether the self-reported measures of hearing -including hearing in background noise- are valid in comparison to objective measures of hearing and which the predictors of the potential inaccuracies are across different population subgroups of a representative population sample. Results 30.2% of individuals with HL went undetected by the self-report measure in ELSA. Statistically significant predictors of misreporting hearing difficulties (while they had objectively measured HL >35dBHL at 3.0kHz, in the better-hearing ear) were: female gender (OR 1.97, 95%CI 1.18-3.28), no educational qualifications (OR 1.37, 95%CI 1.26-2.55), routine/manual occupation (OR 1.43, 95%CI 1.28-2.61), tobacco consumption (OR 1.14, 95%CI 1.08-1.90), alcohol intake above the low risk level guidelines (OR 1.13, 95%CI 1.11-2.34), and lack of moderate ...