[Audiological testing in complex geriatric assessment of patients.]

The aim of the study is to evaluate the advantage of including audiological testing in the system of comprehensive geriatric assessment (CGA) of patients. The results of a survey of 988 elderly and senile people (average age 77±7,4 years) are presented, each of whom underwent a CGA and hearing assessment by filling out a questionnaire Hearing Handicap Inventory for the Elderly, Screening version (HHIE-S). All patients were divided into two groups: the first group included 780 inpatient patients undergoing medical and social rehabilitation in different departments of the Saint-Petersburg City Geriatric Center. The second group included 208 outpatient patients, of whom 81 additionally underwent an audiological examination, which included ENT examination and pure tone audiometry to determine the degree of hearing loss. A correlation was revealed between the hearing state and the cognitive status of patients according to the results of the Mini-Mental State Examination (MMSE) questionnaire, as well as the senile asthenia index. The results of the work indicate the need to include the HHIE-S questionnaire in the system of comprehensive geriatric assessment for early detection and correction of hearing loss, and prevention of cognitive disorders.

[Analysis of hearing aids application in elderly patients.]

The aim of the study is to evaluate the possibility to implement machine learning to create a digital auditory profile for elderly patients and to analyze the hearing aid fitting efficacy depending on involvement of the peripheral and central auditory pathways in a pathological process. Data analysis of 375 people aged 60-93 years is presented. 355 patients with chronic bilateral hearing loss (230 of them used hearing aids) were included in the main group, and 20 normal hearing elderly people were included in the control group. Audiological examination consisted of standard tests (pure tone audiometry, impedancemetry, speech audiometry in quiet) and tests to evaluate the central auditory processing (binaural fusion, dichotic digits, speech audiometry in noise, random gap detection). The Montreal Cognitive Assessment was used to detect cognitive impairment. The hearing aid fitting efficiency was evaluated with COSI questionnaire and speech audiometry in free field. Processing of the results was carried out using Pearson's correlation analysis aimed at creating a polynomial model of a patient's hearing on the basis of the limited test battery. There were close correlations between the state of cognitive functions and age, results of tests to evaluate the central auditory processing, as well as patients' satisfaction of hearing aid. The results of the work indicate the possibility of using computer technologies of data analysis to develop rehabilitation programs for elderly hearing impaired patients.

[Audiological correlates of age-related manifestations of auditory disorders.]

The aim of the study was a comparative analysis of complaints and audiological findings in patients of the audiological center depending on their age. The results of the examination of 300 firstly consulted patients (random sample) are presented. The group of young patients (19-44 years) included 40 people; middle age (45-59 years) - 62 people; elderly (60-74 years) - 100 people; senile age (75-90 years) - 98 people. The survey included the collection of complaints and anamnesis, ENT checkup, pure tone audiometry, impedancemetry, speech audiometry in headphones to detect the signs of Central Auditory Processing Disorder or in the free sound field to assess the effectiveness of hearing aids. It was found that for early diagnosis of hearing loss and prevention of age-related sensory-cognitive dysfunction, it is advisable to use not only the results of pure tone audiometry, but also the data of speech audiometry, as well as the analysis of subjective complaints. The results of the work indicate the need for hearing screening in the population over 60 years old.

[Age-related issues of the quality of life in hearing impaired patients.]

The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old (R2=0,98 with statistically significant difference, p<0,05), with decreasing correlation in patients from 60 years and older (R2=0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.

[Hearing loss in adults in older age groups.]

There has been a steady increase in the prevalence of hearing loss among people in many countries around the world. One of the main reasons for this negative trend is an increase in life expectancy and an increase in the proportion of the elderly people, which means an increase in the number of people with age-related changes in the auditory system (presbycusis). Aging is accompanied primarily by damage to the structures of the inner ear, but it can also affect the central parts of the auditory analyzer, causing frustration at all levels of the auditory neural pathway. Presbycusis is accompanied by impaired hearing and speech intelligibility. Along with speech hearing, spatial hearing suffers. Just as in other countries of the world, in Russia the prevalence of age-related hearing loss is increasing year by year. The data on the prevalence of hearing impairment in the Russian Federation vary, due to the lack of uniform approaches to the registration of persons with hearing impairment. Creation of a surdologic register is necessary for information support of complex medical and social rehabilitation of surdological patients. Since hearing loss has a significant negative impact on the quality of life of patients, knowledge of the prevalence of hearing disorders among the population will allow to plan properly the need for technical means of hearing and speech rehabilitation at the state level, to promote social rehabilitation and active longevity of citizens of older age groups.

[Rehabilitation of hearing impaired elderly patients by means of hearing aids with frequency lowering technology.]

The objective of this study was to assess the effectiveness of rehabilitation of hearing impaired elderly patients using hearing aids with frequency lowering technology called Frequency Composition ™. 23 hearing aid users (mean age 64 years) with moderate to severe sensorineural hearing loss were tested. All participants were divided into two groups according to configuration of audiogram: 11 people with averaged slope of 27,9 dB per an octave within frequency range of 1-2 kHz (the 1st group) and 12 people with slope of 24,1 dB at 2-4 kHz (the 2nd group). Average speech tests scores of the 1st group were significantly worse than for the 2nd group (p<0,05 in quiet; p<0,01 in noise). It has been seen that the 1st group had significant better improvement of speech understanding using of Frequency Composition™ than the 2nd group. It has been shown that frequency lowering can improve perception of high frequency sounds and enhance speech intelligibility especially in patients with audiogram slope within frequency range of 1-2 kHz. To effective use of frequency lowering technology a careful selection of patients and adaptation to the new algorithm of amplification are required.

[Age related aspects of cochlear implantation.]

The objective of this study was to assess the long-term results of cochlear implantation in terms of age-related changes. 67 patients of different age with chronic bilateral severe sensorineural hearing loss and deafness with experience of use of cochlear implants (CI) for at least 5 years were tested. The 1st group included young patients (25,5±7,9 years), the 2nd group - middle-aged (51,4±5,4 years), the 3rd group - elderly patients (67±5,6 years). The examination, which conducted before and after the planned replacement of the speech processor, included: pure tone and speech audiometry in the free field, subjective assessment of satisfaction with CI, assessment of the state of speech function and psychological testing using the Montreal Cognitive Assessment and Mini-Mental State Examination. The increase in speech intelligibility in silence and in a background noise after the replacement of speech processors was revealed. The expediency of cochlear implantation in geriatric practice to maintain the mental and social status of elderly people, prevention of dementia, improving the quality of their lives in the conditions of increasing the age-related risks of sensory and cognitive dysfunction was shown.