Remote examination and testing of elderly persons in detecting hearing impairments

Objectives – to assess the efficiency of using a comprehensive hearing test, including a questionnaire survey and determination of hearing thresholds using the "Automated system of primary hearing assessment" web application, in comparison with tone threshold audiometry in elderly people.

Material and methods. We examined 138 patients of the Samara Regional Clinical Hospital for War Veterans who were over 60 years old. The group included 67 women and 71 men with the average age of 71.6 ± 6.4 years. The patients underwent ENT endoscopy, an online survey on hearing self-assessment, hearing thresholds study using the Automated Primary Hearing Assessment web application, and tone threshold audiometry.

Results. The prevalence of hearing impairment in the group was 76.1% according to the online questionnaire on hearing self-assessment. When comparing the general results of the on-line test questionnaire and the study of hearing thresholds, the on-line test data were confirmed when conducting tonal threshold audiometry in 75.0% of people with normal test indicators, in 25.0% of people an in-depth study showed some hearing loss. According to an online survey of patients with hearing complaints, 89.1% had a certain degree of hearing loss. Hearing parameters according to the web application were comparable in terms of both hearing threshold values and the degree of hearing loss with the data of tonal threshold audiometry. The maximum difference was 3.9 and 3.5 dB at 1 and 2 kHz for the right ear and 7.2 dB at 4 kHz for the left ear. Low agreement of mean hearing thresholds was observed in patients at frequencies of 1 and 4 kHz on the right (κ = 0.24 and κ = 0.3, respectively) and at a frequency of 4 kHz - on the left (κ = 0.14), which may be due to high-frequency hearing loss in this group of patients and more significant fluctuations of indicators. The discrepancies in the data of the web application and in the values of the hearing thresholds when taking into account the comorbid status were minimal in persons with diabetes mellitus and amounted to 2 dB at a frequency of 8 kHz, the maximum deviations were observed in patients with occupational risk factors of 7.2 dB at a frequency of 4 kHz.

Conclusion. The comprehensive study that includes an online survey on hearing self-assessment and the hearing function evaluation in the Automated System for Primary Hearing Assessment web application is a convenient and simple tool for screening hearing impairment in outpatients and clinical examination, as well as at the stage of monitoring, treatment, and rehabilitation of patients with various degrees and types of hearing loss, especially in the elderly people.