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Quality-of-Life Changes and Hearing Impairment: A Randomized Trial

Cynthia D. Mulrow, MD, MSc; Christine Aguilar, MD; James E. Endicott, PhD; Michael R. Tuley, PhD; Ramon Velez, MD, MSc; Walter S. Charlip, PhD; Mary C. Rhodes, MPH; Judith A. Hill, MD; and Louis A. DeNino, PhD
[+] Article, Author, and Disclosure Information

Grant Support: By the Robert Wood Johnson Foundation, a Milbank Scholar Program Award, and an American College of Physicians' Teaching and Research Scholar Award.

Requests for Reprints: Cynthia D. Mulrow, MD, MSc, Audie L. Murphy Memorial Veterans Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78284.

Current Author Addresses: Drs. Mulrow, Aguilar, Tuley, Velez, Hill, and DeNino and Mrs. Rhodes: Division of General Internal Medicine, Audie L. Murphy Memorial Veterans Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78284.

Drs. Endicott and Charlip: Audiology and Speech Pathology Service, Audie L. Murphy Memorial Veterans Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78284.

Ann Intern Med. 1990;113(3):188-194. doi:10.7326/0003-4819-113-3-188
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Objective: To assess whether hearing aids improve the quality of life of elderly persons with hearing loss.

Setting: Primary care clinics at a Bureau of Veterans Affairs hospital.

Patients: One hundred and ninety-four elderly veterans who were identified as being hearing impaired from a screening survey involving 771 consecutive clinic patients. Of the original 194, 188 (97%) completed the trial.

Intervention: Subjects were randomly assigned to either receive a hearing aid (n = 95) or join a waiting list (n = 99).

Main Endpoints: A comprehensive battery of disease-specific and generic quality-of-life measures were administered at baseline, 6 weeks, and 4 months.

Measurements and Main Results: Persons assigned to the two groups were similar in age, ethnicity, education, marital status, occupation, and comorbid diseases. At baseline, 82% of subjects reported adverse effects on quality of life due to hearing impairment, and 24% were depressed. At follow-up, a significant change in score improvements for social and emotional function (34.0; 95% CI, 27.3 to 40.8; P < 0.0001), communication function (24.2; CI, 17.2 to 31.2; P < 0.0001), cognitive function (0.28; CI, 0.08 to 0.48; P = 0.008), and depression (0.80; CI, 0.09 to 1.51; P = 0.03) was seen in subjects who received hearing aids compared with those assigned to the waiting list. Six drop-outs (three per group), no crossovers, and no significant changes in cointerventions were seen. Average, self-reported, daily aid use in the hearing aid group was 8 hours.

Conclusion: Hearing loss is associated with important adverse effects on the quality of life of elderly persons, effects which are reversible with hearing aids.





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