Epidemiological profile of hearing impairments: the scale and nature of the problem with special reference to the elderly.

The nature and scale of services for hearing-impaired people should be formed in the light of the demographic profile of the hearing-impaired. This paper furnishes data for three elements of that profile: the number of hearing-impaired people in England and Wales, the increase in the number of hearing-impaired that might be expected given the growth of the elderly population in England and Wales, and the major factors that influence use of hearing services at present. The combination of reliable prevalence data (1) with demographic information (2) gives good estimates of the numbers of hearing-impaired people and their age distribution. Thus an estimate of 7.4 million people with average hearing thresholds at mid frequencies of 25+ dBHL can be made for an adult population of 38.7 million (aged 18+ years). Eighty percent of these hearing-impaired people are aged over 60 years. Given no change in prevalence rates over the next 20 years, the demographic structure of England and Wales will increase the number of hearing-impaired by approximately 20%. The detailed form of service for the elderly will need to take into account factors shown to put groups at a disadvantage. In particular, the large shortfall in services for the very elderly (over 80 years) and those in manual occupations needs to be addressed.