Distortion Product Otoacoustic Emissions and Screenings
Jupiter (2009) reports that there are many hearing screening methods and tools that have been used on the elderly. Jupiter notes that pure-tone testing (some sources recommend using 25 dB HL screening level, some recommend 30-35 dB HL, and some recommend 40 dB HL when screening elderly people), hearing handicap scales, self assessment scales, “audioscopes,” and the very straightforward and simple question, “Do you have a hearing problem now?” as well as combinations and modifications of these methods and tools, all have their proponents.
However, otoacoustic emissions (OAEs) have not been used extensively as a screening tool in the elderly as the potential influence of age and hearing impairment combined is as of yet unresolved. Distortion product OAEs (DPOAEs) have good test-retest reliability; DPOAEs do not require a behavioral response and DPOAEs are non-invasive and objective.
Jupiter endeavored to determine if DPOAEs could be used as a screening tool for elderly people and to compare DPOAE screenings to pure-tone screenings and to HHIE-S and various combinations. She evaluated 106 people with an average age of 76.5 years, including 18 men and 88 women. She concluded DPOAEs can be used as a screening test if the goal is to have an objective tool that does not require a behavioral response from the subject, and if the goal is to identify people whose pure-tone thresholds are likely to reveal greater than a mild-to-moderate sensorineural hearing loss. Jupiter notes that DPOAEs by themselves may lead to over-referral, but this too, may be desirable in this population.
For More Information, References, and Recommendations
Jupiter T. (2009) Screening for Hearing Loss in the Elderly Using Distortion Product Otoacoustic Emissions, Pure Tones and A Self Assessment Tool. American Journal of Audiology. (18) December:99-107.