Asymmetric hearing loss is common and benign in patients aged 95 years and older

Objectives/Hypothesis: The objective of our study was to investigate age-specific auditory function in the patient population aged 95 years and older. Study Design: Retrospective chart review at a tertiary medical center. Methods: Medical records of 51 patients older than 95 years ( 82% female, 18% male) who underwent audiologic testing were reviewed. The following information was collected: age at time of most recent audiogram and prior audiograms; results of pure tone, immittance, and speech audiometry; and findings on radiologic imaging. Results: None of the subjects had hearing in the normal range. For the poorer hearing ear, average low-frequency, high-frequency, and overall pure tone averages ( PTA) for the population were 67.9, 82.1, and 74.9 dB hearing level, respectively. Mean word recognition score ( WRS) was 57.6% and deteriorated with increasing PTA ( P=.0002). Asymmetry, defined by a 10-dB difference at two frequencies, was present in 39.2% of the sample, and WRS asymmetry, defined as a difference of 12% in WRS between ears, was present in 33.0% of the sample. Retrocochlear evaluation did not identify pathology in any of the cases tested. In the poorer hearing ear, average decline in PTA per year was 2.9 dB. Conclusions: In individuals >95 years of age, hearing loss was universal, moderately severe to profound in magnitude, and associated with substantial loss of speech recognition. Hearing loss progresses at a rate greater than for younger cohorts. In this "oldest old" population, asymmetry of loss and WRS was common and is not indicative of retrocochlear pathology.