Introduction

The prevalence of hearing loss increases with age. In people aged over 65 years it is 30–60%, and increases to 70–90% in people aged over 85 years (Cruickshanks et al., 1998; Sindhusake et al., 2001; Amieva et al., 2015). In older adults (i.e., >65 years) the negative impact of hearing loss on quality of life is substantial, with population norms showing that any form of hearing disability results in poorer physical and mental health outcomes.

People with a greater degree of hearing loss are the most affected (Hogan et al., 2009; World Health Organization [WHO], 2009; Swan, 2010). A study of the impact of hearing loss on physical health in older people found that hearing loss was rated the third most problematic condition, after chronic pain and restricted physical activity (Hogan et al., 2009). Hearing loss also causes the poorer quality of life, with social, emotional and communication difficulties of increasing magnitude the greater the degree of the hearing loss (Bryant and Sonerson, 2006; Hogan et al., 2009).

Communication difficulties often lead to communication breakdown and resulting social and emotional isolation (Wilson et al., 1998) and loneliness (Heine and Browning, 2002; Arlinger, 2003). Social isolation is a form of chronic stress that has been shown to cause depression, poorer cognitive function and poorer overall quality of life (Gopinath et al., 2009; World Health Organization [WHO], 2009; Huang et al., 2010). The World Health Organization has identified three characteristics to define healthy ageing: participation in society, physical and mental health, and security. Hearing loss in many cases prevents people from achieving the first two of these characteristics.

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