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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 23  |  Issue : 3  |  Page : 168-170

Beck depression Inventory-II in hearing impaired elderly patients: A presbycusis study


1 Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
2 Communication Disorders Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Date of Web Publication31-Aug-2017

Correspondence Address:
Zahra Habibi
Communication Disorders Research Center, Isfahan University of Medical Sciences, Isfahan
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/indianjotol.INDIANJOTOL_63_16

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  Abstract 

Background and Objective: Hearing impairment is one of the most common sensory deficits in human communities. Recent studies have shown that presbycusis happens earlier than before. Hearing loss due to the aging process, or presbycusis, can cause inability to interpret sounds in speech, decreased ability to communicate and withdrew from society. Therefore these factors may lead to psychological problems such as depression. Since there are few studies evaluating the side effects of presbycusis in Iran, we started the study of depression in presbycusis clients referred to the audiology clinics of Isfahan University of medical science, Isfahan, Iran. Materials and Methods: In this cross-sectional study, the relationship between demographic characteristics and depression was determined. In order to collect information and evaluate depression, Beck Depression Inventory-II (BDI-II) was utilized and conducted on 35 cases. Results: Results indicated that 8.6fcr% had minimal depression, 14.3% with mild, 20.0% moderate depression and 57.1% had severe depression. No significant correlation between age, gender and depression was achieved. Conclusion: Using depression questionnaire such as BDI-II during aural rehabilitation process could be valuable. More complications were found in acceptance of hearing aids in elderly people with depression. Psychological treatment can be suitable while audiological management was accomplished simultaneously for this group.

Keywords: Beck Depression Inventory-II, depression, elderly, presbycusis


How to cite this article:
Nilforoush MH, Sepehrnejad M, Habibi Z. Beck depression Inventory-II in hearing impaired elderly patients: A presbycusis study. Indian J Otol 2017;23:168-70

How to cite this URL:
Nilforoush MH, Sepehrnejad M, Habibi Z. Beck depression Inventory-II in hearing impaired elderly patients: A presbycusis study. Indian J Otol [serial online] 2017 [cited 2020 Feb 25];23:168-70. Available from: http://www.indianjotol.org/text.asp?2017/23/3/168/213873


  Introduction Top


Hearing impairment has affected more than 250 million people around the world.[1] Aging progress and changes associated with that can affect the auditory system and cause presbycusis [2] which is the most common sensory impairment.[3]

According to the definitions given, presbycusis is a hearing loss caused by aging.[4] Many studies have shown that presbycusis in elderly (60 years old or over) is very common [5] that it is also the most prevalent impairment. Furthermore, in the US health system, presbycusis is the third medical problem after hypertension and arthritis in elderly.[4]

Based on some studies' results, it is estimated that the prevalence of hearing loss in 65 years old and over is 25%–40%, 75 years old and over is 40%–66%, and in 85 years and over is 80%–90%.[6] Recent studies demonstrate that presbycusis happens more often and also earlier than before. However, millions of people do not care about their hearing loss.[7],[8]

Hearing loss can cause inability to interpret sounds in speech and decreased ability to communicate and withdrew from the society.[9] Therefore, these factors may lead to psychological problems such as depression.[1] Since there are few studies evaluating the side effects of presbycusis, we started the study of depression in presbycusis clients referred to the audiology clinics of Isfahan University of Medical Science, Isfahan, Iran.


  Materials and Methods Top


The study included 35 clients (19 men and 16 women) who were over 60 years old; a cross-sectional study was performed. To assess depression, the validated questionnaire Beck Depression Inventory-II was utilized which is validated and reliable in Iran,[10] along with that demographic data were also collected. The BDI-II is the most recent version of a widely used self-report measure of depression severity. Furthermore, this test represents a successful acknowledged standard in the measurement of depressed mood. It takes 5–10 min to fill out this questionnaire.[11] The BDI-II is scored by summing the highest ratings for each of the 21 questions. Each question is rated on a 4-point scale ranging from 0 to 3, and total scores can range from 0 to 63.[12] Score results are divided into four categories including 0–13 to indicate minimal or no depression; 14–19, mild depression; 20–28, moderate depression; and 29–63, severe depression.[13]

This study was conducted in three audiology clinics affiliated to Isfahan University of Medical Sciences, Isfahan, Iran.

Inclusion criteria included the presence of presbycusis (sensorineural hearing loss), age over 60 years, and the absence of underlying diseases such as diabetes and hypertension, according to the individuals' statement. There was no force to fill out the questionnaire and clients could stop testing if they were willing to.

After presbycusis confirmation by audiometry tests such as pure tone audiometry and speech audiometry, a written informed consent to cooperate was given from each client; afterward the questionnaire was given to them. Then, according to the instructions of the questionnaire, the score of each individual was determined, and eventually, all the data were analyzed statistically by SPSS 18 software (SPSS, Chicago, IL, USA), and with Spearman correlation, ANOVA, and Pearson methods, correlation between the variables of interest was measured.


  Results Top


A range of mild-to-severe hearing loss in those who surveyed was observed. The average age of these clients was nearly 68 years. Results indicated that 8.6% had minimal depression, 14.3% with mild depression, 20.0% had moderate depression, and 57.1% had severe depression [Table 1].
Table 1: The prevalence of depression among the participants

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The results showed that there is no significant relationship between the age and sex of clients with depression. However, a direct relationship between the presbycusis clients' hearing loss level and depression was observed (P < 0.05) [Table 2].
Table 2: The relationship between age, sex and hearing loss level in subjects with their depression score

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However, there was a direct correlation between hearing loss and depression in clients.

The survey also found that most presbycusis elderly have severe depression [Table 3].
Table 3: Classification of depressed clients according to their hearing loss level

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  Discussion Top


According to the WHO, it is estimated that there will be 1.2 billion people over 60 years of age worldwide. In addition, 500 individuals of this population will suffer from significant presbycusis.[14] Depression can affect people 60 years and above, especially in the elderly who have clinical problems.[15] As it can be seen, there is a high percentage of depression among the elderly with presbycusis and in general, depression in the elderly is the second most common psychological disorder.[16],[17] Furthermore, based on the results of Sajjadi et al.'s [18] study in Iran, depression among Iranian elderly was 57.58%. According to research results of Majdi et al.'s study, prevalence of depression in the Iranian elderly population was 23.5%.[9] The depression study conducted on elderly people in the city of Isfahan by Manzouri et al.[19] indicated a 63.7% depression prevalence in the studied population which includes 40.7% suffered from moderate depression and 23% suffered from severe depression. Likewise, our results indicate that depression in the elderly with hearing loss was 91.4% including 14.3% mild depression, 20.0% suffered from moderate depression, and 57.1% had severe depression.


  Conclusion Top


Due to the high prevalence of depression in the elderly, especially in elderly with hearing loss, it calls for more attention to psychological disorders of these people. These elderlies would have additional difficulties in acceptance and suitable use of their hearing aids; therefore, the psychological and psychiatric treatment simultaneously can play an important role in rehabilitation success. Using depression questionnaire such as BDI-II during aural rehabilitation process can be valuable. This study and other researches in the field of the relationship between hearing loss and depression indicate a substantial relationship between audiology, psychology, and psychiatry. Furthermore, a need for further cooperation in these fields to improve the quality of life as well as the health enhancement is felt.

Acknowledgment

The authors would like to thank audiology clinics personnel and also clients that helped and participated in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mathers C, Smith A, Concha M. Global burden of hearing loss in the year 2000. Global burden of Disease 2000;18:1-30.  Back to cited text no. 1
    
2.
Schneider M, Dasappa P, Khan N, Khan A. Measuring disability in censuses: The case of South Africa. ALTER Eur J Disabil Res/ Revue Européenne de Recherche sur le Handicap 2009;3:245-65.  Back to cited text no. 2
    
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Martini A. Hearing, balance and communication problems in the elderly: Editorial. Hearing Balance Commun 2015;13:43-5.  Back to cited text no. 3
    
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Satheesh S, Sunil Kumar KP, Ahmed SM. Keywords: ARHL, audiometry, speech audiometry, loss of hearing, profound hearing loss, PTA, phonetically balanced words, Presbycusis, pure tone and frequencies. Audiological Evaluation In Geriatric Age Group. 2015 May 30(92745).  Back to cited text no. 4
    
5.
World Health Organization. Definition of an older or elderly person: proposed working definition of an older person in Africa for the MDS Project. Available from: http://www.who.int/healthinfo/survey/ageingdefnolder/en/index.html [Last accessed on 2012 Nov 03].[WebCite Cache]. 2013.  Back to cited text no. 5
    
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Yueh B, Shapiro N, MacLean CH, Shekelle PG. Screening and management of adult hearing loss in primary care: Scientific review. JAMA 2003;289:1976-85.  Back to cited text no. 6
    
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Bogardus ST Jr., Yueh B, Shekelle PG. Screening and management of adult hearing loss in primary care: Clinical applications. JAMA 2003;289:1986-90.  Back to cited text no. 7
    
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Cruickshanks KJ, Tweed TS, Wiley TL, Klein BE, Klein R, Chappell R, et al. The 5-year incidence and progression of hearing loss: The epidemiology of hearing loss study. Arch Otolaryngol Head Neck Surg 2003;129:1041-6.  Back to cited text no. 8
    
9.
Majdi MR, Mobarhan MG, Salek M, Taghi M, Mokhber N. Prevalence of depression in an elderly population: A population-based study in Iran. Iran J Psychiatry Behav Sci 2011;5:17-24.  Back to cited text no. 9
    
10.
Vasegh S, Baradaran N. Using the Persian-language version of the Beck Depression Inventory-II (BDI-II-Persian) for the screening of depression in students. J Nerv Ment Dis 2014;202:738-43.  Back to cited text no. 10
    
11.
Beck AT, Steer RA, Brown GK. Beck depression inventory-II. San Antonio 1996;78:490-8.  Back to cited text no. 11
    
12.
Steer RA, Ball R, Ranieri WF, Beck AT. Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. J Clin Psychol 1999;55:117-28.  Back to cited text no. 12
    
13.
Wang YP, Gorenstein C. Psychometric properties of the Beck Depression Inventory-II: A comprehensive review. Rev Bras Psiquiatr 2013;35:416-31.  Back to cited text no. 13
    
14.
Flook M, Lopes S, Aparicio M, Santos R, Andrade C, Andrade S, et al. ARHL and Tinnitus in Portuguese Population: What we Can Hear from a Sample of Elderly Individuals. In 10th International Tinnitus Research Initiative Conference; 2016.  Back to cited text no. 14
    
15.
Alcalá V, Camacho M, Giner J. Affect and depression in the elderly. Psicothema 2007;19:49-56.  Back to cited text no. 15
    
16.
Sadock BJ. Sadock's Comprehensive Textbook of Psychiatry. Philadelphia: Lippincott; 2000.  Back to cited text no. 16
    
17.
Nilforoush MH, Nasr Esfahani AA, Ishaghi R, Sepehrnejad M. Comparison of nursing home hearing handicap index with audiological findings: A presbycusis study. J Aging Res 2012;2012:423801.  Back to cited text no. 17
    
18.
Sajjadi H, Mohaqeqi Kamal SH, Rafiey H, Vameghi M, Forouzan AS, Rezaei M. A systematic review of the prevalence and risk factors of depression among Iranian adolescents. Glob J Health Sci 2013;5:16-27.  Back to cited text no. 18
    
19.
Manzouri L, Babak A, Merasi M. The depression status of the elderly and it's related factors in Isfahan in 2007. Iran J Ageing 2010;4.  Back to cited text no. 19
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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