In the inevitable process of aging (long period of frailty and need for nursing care), it is certain to aim for healthy longevity, however we would also like the people to aim for “longevity with well-being”. This is why there are questions about whether the various administrative measures and support systems in the medical and welfare fields implemented both for healthcare maintenance and achievement of healthy longevity, really lead to the well-being (happiness and purpose in life) of people. In order to raise the level of healthcare approaches in Japan, it is now necessary to create new evidence, promote evidence-based policy making, and create communities through collaboration among industry, government, academia, and the private sector, including local residents.

　　To prevent and improve frailty, it is necessary not only to further strengthen the conventional viewpoint of cooperation among the fields of medicine, dentistry, and nutrition, but also to promote multi-faceted approaches from broad perspectives, including various social factors. In terms of sensory organ functions, vision (sense of sight), hearing, taste, and smell, represented by the five senses, these are essential for comprehensive maintenance of the quality of life (QOL). Among these functions, decline in visual and auditory functions can cause significant progression acceleration of frailty in older adults. In recent years, a decline in visual function with aging, or “Eye Frailty” has come to be recognized, and at the same time, the term “Hearing Frailty” has also been attracting attention. Both cross-sectional and longitudinal studies have reported an association between hearing impairment and frailty. Further evidence is needed on the effects of the COVID-19 pandemic on hearing and the adverse effects of refraining from medical examinations seeking medical advice.

　　 Regular early screening and regular care of the sensory organs in older adults are extremely important for extending their healthy life expectancy and preventing dementia and frailty. This is because these issues are associated not only with the hearing level, but also directly with the activities of daily living and QOL. Therefore, a major question is how to devise a series of comprehensive and multifaceted approaches to counter frailty (such as physical, psychological/cognitive, and social) in each community. It is also essential to encourage volunteer activities by older residents and create (built) a series of receptacles (=infrastructure) stable infrastructure in the community for health promotion, prevention, and care. In Japan, the time has come to promote “community re-designing based on comprehensive knowledge” in order to realize healthy longevity, with an emphasis on wellbeing, in the 100-year life era.

　　 The Basic Law on Dementia to promote an inclusive society was enforced in early 2024. Considering the role of hearing care in such a society, the following three topics were discussed: “Hearing loss in old age may be a barrier to health promotion and care prevention programs,” “The need to promote awareness of hearing loss in middle age and beyond,” and “Efforts through health promotion programs for the elderly.” Hearing loss may affect the behavior of elderly people in regard to seeking medical advice, and may be a barrier to health promotion and care prevention programs. Meanwhile, slowly progressive hearing loss is difficult to notice, not only by the person himself/herself, but also by those around, including family members.

　　A survey of local residents revealed that the detection of hearing impairment may be an indirect surrogate indicator of the risk of cognitive decline. We released a guidebook online that will enable even municipalities with no experience to immediately launch projects to address hearing loss, and hope that activities to encourage residents to become aware of their hearing loss spread throughout Japan. We feel that hearing care will play an increasingly important role in the health of the people in a country with a long life expectancy.

　　 In this narrative review, we collected community-based epidemiological studies and summarized evidence for the health effects and primary prevention of hearing impairment. Past epidemiological evidence suggests that hearing impairment is associated with a shortened healthy life expectancy and premature death via depression, dementia, falls, traffic accidents, and frailty. Some factors that could prevent the occurrence of hearing impairment related to adverse health outcomes are noise, specific medications, and some candidate factors such as smoking, alcohol consumption, obesity, diabetes, physical activity, and nutrition/diet. In 2019, it was estimated that approximately one in five persons in the world suffer from hearing impairment, which interferes with daily living, and the incidence is expected to increase further with the increasing population of the elderly. From the viewpoint of public health and social medicine, we believe that there is an urgent need to accumulate epidemiological evidence to devise preventive measures against hearing impairment.

　　 The severity of tinnitus is closely linked to emotions, making control of emotional factors crucial to its treatment. This study was aimed at exploring the relationship between emotional intelligence (the ability to manage and adapt to emotions) and the effectiveness of treatment in patients with tinnitus. The Emotional Intelligence Quotient Scale (EQS) questionnaire, categorized into three domains: self-response, interpersonal response, and situational response, was used to assess emotional intelligence, with higher scores indicating higher emotional intelligence. Comparative analysis of the EQS scores throughout a year of treatment in patients who responded or did not respond satisfactorily to tinnitus treatment revealed noteworthy findings. In the group that responded satisfactorily to treatment, the mean scores for all the three domains increased significantly after 12 months, signifying improved emotional intelligence. Conversely, no substantial changes in the EQS scores were observed in the group that did not respond satisfactorily to treatment. These results suggest that evaluating emotional intelligence using the EQS and implementing strategies to enhance it could play a pivotal role in advancing tinnitus treatment methods.

　　 Auditory steady-state response (ASSR) is objective audiometry with frequency specificity. Recently, two devices to assess ASSR using narrow-band chirps became commercially available. In this study, we compared the difference score (DS; threshold difference in ASSR and pure tone audiometry) and test time in 16 adults with normal hearing. The mean DS was within 20dB at all frequencies for both devices. The mean DS with SENTIERO was significantly smaller at 500Hz, and that with Eclipse was significantly smaller at 4000Hz. The mean test time was 24 minutes for SENTIERO and 21 minutes for Eclipse, with the test time being significantly shorter for Eclipse. Both devices were considered as being very useful.

　　 We investigated the gap detection thresholds in older adults. In the present study, 15 older adults with normal hearing (mean age 71.4 years) were tested in the between-channel gap detection test by varying the frequency of the stimulus sounds leading and trailing the gap (condition 1: 800-1600Hz; condition 2: 800-3200Hz). The results showed that the gap detection thresholds in the older adults were poorer than those reported for younger subjects. To investigate the relationship between-channel gap detection thresholds and speech perception, a listening test was also conducted in the older adults. Correlations were found in both conditions (1) and (2) in the auditory attention test and in condition (2) in the multiple listening test under speech. Between-channel gap detection threshold has been reported to be related to attentional function. Speech perception in older adults is also related to cognitive function. It is important to look at listening from multiple perspectives in order to understand how ageing affects cognitive function and listening ability.

　　 Following the outbreak of the new coronavirus infection, the environment surrounding children has changed dramatically, including their need to wear masks and take online classes. There have been reports of the impact of the coronavirus pandemic on children who are still growing, and there are concerns that the impact of the coronavirus pandemic on children with hearing loss is particularly severe.

　　 Therefore, we conducted a questionnaire survey targeting hearing-impaired children attending special-needs schools and special-needs classes and their parents as well as teachers, to assess the changes in their lives and minds, and the effects of mask wearing. Responses were received from 291 hearing-impaired children, their parents, and 332 teachers.

　　 The results of the survey revealed that the coronavirus pandemic placed a heavy burden, including stress, on the children with hearing loss, in addition to their hearing difficulty. Wearing a mask had a particularly large effect, with more than 80% of hearing-impaired children saying they had trouble seeing their mouths the mouth movements of people speaking to them, and it was also the most common cause of poor health. We shall also report on the effects of differences in the language modalities used and the current situation of these children.?

　　 The subjects of this survey were 10 sets of parents of preschool-aged children with mild to moderate hearing loss. The purpose of this study was to examine the psychology of the patients from the time of the newborn hearing screening (NHS) to the present, after their children had been diagnosed as having confirmed to have hearing loss and been started on treatment and education. The survey used free-text and retrospective assessments of the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS). From the free-text, there was a change from unacceptable feelings at the time of diagnosis to positive acceptance after treatment and education. EPDS evaluation showed psychological recovery in most patients from the time of diagnosis. The EPDS scores after the diagnosis of hearing loss did not differ depending on the parents' personal attributes (gender, employment, first birth/first delivery) or characteristics of the children, and no consistent trend was observed. Support for psychological recovery was consisted of professional support and peer support at the School for the Deaf. There is a need to accumulate evidence on the long-term developmental challenges in children with mild to moderate hearing loss.