Jerome D. Schein, PhD, Professor Emeritus, New York University, New York, NY, USA; Adjunct Professor, University of Alberta, Edmonton, AB.
Maurice H. Miller, PhD, Department of Speech-Language Pathology & Audiology Steinhardt School of Education, New York University, New York, NY, USA.

For persons whose hearing does not return in 60–90 days following idiopathic sudden sensorineural hearing loss (ISSNHL), audiologic rehabilitation should be provided. This article describes aspects of audiologic rehabilitation, including counselling, information about lifestyle changes, and techniques (such as amplification) for overcoming the communication handicap ISSNHL imposes. Advantages and limitations of various hearing aids are presented.
Key words: audiology, counselling, hearing aids, otology, rehabilitation, sensorineural, hearing loss.

John P. Preece, PhD, Department of Communicative Disorders, University of Rhode Island, Kingston, RI.
Richard S. Tyler, PhD, Department of Otolaryngology-Head & Neck Surgery, Department of Speech Pathology & Audiology, University of Iowa, Iowa City, IA.
William Noble, PhD, School of Psychology, University of New England, Armidale, NSW, Australia.

Hearing loss in the elderly is a frequently acknowledged problem. Prevalence of hearing loss clearly increases with age, to as high as 50% of persons older than 70 years. Less recognised is an often-related problem, tinnitus. We are concerned here about pathological tinnitus: that which lasts more than five minutes more than once a week. In this article we review the prevalence of tinnitus as a function of age, and its causes and mechanisms. We also describe problems commonly associated with chronic tinnitus and some treatment options. We conclude with some special considerations for the elderly patient.
Key words: tinnitus, prevalence, counseling, sound therapy.

Wendy S. Meschino, MD, CCFP, FRCPC, FCCMG
Clinical Geneticist,
North York General Hospital,
Toronto, ON.

"My mother has Alzheimer disease. Can I be tested to see if I carry the gene?" Such questions from patients are likely to be a familiar refrain to many physicians. While there is a great deal of discussion regarding the potential hereditary aspects of Alzheimer disease (AD), genetic testing is not appropriate for the vast majority of patients or their unaffected relatives. Genetic testing is possible only in selected situations where there is a significant family history of early-onset disease. In this article, we will explore how to take a family history of Alzheimer disease, how to recognize when genetic testing is appropriate, the critical issues to be discussed in genetic counselling and a brief review of the genes identified to date which are associated with familial Alzheimer disease (FAD).

In taking a family history, it is important to inquire about affected and unaffected relatives on both sides of the family. Details of the family history may be recorded in pictorial form as a pedigree (Figure 1). A minimum of three generations should be noted including siblings, parents, aunts, uncles, cousins and grandparents.