Purpose The purpose of this study was to explore the effects of hearing, cognition, and personal factors on hearing aid (HA) uptake, use, and benefit. Method Eighty-five older adults aged 60–80 years ( M = 70.23, SD = 5.17) participated in the study. Hearing was assessed using pure-tone audiometry and the Listening in Spatialised Noise–Sentences test. Cognition was measured using the Cogstate Brief Battery and the Cogstate Groton Maze Learning task. Personal demographics were recorded from participants' answers on a series of take-home questionnaires. HA benefit and use was subjectively reported at 3 and 6 months post HA fitting for those who chose to use HAs. Results Stepwise-regression and mixed-effects models indicated that stronger psychomotor function predicted greater reported use of HAs at 3 and 6 months post HA fitting. Greater family interaction scores also predicted greater HA use at 3 months after fitting. Participants who chose to be fitted with HAs had significantly poorer self-reported health and poorer audiometric thresholds. Poorer hearing was also significantly related with greater reported HA benefit. Conclusions A combination of cognitive, psychosocial factors and hearing impacted HA outcomes for the older Australians in this study. Self-reported HA use was significantly greater in participants with better psychomotor function. Furthermore, those with poorer self-reported health were more likely to choose to use HAs. These factors should be considered in audiological rehabilitation to best maximize patient HA outcomes.
Background Hearing loss is associated with accelerated cognitive decline in older adults, and has been identified as a modifiable risk factor for dementia. Although hearing aids are a successful treatment for hearing loss, it is unknown whether hearing aid use can delay the onset of cognitive decline or improve cognitive function in older adults with hearing loss. This prospective longitudinal study is investigating the effect of hearing aid use on cognitive decline and addresses many of the methodological limitations of previous studies. Method Patients are recruited from the University of Melbourne Academic Hearing Aids Audiology Clinic and assessed before and every 18 months after hearing aid fitting. When numbers are sufficient, results will be compared with those of a control group of approximately 400 participants of a cohort study of ageing in older adults. Assessments include cognitive function (visually presented computerised assessment battery), hearing, speech perception, quality of life, activity, diet, loneliness and isolation, anxiety, depression, medical health and genetic risk. Result At baseline, multiple linear regression for 98 participants (62‐82 years), controlling for age, gender, cardiovascular conditions, education, and working/retired, with mean better ear PTA 31dB showed hearing loss and age predicted significantly poorer executive function, while tertiary education predicted significantly better executive function and visual learning. At 18‐month follow up, results for a subset of participants showed significant improvements in speech perception, listening disability and quality of life. Group mean scores across the cognitive assessment battery showed no significant decline and executive function was significantly improved. There was either clinically significant improvement or stability for executive function for over 97% of the subset, and for females for working memory, visual learning and visual attention, despite significantly greater hearing loss over this period. Conclusion Despite a small initial sample size, hearing loss, age and education significantly predicted baseline cognitive function. At 18‐month follow up, the majority of participants had either remained stable or demonstrated a meaningful clinical improvement in cognitive function, with significant group mean improvements for executive function and working memory. Treatment of hearing loss with hearing aids may delay cognitive decline. These are initial results, and further follow up is required.
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