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BackgroundHearing aid (HA) use is known to improve health outcomes for people with hearing loss. Despite that, HA use is suboptimal, and communication issues and hearing-related activity limitations and participation restrictions often remain. Web-based self-management communication programs may support people with hearing loss to effectively self-manage the impact of hearing loss in their daily lives. ObjectiveThe goal of the research is to examine the short- and long-term effects of a web-based self-management SUpport PRogram (SUPR) on communication strategy use (primary outcome) and a range of secondary outcomes for HA users aged 50 years and older. MethodsClients of 36 HA dispensing practices were randomized to SUPR (SUPR recipients; n=180 HA users) and 34 to care as usual (controls; n=163 HA users). SUPR recipients received a practical support booklet and online materials delivered via email over the course of their 6-month HA rehabilitation trajectory. They were encouraged to appoint a communication partner and were offered optional email contact with the HA dispensing practice. The online materials included 3 instruction videos on HA handling, 5 videos on communication strategies, and 3 testimonial videos. Care as usual included a HA fitting rehabilitation trajectory only. Measurements were carried out at baseline, immediately postintervention, 6 months postintervention, and 12 months postintervention. The primary outcome measure was self-reported use of communication strategies (3 subscales of the Communication Profile for the Hearing Impaired [CPHI]). Secondary outcome measures included self-reported personal adjustment to hearing loss (CPHI); use, satisfaction and benefit of HAs and SUPR (use questionnaire; International Outcome Inventory for Hearing Aids [IOI-HA], Alternative Interventions [IOI-AI]); recommendation of HA dispensing services; self-efficacy for HA handling (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids [MARS-HA]); readiness to act on hearing loss (University of Rhode Island Change Assessment adapted for hearing loss [URICA-HL]); and hearing disability (Amsterdam Inventory for Auditory Disability and Handicap [AIADH]). ResultsLinear mixed model analyses (intention to treat) showed no significant differences between the SUPR and control group in the course of communication strategy use (CPHI). Immediately postintervention, SUPR recipients showed significantly higher self-efficacy for advanced HA handling than the controls, which was sustained at 12 months (MARS-HA; mean difference immediately postintervention: 5.3, 95% CI 0.3 to 10.4; P=.04). Also, SUPR recipients showed significantly greater HA satisfaction than controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.09 to 0.5; P=.006), which was sustained at 12 months, and significantly greater HA use than the controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.02 to 0.5; P=.03), which was not sustained at 12 months. ConclusionsThis study provides ground to recommend adding SUPR to standard HA dispensing care, as long-term, modest improvements in HA outcomes were observed. Further research is needed to evaluate what adjustments to SUPR are needed to establish long-term effectiveness on outcomes in the psychosocial domain. Trial RegistrationISRCTN77340339; http://www.isrctn.com/ISRCTN77340339 International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2016-015012

AbstractBackgroundAimMaterials and methodsResultsConclusionHearing-dementia research mainly focuses on determining the causal direction of this association. Little is known about the prevalence of cognitive problems in a representative audiology patient population.To examine the occurrence of self-reported cognitive complaints (SCC) and dementia risk factors (RF) in an audiology patient population.Patients visiting audiology clinics (n = 1100, 51% female and avg. age 61yrs) were administered an online intake tool based on the International Classification of Functioning Disability and Health. Domains extracted for analyses were memory and concentration (SCC) and loneliness, depression, sleep and vision (dementia RF) and self-reported hearing problems (SHP). Prevalence rates and associations with demographic variables and SHP were examined.SCC were highly prevalent, with over half of the patients reporting memory or concentration problems. Regarding dementia RF, 68% reported sleeping problems and > 50% reported sadness, anxiety or depressed mood. SHP correlated significantly with self-reported memory problems, loneliness, and vision problems.This descriptive cohort-study suggests a high risk of cognitive issues within the audiology clinic population, indicated by the high prevalence of SCC and some dementia RF. Our findings underscore the importance of considering closer cooperation between care pathways like audiology and neurology and use of a holistic patient-centered approach. [ABSTRACT FROM AUTHOR]

This study assessed the impact of the COVID-19 pandemic on psychosocial health among individuals with different levels of hearing ability. For this cross-sectional study, adults completed an online digits-in-noise test and survey. Participants were categorised into "good", "insufficient", or "poor" hearing groups. Survey questions included topics on depression, anxiety, distress, somatisation, and loneliness levels. Multiple logistic, linear, and negative binomial regressions examined differences in psychosocial health between hearing groups. Moderation analyses identified vulnerable subgroups. Mediation analyses examined mediating effects of pandemic measures on hearing ability and psychosocial health. Eight-hundred and sixty-five adults with or without hearing impairment. Individuals with poor hearing had a higher odds of having elevated anxiety levels and had higher somatisation levels compared to participants with good hearing. Chronic diseases significantly moderated the relationship between poor hearing ability and loneliness. Difficulties with communicating through facemasks, 1.5 m distance, plastic screens, and during video calls significantly mediated the relationships between hearing ability, anxiety and somatisation. Results highlight the elevated anxiety and somatisation levels experienced among individuals with hearing impairment during the COVID-19 pandemic. More awareness is needed of the negative impact pandemic measures can have on psychosocial health during future health crises. [ABSTRACT FROM AUTHOR]

Purpose: The pupil dilation response is sensitive not only to auditory task demand but also to cognitive conflict. Conflict is induced by incompatible trials in auditory Stroop tasks in which participants have to identify the presentation location (left or right ear) of the words "left" or "right." Previous studies demonstrated that the compatibility effect is reduced if the trial is preceded by another incompatible trial (conflict adaptation). Here, we investigated the influence of hearing status on cognitive conflict and conflict adaptation in an auditory Stroop task. Method: Two age-matched groups consisting of 32 normalhearing participants (M[subscript age] = 52 years, age range: 25-67 years) and 28 participants with hearing impairment (M[subscript age] = 52 years, age range: 23-64 years) performed an auditory Stroop task. We assessed the effects of hearing status and stimulus compatibility on reaction times (RTs) and pupil dilation responses. We furthermore analyzed the Pearson correlation coefficients between age, degree of hearing loss, and the compatibility effects on the RT and pupil response data across all participants. Results: As expected, the RTs were longer and pupil dilation was larger for incompatible relative to compatible trials. Furthermore, these effects were reduced for trials following incompatible (as compared to compatible) trials (conflict adaptation). No general effect of hearing status was observed, but the correlations suggested that higher age and a larger degree of hearing loss were associated with more interference of current incompatibility on RTs. Conclusions: Conflict processing and adaptation effects were observed on the RTs and pupil dilation responses in an auditory Stroop task. No general effects of hearing status were observed, but the correlations suggested that higher age and a greater degree of hearing loss were related to reduced conflict processing ability. The current study underlines the relevance of taking into account cognitive control and conflict adaptation processes.

Purpose: Various directional hypotheses for the observed links between aging, hearing, and cognition have been proposed: (a) cognitive load on perception hypothesis, (b) information degradation hypothesis, (c) sensory deprivation hypothesis, and (d) common cause hypothesis. Supporting evidence for all 4 hypotheses has been reported. No studies have modeled the corresponding 4 causal pathways into 1 single model, which would be required to evidence that multiple directional hypotheses apply. The aim of the current study was to tease out which pathways apply for 5 different cognitive measures. Method: Data from 1,029 respondents of the Longitudinal Aging Study Amsterdam were used spanning a maximum follow-up of 7 years (3 measurements). Speech-in-noise recognition ability (digit triplet speech-in-noise test) was included as a measure of auditory function. Cognitive measures included global cognitive functioning, fluid intelligence, information processing speed, and verbal memory (immediate recall and retention). Bivariate dual change score modeling was used to model the causal pathways between hearing, cognition, and baseline age. Results: For information processing speed, global cognitive functioning, fluid intelligence, and memory-immediate recall, all pathways except for the sensory deprivation pathway were supported. For memory-retention, only the common cause and the sensory deprivation pathways were supported. Conclusions: Causal pathways corresponding to all 4 hypotheses were supported. Support for the common cause hypothesis, the information degradation hypothesis, and the cognitive load on perception hypotheses was found for 4 of 5 cognitive measures. This was unexpected in some cases (e.g., support for the information degradation pathway for cognitive measures that do not rely on auditory stimuli). The sensory deprivation pathway that emerged for memory-retention might point toward processes related to early stages of dementia. In summary, the results show that the links between decline in auditory function, cognition, and aging are complex and most likely are captured by pathways belonging to various directional hypotheses.

Previous research has shown that learning effects are present for speech intelligibility in temporally modulated (TM) noise, but not in stationary noise. The present study aimed to gain more insight into the factors that might affect the time course (the number of trials required to reach stable performance) and size [the improvement in the speech reception threshold (SRT)] of the learning effect. Two hypotheses were addressed: (1) learning effects are present in both TM and spectrally modulated (SM) noise and (2) the time course and size of the learning effect depend on the amount of masking release caused by either TM or SM noise. Eighteen normal-hearing adults (23–62 years) participated in SRT measurements, in which they listened to sentences in six masker conditions, including stationary, TM, and SM noise conditions. The results showed learning effects in all TM and SM noise conditions, but not for the stationary noise condition. The learning effect was related to the size of masking release: a larger masking release was accompanied by an increased time course of the learning effect and a larger learning effect. The results also indicate that speech is processed differently in SM noise than in TM noise. [ABSTRACT FROM AUTHOR]

Purpose: The pupil dilation response is sensitive not only to auditory task demand but also to cognitive conflict. Conflict is induced by incompatible trials in auditory Stroop tasks in which participants have to identify the presentation location (left or right ear) of the words 'left' or 'right.' Previous studies demonstrated that the compatibility effect is reduced if the trial is preceded by another incompatible trial (conflict adaptation). Here, we investigated the influence of hearing status on cognitive conflict and conflict adaptation in an auditory Stroop task. Method: Two age-matched groups consisting of 32 normal-hearing participants ([M.sub.age] = 52 years, age range: 25-67 years) and 28 participants with hearing impairment ([M.sub.age] = 52 years, age range: 23-64 years) performed an auditory Stroop task. We assessed the effects of hearing status and stimulus compatibility on reaction times (RTs) and pupil dilation responses. We furthermore analyzed the Pearson correlation coefficients between age, degree of hearing loss, and the compatibility effects on the RT and pupil response data across all participants. Results: As expected, the RTs were longer and pupil dilation was larger for incompatible relative to compatible trials. Furthermore, these effects were reduced for trials following incompatible (as compared to compatible) trials (conflict adaptation). No general effect of hearing status was observed, but the correlations suggested that higher age and a larger degree of hearing loss were associated with more interference of current incompatibility on RTs. Conclusions: Conflict processing and adaptation effects were observed on the RTs and pupil dilation responses in an auditory Stroop task. No general effects of hearing status were observed, but the correlations suggested that higher age and a greater degree of hearing loss were related to reduced conflict processing ability. The current study underlines the relevance of taking into account cognitive control and conflict adaptation processes., The measurement of the pupil dilation response is a means to gain insight into mental effort mobilization (Beatty, 1982; Kahneman & Beatty, 1966). Effort mobilization is the mobilization of energy [...]

Purpose: The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults' functional speech-in-noise test result and their self-reported hearing problems. Method: Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is "aware": those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is "well": those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Results: Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher self-efficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke R[superscript 2] = 0.11 for the "unaware" model, and 0.10 for the "false complaints" model). Conclusions: The findings suggest that a small proportion of the discrepancies between older individuals' results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person's health (chronic diseases), demographics (gender), personality (self-efficacy to initiate behavior and to persist in adversity, self-esteem), mood (depressive symptoms), and social situation (social network size). Implications are discussed.

Objective: This study assessed the impact of coronavirus disease-2019 (COVID-19) preventative measures on hearing and communication among individuals with normal and impaired hearing. We also evaluated the use of digital communication tools between these groups. Design: For this cross-sectional study, participants completed an online digits-in-noise test and survey. Survey topics included understanding through masks, behind plastic screens, from a 1.5-m distance, and use of social network sites/apps, direct messaging, and video calling. Logistic regressions assessed the odds of disagreeing versus agreeing with survey statements. Study Sample: A total of 880 adults from the National Longitudinal Study on Hearing completed a survey and hearing test. Based on speech reception threshold scores, participants were categorised into "good" (reference group for all analyses), "insufficient", or "poor" hearing groups. Results: Those with insufficient and poor hearing had more difficulty understanding others through facemasks, plastic screens, and from 1.5 m. Those with poor hearing had a higher odds of video calling more to contact family/friends/acquaintances during the pandemic, but also had more difficulty hearing sufficiently through video calls. Conclusions: This study addresses methodological weaknesses in previous studies. Results strengthen current evidence of the burden COVID-19 measures place on individuals with hearing impairment. [ABSTRACT FROM AUTHOR]

Purpose: Various directional hypotheses for the observed links between aging, hearing, and cognition have been proposed: (a) cognitive load on perception hypothesis, (b) information degradation hypothesis, (c) sensory deprivation hypothesis, and (d) common cause hypothesis. Supporting evidence for all 4 hypotheses has been reported. No studies have modeled the corresponding 4 causal pathways into 1 single model, which would be required to evidence that multiple directional hypotheses apply. The aim of the current study was to tease out which pathways apply for 5 different cognitive measures. Method: Data from 1,029 respondents of the Longitudinal Aging Study Amsterdam were used spanning a maximum follow-up of 7 years (3 measurements). Speech-in-noise recognition ability (digit triplet speech-in-noise test) was included as a measure of auditory function. Cognitive measures included global cognitive functioning, fluid intelligence, information processing speed, and verbal memory (immediate recall and retention). Bivariate dual change score modeling was used to model the causal pathways between hearing, cognition, and baseline age. Results: For information processing speed, global cognitive functioning, fluid intelligence, and memory-immediate recall, all pathways except for the sensory deprivation pathway were supported. For memory-retention, only the common cause and the sensory deprivation pathways were supported. Conclusions: Causal pathways corresponding to all 4 hypotheses were supported. Support for the common cause hypothesis, the information degradation hypothesis, and the cognitive load on perception hypotheses was found for 4 of 5 cognitive measures. This was unexpected in some cases (e.g., support for the information degradation pathway for cognitive measures that do not rely on auditory stimuli). The sensory deprivation pathway that emerged for memory-retention might point toward processes related to early stages of dementia. In summary, the results show that the links between decline in auditory function, cognition, and aging are complex and most likely are captured by pathways belonging to various directional hypotheses., Hearing loss and cognitive decline are both known to be strongly related to aging (e.g., Gates & Mills 2005; Schneider, Pichora-Fuller, & Daneman, 2010). In 1994, the cross-sectional structural equation [...]

To study weekly use of smartwatches, fitness watches and physical activity apps among adults with and without impaired speech-in-noise (SIN) recognition, to identify subgroups of users. Cross-sectional study. Adults (aged 28–80 years) with impaired (n = 384) and normal SIN recognition (n = 341) as measured with a web-based digits-in-noise test, from the Netherlands Longitudinal Study on Hearing. Multiple logistic regression analyses were used to study differences and to build an association model. Employed adults in both groups are more likely to use each type of fitness technology (all ORs >3.4, all p-values < 0.004). Specific to fitness watch use, adults living with others use it more (OR 2.5, 95%CI 1.1;5.8, p = 0.033) whereas those abstaining from alcohol (OR 0.3, 95%CI 0.1;0.6) or consuming >2 glasses/week (OR 0.4, 95%CI 0.2;0.81, overall p = 0.006) and hearing aid users (OR 0.5, 95%CI 0.2;0.9, p = 0.024) make less use. Subgroups of adults more and less likely to use fitness technology exist, but do not differ between adults with and without impaired SIN recognition. More research is needed to confirm these results and to develop interventions to increase physical activity levels among adults with hearing loss. [ABSTRACT FROM AUTHOR]

The objective of this study is (1) to assess whether the presentation level of the antiphasic digits-in-noise (DIN) test affects the speech recognition threshold (SRT), (2) to evaluate how accurately simulated unilateral and bilateral conductive hearing loss is detected (CHL) and (3) to determine whether increasing the presentation level normalises the antiphasic DIN SRT. Participants performed antiphasic and diotic DINs at different presentation levels with unilateral, bilateral or no earplugs. Twenty-four and twelve normal hearing adults. Without earplugs, antiphasic DIN SRTs did not differ between 60 and 80 dB SPL. At 60 dB SPL, the antiphasic DIN correctly classified 92% of the unilateral earplug cases; the diotic DIN 25%. The binaural intelligibility level difference did not differ between the no-earplug condition and the condition with bilateral earplugs when the presentation was increased with the attenuation level. In normal hearing participants, diotic and antiphasic DIN SRTs are independent of presentation level above a minimum level of 60 dB SPL. The antiphasic DIN is more sensitive than the diotic DIN for detecting unilateral CHL; not for bilateral CHL. The effect of CHL on DIN SRTs can be largely compensated by increasing the presentation level. Audibility plays an important role in the antiphasic and diotic DIN. [ABSTRACT FROM AUTHOR]

Purpose: We reevaluated the psychometric properties of the Amsterdam Inventory for Auditory Disability and Handicap (AIADH; Kramer, Kapteyn, Festen, & Tobi, 1995) using item response theory. Item response theory describes item functioning along an ability continuum. Method: Cross-sectional data from 2,352 adults with and without hearing impairment, ages 18-70 years, were analyzed. They completed the AIADH in the web-based prospective cohort study "Netherlands Longitudinal Study on Hearing." A graded response model was fitted to the AIADH data. Category response curves, item information curves, and the standard error as a function of self-reported hearing ability were plotted. Results: The graded response model showed a good fit. Item information curves were most reliable for adults who reported having hearing disability and less reliable for adults with normal hearing. The standard error plot showed that self-reported hearing ability is most reliably measured for adults reporting mild up to moderate hearing disability. Conclusions: This is one of the few item response theory studies on audiological self-reports. All AIADH items could be hierarchically placed on the self-reported hearing ability continuum, meaning they measure the same construct. This provides a promising basis for developing a clinically useful computerized adaptive test, where item selection adapts to the hearing ability of individuals, resulting in efficient assessment of hearing disability.

Purpose: The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults' functional speech-in-noise test result and their self-reported hearing problems. Method: Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is aware: those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is well: those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Results: Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher self-efficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke [R.sup.2] = .11 for the unaware model, and .10 for the false complaints model). Conclusions: The findings suggest that a small proportion of the discrepancies between older individuals' results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person's health (chronic diseases), demographics (gender), personality (self-efficacy to initiate behavior and to persist in adversity, self-esteem), mood (depressive symptoms), and social situation (social network size). Implications are discussed., It is often observed that measures of self-reported hearing problems correlate to a limited degree with objective, functional measures of hearing disability, such as pure-tone audiometry or speech-in-noise test (SNT) [...]