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The analysis of factors which influence on the hearing aid efficacy in elderly with presbycusis is presented in the article. 125 patients from 60 to 90 years old with moderate to severe hearing loss, hearing aid users, were examined. The audiology examination included standard methods as well as tests evaluating central auditory pathways processing. According to the results of speech audiometry in free field low efficacy of hearing aid is revealed in 21 % patients. The main factor that decreases hearing aid benefit is the presence of central auditory processing disorders, the additional one is poor technical characteristics of a hearing aid. To increase hearing aid benefit in elderly the correction of central auditory processing disorders, rational hearing aid fitting according to individual features of auditory system and help in adaptation to hearing aid using are required.

The matrix sentence test in which the five-word semantically unpredictable sentences presented under the background noise conditions are used as the speech material was designed and validated for many languages. The objective of the present study was to evaluate the Russian version of the matrix sentence test (RuMatrix test) in the listeners of different ages with normal hearing. At the first stage of the study, 35 listeners at the age from 18 to 33 year were examined. The results of the estimation of the training effect dictated the necessity of conducting two training tracks before carrying out the RuMatrix test proper. The signal-to-noise ratio at which 50% speech recognition (SRT50) was obtained was found to be -8.8±0.8 dB SNR. A significant effect of exposure to the background noise was demonstrated: the noise level of 80 and 75 Db SPL led to a considerably lower intelligibility than the noise levels in the range from 45 to 70 dB SPL; in the subsequent studies, the noise level of 65 dB SPL was used. The high test-retest reliability of the RuMatrix test was proved. At the second stage of the study, 20 young (20-40 year old) listeners and 20 aged (62-74 year old) ones were examined. The mean SRT50 in the aged patients was found to be -6.9±1.1 dB SNR which was much worse than the mean STR50 in the young subjects (-8.7±0.9 dB SNR). It is concluded that, bearing in mind the excellent comparability of the results of the RUMat rix test across different languages, it can be used as a universal tool in international research projects.

The results of studying the features of auditory perception of speech stimuli in aged patients with hearing loss are presented in the article. 145 patients with moderate to severe sensorineural hearing loss from 52 to 90 years old underwent the tonal threshold audiometry and the tests battery to evaluate central auditory pathways functioning: the gap detection test, frequency difference limens, masking level difference, dichotic digits test. After analyzing speech discrimination scores of monosyllable words in quiet and in noise significantly worse results of all listeners in comparison with listeners with normal hearing are revealed; the deterioration of speech discrimination scores depending on age is noted. The impairment of speech discrimination is maximal when the speech stimuli are presented in background noise. Direct correlation between the deterioration of speech discrimination and the degree of hearing loss, it's duration, the presence of central auditory pathways dysfunction was ascertained.

Results of the investigation of hearing of elderly people living in nursing houses in Saint-Petersburg, obtained through a tonal threshold audiometry are described in this article. The analysis of hearing-loss prevalence depending on the age, the hearing-loss degrees, the presence of complaints about the hearing loss are also represented as well as the discussion about the possible causes of hearing loss (accompanying somatic diseases, working in noisy environment, hearing diseases inheritance).

Data about rehabilitation in hearing impaired elderly people living in nursing houses in Saint-Petersburg are presented in the article. Hearing aid demand depending on age and degree of hearing loss is analyzed and problems of electro acoustic correction of hearing loss and possibilities to increase its efficacy in studied age group are discussed as well.

Described in the paper is the normative-and-legal system for the state purchases of medical services in the Republic of Kazakhstan.