Does hearing aid use slow cognitive decline?

Prolonged, untreated hearing loss has been linked to increased social isolation, decreased brain volume, and range of subjective and objective declines in cognitive abilities. Hearing aids have been shown to beneficially affect some of these traits but a great deal of unknown details remain. A number of active studies aim to answer the question “does hearing aid use slow cognitive decline?”. The work of Deal and colleagues is a valuable step toward finding that answer.

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Deal, J., Sharrett, A., Albert, M., Coresh, J., Mosley, T., Knopman, D., Wruck, L. & Lin, F. (2015). Hearing impairment and cognitive decline: A pilot study conducted within the Atherosclerosis Risk in Communities Neurocognitive Study. American Journal of Epidemiology 181 (9), 680-690.

Listening is more effortful for new hearing aid wearers

Recent work out of Linkoping, Sweden suggests that new hearing aid wearers experience greater cognitive demands when listening. Over time they adapt to better resolve new auditory cues, decreasing the effort required for listening.

Ng, E., Classon, E., Larsby, B., Arlinger, S., Lunner, T., Rudner, M., Ronnberg, J. (2014). Dynamic relation between working memory capacity and speech recognition in noise during the first six months of hearing aid use. Trends in Hearing 18, 1-10.

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Cognitive benefits of digital noise reduction

A number of studies have suggested that activating digital noise reduction in hearing aids may improve performance on tasks that are associated with cognitive capacity. This change in performance is attributed to a reduction in effort required for effective listening. This study from Desjardins and Doherty is one of the first to reveal these effects in a sample of participants with hearing loss.

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Desjardins, J. & Doherty, K. (2014). The effect of hearing aid noise reduction on listening effort in hearing-impaired adults. Ear and Hearing 35 (6), 600-610.

American Auditory Society 2015

At this year’s meeting of the American Auditory Society we are sharing five research posters. Links to the PDF of these posters are listed below.

Hearing Aid Use is Becoming More Accepted

On this month’s blog we review one of last year’s top 5 research articles. Rauterkus and Palmer (2014) asked people to rate characteristics of people wearing a variety of ear-level devices, some of which were hearing aids. Ratings taken today, as compared to those collected decades ago suggest that hearing aid use is carrying less social stigma than it once did.

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Rauterkus, E. & Palmer, C. (2014). The hearing aid effect in 2013. Journal of the American Academy of Audiology 25, 893-903.

Top 5 Hearing Aid Research Publications from 2014!

top5_2014

Over the last year, we were presented with audiology research that spanned topics related to engineering, clinical expectations, and statistical exercises for predictive or retrospective analyses. This selection of articles is representative of that diversity, highlighting articles that present new models for speech quality, describing third-party perception of hearing aid use, and several that peel away layers obscuring the complexity of adapting to new hearing aid use.

1. The Hearing Aid Effect in 2013

Hearing aid use carries stigma: this is a fact that all people with hearing loss, researchers, and audiologists understand. It’s safe to say that there is a generalized assumption that the adoption of body-worn technology will eventually erode the stigmatizing effect of hearing aid use. During this study, adults were asked to rate their perception of a person wearing several styles of ear-level devices, including hearing aids, earphones, and a Bluetooth headset. While the observed differences could be considered moderate, there were no perceived differences between a person wearing hearing aids and those not wearing hearing aids. The authors propose that this observation indicates a more positive perception of hearing aid use, as compared to earlier studies.

Rauterkus, E., & Palmer, C. (2014). The Hearing Aid Effect in 2013. Journal of the American Academy of Audiology, 25, 893-903.

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2. Dynamic relation between working memory capacity and speech recognition in noise during the first 6 months of hearing aid use

Attempting to clearly interpret past research in the area of adaptation to new hearing aids is a complex proposition. Some studies offer conflicting results, even questioning the nature of the adaptation effect. This is one of several studies in recent years that have looked at measures of cognition as they relate to new hearing aid use. The authors find that working memory demands (a form of functional short-term memory) changed over 6-months. The implications of these observations are increased cognitive demands at the time of the first hearing aid fitting, as patients work to interpret newly audible cues.

Ng, E., Classon, E., Birgitta, L., Arlinger, S., Lunner, T., Rudner, M., & Ronnberg, J. (2014). Dynamic relation between working memory capacity and speech recognition in noise during the first 6 months of hearing aid use. Trends in Hearing, 18, 1-10.

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3. Factors associated with success with hearing aids in older adults

This large-scale assessment tracked the outcomes of patients through a battery of 16 measurements, both subjective and objective. A number of valuable clinical factors were identified as linking to hearing aid success. Three of these factors stand out as providing excellent clinical insight. Firstly, the role of a supportive spouse is extremely important; secondly, the patient must be able to confidently manipulate the hearing aids themselves; finally, patients fit with hearing aids at prescriptively appropriate gains are more successful than those who are fit far below the prescription. Some of these observations have been made in previous studies but this one is the first to succinctly report them with modern hearing aids.

Hickson, L., Meyer, C., Lovelock, K., Lampert, M., & Khan, A. (2014). Factors associated with success with hearing aids in older adults. International Journal of Audiology, 53, S18-S27.

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4. The Hearing-Aid Speech Quality Index (HASQI) Version 2

The optimization and verification of hearing aid signal processing algorithms is greatly eased by our ability to model (or predict) a person’s perception of changes in the processed sound. The HASQI is a tool that allows for the prediction of changes in sound quality though the comparison of two recordings, one unprocessed sample that is used as a reference and a second processed sample. This recent revision to the original HASQI works well to overcome some limitations of the first iteration.

Kates, J., & Arehart, K. (2014) The Hearing-Aid Speech Quality Index (HASQI) Version 2. Journal of the Audio Engineering Society, 62(3), 99-117.

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 5. A 3-pack on the acclimatization conundrum

This package of three articles is being presented as one (on the list). Individually, each offers a small but meaningful insight into the topic of adapting to new hearing aid use. As all three were published from the same lab during 2014, they offer a collective series of insights that will impact all future work in this area. In brief, the investigators sought to document acclimatization effects through several metrics, including a round of focus group interviews. Their objective observations showed mild effects of experience with hearing aids, while the focus group interviews reinforce expectations that adjusting to hearing aids is an experience that extends beyond the perception of amplified sound alone.

Dawes, P., Maslin, M., & Munro, K. (2014). ‘Getting used to’ hearing aids from the perspective of adult hearing-aid users. International Journal of Audiology, 53, 861-870.

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Dawes, P., Munro, K., Kalluri, S., & Edwards, B. (2014). Auditory acclimatization and hearing aids: Late auditory evoked potentials and speech recognition following unilateral and bilateral amplification. Journal of the Acoustical Society of America, 135(6), 3560-3569.

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Dawes, P., Munro, K., Kalluri, S., & Edwards, B. (2014). Acclimatization to Hearing Aids. Ear and Hearing, 32(2), 203-212.

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Tinnitus Treatment through Sound Therapy

For the patient suffering from tinnitus, management of this persistent internal sound can be debilitating. Most treatment plans have converged on a format that includes sound therapy with a device presenting distracting noise or tonal sounds. Prior to the reviewed study, few randomized control trials with hearing aids featuring sound therapy had been completed. Read on to learn about the work of Henry and colleagues, who report on the benefits of hearing aids alone and hearing aids with a feature for tinnitus sound therapy.

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Henry, J., Frederick, M., Sell, S., Griest, S. & Abrams, H. (2014). Validation of a novel combination hearing aid and tinnitus therapy device. Ear and Hearing, e-published ahead of print, September 2014.

Can changing hearing aid settings improve working memory?

This month we review a recent study from Souza and Sirow that assessed working memory with several clinically fit hearing aids. The results suggest that aspects of cognitive status may play a role in how patients respond to different hearing aids settings.

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Considerations for Music Listening

This month’s blog reviews a newly published article from Crogan and colleagues*. The authors discussed a project investigating the quality of music perception through hearing aids. Various factors related to the patient and hearing aid signal processing were found to be meaningful. We offer clinical advice relative to optimizing a music listening memory for patients that present themselves as music aficionados.

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*Croghan, N., Arehart, K. & Kates, J.  (2014). Music preferences with hearing aids: effects of signal properties, compression settings and listener characteristics. Ear & Hearing, in press.

A hierarchical model for the analysis of intra-individual variability

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When analyzing and reporting results of studies involving multiple participants, researchers are often faced with two choices: average data across participants to estimate group-level effects or treat each participant separately. Neither of these two options is entirely satisfactory: averaging data across participants ignores inter-individual differences and treating each participant as a separate entity ignores commonalities across participants. Hierarchical (i.e., multi-level) Bayesian models (HBMs) provide a principled solution to this conundrum. We show that, in most cases, estimates of performance or of treatment effects computed using HBMs are more precise and more accurate than estimates of performance obtained using traditional methods.