Hearing Loss
Conditions
Keywords
Hearing Loss, Hearing Aids, Rehabilitation of hearing impaired
Brief summary
The purpose of this study is to determine the effects of age-related cognitive changes on hearing aid benefit based on hearing aid compression time constants. The hypothesis is that people with poor working memory skills will benefit from slow time constants in hearing aid compression while those with good working memory skills will be able to benefit from more sophisticated compression algorithms with rapid time constants.
Detailed description
Recent research has shown the relevance of cognitive function in hearing aid evaluation and the sensitivity of the aging auditory system to temporal distortions. The proposed investigation will examine the interaction of working memory and hearing aid compression method on speech recognition in background competition for older listeners. This interaction will be investigated for the following three forms of background competition: 1. Competition from continuous speech-shaped noise. 2. Competition from speech-modulated noise. 3. Competition from a single interfering talker. The goals of the study will be accomplished in two phases. In the first phase, 160 adults aged 50 through 75 years will be evaluated on a battery of tests to determine their cognitive capacity, time-compressed speech scores and their candidacy for inclusion in the second phase of the study. At the conclusion of this phase of testing, the participants will be divided into three groups: 1. subjects with TCS test scores in the highest quartile (the HIGH group) 2. subjects with TCS test scores in the lowest quartile (the LOW group) 3. the remaining listeners The second phase of the experiment will include listeners from the HIGH and LOW groups only. These subjects will be evaluated with respect to their speech recognition ability for three types of interference (steady-state noise, speech-modulated noise, single interfering talker). The HINT test (Nilsson, Soli, & Sumida, 1995; Nilsson et al., 1994) will be used to obtain the signal-to-noise ratio (SNR) at 50% recognition for the three masking conditions for each of three types of amplification: 1. one- channel linear amplification (LINEAR) with frequency shaping 2. two-channel wide dynamic range compression with fast time constants (FAST) 3. two-channel wide dynamic range compression with slow time constants (SLOW) Listener groups will be compared across hearing aid conditions and across background interference conditions.
Interventions
PROCEDUREAudiological Evaluation
Tests of hearing, cognition, and speech perception
Sponsors
US Department of Veterans Affairs
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Participants will be 50 to 75 years old. * Hearing loss will be limited to 40 dB HL from 250 Hz through 1000 Hz, and to 60 dB HL through 4000 Hz. * Hearing loss must be greater than 25 dB at two or more frequencies from 250 to 4000 Hz.
Exclusion criteria
* None of the participants will be current or past hearing aid users; all will be free of ear disease. * Participants with conductive hearing losses, defined as air-bone gap greater than 15 dB, will be excluded. * The audiometric battery with acoustic reflex thresholds and decay measurements will be used to exclude anyone with evidence of a central disorder or a pathology other than a sensorineural loss. Those potential participants will be referred to a medical professional.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ability to Understand Speech in Noise Background | one year | Measure speech perception for sentences in background noise |
Participant flow
Recruitment details
Veterans from 50 to 75 years of age with hearing loss, not hearing aid wearers
Pre-assignment details
After audiometric thresholds were tested, subjects were assigned to one of three groups based on their pure tone averages (PTA) of thresholds at 500, 1000, 2000, and 4000 Hz. The groups were: Mild (PTAs of 20-39 decibels (dB) hearing level (HL) Moderate (PTAs of 40-49 dB HL) Moderate-Severe (PTAs over 50 dB HL)
Participants by arm
| Arm | Count |
|---|---|
| Mild HL Average hearing loss between 20 and 39 decibels hearing level (HL)
Study performance on cognitive and hearing tests
Audiological Evaluation: Tests of hearing, cognition, and speech perception | 32 |
| Mod HL Average hearing loss between 40 and 49 decibels hearing level (HL)
Study performance on cognitive and hearing tests
Audiological Evaluation: Tests of hearing, cognition, and speech perception | 13 |
| ModSev HL Average hearing loss greater than 50 decibels hearing level (HL)
Study performance on cognitive and hearing tests
Audiological Evaluation: Tests of hearing, cognition, and speech perception | 7 |
| Total | 52 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Death | 4 | 0 | 0 |
| Overall Study | Lost to Follow-up | 6 | 3 | 2 |
| Overall Study | Withdrawal by Subject | 7 | 4 | 0 |
Baseline characteristics
| Characteristic | Mild HL | Mod HL | ModSev HL | Total |
|---|---|---|---|---|
| Age, Continuous | 59.9 years STANDARD_DEVIATION 6.8 | 62.7 years STANDARD_DEVIATION 7 | 65.1 years STANDARD_DEVIATION 5.1 | 61.7 years STANDARD_DEVIATION 5.1 |
| Sex: Female, Male Female | 1 Participants | 1 Participants | 1 Participants | 3 Participants |
| Sex: Female, Male Male | 31 Participants | 12 Participants | 6 Participants | 49 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 6 / 69 |
Outcome results
Primary
Ability to Understand Speech in Noise Background
Measure speech perception for sentences in background noise
Time frame: one year
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Mild HL | Ability to Understand Speech in Noise Background | 84 Percent correct of 100 presented words | Standard Deviation 4 |
| Mod HL | Ability to Understand Speech in Noise Background | 78 Percent correct of 100 presented words | Standard Deviation 7 |
| ModSev HL | Ability to Understand Speech in Noise Background | 47 Percent correct of 100 presented words | Standard Deviation 9 |