The cognitive and psychosocial effects of auditory training and hearing aids in adults with hearing loss

Abstract

Purpose

Our study assessed the efficacy of the simultaneous use of hearing aids and auditory training for improving cognition and psychosocial function in adults with hearing loss, and the relationships between hearing loss, speech perception and cognition.

Participants and methods

A 40-person (aged 50–90 years) pilot study in Melbourne, Australia, was conducted. Participants with hearing impairment completed the Geriatric Depression Scale-Short Form, questions about social activity participation, a wide range of cognitive tasks and a speech perception test at baseline, 3 and 6 months. Participants underwent auditory training for 6 months and used hearing aids for 3 months.

Results

Correlations and structural equation modeling suggested that several cognitive domains were associated with speech perception at baseline, but only the Incongruent Stroop cognition measure was associated with hearing loss. Hearing aid use reduced problems with communication, but there were no significant improvements in speech perception, social interaction or cognition. The effect of hearing aids and auditory training for improving depressive symptoms was significant with a moderate to large effect size (Cohen’s d=0.87).

Conclusion

The small sample size and a relatively high rate of attrition meant that this study was underpowered. However, baseline results suggested relationships between hearing loss, speech perception and cognition, and the hearing intervention provided evidence of reduced depressive symptoms. A full-scale, randomized hearing loss intervention and a longer neuroim-aging study with cognitive outcomes measured in the short term as well as after several years of hearing aid use are needed.

Keywords:

• cognition
• depression
• hearing loss intervention
• speech perception

Acknowledgments

We are grateful to all the clinicians at Blamey and Saunders Hearing Pty Ltd and the retirement aged care facilities in Melbourne who participated in this research study. We would also like to acknowledge Professor Frank R Lin, Professor Sunil Bhar, and Professor Peter Blamey for making substantial contributions to the work reported in this manuscript. In addition, we wish to thank Greg Kennedy for his guidance in terms of the Swinburne University Computerized Cognitive Assessment Battery testing.

Author contributions

All authors contributed toward data analysis, drafting and critically revising the paper, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Supplementary materials

Table S3 suggests that forgetting and learning rates were significant only for the first 3 months for both groups.

In Table S4, in addition to controlling for baseline outcome measures, we controlled for baseline scores for Contextual Working Memory and SQRT (Aversiveness) because there were large differences between the two groups in these variables at baseline. In addition, age and attrition probability were controlled for, in order to adjust for age effects and any attrition bias. In these analyses, effect sizes (Cohen’s d) were obtained by dividing the estimated coefficients by the residual SD, as recommended by Feingold.¹

Confirming the results from Table 1, there was a significant increase in Aversiveness when a hearing aid was worn, with marginal mean values of 4.431 and 5.781 for the two conditions (Cohen’s d=−1.01). There was a significant decline in delayed recognition memory performance when hearing aids were used (Cohen’s d=0.95). There was also a narrowly significant carryover effect in the case of delayed recognition memory.

Table S1 Baseline characteristics

Table S2 Outcome of hearing aid benefit with respect to SPT results when HAs were first fitted and when HAs were removed

Table S3 Estimated parameters (standard errors) derived from speech tracking data

Table S4 Mixed model crossover analysis

Reference

• FeingoldAA regression framework for effect size assessments in longitudinal modeling of group differencesRev Gen Psychol201317111112123956615
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