Eckert Mark A, Matthews Lois J, Dubno Judy R
Medical University of South Carolina, Charleston.
J Speech Lang Hear Res. 2017 Jan 1;60(1):251-262. doi: 10.1044/2016_JSLHR-H-16-0011.
Even older adults with relatively mild hearing loss report hearing handicap, suggesting that hearing handicap is not completely explained by reduced speech audibility.
We examined the extent to which self-assessed ratings of hearing handicap using the Hearing Handicap Inventory for the Elderly (HHIE; Ventry & Weinstein, 1982) were significantly associated with measures of speech recognition in noise that controlled for differences in speech audibility.
One hundred sixty-two middle-aged and older adults had HHIE total scores that were significantly associated with audibility-adjusted measures of speech recognition for low-context but not high-context sentences. These findings were driven by HHIE items involving negative feelings related to communication difficulties that also captured variance in subjective ratings of effort and frustration that predicted speech recognition. The average pure-tone threshold accounted for some of the variance in the association between the HHIE and audibility-adjusted speech recognition, suggesting an effect of central and peripheral auditory system decline related to elevated thresholds.
The accumulation of difficult listening experiences appears to produce a self-assessment of hearing handicap resulting from (a) reduced audibility of stimuli, (b) declines in the central and peripheral auditory system function, and (c) additional individual variation in central nervous system function.
即使是听力损失相对较轻的老年人也报告有听力障碍，这表明听力障碍并不能完全由言语可听度降低来解释。
我们使用老年人听力障碍量表（HHIE；Ventry和Weinstein，1982）检查了自我评估的听力障碍评分与噪声中言语识别测量之间的关联程度，该测量控制了言语可听度的差异。
162名中年和老年人的HHIE总分与低语境而非高语境句子的可听度调整后的言语识别测量显著相关。这些发现是由HHIE中涉及与沟通困难相关的负面情绪的项目驱动的，这些项目也捕捉到了预测言语识别的努力和挫折主观评分中的差异。平均纯音阈值在HHIE与可听度调整后的言语识别之间的关联中占了一些方差，表明与阈值升高相关的中枢和外周听觉系统衰退的影响。
困难听力体验的积累似乎会导致对听力障碍的自我评估，这是由以下原因造成的：（a）刺激的可听度降低，（b）中枢和外周听觉系统功能下降，以及（c）中枢神经系统功能的额外个体差异。
