Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Quebec, Canada.
École d'orthophonie et d'audiologie de l'Université de Montréal, Quebec, Canada.
Ear Hear. 2021 Jan/Feb;42(1):193-205. doi: 10.1097/AUD.0000000000000913.
Audiologists and hearing aid users (HAUs) generally agree that an adaptation period is needed following the first hearing aid (HA) experience. The main purpose of this study is to investigate the acclimatization of older adult listeners with hearing loss to HAs using listening effort and behavioral measures.
Participants (N=47) were older adults with mild to moderately severe sensorineural hearing loss. Thirty-two participants were new HAUs and 15 participants were experienced HAUs. New HAUs were randomly assigned to one of two groups: noise reduction algorithms and directional microphones activated or noise reduction algorithms and directional microphones deactivated. Speech recognition in noise and listening effort were assessed on 8 different occasions during a 10-month period. A dual-task paradigm was used to measure the listening effort deployed to recognize speech in noise. The primary task consisted of the Hearing in Noise Test which also served as the behavioral speech in noise measure. The secondary task was a tactile pattern-recognition task in which participants had to identify a sequence of three tactile stimuli that varied in duration. The two listening effort outcomes were the proportional dual-task cost and the response time on the secondary task. Cognitive abilities, including working memory and speed of processing, were evaluated using the Reading Span Test and the Digit Symbol Substitution Test, respectively.
Results show a significant time*group interaction. Both groups of new HAUs showed improvement over time in speech in noise performances (change of ~2 dB signal to noise ratio) and the experienced HAUs did not improve over time. The acclimatization effect was observed over a period of 4 weeks. There was no significant change over time on both measures of listening effort. There was no association between amplitude of acclimatization and the cognitive abilities measured.
An acclimatization effect following HA experience was observed. Specifically, the new HAUs displayed a clinically significant change of 2 dB in signal to noise ratio on the Hearing in Noise Test 4 weeks following their initial fitting. The acclimatization effect is not correlated to cognitive abilities.
听力学家和助听器使用者(HAU)普遍认为,在首次使用助听器(HA)后需要适应一段时间。本研究的主要目的是使用听力努力和行为测量来研究听力损失的老年听众对助听器的适应情况。
参与者(N=47)为患有轻度至中度感音神经性听力损失的老年人。32 名参与者为新的 HAU,15 名参与者为经验丰富的 HAU。新的 HAU 被随机分配到以下两组中的一组:激活降噪算法和指向性麦克风或不激活降噪算法和指向性麦克风。在 10 个月的时间内,通过 8 个不同的场合评估言语识别和听力努力。使用双任务范式来衡量识别噪声中的言语所使用的听力努力。主要任务是噪声中的听力测试,该测试也作为行为噪声中的言语测量。次要任务是一种触觉模式识别任务,参与者必须识别三个不同持续时间的触觉刺激的序列。两个听力努力结果是比例双重任务成本和次要任务的响应时间。使用阅读广度测试和数字符号替代测试分别评估认知能力,包括工作记忆和处理速度。
结果显示时间*组交互作用显著。两组新的 HAU 的言语识别在噪声中的表现都随着时间的推移而提高(信号对噪声比提高约 2 dB),而经验丰富的 HAU 随着时间的推移没有提高。适应效应在 4 周的时间内观察到。在两个听力努力措施上,随着时间的推移都没有显著变化。适应幅度与所测量的认知能力之间没有关联。
在 HA 体验后观察到适应效应。具体来说,新的 HAU 在他们最初的适配后 4 周,在噪声中的听力测试中显示出了 2 dB 的信号对噪声比的临床显著变化。适应效应与认知能力无关。