Hearing aid outcomes in older adults Implications for millions of adults with hearing loss

The first-ever placebo-controlled, double-blind, randomized clinical trial of hearing aid outcomes published today in the American Journal of Audiology shows that older adults benefit from hearing aid use.

Led by researchers at Indiana University with funding support (Grant No. R01 DC011771) from the National Institute on Deafness and Other Communication Disorders (NIDCD), the study sought to compare patient outcomes when hearing aids are delivered via an audiology “best practices” model compared with an “over-the-counter” (OTC) model. In the context of this study, the OTC model meant that patients received a high-quality, pre-programmed hearing aid that was not fitted by an audiologist.

The methodology is generally considered the highest standard for clinical trials.

“The research findings provide firm evidence that hearing aids do, in fact, provide significant benefit to older adults,” said Larry Humes, PhD, CCC-A, a distinguished professor in the Department of Speech and Hearing Sciences at Indiana University Bloomington and the study’s lead author. “This is important because, even though millions of Americans have hearing loss, there has been an absence of rigorous clinical research that has demonstrated clear benefits provided by hearing aids to older adults. Consequently, the U.S. Preventive Services Task Force has not been able to support widespread hearing screening for adults over age 50. This study, along with others to follow, will help establish the evidence base needed to foster better hearing health care for many older Americans.”

The study looked at 154 adults ages 55-79 years with mild-to-moderate hearing loss. All participants received the same high-end digital mini hearing aids fitted in both ears. Subjects were divided into three groups. One (the best practices group) received “best practices” services from audiologists that included professional fitting and counseling; one (the OTC group) received no professional fitting by an audiologist and selected their own pre-programmed hearing aids; and one (the placebo group) received a professional fitting but used a hearing aid that was programmed to provide no acoustical benefit.

Researchers found that hearing aids are effective in older adults for both the audiology best practices model and the OTC model. There were no significant differences in outcome between these two service-delivery approaches for five of the six outcome measures, but the OTC group fared somewhat worse when it came to satisfaction with their hearing aids. Fewer OTC participants were also likely to purchase their hearing aids after the trial (55% for the OTC group vs. 81% for the best practices group, with 36% for the placebo group). Following the initial 6-week trial, both the OTC and placebo groups were offered hearing aids under the best practices model. Satisfaction significantly increased for patients in both groups who chose to continue under audiologist care, and more participants opted to purchase their hearing aids after this continued period of care than after the initial trial.

In the United States, a large discrepancy exists between the number of people who could benefit from hearing aids and those who actually wear them. Close to 29 million U.S. adults could benefit from using hearing aids, according to NIDCD. Yet, among adults aged 70 and older with hearing loss who could benefit from wearing hearing aids, fewer than one in three (30%) have ever used them. Even fewer adults aged 20-69 (approximately 16%) who could benefit have ever used them.

In the study, researchers noted that NIDCD has prioritized identifying research areas that could lead to the improvement of hearing health care for adults with mild-to-moderate hearing loss — in particular, enhancing the accessibility and affordability of hearing health care. This study helps answer a high-priority research question of how current delivery systems can be used or modified to increase accessibility and affordability of hearing health care, according to study authors.

“More studies are needed to assess the generalization of the results obtained here to other patient populations, other devices, and other models of OTC service delivery,” said Humes, adding, “All of the devices used in this study were of high quality as opposed to the simpler, less expensive devices many associate with an OTC model. Also, all patients received a complete audiologic evaluation prior to treatment — another potential difference from some OTC models under consideration. These factors could impact patient outcomes. However, the results of this study should serve as a yardstick for comparing outcomes of future hearing aid studies.”

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Materials provided by American Speech-Language-Hearing Association. Note: Content may be edited for style and length.



Hearing Loss Can Change How Nerve Cells Are Wired

Hearing Loss Can Change How Nerve Cells Are Wired

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Common causes of occluded ears and temporary hearing loss like childhood ear infections and build-up of ear wax, or even the common cold–where everything sounds muffled, can lead to changes in the hearing system. Even short-term blockages of this kind can lead to remarkable auditory changes, altering the behavior and structure of nerve cells that relay information from the ear to the brain, according to a new University at Buffalo (UB) study.

The research, published online in the December 1, 2016 edition of the Journal of Neuroscience, investigated what happened when mice had their ears surgically blocked for a period of several days to “dampen” hearing. The investigators saw that some significant changes do occur within a few days. “What’s still unclear, however, is whether the cells return to their normal state when acoustic conditions return to normal,” said Matthew Xu-Friedman, PhD, the lead researcher and an associate professor of biological sciences in UB’s College of Arts and Sciences. We see in our research that the cells do seem to mostly bounce back, but we don’t yet know whether they completely recover.”

According to a recent announcement from UB, the changes the research team observed had to do with neurotransmitters — chemicals that help send signals from the ear to the brain. In mice whose ears were blocked, cells in the auditory nerve started to use their supplies of neurotransmitter more freely. They depleted their reserves of these chemicals rapidly each time a new auditory signal came in, and they decreased the amount of space within the cells that housed sac-like structures called vesicles — biological storage tanks where neurotransmitter chemicals are kept.

“When it’s quiet, the demands on the auditory nerve cells are not as great,” said Xu-Friedman in the announcement. “So it makes sense that you would see these changes: You no longer need as much neurotransmitter, so why invest in a lot of storage? If you’re not that active, you don’t need a big gas tank. And you’re not as afraid to use up what you have. This is one plausible explanation for what we observed.”

The changes in cellular structure and behavior were the opposite of what Xu-Friedman’s team saw in a previous study that placed mice in a consistently noisy environment. In that project, the mice’s auditory nerve cells started to economize their resources, conserving supplies of neurotransmitter while increasing the storage capacity for the chemicals.

“It looks like these effects are two sides of the same coin, and they might be the first hints of a general rule that nerve cells regulate their connections based on how active they are,” Xu-Friedman says.

In the more recent study, cellular changes began to reverse themselves when the mice’s ears were unplugged. When a treatment was “undone, the cells started to go back to what they were like before. Yet, it’s not clear to the researchers if the cells completely recover, so the team needs to do more research to see if that’s the case. Xu-Friedman also wants to study what happens when cells are repeatedly exposed to conductive hearing loss, as happens in some small children who get recurring ear infections. Xu-Friedman’s co-authors on the paper were first author Xiaowen Zhuang, a UB PhD student in biological sciences, and Wei Sun, PhD, UB associate professor of Communicative Disorders and Sciences. The research was suported by the National Science Foundation.


Science Has Uncovered Worst Sound on the Planet – And It’s Not What You Think

We consider hearing a gift. Each day we see  faces light up with joy as people hear sounds they are hearing for the first time in years. But even we find a few noises – an ambulance squealing down the street or the sound of teenager’s ringtone – so awful we sometimes wish we could program hearing aids (and ears!) to tune them out completely.

According to science, we’re not alone. In 2007, one British researcher went on a quest to uncover the most cringeworthy sounds on earth, according to people from across the globe. To start, University of Salford Professor of Acoustic Engineering Trevor J. Cox rounded up 34 horrible sounds, ranging from the whir of the dental drill to the smack of a cat eating. Next he put them online through a scientific survey that collected participants’ demographic data and allowed them to rank each sound. After one year and more than 1.1 million responses, the results were presented in a scientific paper presented at 19th International Congress on Acoustics.

And the worst sound in the world?

1. Vomiting

It may help to know that the sound in the study was actually a re-creation involving an actor, a bucket, and a can of baked beans. Still, the sound easily beat out fingernails on a chalkboard (a surprisingly low #16) to rank as the worst sound around thanks to the universal disgust it triggers in people across the globe.

Researchers say our revulsion may be an innate survival mechanism. If one member of a tribe shows signs of having ingested something harmful, sympathetic disgust can help others who ate the same thing expel it before they become ill.

Here’s what else made it to the top of the unfortunate heap. Turn up your speakers and see if you agree.

2. Microphone feedback

The concert-ruining squeal of audio feedback ranks high on the cringe list. Some scientists say this one also goes back to our evolutionary heritage. They speculate high-pitched squeals sound a like monkey warning calls, setting our primate brains on edge.

3. Crying Babies

Think one baby crying is bad? Try three or four.

Multiple babies crying outranked a solitary one, which still clocked in at number eight. Interestingly, men found a baby’s cry to be worse than women, who Cox speculates may be more habituated to the noise.

4. Train Scraping on Tracks

Not exactly music to the ears, is it?

5. Metal-on-Metal Squeaking 

The study used the sound of a squeaky seesaw to test a slightly less dramatic version of metal-on-metal. And no surprise, it’s grating.

Other sounds that made the top ten include badly played violin, a flatulent whoopee cushion, a single baby crying, soap opera argument, and electrical humming.

– See more at: https://www.connecthearing.com/blog/worst-sound-in-the-world/#sthash.oA0t8rUy.dpuf


Holidays with Hearing Loss: 12 Tips for Families

The holidays can be the most wonderful time of the year – or the most stressful! For people with hearing loss, the season’s gatherings often mean struggling to connect with friends and family through tables of competing conversations and clattering dishes.

Whether you have hearing loss or are hosting someone who does, there are a number of things you can do to help everyone stay connected during festivities. Read below for 12 survival tips guaranteed to keep the holidays merry and bright.

If you have hearing loss…

  • Wear your hearing aids, if you have them! It should go without saying, but this step is often forgotten. Also considering paying your hearing specialist a visit for a hearing aid tune-up before heading out for the holidays and be sure to bring extra batteries to all holiday events.
  • Don’t be shy about your needs. Let your loved ones know that you want to make sure you’re a part of conversations. Ask them to keep background noise such as music or television to a minimum and speak clearly.
  • Team up! Partner with a friend or relative ahead of time who can help keep you in the loop by filling you in on any bits of conversation you may miss.
  • Stay rested. It’s a lot of work trying to keep up with conversations when you have hearing loss. Be sure to get rest the day before and take a few minutes away from the crowd to refresh as needed to avoid hearing fatigue.
  • Go one-on-one.  Find chances to connect with individuals in a quiet room. Take the grandkids aside for some playtime or help the cook out in the kitchen.
  • Be strategic with your seating. Try to sit against a wall, in a position where you will be able to see as many people as possible. If you have a “good ear” position yourself to maximize its use. Seat those with quiet or high-pitched voices (such as children) closest to you.
  • Clear your view. Visual cues are critical for keeping up with the conversation, so make sure you can see everyone at the dinner table. Keep the room well-lit and remove any excessive centerpieces.
  • Go easy on yourself! Group settings are a challenging hearing situation. Even people with no hearing loss may have trouble following every conversation. Have your best holiday by having realistic expectations and celebrating the positives.

If you’re hosting a guest with hearing loss…

  • Get their attention. Before you start speaking, say the person’s name or touch their arm so they can “tune in” to what you’re saying.
  • Reduce excess noise. Turn off background noise like TV and music.
  • Speak naturally, but clearly. Shouting or over-emphasizing your words can actually make them harder to understand. Make lip-reading easier by refraining from chewing while talking.
  • Have the conversation, one-on-one. Holidays and family gatherings are often the moment when the difficulties of hearing loss become most apparent. If you’re ready to approach a loved one about treating their hearing loss, wait until after the big gathering has died down so you can talk one-on-one. Use our tips for helping a loved one with hearing loss to address the issues and see if they’ll take the first step toward better hearing through an easy online hearing test.