Reduction in caregiver-identified problem behaviors in patients with Alzheimer disease post-hearing-aid fitting

Studies and clinical procedures related to patients with Alzheimer disease (AD) largely have ignored the hearing ability of either the patient or caregiver. Yet the majority of treatment and investigation depends on or presupposes communication ability. Further, caregiver complaints often center around communication-based issues. Hearing deficits may be the most frequently unrecognized condition in patients with AD because patients either communicate adequately in quiet or the impairment is masked by other behavioral symptoms of AD. The current investigation identified individuals with AD with perceived and measured hearing impairment, provided amplification management, and evaluated the impact of treatment on caregiver-identified problem behaviors believed to be related to hearing status. Specifically, treatment compliance (hearing-aid use) and treatment efficacy (reduction in perceived hearing handicap and problem behaviors) were measured in the current investigation. A multiple-baseline design across individuals with multiple dependent variables was used to evaluate the reduction of problem behaviors post-hearing-aid treatment. Eight participants were included and 1 to 4 problem behaviors were significantly reduced for each patient after hearing-aid treatment. All participants were able to complete the necessary evaluation for hearing-aid fitting and wore their hearing aids between 5 and 15 hours per day by the end of the study. This investigation employed novel methodology in the areas of on-site hearing evaluation and hearing-aid selection, advanced hearing-aid technology, and primary data recording of caregiver-identified problem behaviors by caregivers.