Poor performance on fast-rate and rapidly alternating speech perception tests is associated with hearing-aid...

Hearing-aid (HA) satisfaction influences sustained use in older adults, and performance on auditory-processing tests may be associated with HA satisfaction.

To determine whether audiometric and auditory-processing measures are associated with HA satisfaction in individuals with presbycusis and preserved cognition.

Retrospective review at a tertiary centre. Twenty-two adults (63-88 years) underwent pure-tone audiometry, monosyllabic word recognition, fast-rate speech test (FST) and rapidly alternating speech perception test (RASPT), presented 40 dB SL at a comfortable hearing level. Self-reported questionnaires evaluated HA satisfaction (0-100%), hearing-related distress (100-mm visual analogue scale) and self-perceived hearing handicap (0-50 points). Groups: thresholds ≤55 vs. >55 dB HL; word recognition ≥80% vs. <80%; FST/RASPT ≤5% vs. ≥10%.

Outcomes did not differ by average thresholds. Compared with ≥80% recognition, <80% yielded lower satisfaction and higher distress and handicap (p ≤ 0.01). FST ≤5% vs. ≥10% predicted lower satisfaction and greater handicap (p < 0.05). RASPT ≤5% vs. ≥10% predicted lower satisfaction and higher distress and handicap (p ≤ 0.01-0.001).

In older adults, satisfaction aligns more with word- and sentence-level processing than with pure-tone thresholds. Auditory processing tests alongside word recognition may refine counselling and support sustained HA use.