Hearing aid use, central auditory disorder, and hearing handicap in elderly persons

We compared self-reported handicap (Hearing Handicap Inventory for the Elderly, HHIE) scores before and after a 6-week period of hearing aid use in subjects drawn from a pool of 115 elderly persons with hearing impairment. Study patients (PTs) were divided into two categories according to whether scores on a dichotic listening test (Dichotic Sentence Identification Test, DSI) were normal or abnormal. In a subgroup of 63 persons who had not previously used amplification, subjects in the two DSI categories showed equivalent average HHIE scores. After 6 weeks of first-time hearing aid use, there was a significant improvement in average HHIE scores, but only in the DSI-normal category. In the subgroup with dichotic deficits (DSI-abnormal group), average HHIE scores did not change significantly after hearing aid use. In a subgroup of 89 PTs, we compared the self-assessed HHIE scores of the PTs with the HHIE scores rated by their significant others (SOs). In both DSI categories, the average handicap, as judged by the subject's SO, was significantly greater than the handicap as judged by the PT. In addition, both ratings reflected significant improvement after hearing aid use. It was the case, however, that improvement consequent on amplification was significantly smaller for subjects in the DSI-abnormal category. Finally, we show, in the entire pool of 115 PTs, that the effect of practice on the HHIE score is not sufficient to explain the improvement after amplification. Results affirm both the positive value of amplification and the negative impact of central auditory deficit as they affect the HHIE scores of the elderly hearing-impaired person.