Exploring the Impact of Social and Demographic Factors on Hearing Aid Benefit for Hearing Ability and Cognition

Abstract

This PhD study examined the effect of non-audiological factors including age, sex, ethnicity, marital status, education, living arrangement, smoking, alcohol consumption, physical activity, hypertension, and depression on hearing aid outcomes and explored the facilitators of and barriers to obtaining and using hearing aids. Sixty-six Participants were recruited through New Zealand’s University audiology clinics. Hearing, cognition, and perceived hearing aid benefit for hearing ability were measured using the National Institutes of Health Toolbox Words-in-Noise Test, age-unadjusted fluid cognition composite and crystallised cognition composite scores and the modified Abbreviated Profile of Hearing Aid Benefit questionnaires, respectively. A generalised linear regression with hierarchical modelling examined the effect of non-audiological factors on hearing aid benefit for hearing ability and cognition. Eleven participants participated in a qualitative study using a thematic analysis and inductive approach. Males achieved more significant hearing benefits but had lower perceived hearing aid benefit for hearing ability than females. Being widowed, separated, or divorced was associated with greater hearing benefits but lower fluid cognitive and perceived hearing aid benefit for hearing ability than being married or partnered. Living alone was associated with lower hearing benefits but greater fluid cognitive and perceived hearing aid benefit for hearing ability than living with someone. Alcohol consumption monthly or less was related to higher fluid cognitive benefit. Participants with higher physical activity had lower hearing benefit. Hypertension was associated with lower hearing and fluid cognitive benefits. Higher depression scores were associated with greater hearing benefits, but lower fluid cognition benefits. Perceived less severe and gradual onset of hearing loss, negative mindset on age-related hearing loss, advice from family members or friends and indirect peer pressure, and economic factors were barriers to getting hearing aids. Factors influencing consistent use of hearing aids included lack of motivation to use and forgetting to use, comfort of and ease of use, physical environment, and difficulty to understand conversation due to accents and enunciation. In conclusion, this research identified important nonaudiological factors for hearing aid service delivery.