Purpose: The COVID-19 pandemic has led to the isolation of the population in Israel, including the elderly, some of whom are chronically ill. The present study examines the consumption of medical services among adults over the age of 65 in Israel at the time of the first COVID-19 lockdown relative to the corresponding period the year before, according to various socio-demographic variables: gender, age, marital status, ethnicity, degree of religiosity and socioeconomic status. Methods: A retrospective longitudinal observational quantitative research based on the Natali Healthcare Solutions Israel database of subscribers. Company subscribers over the age of 65 (N=103,955) were included in the sample (64.5% women) in two time periods, before the COVID-19 outbreak-P1, in 2019, and during the first COVID-19 lockdown- P2 in 2020. Medical needs included referrals to a medical or emergency services, ordering an ambulance, physician home visits and service refusal. Results: The average number of referrals to services was lower during the COVID-19 lockdown period (M=0.3658, SD=0.781) compared to the corresponding period the previous year (M=0.5402, SD=0.935). At the time of the COVID-19 lockdown, the average number of referrals to medical services was lower, but the average number of ambulance orders, physician visits and service refusals was higher compared to the same period in the previous year. During both time periods, women (P1- M=0.5631, SD=0.951; P2- M=0.3846, SD=0.800) required significantly more (p<.000) services than men (P1- M=0.5114, SD=0.910; P2- M=0.3417, SD=0.753). In both time periods, subscribers who were older, widowed, living in non-Jewish/mixed localities or in average or below average socioeconomic status localities required more services relative to younger, married people living in Jewish localities, or in above-average socioeconomic localities (p<.000). Summary and Conclusions: In a large sample of elderly in Israel, findings indicate a decrease in referrals to medical care during the first COVID-19 lockdown period, yet an increase in ambulance orders, physician visits and service refusals. There were no significant differences between the periods according to different socio-demographic characteristics. The period of the first COVID-19 lockdown was characterized by a higher incidence of medical service refusals compared to routine times. The incidence of requiring medical service at the time of the first COVID-19 lockdown was 2.5 times higher among those who required services during the previous year, 1.7 times higher among unmarried seniors, and 1.4 times higher among the older age group of 85 and over in comparison to the younger seniors.

Auditory training (AT) has limited generalization to non-trained stimuli. Therefore, in the current study, we tested the effect of stimuli similar to that used in daily life: sentences in background noise. The sample consisted of 15 Hebrew-speaking adults aged 61–88 years with bilateral hearing impairment who engaged in computerized auditory training at home four times per week over a two-month period. Significant improvements were observed in sentences comprehension (Hebrew AzBio (HeBio) sentences test) with both four-talker-babble-noise (4TBN) and speech-shaped-noise (SSN) and in words comprehension (consonant-vowel-consonant (CVC) words test), following one month of AT. These improvements were sustained for two months after completing the AT. No evidence of spontaneous learning was observed in the month preceding training, nor was there an additional training effect in the additional month. Participants’ baseline speech perception abilities predicted their post-training speech perception improvements in the generalization tasks. The findings suggest that top-down generalization occurs from sentences to words and from babble noise to SSN and quiet conditions. Consequently, synthetic training tasks focusing on sentence-level comprehension accompanied by multi-talker babble noise should be prioritized. Moreover, an individualized approach to AT has demonstrated effectiveness and should be considered in both clinical and research settings.