Hearing Aid Use in Older Adults With Postlingual Sensorineural Hearing Loss: Protocol for a Prospective Cohort Study

Abstract

BackgroundOlder adults with postlingual sensorineural hearing loss (SNHL) exhibit a poor prognosis that not only includes impaired auditory function but also rapid cognitive decline, especially speech-related cognition, in addition to psychosocial dysfunction and an increased risk of dementia. Consistent with this prognosis, individuals with SNHL exhibit global atrophic brain alteration as well as altered neural function and regional brain organization within the cortical substrates that underlie auditory and speech processing. Recent evidence suggests that the use of hearing aids might ameliorate this prognosis.ObjectiveThe objective was to study the effects of a hearing aid use intervention on neurocognitive and psychosocial functioning in individuals with SNHL aged ≥55 years.MethodsAll aspects of this study will be conducted at Swinburne University of Technology (Hawthorn, Victoria, Australia). We will recruit 2 groups (n=30 per group) of individuals with mild to moderate SNHL from both the community and audiology health clinics (Alison Hennessy Audiology, Chelsea Hearing Pty Ltd). These groups will include individuals who have worn a hearing aid for, at least, 12 months or never worn a hearing aid. All participants would be asked to complete, at 2 time points (t) including baseline (t=0) and follow-up (t=6 months), tests of hearing and psychosocial and cognitive function and attend a magnetic resonance imaging (MRI) session. The MRI session will include both structural and functional MRI (sMRI and fMRI) scans, the latter involving the performance of a novel speech processing task.ResultsThis research is funded by the Barbara Dicker Brain Sciences Foundation Grants, the Australian Research Council, Alison Hennessy Audiology, and Chelsea Hearing Pty Ltd under the Industry Transformation Training Centre Scheme (ARC Project #IC140100023). We obtained the ethics approval on November 18, 2017 (Swinburne University Human Research Ethics Committee protocol number SHR Project 2017/266). The recruitment began in December 2017 and will be completed by December 2020.ConclusionsThis is the first study to assess the effect hearing aid use has on neural, cognitive, and psychosocial factors in individuals with SNHL who have never used hearing aids. Furthermore, this study is expected to clarify the relationships among altered brain structure and function, psychosocial factors, and cognition in response to the hearing aid use.Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12617001616369; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617001616369 (Accessed by WebCite at http://www.webcitation.org/70yatZ9ze)International Registered Report Identifier (IRRID)RR1-10.2196/9916

The cognitive and psychosocial effects of auditory training and hearing aids in adults with hearing loss

“…Given the limitations of this study, including the small sample size, the magnitude of the effects reported here should not be interpreted as would be the case for a fully powered trial 36. Our baseline results have provided the motivation needed to proceed with a full-scale, randomized hearing loss intervention and a longer neuroimaging study with cognitive outcomes measured in the short term as well as after several years hearing aid use is needed 37. This may be the first prospective cohort randomized controlled trial to test the neural, cognitive and psychosocial efficacy of hearing aid use in adults with post-lingual SNHL.…”

“…In view of the problems encountered with the extraction of logged hearing aid use data in this pilot study, future studies will ensure that participants are instructed to manually record hours of hearing aid use every week, in order to confirm the automatically logged hearing use records. It is also hoped that our planned hearing loss intervention study, which will investigate the long-term impact of hearing aids on cognitive function,37 will address a further limitation of this pilot study.…”

Hearing interventions to prevent dementia

“…Some researchers have grappled with these issues, and prospective studies of hearing interventions for long-term cognitive outcomes are planned or under way [ 24 – 27 ]. However, the limitations of conducting well-controlled hearing intervention studies with long-term cognitive outcomes means that the primary source of evidence will come from studies other than randomised controlled trials.…”

Differences in Intrinsic Brain Abnormalities Between Patients With Left- and Right-Sided Long-Term Hearing Impairment

“…Awareness has increased over the past decade regarding how the brain remodels itself in response to hearing impairment and the mechanisms underlying the processing and integration of auditory information; this increasing awareness is due to the development and advancement of neuroimaging technologies in auditory research, such as magnetoencephalography and functional magnetic resonance imaging (fMRI) ( Burton et al, 2012 ; Hughes et al, 2018 ). The complex processes of auditory information recognition and functional coding undergo restructuring in response to hearing impairment ( Andoh et al, 2015 ).…”