American Journal of Audiology最新文献

Purpose: Hearing loss is an independent risk factor for falls. Research has demonstrated the importance of a combination of self-report and performance-based tools in predicting falls. Using this approach, the purpose of this study was to examine the association between the degree of hearing loss and fall risk.

Method: Community-dwelling older adults with hearing loss, aged 60 years and above, completed a history form, the Activities-Specific Balance Confidence Scale and the modified Clinical Test of Sensory Interaction in Balance. Average pure-tone audiometry of the better hearing ear was calculated. Fall risk was determined for each participant. Binomial logistic regression and Cohen's kappa were performed.

Results: Fifty-eight participants, with mild (n = 12), moderate (n = 27), moderately severe (n = 14), and severe (n = 5) hearing losses were included in the analysis. Overall fall risk incidence was 46.6%. No significant association was found between the degree of hearing loss and fall risk, while age, gender, and diabetes were revealed to be significant fall risk factors. A key finding was the tendency to overestimate balance confidence using self-report measures.

Conclusions: To our knowledge, this is the first study in Asia employing self-report and performance-based measures to examine hearing loss and fall risk. Our findings provide insight into region-specific factor(s) affecting fall risk and serves to pave the way for future fall risk research. Future studies should include a combination of self-report and performance-based measures, as well as account for protective fall risk factors.

Purpose: Military personnel may be repeatedly exposed to high-noise environments that may increase tinnitus risk. Previous military research on tinnitus has often utilized small samples of personnel with specific experiences and exposures (e.g., combat deployment), with few examinations leveraging longitudinal data. The purpose of this study was to determine the incidence and associated risk factors for new-onset tinnitus in a large prospective and representative military cohort.

Method: This study utilized data from the Millennium Cohort Study, the largest and longest running longitudinal health study of service members and veterans, to ascertain self-reported and medical diagnoses of tinnitus. Multivariable logistic regression was employed to identify factors associated with new-onset tinnitus.

Results: New-onset tinnitus was self-reported by 10.7% (n = 2,527) of participants while 3.5% (n = 511) had a medical record tinnitus diagnosis. Tinnitus risk was associated with multiple characteristics, including active duty service, being a member of the Army or Marine Corps, combat deployment experience, combat specialist occupation, prior history of mild traumatic brain injury, panic/anxiety, posttraumatic stress disorder (PTSD) alone, and PTSD comorbid with depression.

Conclusions: This may be the first study to determine new-onset tinnitus utilizing both self-reported and medical record data in a large prospective cohort of service members and veterans. Additional prospective studies are needed to corroborate our findings and further describe the temporal relationships of military occupational and mental health characteristics with service-related new-onset tinnitus.

Purpose: The purpose of this study was to assess whether using the International Speech Test Signal (ISTS) as a nonmeaningful target signal changes listener outcomes on the Tracking of Noise Tolerance (TNT) test and their relationship to hearing loss and neuroelectrophysiological indices of central inhibition.

Method: Single-blind mixed design conducted in 23 normal-hearing (NH) and 16 hearing-impaired (HI) older adults with moderate-to-severe degrees of sensorineural hearing loss. Participants performed a modified version of the TNT test where they were asked to react to a dynamic background noise while listening to the ISTS target stimulus. Test performance was characterized by average TNT test noise acceptance (TNT_Ave) and by the average difference between peaks and valleys in tracked noise level tracings (excursion). All listeners had previously performed the TNT test using English speech passages as target signals. Cortical sensory gating magnitudes were also measured from these listeners as electrophysiological indices of central inhibition.

Results: Whereas NH listeners tolerated significantly less noise when performing the TNT test with ISTS relative to English speech targets, type of target signal had no effect on TNT_Ave scores in HI listeners. Conversely, HI listeners exhibited significantly greater excursion in their tracked noise levels when tested with the ISTS compared to English passages, but target type did not affect excursion in NH listeners. Regardless of target type or hearing group, TNT excursion was strongly predicted by listeners' bilateral four-frequency pure-tone averages. As previously observed for the English TNT, sensory gating magnitudes of the N1-P2 component negatively predicted TNT excursion scores measured using the ISTS target after accounting for listener age and hearing thresholds. In addition, noise acceptance (TNT_Ave) outcomes for ISTS targets were positively predicted by cortical gating magnitudes of the P1 component.

Conclusions: Replacing meaningful English speech with ISTS targets affected listener performance on the TNT test differently in NH and HI listeners. Comparing TNT outcomes for nonmeaningful and meaningful speech signals may be useful for gaining insight into the acoustic and nonacoustic (e.g., central/contextual) factors that affect listeners' dynamic reactivity to changing levels of background noise.

Purpose: The ability to discriminate speech with background noise decreases with age. This study examined the effect of masker type and spatial location in older and young adults.

Method: Using Portable Automated Rapid Testing software on an iPad, participants were asked to understand target speech (always simulated at 0° azimuth) in the presence of speech or "garbled speech" maskers (simulated from 0°, 6°, or 45° azimuth spatial locations). Additionally, suprathreshold sensitivities to temporal (TM), spectral (SM), and spectrotemporal (STM) modulation as well as binaural temporal fine structure (TFS) were estimated.

Results: Older adults showed worse speech in competition (SiC) performance with 6° and 45°, but not 0°, masker spatial locations and benefited less from only 45° of spatial separation compared to young controls for speech masking. For garbled-speech masking, older adults showed worse performance overall, but benefited similarly from spatial separation compared to young controls. Older adults also showed worse sensitivity for binaural TFS, but comparable TM, SM, and STM sensitivity. Age as well as TM and SM sensitivities predicted SiC performance, whereas STM and binaural TFS sensitivities did not.

Conclusion: These findings expand our knowledge of how aging and suprathreshold sensitivities affect SiC comprehension.

Purpose: The purpose of this study was to determine if there is a difference in preferred listening levels when altering song choice, listening device, and transducer (headphone) type, while controlling previously uncontrolled variables.

Method: Twenty-one college students completed the repeated-measures design. Pure-tone audiometry and distortion product otoacoustic emissions (DPOAE) were completed pre- and postmethods to determine the presence of a temporary threshold shift (TTS). The external auditory meatus sound pressure level (EAM SPL) was measured as participants listened to the researchers' and their songs via their personal device and the researchers' computer using in-the-ear, over-the-ear, in-the-canal, and their personal transducers. Paired t tests were completed on pure-tone thresholds and DPOAE amplitude. A four-factor multivariate analysis of variance (MANOVA; p = .05) investigated the presence of an EAM SPL difference between songs, transducers, and devices. A second four-factor MANOVA investigated a difference between the participants' and matched researchers' transducers by ear, song, and device.

Results: No TTS was identified. The computer produced significantly lower EAM SPL compared to the participants' device. Over-the-ear transducers produced significantly lower EAM SPLs compared to in-the-ear, in-the-canal, and the participants' transducers. The participants' transducers produced significantly lower EAM SPLs compared to in-the-canal style.

Conclusions: Preferred listening levels are inconsistent across devices. Over-the-ear transducers and the computer present the lowest hearing loss risk as they produced the lowest EAM SPLs. Caution is urged with personal listening device use regarding the duration of listening time and volume levels.

Purpose: This clinical focus article describes the development of a novel, remotely delivered counseling program for patients with hyperacusis. For many patients, seeking management of hyperacusis is limited by accessibility and affordability issues of care. By reducing these barriers, remote counseling has the potential to advance hyperacusis care and improve outcomes for many people suffering from hyperacusis.

Method: We created a 4-week remote counseling program that included asynchronous videos, hands-on activities and quizzes, handouts and resources for teaching coping skills and keeping patients engaged, and synchronous discussions for coaching. Weekly content was derived from in-person therapy using hyperacusis activities treatment (HAT) and focused on five relevant topics that included (a) an overview of hyperacusis, tinnitus, hearing, and hearing loss; (b) reactions to hyperacusis and strategies to reduce negative reactions to sounds; (c) thought analysis and restructuring; (d) relaxation techniques and mindfulness; and (e) gradual sound exposure and proper use of hearing protection.

Results: Our remote counseling program, HAT-Online, provides holistic education about hyperacusis, coping strategies to lessen reactions to everyday sounds and challenge thoughts and fears, and management options including customized sound therapy and relaxation exercises.

Conclusion: With implementation of this remote counseling program, our team anticipates gathering early clinical evidence needed to support larger, multisite, future randomized clinical trials that will be designed to more fully evaluate the effectiveness of the remote delivery of HAT's counseling and customized sound therapy components to reduce reactions to hyperacusis.

Purpose: Speech-in-noise performance of cochlear implant (CI) users varies considerably, and understanding speech in a complex auditory environment remains challenging. It is still unclear which auditory skill is causing this difficulty. This study aimed to evaluate spectral resolution, temporal resolution, and melodic contour identification (MCI) skills to determine which of these skills is most closely related to speech understanding in noise and to investigate whether these three skills differ among CI users with varying performances in speech-in-noise tasks.

Method: The three-syllable word identification test (in quiet), the Turkish Matrix Test (in quiet, at fixed +8 dB SNR, and adaptively in noise) were administered to evaluate speech perception to 24 adult CI users (18-55 years old). To evaluate auditory abilities, tests involving spectral-temporally modulated ripple, gap detection, and MCI were administered. CI recipients were separated into two groups (good and low performers) based on their adaptive matrix speech reception threshold (SRT) in noise.

Results: The abilities of temporal and spectral resolution were correlated with speech understanding at +8 dB SNR. However, the effect of spectral resolution on understanding at +8 dB SN was not significant. The skill most associated with the Matrix SRT in noise was spectral resolution. The groups differed significantly in both the speech tests and spectral resolution skills.

Conclusions: Varying spectral resolution skills among CI users may affect their speech perception performance in noise. The effects of spectral and temporal resolution on speech perception in noise varied across noise conditions. Thus, there may be an increased requirement for spectral resolution in more adverse listening environments.

Purpose: The goal was to gain insight into the effects of hearing loss and hearing aids (HAs) on the perception of "natural sounds" and their importance in daily life by documenting the opinions of hearing care professionals (HCPs).

Method: A questionnaire was designed where HCPs were asked to rate their patients' perception of natural sounds before and after receiving an HA. The online survey was conducted with 301 HCPs in France.

Results: According to respondents, the incidence of hearing natural sounds increased substantially at the end of the trial period relative to the start, especially for patients living in remote rural areas. Respondents also indicated an increase in listening accuracy, pleasantness, and importance of natural sounds at the end of the trial period. The majority of respondents indicated (a) that their patients find it important to listen to natural sounds and (b) that they are satisfied with their HAs in that respect.

Conclusions: This study demonstrates the importance of natural sounds for most people with hearing loss. It highlights the effects of HA on patients' awareness of natural sounds and suggests that future research should consider the patients' place of residence.

Purpose: Although hearing loss can have a substantial impact on mental health, relatively little research has focused on factors that predict mental health outcomes among adults with hearing loss. In this study, we examined the effects of self-perceived hearing difficulty and resilience on psychological distress in adults.

Method: Adult patients with hearing loss (N = 118) completed several questionnaires, including a demographic questionnaire, the Abbreviated Profile of Hearing Aid Benefit, the Brief Resilience Scale, and Kessler 6 Psychological Distress Scale. The relationships between demographic characteristics, self-perceived hearing difficulty, resilience, and psychological distress were assessed using bivariate analyses and multiple regressions.

Results: Self-perceived hearing difficulty and resilience both predict psychological distress in adults with hearing loss, while controlling for age and income.

Conclusions: Findings suggest that both audiologic and mental health interventions support positive mental health outcomes in adults with hearing loss. Improving patients' resilience may be a particularly important goal for audiologists and mental health professionals who are working with adults with hearing loss.

Purpose: The goal of this study was to provide evidence of the inherent variability associated with monitored live voice (MLV) presentation methods and encourage audiologists to more closely follow best practice of using recorded stimuli. To accomplish the goal, administration times for word recognition testing were compared between MLV and MP3 recorded stimuli presented directly from an audiometer (computer assisted, CA). Furthermore, the variability of administration time across testers was evaluated.

Method: Fifty-word NU-6 lists were presented via MLV and CA to listeners with typical hearing (TH; defined as a four-frequency [500, 1000, 2000, and 4000 Hz] pure-tone average [PTA] of 20 dB HL or better) and hearing loss (HL; defined as a four-frequency PTA poorer than 20 dB HL). Audiologists and doctor of audiology students administered the word lists. Administration times were compared between the two presentation methods (MLV and CA).

Results: MLV administration time was significantly shorter than CA presentation time for both the TH and HL groups. There was also a significant difference in word recognition scores (WRS) between the TH and HL groups only when using the CA method. Most notably, there was significantly more variability in the administration time for MLV presentation across testers compared to the CA method. Data were compared to Mendel and Owen (2011), and MLV administration time was found to be significantly shorter than CA and compact disk (CD) administration time.

Conclusions: Despite the shorter average administration time for MLV presentation compared to CA or CD, the significant variability in administration time among individual testers limits the clinical value of the test results. In addition, WRS for those with hearing loss were significantly poorer than those with TH when using CA but not for MLV, indicating that MLV is not sensitive to the presence of sensorineural hearing loss. Thus, using recorded word recognition is strongly recommended.