In-Home Auditory Training for Older Adults with Hearing Aids: A Clinical Trial

描述（由申请人提供）：在2000年美国人口普查中，有3500万65岁以上的美国人被统计在内，占美国人口的12.4%。在美国65岁以上的老年人中，大约有三分之一（约1200万）的人有严重的听力损失，这足以让他们成为助听器的候选人。然而，在那些可以从助听器中受益的人中，只有大约20%的人真正去找了助听器，而在那些去找助听器的人中，只有大约40-60%的人对助听器感到满意，并定期使用助听器。为了取得成功，助听器必须解决听力受损的老年人最常见的沟通抱怨：他们能听到说话，但听不懂。当背景中有相互竞争的声音时尤其如此，通常是其他声音。虽然现代助听器为老年人提供了显著的好处，但要将辅助言语交流恢复到正常或接近正常的表现水平并优化成功的机会，语音噪声比需要大大提高。对于许多老年人来说，现代助听器技术无法充分提高语音噪声比。解决这个问题的另一种方法是训练老年人更好地利用现有的语音噪声比中的信息。本建议继续我们关于这种听觉训练方法的工作。具体来说，我们开发了一种创新的词汇激励的基于单词的听觉训练方案，该方案在受控的实验室条件下多次被证明是有效的。我们的目标是将这个方案从一个有效的实验室系统转变为一个有效的老年人家庭听觉训练系统。这种转变的第一步是对训练方案的最佳剂量和持续时间进行额外的实验室研究。同时，还将开发家庭系统的平台。最后，将采用三分支平行设计进行家庭训练系统的临床试验，包括对照组、安慰剂训练组和实验训练组。

DESCRIPTION (provided by applicant): In the 2000 U.S. Census, 35 million Americans over 65 years of age were counted, representing 12.4% of the U.S. population. Approximately one-third of those over age 65 in the U.S., or roughly 12 million Americans, have a significant hearing loss that is sufficient to make them hearing-aid candidates. Yet, only about 20% of those who could benefit from hearing aids actually seek them out and, of those who do seek them out, only about 40-60% are satisfied with them and use their hearing aids regularly. To be successful, hearing aids must address the most common communication complaint of older adults with impaired hearing: they can hear speech, but can't understand it. This is especially true when there are competing sounds, typically other speech, in the background. Although contemporary hearing aids provide significant benefits to older adults, to restore aided speech communication to normal or near-normal performance levels and optimize the chances for success, the speech-to-noise ratio needs to be enhanced considerably. For many older adults, contemporary hearing-aid technologies are unable to enhance the speech-to-noise ratio sufficiently. An alternate approach to this problem is to train the older adult to make better use of the information in the existing speech-to-noise ratio. The present proposal continues our work on such an auditory-training approach. Specifically, we have developed an innovative lexically motivated word-based auditory-training protocol which has been demonstrated repeatedly to be efficacious under controlled laboratory conditions. Our objective is to transition this protocol from an efficacious laboratory system to an effective in-home auditory-training system for older adults. The first step in this transition is an additional laboratory study of the optimal dosing and duration of the training regimen. Concurrently, the platform for the in-home system will be developed. Finally, a clinical trial of the in-home training system will be conducted using a three-branch parallel design with control, placebo-training, and experimental-training groups. PUBLIC HEALTH RELEVANCE: The most common communication complaint of older adults with impaired hearing is that they can hear speech, but can't understand it, especially when there are competing sounds in the background. Hearing aids, to be effective for older adults, must address this common complaint and improve speech understanding. Auditory training represents one approach to supplement the benefits provided by hearing aids and the effectiveness of an in-home auditory-training method in older adults is the focus of this project.