Effects of Environment Complexity on Listening Performance in Adult Hearing Aid Users

项目总结/摘要 听力损失是成年人中第二常见的健康状况。未治疗的听力损失与 抑郁、焦虑、社交孤立、痴呆和全因死亡的风险增加。尽管如此， 只有14%的人会从助听器中受益。成年人最常见的原因是 不使用助听器是助听器不帮助他们在非常情况下，他们努力听到， 最复杂的听音环境（克莱斯）。克莱斯是有许多不同声源的地方，例如 餐厅.事实上，对于大多数成年人来说，餐馆是最难听的环境。 听力损失助听器技术旨在改善噪音中的言语感知，例如噪音 在实验室环境中进行测试时，减少和定向麦克风显示出一些适度的好处。 然而，在真实的世界中，这些技术没有显示出任何好处。助听器可以证明 功效（它们在最佳可能的情况下工作得有多好，即，在实验室测试中），但未能有效 (how好吧，它们在真实的世界中工作）。我们建议，听力环境的复杂性差异之间的 实验室和真实的世界之间的差异导致助听器的功效差距。我们进一步建议， 环境复杂性对听力表现的影响受认知能力的调节，助听器的益处 环境复杂性对听力成绩的影响具有调节作用。我们的目标是测试这些 假设在实验室中使用受控的实验范式，以及在真实的世界中使用场 实验这项研究是由信息理论提供信息的，该理论将复杂性定义为 通信系统中的信息。在这个理论下，复杂性可以用熵来量化， 系统中有多少信息。我们的团队将应用这个框架来理解真实的通信 世界克莱斯。在目标1中，我们描述了复杂性，认知能力和助听器功能之间的关系 在实验室中使用受控实验范式的有效性。在目标2中，我们描述了 复杂性、认知能力和助听器功能在真实的世界中使用智能手机记录真实的 世界环境，并向参与者提供调查，以及实验助听器， 特征实时处理信号。这项研究的结果将：加强我们对听力如何 帮助用户感知真实的世界的克莱斯，扩展信息理论来量化真实的世界克莱斯的复杂性， 对听力表现的影响，提供了重要的洞察因素的基础上，助听器的功效- 有效性差距，并提供基础，可能有助于指导发展，以缩小效率-效果 通过临床和工程方法的差距。这项拟议的研究直接涉及NIH/NIDCD的 战略计划的优先事项，以增加我们对听觉和认知之间的相互作用的理解 帮助解释真实的世界听力环境中的感知并提高助听器性能的功能 在背景噪音和真实的环境中。

PROJECT SUMMARY/ABSTRACT Hearing loss is the second most common health condition among adults. Untreated hearing loss is associated with an increased risk of depression, anxiety, social isolation, dementia, and all-cause mortality. Despite this, only 14% of people who would benefit from hearing aids use them. The most common reason adults give for not using hearing aids is that hearing aids do not help them in the very situations they struggle to hear in the most—complex listening environments (CLEs). CLEs are places with many different sound sources, like restaurants. Indeed, restaurants are the most difficult listening environments for the majority of adults with hearing loss. Hearing aid technologies that are designed to improve speech perception in noise, such as noise reduction and directional microphones, show some modest benefits when tested in a laboratory environment. In the real world, however, these technologies show no benefits. Hearing aids can therefore demonstrate efficacy (how well they can work in the best possible scenario, i.e., in a laboratory test), but fail to be effective (how well they work in the real world). We propose that listening environment complexity differences between the lab and the real world drives the hearing aid efficacy-effectiveness gap. We further propose that the effect of environment complexity on listening performance is moderated by cognitive ability, and the benefit of hearing aid features on listening performance is moderated by environment complexity. Our aims are designed to test these hypotheses in the laboratory using controlled experimental paradigms, as well as in the real world using field experiments. The proposed study is informed by information theory, which defines complexity as the amount of information in a communication system. Under this theory, complexity can be measured using entropy to quantify how much information is in the system. Our team will apply this framework to understanding communication in real world CLEs. In Aim 1, we characterize the relationship between complexity, cognitive ability, and hearing aid feature efficacy in the lab using a controlled experimental paradigm. In Aim 2, we characterize the relationship between complexity, cognitive ability, and hearing aid feature effectiveness in the real world using smartphones to record real world environments and deliver surveys to participants, as well as experimental hearing aids that record how features process signals in real-time. The findings from this study will: enhance our understanding of how hearing aid users perceive real world CLEs, extend information theory to quantify the complexity of real world CLEs and its effect on listening performance, provide important insight into the factors that underlie the hearing aid efficacy- effectiveness gap, and provide groundwork that may help guide developments to close the efficacy-effectiveness gap through clinical and engineering approaches. The proposed study directly addresses the NIH/NIDCD's strategic plan priorities to increase our understanding of the interactions among auditory and cognitive functions to help explain perception in real world listening environments and improve hearing aid performance in background noise and real environments.