Hearing Assessment and Rehabilitation for People Living With Dementia.

Hearing impairment commonly co-occurs with dementia. Audiologists, therefore, need to be prepared to address the specific needs of people living with dementia (PwD). PwD have needs in terms of dementia-friendly clinical settings, assessments, and rehabilitation strategies tailored to support individual requirements that depend on social context, personality, background, and health-related factors, as well as audiometric HL and experience with hearing assistance. Audiologists typically receive limited specialist training in assisting PwD and professional guidance for audiologists is scarce. The aim of this review was to outline best practice recommendations for the assessment and rehabilitation of hearing impairment for PwD with reference to the current evidence base. These recommendations, written by audiology, psychology, speech-language, and dementia nursing professionals, also highlight areas of research need. The review is aimed at hearing care professionals and includes practical recommendations for adapting audiological procedures and processes for the needs of PwD.

"It's Huge, in a Way." Conflicting Stakeholder Priorities for Managing Hearing Impairment for People Living with Dementia in Residential Aged Care Facilities.

OBJECTIVES: The aims of this study were to a) explore the impact of hearing impairment on people living with dementia in residential aged care facilities (RACFs) and b) investigate management of hearing impairment for this population. METHODS: A descriptive qualitative approach, consisting of semi-structured interviews, was conducted with 23 participants across four stakeholder groups (audiologists, care staff, family members and individuals with dementia and hearing impairment living in RACFs). RESULTS: Thematic analysis revealed an overarching theme of "different priorities for managing hearing impairment" that emerged from the data. Audiologists and care staff prioritized different practices for managing hearing impairment: audiologists emphasized hearing aids and care staff emphasized communication strategies. Care staff also identified that current management of hearing impairment was sub-optimal as they do not prioritize managing it. CONCLUSIONS: Residents with dementia and hearing impairment living in RACFs are not receiving optimal hearing management. Further research is required to understand the factors that influence this. CLINICAL IMPLICATIONS: Changes in practices of both care staff and audiologists are required to improve hearing impairment management for this population.

A scoping review of studies investigating hearing loss, social isolation and/or loneliness in adults.

OBJECTIVES: Social isolation and loneliness are interrelated but independent constructs that threaten healthy aging and well-being and are thought to be associated with hearing loss. Our aim was to review the empirical studies that have examined the association between hearing loss and social isolation and/or loneliness to highlight future research needs. DESIGN: Scoping review. STUDY SAMPLE: Three electronic databases were searched combining key terms of "hearing loss", "hearing impairment" and "deaf*" with "social isolation" or "loneliness", yielding an initial result of 939 articles. After removing duplicate articles, abstract screening and full-text review, 57 original articles met our inclusion criteria. RESULTS: Studies were diverse in terms of methodology with the most common type of study being studies that have explored the relationship between hearing loss and social isolation/loneliness from large population-based datasets. Only eight studies were intervention studies and of these, only one specifically explored the outcomes of hearing aids (HAs) on social isolation/loneliness. CONCLUSIONS: Further research is warranted to examine the influence that hearing interventions, in particular HAs, have on social isolation and/or loneliness, with a specific need to include people who identify as being socially isolated and/or lonely at baseline.

Changing the narrative for hearing health in the broader context of healthy living: a call to action.

OBJECTIVE: To discuss the steps necessary to facilitate hearing health care in the context of well-being and healthy living. DESIGN: Common themes among the articles in this special supplement of the International Journal of Audiology were used to identify issues that must be addressed if audiology is to move from being hearing-focussed to taking a holistic perspective of hearing care in the context of healthy aging. These are discussed within the context of other published literature. RESULTS AND CONCLUSIONS: Three needs were identified: (i) Increased interdisciplinary education to raise awareness of the interplay between hearing and health. (ii) Increased emphasis on counselling education in audiology programs so that audiologists are equipped with the knowledge, competence and confidence to provide counselling and emotional support to their patients, beyond care. (iii) Redefinition of therapeutic goal setting and hearing outcomes to include aspects of well-being, so that audiologists can capture and patients realise that that good hearing outcomes can have a direct positive impact on a person's quality of life that extends beyond their improved ability to hear. It was emphasised that each of these needs to be considered within the context of the audiologists' scope of practice and audiologists' well-being.

Is cortical automatic threshold estimation a feasible alternative for hearing threshold estimation with adults with dementia living in aged care?

Objective: This study explored the feasibility of cortical automatic threshold estimation (CATE), a fully automated late auditory evoked potential (AEP) test, as an alternative to pure-tone audiometry for hearing threshold estimation for adults with dementia living in aged care.Design: A single group cross-sectional study was conducted. Participants' dementia severity was determined through the Clinical Dementia Rating scale. Hearing thresholds were obtained for four audiometric frequencies in at least one ear by using both pure-tone audiometry and CATE.Study sample: Sixteen participants enrolled in the study, of which 14 completed at least one of the hearing tests. Twelve ears, from six participants, were included in the final correlation analysis.Results: Pearson correlation coefficients were significant between CATE and pure-tone audiometry for all frequencies: r2 = 0.52 (p = 0.008) for 500 Hz, r2 = 0.79 (p = 0.0001) for 1000 Hz, r2 = 0.71 (p = 0.0005) for 2000 Hz, and r2 = 0.92 (p < 0.0001) for 4000 Hz. Cortical thresholds were within 10 dB of behavioural thresholds for all four frequencies.Conclusions: Findings are encouraging for the feasibility of CATE as an alternative diagnostic test to pure-tone audiometry for adults living with dementia in aged care.

Can adults living with dementia complete pure-tone audiometry? A systematic review.

OBJECTIVE: It is estimated that over 60% of adults with dementia will also have a hearing impairment, resulting in a dual sensory-cognitive communication disability. Hearing interventions may lessen the impact of hearing impairment on a communication disability; yet, for audiologists to recommend appropriate hearing interventions, the individual's hearing thresholds must first be accurately established. The gold standard test for establishing hearing thresholds is pure-tone audiometry (PTA). However, the ability of adults with dementia to successfully complete PTA is uncertain. This systematic review examined studies of adults with dementia to better determine the proportion who could complete PTA. DESIGN: Systematic review. STUDY SAMPLE: Studies were included that assessed hearing in older adults who were reported as having mild and greater dementia. From a total of 1,237 eligible studies, only three were found to meet all inclusion criteria. RESULTS: Across these three studies, the proportion of adults with dementia who could successfully complete PTA ranged from 56% to 59%. CONCLUSIONS: Further research is needed in this area, particularly for adults with moderate and severe stages of dementia. Future research should also consider the feasibility of complementary, non-behavioural hearing tests. This systematic review was registered with the PROSPERO database, registration number CRD42017073041.

Hearing Care Providers' Perspectives on the Utility of Datalogging Information.

Purpose The aim of the study was to learn (a) how datalogging information is being used in clinical practice by hearing care providers (HCPs) in the United States and (b) HCPs' opinions about how information collected through the hearing aids could be broadened in clinical application. Method A mixed-method approach was undertaken consisting of an online quantitative survey and qualitative structured telephone interviews. Survey data were analyzed using descriptives and chi-square analyses. The interview data were transcribed and analyzed using inductive content analysis. Results In total, 154 HCPs completed the survey, of whom 10 also completed an interview. Survey data showed that most HCPs use datalogging for conventional applications, such as counseling and fine-tuning during a hearing aid trial. Interview data highlighted four additional desirable datalogging features: (a) data about the sound environment, (b) details about operational aspects of hearing aid use, (c) data about use and nonuse, and (d) automated diagnosis of a hearing aid malfunction. HCPs also envisaged using datalogging in novel ways, such as for demonstrating hearing aid value and supporting decision making. Conclusions Today, datalogging is primarily used as a tool for counseling clients about hours and patterns of hearing aid use and for troubleshooting and fine-tuning. However, HCPs suggested novel and more ambitious uses of datalogging such as for sending alerts about nonuse, for automated diagnosis of a hearing aid malfunction, and for helping the client in their decision making. It remains to be seen whether in the future these will be implemented into clinical practice.