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Kowalewski V.1, Patterson R.2, Thidobeau L.3, Bugnariu N.1
1University of North Texas Health Science Center, Physical Therapy, Fort Worth, United States, 2University of North Texas Health Science Center, Family Medicine, Fort Worth, United States, 3University of Texas at Dallas - Callier Center for Communication Disorders, Audiology, Dallas, United States
Background: Hearing loss affects a large percentage of older adults and may compromise postural control and increase the risk of falls. Nevertheless, the delay between first noticing a hearing problem and seeking help is often more than ten years and only a fraction of those who might benefit receive hearing aids. A barrier in defining the relationship between hearing loss and balance impairments, and consequently the potential benefits of hearing aid on postural control, has been the disconnect that exists between audiology findings obtained in soundproof booths, and the impact of these findings in the real world where patients need to maintain balance and walk in noisy environments.
Purpose: We tested the effectiveness of different types of hearing aids at improving not only speech recognition, but also measures of postural control and gait.
Methods: Adults 51 to 80 years old, newly diagnosed with hearing loss, without vestibular or other neurologic impairments and age-matched controls participated. Patients were tested at the time of hearing loss diagnosis and after a two months accommodation and use of their hearing aids. Patients randomly received one of the three types of hearing aids: 1) regular hearing aid (HA), 2) hearing aid interfaced with mini-microphones (HAM), and 3) hearing aid interfaced with wireless remote adaptive digital microphone with frequency modulator (HAFM), 12 subjects per group. Outcome measures included: standing center of pressure sway, performance on dual task involving cognitive decisions, performance on auditory task, and self-selected gait speed on flat and uneven terrain. Testing conditions: no HA, HA, HAM, HAFM; auditory task: listening only or repeating back sentences. ANOVA were conducted for each dependent variable with respect to: group, condition of HA and condition of auditory task.
Results: Center of pressure sway variability in M/L direction was increased (p .05) in participants with hearing loss vs. controls when subjects had to perform a dual standing/auditory task. All types of hearing aids decreased sway in conditions of repeating back sentences. Without HAs, self- selected gait speed was lower (p .05) in individuals with hearing loss vs. controls, as long as they attended to the auditory task. Adults with hearing loss, significantly improved gait speed (p .05) after two month accommodation to hearing aids. Use of HAM and HAFM, but not of regular HA significantly increased self-selected gait speed (p .01).
Conclusion(s): Hearing loss negatively impacts postural control particularly in dual-task conditions. Adults with hearing loss have poorer balance and slower gait speed compared to adults with normal hearing; hearing aids significantly improve balance for older adults with hearing loss.
Implications: Age-related hearing loss affects a large percentage of the older adult population, who also struggles with balance and gait impairments. Use of hearing aids, especially HAM and HAFM, significantly improve not only speech recognition but also measures of balance and gait. While laboratory audiology tests focus on sound localization and speech recognition, perhaps outcome measures such as balance /gait while conducting a conversation are more meaningful for assessing the impact of hearing loss/hearing aids on level of function and participation.
Funding acknowledgements: Texas Medical Research Consortium, RI 6042 " Good hearing, Steady feet" and Neurobiology of Aging NIH T32 AG 020494
Topic: Older people
Ethics approval: UNT Health Science Center IRB committee approved the Research Project #2012-114 titled, Good Hearing, Steady Feet.
All authors, affiliations and abstracts have been published as submitted.
