ORIGINAL RESEARCH— OTOLOGY AND NEUROTOLOGY Measurement of hearing aid outcome in the elderly: Comparison between young and old elderly Wei-Hsiu Chang, MD, Hsueh-Ching Tseng, MS, Ting-Kuang Chao, MD, Chuan-Jen Hsu, MD, and Tien-Chen Liu, MD, PhD, Taipei, Taiwan OBJECTIVE: To evaluate speech performance and subjective outcomes for older individuals who have hearing impairment and use digital hearing aids. The outcomes between young and old elderly users were compared. STUDY DESIGN: Prospective. SUBJECTS AND METHODS: Fifty-nine patients with hear- ing loss fitted with digital hearing aids were included. They were divided into two groups. Group A consisted of 32 subjects aged 65 to 80 years, whereas group B had 27 subjects older than 80 years. Speech performance and subjective outcomes were measured 4 months after fitting of hearing aids. Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S), Client Oriented Scale of Improvement (COSI), satisfaction, and usage questionnaires were used as subjective assessments. RESULTS: Improvements in speech performance were not sig- nificantly different between these two groups. There were no statistical differences in terms of HHIE-S score reduction, satis- faction rate, daily usage time, and COSI scores between both groups. CONCLUSION: Age by itself is not a limiting factor for older patients with hearing impairment to benefit from digital hearing aids. © 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved. H earing impairment is one of the most prevalent chron- ically handicapping conditions among people aged 65 years and older. With the rise in the aging population, it is expected that the demands placed on hearing care in the coming years will be substantially increased. Currently, there is no known medical or surgical treatment for age- related hearing loss. The best treatment or alleviation avail- able is to provide a hearing aid followed by aural rehabili- tation. 1 The satisfaction and use of hearing aids by older individuals with hearing loss have been studied extensively. Literature of substantial magnitude reports on the successful or unsuccessful use of hearing aids by the elderly popula- tion. 2-6 However, these reports were all done on older sub- jects wearing analog linear hearing aids. In recent years, hearing aid technology has improved at an astonishingly fast pace. The signal processing of modern hearing aids has evolved from being linear, single-channel, and analog to being nonlinear, multichannel, and digital. Advantages of modern digital hearing aids over analog, linear hearing aids include active feedback cancellation, more flexibility in shaping the frequency-gain responses, better noise reduc- tion algorithms, and superior optimization of microphones in directional instruments. Also, the market share for digital hearing aids has increased greatly. 7 However, there has never been a systematic evaluation of the subjective and objective responses of older users of digital hearing aids. The purpose of this study, therefore, was to examine the objective and subjective benefits and uses of digital hearing aids in older subjects with hearing loss, and also to compare the outcome between young elderly (65 to 80 years old) and old elderly (older than 80 years) people. MATERIALS AND METHODS Subjects A total of 59 subjects older than 65 years were included in this study. None of them had any severely disabling, sys- temic, comorbid diseases except for hearing impairment. All subjects had bilateral sensorineural hearing loss and were fitted with digital, multichannel (four to seven chan- nels) compression hearing aids in our hearing aid clinic between 2005 and 2007. Hearing aid counseling, fitting, verification, and validation were all performed by the same audiologist according to a standard procedure. The prescrip- tion formula used was the National Acoustic Laboratories’ nonlinear fitting procedure, version 1 (NAL-NL1). 8 The subjects were further divided into two groups according to their age. Group A consisted of 32 subjects aged 65 to 80 years, whereas group B had 27 subjects older than 80 years. Twenty-two of the 32 (68.8%) subjects in group A and 18 of 27 (66.7%) in group B were fitted bilaterally. The re- maining patients had unilateral fittings for reasons including cost consideration, interaural interference, and an aural blockage sensation when wearing two hearing aids at the Received June 1, 2007; revised February 4, 2008; accepted February 20, 2008. Otolaryngology–Head and Neck Surgery (2008) 138, 730-734 0194-5998/$34.00 © 2008 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved. doi:10.1016/j.otohns.2008.02.012