In the United States, a large discrepancy exists between the number
of people who could benefit from hearing aids and those who actually
wear them. Close to 29 million U.S. adults could benefit from using
hearing aids, according to National Institute on Deafness and Other
Communication Disorders (NIDCD).
Yet, among adults aged 70 and older
with hearing loss who could benefit from wearing hearing aids, fewer
than one in three (30%) have ever used them. Even fewer adults aged
20-69 (approximately 16%) who could benefit have ever used them.
‘Hearing aids are effective in older adults when they are delivered via an audiology "best practices" model or with an "over-the-counter" (OTC) model.’
The first-ever placebo-controlled, double-blind, randomized clinical trial of hearing aid outcomes published today in the American Journal of Audiology
shows that older adults benefit from hearing aid use.
Led by researchers at Indiana University with funding support (Grant
No. R01 DC011771) from the National Institute on Deafness and Other
Communication Disorders (NIDCD), the study sought to compare patient
outcomes when hearing aids are delivered via an audiology "best
practices" model compared with an "over-the-counter" (OTC) model. In the
context of this study, the OTC model meant that patients received a
high-quality, pre-programmed hearing aid that was not fitted by an
The methodology is generally considered the highest standard for clinical trials.
"The research findings provide firm evidence that hearing aids do,
in fact, provide significant benefit to older adults," said Larry Humes, a distinguished professor in the Department of Speech and
Hearing Sciences at Indiana University Bloomington and the study's lead
"This is important because, even though millions of Americans
have hearing loss, there has been an absence of rigorous clinical
research that has demonstrated clear benefits provided by hearing aids
to older adults. Consequently, the U.S. Preventive Services Task Force
has not been able to support widespread hearing screening for adults
over age 50. This study, along with others to follow, will help
establish the evidence base needed to foster better hearing health care
for many older Americans."
The study looked at 154 adults ages 55-79 years with
mild-to-moderate hearing loss. All participants received the same
high-end digital mini hearing aids fitted in both ears. Subjects were
divided into three groups. One (the best practices group) received "best
practices" services from audiologists that included professional
fitting and counseling; one (the OTC group) received no professional
fitting by an audiologist and selected their own pre-programmed hearing
aids; and one (the placebo group) received a professional fitting but
used a hearing aid that was programmed to provide no acoustical benefit.
Researchers found that hearing aids are effective in older adults
for both the audiology best practices model and the OTC model. There
were no significant differences in outcome between these two
service-delivery approaches for five of the six outcome measures, but
the OTC group fared somewhat worse when it came to satisfaction with
their hearing aids. Fewer OTC participants were also likely to purchase
their hearing aids after the trial (55% for the OTC group vs. 81% for
the best practices group, with 36% for the placebo group). Following the
initial six-week trial, both the OTC and placebo groups were offered
hearing aids under the best practices model. Satisfaction significantly
increased for patients in both groups who chose to continue under
audiologist care, and more participants opted to purchase their hearing
aids after this continued period of care than after the initial trial.
In the study, researchers noted that NIDCD has prioritized
identifying research areas that could lead to the improvement of hearing
health care for adults with mild-to-moderate hearing loss - in
particular, enhancing the accessibility and affordability of hearing
health care. This study helps answer a high-priority research question
of how current delivery systems can be used or modified to increase
accessibility and affordability of hearing health care, according to
"More studies are needed to assess the generalization of the results
obtained here to other patient populations, other devices, and other
models of OTC service delivery," said Humes, adding,
"All of the devices used in this study were of high quality as opposed
to the simpler, less expensive devices many associate with an OTC model.
Also, all patients received a complete audiologic evaluation prior to
treatment - another potential difference from some OTC models under
consideration. These factors could impact patient outcomes. However, the
results of this study should serve as a yardstick for comparing
outcomes of future hearing aid studies."