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To investigate the association between sensory loss and the timing and type of self-reported departures from the labor force, via retirement or disability, we used data from the Health and Retirement Study, cycles 2004–2018. Based on self-reported sensory loss, we classified individuals into four groups: no sensory loss, hearing loss only, vision loss only, and dual sensory loss (vision and hearing loss). We assumed that older adults could leave the labor force either by retirement or due to disability. Because once one type of exit is observed the other type cannot be observed, we implemented a competing risk approach to estimate the instantaneous rate of departure (sub-distribution hazard rate) for leaving the labor force due to disability, treating retirement as a competing risk, and for departures via retirement, with disability as the competing risk. We found that compared to older adults with no sensory loss, adults with vision loss are at a higher risk for leaving the labor force via disability (when treating retirement as a competing risk). Compared to no sensory loss, hearing loss was associated with a higher risk for retirement in models treating disability as a competing risk. Given the differences between disability and retirement benefits (before and after retirement age), policies intended to keep people with sensory loss from early labor force departures, such as accommodations in the workplace and/or hearing and vision care coverage, might contribute to better retiring conditions and healthy aging among older adults with sensory loss. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Many neurocognitive evaluations involve auditory stimuli, yet there are no standard testing guidelines for individuals with hearing loss. The ensuring speech understanding (ESU) test was developed to confirm speech understanding and determine whether hearing accommodations are necessary for neurocognitive testing. METHODS: Hearing was assessed using audiometry. The probability of ESU test failure by hearing status was estimated in 2679 participants (mean age: 81.4 ± 4.6 years) using multivariate logistic regression. RESULTS: Only 2.2% (N = 58) of participants failed the ESU test. The probability of failure increased with hearing loss severity; similar results were observed for those with and without mild cognitive impairment or dementia. DISCUSSION: The ESU test is appropriate for individuals who have variable degrees of hearing loss and cognitive function. This test can be used prior to neurocognitive testing to help reduce the risk of hearing loss and compromised auditory access to speech stimuli causing poorer performance on neurocognitive evaluation. [ABSTRACT FROM AUTHOR]

Background and Objectives The objectives of this study are to identify patterns of hearing aid usage among U.S. National Health & Aging Trends Study (NHATS) participants and to examine users' characteristics associated with each pattern. Research Design and Methods Using data from 666 adults ages 65 and above from NHATS, we analyzed individuals' self-reported hearing aid use from eight waves of data, 2011–2018, using group-based trajectory modeling to identify clusters of individuals with similar utilization patterns of use over time. Potential risk factors associated with membership to a specific group included baseline sociodemographic characteristics, problems with activities of daily living, presence of a caregiver, and experiencing problems with their hearing aid. We compute and analyze the odds ratios between individuals' baseline characteristics and group membership. Results We identified three utilization group patterns: continued use (n  = 510, 76.6%), interrupted use (n  = 121, 18.2%), and ceased use (n  = 35, 5.2%). Individuals with an income under the poverty line had 2.9 (95% CI: 1.09, 7.75) and 2.7 times (95% CI: 1.38, 5.27) the odds of being in the interrupted and ceased use group, respectively, compared with the continued use group. Other risk factors for interrupted and ceased use included lower education and having a caregiver. Discussion and Implications Nearly a quarter of hearing aid users experience interrupted or ceased use of hearing aids. Socioeconomic factors, such as age, income, and education, may be relevant for how individuals use assistive medical devices over time and could inform policymakers to support maintained use of hearing aids. [ABSTRACT FROM AUTHOR]

Background: Hearing loss is highly prevalent and associated with adverse health outcomes but undertreated among individuals with cognitive impairment, particularly African Americans. The incorporation of community health worker (CHW)‐partnered models may increase access and reduce disparities. The HEARS intervention is a hearing care program delivered by CHWs that provides a low‐cost amplification device. To assess the efficacy of CHW‐delivered hearing care provided to community‐dwelling older adults, including those with cognitive impairment, a randomized clinical trial was conducted. Method: An open label randomized clinical trial took place in 13 community sites in Baltimore, Maryland. 348 older adults were screened and 151 participants with hearing loss were randomized to receive a CHW‐delivered hearing care intervention versus 3‐month waitlist control. The primary outcome was change in communication function (Hearing Handicap Inventory for the Elderly‐Screening [HHIE‐S]) from baseline to 3‐months post‐randomization. The average treatment effect was estimated using the doubly‐robust weighted least squares estimator. This pre‐specified subgroup analysis was stratified by cognitive status using the total MoCA score (≤25: cognitive impairment; post hoc sensitivity analysis using ≤22). Result: Among 149 randomized participants with MoCA data, 100 individuals were cognitively impaired (Mean adjusted MoCA: 21(SD 3.5); 52% African American; 70% low‐income). At 3‐months post‐intervention, 66% with cognitive impairment reported daily device use versus 76% for those without cognitive impairment. Communication function significantly improved among individuals with cognitive impairment compared with the control, with an estimated average treatment effect of ‐13.92 HHIE‐S change (95% CI:‐16.84,‐10.86), comparable to those without cognitive impairment (‐11.47; 95% CI:‐18.04,‐4.17). Post hoc sensitivity analysis using a ≤22 MoCA cut‐off for cognitive impairment yielded similar findings. Conclusion: Among individuals with cognitive impairment, a CHW‐delivered low‐cost amplification device intervention, compared with a waitlist control, significantly improved communication function. The improvements were comparable to participants without cognitive impairment and similar in magnitude to improvements documented for older adults who received conventional clinic‐based hearing care with hearing aids fit by audiologists. To the authors' knowledge, this trial was the largest trial to date of a hearing care intervention in the U.S. of African American older adults and low‐income older adults with hearing loss and cognitive impairment. [ABSTRACT FROM AUTHOR]

Background: To measure the association between individual life-course socioeconomic position (SEP) and hearing aid use, we examined childhood and adulthood socioeconomic variables collected at the Atherosclerosis Risk in Communities (ARIC) study baseline visit (1987-1989)/Life Course Socioeconomic Status study (2001-2002) and hearing aid use data collected at visit 6 (2016-2017).Methods: ARIC is a prospective cohort study of older adults (45-64 years) recruited from 4 U.S. communities. This analysis included a subset of 2 470 participants with hearing loss at visit 6 (≥25 decibels hearing level [dB HL] better-ear) with complete hearing aid use data. Childhood SEP variables included parental education, parental occupation, and parental home ownership. Young and older adulthood SEP variables included income, education, occupation, and home ownership. Each life epoch was assigned a score ranging from 0 to 5 and then summed to calculate the individual cumulative SEP score. Multivariable-adjusted logistic regression was used to estimate the association between individual cumulative SEP and hearing aid use. Missing SEP scores were imputed for participants with incomplete socioeconomic data.Results: Of the 2 470 participants in the analytic cohort (median [interquartile interval] age 79.9 [76.7-84.0], 1 330 [53.8%] women, 450 [18.2%] Black), 685 (27.7%) participants reported hearing aid use. Higher cumulative SEP was positively associated with hearing aid use (odds ratio [OR] = 1.09, 95% confidence interval [CI]: 1.04-1.14), and slightly stronger for childhood (OR = 1.09, 95% CI: 1.00-1.20) than older adulthood SEP score (OR = 1.06, 95% CI: 0.95-1.18).Conclusions: In this community-based cohort of older adults with hearing loss, higher individual life-course SEP was positively associated with hearing aid use. [ABSTRACT FROM AUTHOR]

This article aims to investigate the association between hearing and nonfatal injury or falls in a nationally representative sample of adults from the National Health Interview Survey (NHIS) utilizing over 20 years of participant surveys. We conducted a pooled cross-sectional analysis of participant surveys (aged 50 years and older) from 1997 to 2017. Self-report hearing difficulty, history of injury over the last 3 months, reported injury from fall over the last 3 months, and reported reason for fall (including due to balance/dizziness) were collected. Using logistic regression, we investigated the odds of injury, injury from fall, and fall due to balance/dizziness by self-report hearing status. In secondary analysis, we investigated the odds of each outcome by reported hearing aid use. Models were adjusted for demographics, year of study, vision difficulty, diabetes, employment, and cardiovascular disease. Reported moderate or greater difficulty hearing demonstrated a significantly greater odds of injury (odds ratio [OR]: 1.29; 95% confidence interval [CI]: 1.18, 1.42) or fall due to balance/dizziness (OR: 1.26; 95% CI: 1.00, 1.60) compared with reported excellent/good hearing. A dose–response association was seen across levels of reported difficulty hearing for all outcomes. In this nationally representative study of adults aged 50 years and older, greater reported difficulty hearing was significantly associated with increased odds of injury and suggests greater odds of falls or fall due to balance/dizziness compared with reported good hearing. Results suggest hearing loss should be considered as a possible risk factor for both injury and fall prevention studies and programming in older adults. [ABSTRACT FROM AUTHOR]

Introduction: Many neurocognitive evaluations involve auditory stimuli, yet there are no standard testing guidelines for individuals with hearing loss. The ensuring speech understanding (ESU) test was developed to confirm speech understanding and determine whether hearing accommodations are necessary for neurocognitive testing., Methods: Hearing was assessed using audiometry. The probability of ESU test failure by hearing status was estimated in 2679 participants (mean age: 81.4 ± 4.6 years) using multivariate logistic regression., Results: Only 2.2% (N = 58) of participants failed the ESU test. The probability of failure increased with hearing loss severity; similar results were observed for those with and without mild cognitive impairment or dementia., Discussion: The ESU test is appropriate for individuals who have variable degrees of hearing loss and cognitive function. This test can be used prior to neurocognitive testing to help reduce the risk of hearing loss and compromised auditory access to speech stimuli causing poorer performance on neurocognitive evaluation., (© 2023 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)