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20Q: Changes to Auditory Processing and Cognition During Normal Aging – Should it Affect Hearing Aid Programming? Part 2 – Programming Hearing Aids for Older Adults

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1.  Which element of speech do older adults with reduced degrees of cognition, or those with greater degrees of hearing loss, tend to be more dependent on? Temporal fine structure The speech envelope Periodicity All of the above

2.  Some older adults, with impaired auditory processing and cognition, are likely less able to cope with the distortion created by some hearing aid settings. Which of the following settings will create greater levels of distortion to a speech signal? Fast-acting compression High compression ratio Strong noise reduction All of the above

3.  According to the literature, which of the following may be more helpful to those with reduced degrees of central processing or greater degrees of hearing loss, in most situations? Slow-acting compression Fast-acting compression Strong noise reduction Frequency transposition

4.  Which of the following are most likely to enable us to assess distortion during a hearing aid fitting? Measure it in a test box Follow the prescription targets for gain during real ear measurements Validation of the settings and follow-up with the patient A listening check of the hearing aid by the clinician

5.  Which of the following approaches is likely best employed when fitting hearing aids to older adults? Compression speed is best left to the default setting of the manufacturer based on the patient’s profile. It’s difficult to know what compression speed will be best for an individual, so these should be validated or the patient given an opportunity to trial different settings. Most older adults will have reduced auditory processing and cognition, so slow-acting compression will always be best. Irrespective of age, fast-acting compression will provide the best audibility in all situations.