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Abstract：
Although many individuals with hearing loss could benefit from intervention with hearing aids, many do not seek or delay seeking timely treatment after the onset of hearing loss. There is limited data-based evidence estimating the delay in adoption of hearing aids with anecdotal estimates ranging from 5 to 20 years. The present longitudinal study is the first to assess time from hearing aid candidacy to adoption in a 28-year ongoing prospective cohort of older adults, with the additional goal of determining factors influencing delays in hearing aid adoption, and self-reported successful use of hearing aids.
As part of a longitudinal study of age-related hearing loss, a wide range of demographic, biologic, and auditory measures are obtained yearly or every 2 to 3 years from a large sample of adults, along with family, medical, hearing, noise exposure, and hearing aid use histories. From all eligible participants (age ≥18; N = 1530), 857 were identified as hearing aid candidates either at baseline or during their participation, using audiometric criteria. Longitudinal data were used to track transition to hearing aid candidacy and hearing aid adoption. Demographic and hearing-related characteristics were compared between hearing aid adopters and nonadopters. Unadjusted estimated overall time (in years) to hearing aid adoption and estimated delay times were stratified by demographic and hearing-related factors and were determined using a time-to-event analysis (survival analysis). Factors influencing rate of adoption in any given time period were examined along with factors influencing successful hearing aid adoption.
Age, number of chronic health conditions, sex, retirement status, and education level did not differ significantly between hearing aid adopters and nonadopters. In contrast, adopters were more likely than nonadopters to be married, of white race, have higher socioeconomic status, have significantly poorer higher frequency (2.0, 3.0, 4.0, 6.0, and 8.0 kHz) pure-tone averages, poorer word recognition in quiet and competing multi-talker babble, and reported more hearing handicap on the Hearing Handicap Inventory for the Elderly/Adults emotional and social subscales. Unadjusted estimation of time from hearing aid candidacy to adoption in the full participant cohort was 8.9 years (SE ± 0.37; interquartile range = 3.2-14.9 years) with statistically significant stratification for race, hearing as measured by low- and high-frequency pure-tone averages, keyword recognition in low-context sentences in babble, and the Hearing Handicap Inventory for the Elderly/Adults social score. In a subgroup analysis of the 213 individuals who adopted hearing aids and were assigned a success classification, 78.4% were successful. No significant predictors of success were found.
The average delay in adopting hearing aids after hearing aid candidacy was 8.9 years. Nonwhite race and better speech recognition (in a more difficult task) significantly increased the delay to treatment. Poorer hearing and more self-assessed hearing handicap in social situations significantly decreased the delay to treatment. These results confirm the assumption that adults with hearing loss significantly delay seeking treatment with hearing aids.
As part of a longitudinal study of age-related hearing loss, a wide range of demographic, biologic, and auditory measures are obtained yearly or every 2 to 3 years from a large sample of adults, along with family, medical, hearing, noise exposure, and hearing aid use histories. From all eligible participants (age ≥18; N = 1530), 857 were identified as hearing aid candidates either at baseline or during their participation, using audiometric criteria. Longitudinal data were used to track transition to hearing aid candidacy and hearing aid adoption. Demographic and hearing-related characteristics were compared between hearing aid adopters and nonadopters. Unadjusted estimated overall time (in years) to hearing aid adoption and estimated delay times were stratified by demographic and hearing-related factors and were determined using a time-to-event analysis (survival analysis). Factors influencing rate of adoption in any given time period were examined along with factors influencing successful hearing aid adoption.
Age, number of chronic health conditions, sex, retirement status, and education level did not differ significantly between hearing aid adopters and nonadopters. In contrast, adopters were more likely than nonadopters to be married, of white race, have higher socioeconomic status, have significantly poorer higher frequency (2.0, 3.0, 4.0, 6.0, and 8.0 kHz) pure-tone averages, poorer word recognition in quiet and competing multi-talker babble, and reported more hearing handicap on the Hearing Handicap Inventory for the Elderly/Adults emotional and social subscales. Unadjusted estimation of time from hearing aid candidacy to adoption in the full participant cohort was 8.9 years (SE ± 0.37; interquartile range = 3.2-14.9 years) with statistically significant stratification for race, hearing as measured by low- and high-frequency pure-tone averages, keyword recognition in low-context sentences in babble, and the Hearing Handicap Inventory for the Elderly/Adults social score. In a subgroup analysis of the 213 individuals who adopted hearing aids and were assigned a success classification, 78.4% were successful. No significant predictors of success were found.
The average delay in adopting hearing aids after hearing aid candidacy was 8.9 years. Nonwhite race and better speech recognition (in a more difficult task) significantly increased the delay to treatment. Poorer hearing and more self-assessed hearing handicap in social situations significantly decreased the delay to treatment. These results confirm the assumption that adults with hearing loss significantly delay seeking treatment with hearing aids.
摘要：
尽管许多听力损失的人可以从助听器的干预中受益，许多人在听力损失发作后不寻求或延迟寻求及时治疗。基于数据的证据有限，估计助听器的延迟使用时间为5至20年。目前的纵向研究是第一个评估从助听器候选到采用的时间在一个28年的前瞻性队列老年人，额外的目标是确定影响助听器采用延迟的因素，和自我报告成功使用助听器。
作为年龄相关听力损失纵向研究的一部分，广泛的人口统计学，生物学，每年或每2至3年从大量成年人样本中获得听觉测量值，和家人一起,medical,听力,噪声暴露,和助听器使用历史。所有符合条件的参与者(年龄≥18岁；N=1530)，857人在基线或参与期间被确定为助听器候选人。使用听力标准。纵向数据用于跟踪向助听器候选人资格和助听器采用的过渡。比较了助听器采用者和非采用者之间的人口统计学和听力相关特征。根据人口统计和听力相关因素对助听器采用的未调整估计总时间（以年为单位）和估计的延迟时间进行分层，并使用事件发生时间分析（生存分析）确定。研究了影响任何给定时间段内采用率的因素以及影响成功采用助听器的因素。
年龄,慢性健康状况的数量，性别,退休状况,助听器采用者和非采用者之间的教育水平没有显着差异。相比之下,收养者比不收养者更有可能结婚，白人种族，具有较高的社会经济地位，具有明显较差的较高频率（2.0、3.0、4.0、6.0和8.0kHz）的纯音平均值，在安静和竞争的多说话者胡言乱语中，单词识别能力较差，并在老年人/成人情感和社会分量表的听力障碍清单上报告了更多的听力障碍。未调整的估计从助听器候选人资格到采用的全部参与者队列的时间为8.9年（SE±0.37；四分位间距=3.2-14.9年），具有统计学意义的种族分层，以低频和高频纯音平均值衡量的听力，低语句中的关键词识别，和老年人/成年人社会得分的听力障碍量表。在对213名采用助听器并被分配成功分类的个体的亚组分析中，78.4%成功。没有发现成功的重要预测因素。
助听器候选资格后，采用助听器的平均延迟为8.9年。非白人种族和更好的语音识别（在更困难的任务中）显着增加了治疗的延迟。在社交场合中，听力较差和自我评估的听力障碍显着减少了治疗的延迟。这些结果证实了听力损失的成年人明显延迟寻求助听器治疗的假设。
作为年龄相关听力损失纵向研究的一部分，广泛的人口统计学，生物学，每年或每2至3年从大量成年人样本中获得听觉测量值，和家人一起,medical,听力,噪声暴露,和助听器使用历史。所有符合条件的参与者(年龄≥18岁；N=1530)，857人在基线或参与期间被确定为助听器候选人。使用听力标准。纵向数据用于跟踪向助听器候选人资格和助听器采用的过渡。比较了助听器采用者和非采用者之间的人口统计学和听力相关特征。根据人口统计和听力相关因素对助听器采用的未调整估计总时间（以年为单位）和估计的延迟时间进行分层，并使用事件发生时间分析（生存分析）确定。研究了影响任何给定时间段内采用率的因素以及影响成功采用助听器的因素。
年龄,慢性健康状况的数量，性别,退休状况,助听器采用者和非采用者之间的教育水平没有显着差异。相比之下,收养者比不收养者更有可能结婚，白人种族，具有较高的社会经济地位，具有明显较差的较高频率（2.0、3.0、4.0、6.0和8.0kHz）的纯音平均值，在安静和竞争的多说话者胡言乱语中，单词识别能力较差，并在老年人/成人情感和社会分量表的听力障碍清单上报告了更多的听力障碍。未调整的估计从助听器候选人资格到采用的全部参与者队列的时间为8.9年（SE±0.37；四分位间距=3.2-14.9年），具有统计学意义的种族分层，以低频和高频纯音平均值衡量的听力，低语句中的关键词识别，和老年人/成年人社会得分的听力障碍量表。在对213名采用助听器并被分配成功分类的个体的亚组分析中，78.4%成功。没有发现成功的重要预测因素。
助听器候选资格后，采用助听器的平均延迟为8.9年。非白人种族和更好的语音识别（在更困难的任务中）显着增加了治疗的延迟。在社交场合中，听力较差和自我评估的听力障碍显着减少了治疗的延迟。这些结果证实了听力损失的成年人明显延迟寻求助听器治疗的假设。
