How Does the Hearing Handicap Inventory for the Elderly Score Predict the Intention of Hearing Aid Adoption in Older Adults?

Background: Age-related hearing loss has long been linked to various health problems, such as dementia. Although the use of hearing aids (HAs) is one of the most effective ways to manage hearing loss, there is a general reluctance to adopt HAs among older adults. Self-perception of one's hearing loss is one of the major factors influencing HA adoption. The Hearing Handicap Inventory for the Elderly (HHIE), a highly validated questionnaire, represents the perception of hearing loss in everyday life. The aim of this review is to investigate the possible relationship between prefitting HHIE scores and HA adoption.

Method: A comprehensive literature search was conducted on Medline, EMBASE, CINAHL Ultimate, Web of Science, Cochrane Library (CENTRAL and CDSR), and APA PsycINFO. Inclusion and exclusion criteria were developed to select relevant studies. Nine studies were included in the review.

Results: Eight of the nine studies reported a significant association between HA adoption and higher HHIE scores. Five studies found a significant difference in mean HHIE scores between the HA adoption group and the nonadoption group, while six studies found a positive odds ratio between higher HHIE scores and higher rates of HA adoption. Using the combined data reported in the studies, the statistical difference between the mean HHIE scores of the two groups was analyzed. The results showed a significant difference between the HHIE scores of the groups with and without HA adoption.

Conclusions: In general, higher HHIE scores prior to fitting were predictive of a higher rate of subsequent HA adoption. It is possible to use HHIE questionnaires to screen individuals with audiometrically proven hearing loss, and more interventions should be targeted at those who report low HHIE scores, as they have a lower tendency to adopt HAs despite significant hearing problems.

Supplemental Material: https://doi.org/10.23641/asha.29936834.