Longitudinal Dynamics Of Hearing Aid Benefit Across Speech Tasks In Age-related Hearing Loss

Background: Hearing aids are the primary intervention for age-related hearing loss (ARHL), yet the magnitude and trajectory of amplification benefit vary across listening conditions and individuals. We examined how amplification benefits evolve and whether hearing loss severity moderates these effects under challenging listening conditions designed to approximate real-life demands.

Methods: 32 first-time hearing-aid users (Mean age = 77) were assessed across three sessions (at-fitting, 2–3 months, and 6 months post-fitting). Speech recognition was measured under aided and unaided conditions using speech in noise and natural fast speech.

Results: Amplification improved performance in both tasks, but the pattern of benefit differed. In speech in noise, listeners with greater hearing loss showed larger immediate aided benefit that decreased as unaided performance improved, whereas listeners with milder loss showed relatively stable benefit across sessions. Natural fast speech demonstrated stable benefit across sessions, with greater hearing loss associated with both larger amplification benefit and greater longitudinal improvement.

Conclusion: Hearing aid benefit in ARHL is dynamic and influenced by hearing loss severity. Listeners with greater hearing loss derive larger immediate benefits from amplification and show greater improvement over time, although the trajectory of benefit differs across listening conditions. These findings highlight the importance of repeated assessment across listening conditions and support the value of consistent hearing-aid use when evaluating intervention success.