Efficient estimation of auditory sensitivity and cognitive status using spoken-digit tests.

Project Summary/Abstract. Untreated age-related hearing loss (ARHL) is the most prevalent cause of reduced quality of life for persons 55 and older in the US. There are 30+ million hearing-impaired adults in this country, many of whom have never had a hearing test. One reason is the lack of convenient, inexpensive and valid hearing tests that are available to both

individuals and hearing professionals. The goal of this project is to develop a family of tests of auditory sensitivity and of related cognitive status that together measure functional hearing loss. If such tests were widely available large numbers of those who suspect they may have hearing loss would take them. This was demonstrated by over 3000 calls in a single day to the

telephone-administered National Hearing Test (NHT), without commercial promotion, only in response to a few newspaper articles. The identification of spoken three-digit sequences in a noise background, as used in the NHT, has been shown to correlate strongly with traditional pure-tone measures of hearing loss. Digit-in-noise (DIN) tests have recently been shown to be

particularly efficient for screening, since they are reliable, convenient, and require neither sound booths nor highly trained personnel for their administration. A family of DIN tests will be designed to help distinguish poor speech recognition due to sensitivity loss from poor recognition that reflects reduced cognitive processing. The tests will be implemented on

smartphones, tablets, desktop and laptop computers with Android or iOS operating systems. The NHT developed earlier for landline phones (Watson et al., 2012; Williams et al., 2014), has been taken by nearly 130,000 callers since 2014. Those data, plus audiograms from 700+ adults (veterans) who were given the DIN test together with other standard audiometry, will

guide test development. Optional spoken rather than keypad responses will make the test accessible to children and to elderly adults with motor-control problems. Validation studies will test 590 participants in three university hearing centers. DIN sensitivity tests will be validated in relation to pure-tone audiograms, while cognitive-status tests will be compared to established

tests of working memory, executive function, and selective attention. Audiogram slope will be estimated by comparing DIN-test performance using low-frequency masking noise, to that with speech-spectrum noise. This new family of tests on a variety of platforms, will be designed for use in the home, in schools, in primary-care physicians’ offices, in hearing clinics and in noisy

businesses. Widespread use of this family of screening tests can make personal knowledge of hearing health as accessible as weighing oneself on the bathroom scale.