Explaining Discrepancies between the Digit Triplet Speech-in-Noise Test Score and Self-Reported Hearing Problems in Older Adults

• Published in: Journal of speech, language, and hearing research language, and hearing research, 2018-04, Vol.61 (4), p.986-999
• Main Authors: Pronk, Marieke, Deeg, Dorly J. H, Kramer, Sophia E
• Format: Article
• Language: English
• Subjects: Acoustics; Aged; Aged, 80 and over; Aging; Aging (Individuals); Assistive Technology; Auditory Evaluation; Auditory Tests; Awareness; Chronic Illness; Chronic illnesses; Communication Strategies; Comorbidity; Coping; Demography; Depression - psychology; Diagnostic Self Evaluation; Female; Foreign Countries; Gender Differences; Health; Hearing disorders; Hearing Impairments; Hearing Loss - diagnosis; Hearing Loss - epidemiology; Hearing Loss - psychology; Hearing Tests - methods; Humans; Individual Characteristics; Longitudinal Studies; Male; Middle Aged; Noise; Older Adults; Older people; Personality; Personality Traits; Physiological aspects; Predictor Variables; Psychological Patterns; Regression (Statistics); Respondents; Scores; Screening Tests; Self Concept; Self Efficacy; Self Esteem; Self evaluation; Self Report; Severity (of Disability); Sex Factors; Social Behavior; Social factors; Social Influences; Social Networks; Speech; Speech Perception; Speech production; Speech Reception Threshold Test; Speech reception thresholds; Test Results
• ISSN: 1092-4388; 1558-9102
• DOI: 10.1044/2018_JSLHR-H-17-0124

Purpose: The purpose of this study is to determine which demographic, health-related, mood, personality, or social factors predict discrepancies between older adults' functional speech-in-noise test result and their self-reported hearing problems. Method: Data of 1,061 respondents from the Longitudinal Aging Study Amsterdam were used (ages ranged from 57 to 95 years). Functional hearing problems were measured using a digit triplet speech-in-noise test. Five questions were used to assess self-reported hearing problems. Scores of both hearing measures were dichotomized. Two discrepancy outcomes were created: (a) being unaware: those with functional but without self-reported problems (reference is "aware": those with functional and self-reported problems); (b) reporting false complaints: those without functional but with self-reported problems (reference is "well": those without functional and self-reported hearing problems). Two multivariable prediction models (logistic regression) were built with 19 candidate predictors. The speech reception threshold in noise was kept (forced) as a predictor in both models. Results: Persons with higher self-efficacy (to initiate behavior) and higher self-esteem had a higher odds to being unaware than persons with lower self-efficacy scores (odds ratio [OR] = 1.13 and 1.11, respectively). Women had a higher odds than men (OR = 1.47). Persons with more chronic diseases and persons with worse (i.e., higher) speech-in-noise reception thresholds in noise had a lower odds to being unaware (OR = 0.85 and 0.91, respectively) than persons with less diseases and better thresholds, respectively. A higher odds to reporting false complaints was predicted by more depressive symptoms (OR = 1.06), more chronic diseases (OR = 1.21), and a larger social network (OR = 1.02). Persons with higher self-efficacy (to complete behavior) had a lower odds (OR = 0.86), whereas persons with higher self-esteem had a higher odds to report false complaints (OR = 1.21). The explained variance of both prediction models was small (Nagelkerke R[superscript 2] = 0.11 for the "unaware" model, and 0.10 for the "false complaints" model). Conclusions: The findings suggest that a small proportion of the discrepancies between older individuals' results on a speech-in-noise screening test and their self-reports of hearing problems can be explained by the unique context of these individuals. The likelihood of discrepancies partly depends on a person's health (chronic