Efficacy and Effectiveness of Advanced Hearing Aid Directional and Noise Reduction Technologies for Older Adults With Mild to Moderate Hearing Loss.

The analysed sample was 54 older adults with mild-to-moderate hearing loss, all native English speakers from eastern Iowa and northwestern Illinois; six participants withdrew. The findings may not apply to people with more severe hearing loss, different languages, urban areas, or very active lifestyles. All hearing aids were from one manufacturer and were the same hardware and chip, with only two models released in 2013, so results may not generalize to other premium or basic hearing aids. Volume controls were disabled, feature settings were left at default, and participants received brief instructions about manual programs to protect blinding. This may limit generalizability to clinical fittings and may have underestimated the benefit of premium features. The study examined premium directional and noise reduction features as a set, so it could not identify which specific premium feature caused any effect. Real-world outcomes relied on self-reports, which may not match behavioral or physiological measures of listening effort. Only 10.9% of the analysed smartphone surveys were in noisy or very noisy situations. Speech understanding scores were high in quieter situations, so there was little room to detect a hearing aid feature benefit in everyday life. The blinding procedures may have inflated feature-off outcomes because participants were told the devices were fully automatic and had no selectable programs. The windy condition result should be viewed as the combined effect of wind noise reduction and gain-reduction noise reduction, not wind noise reduction alone.

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Do not conclude that premium directional and noise reduction hearing aid features reliably improve everyday communication. The laboratory speech gains did not translate into robust real-world self-report benefits, and one premium condition combining wind noise reduction and gain-reduction noise reduction was associated with worse listening effort preference.