{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T18:25:21Z","timestamp":1751567121574,"version":"3.37.3"},"reference-count":53,"publisher":"American Academy of Audiology","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:p><jats:bold>Abstract<\/jats:bold>  <jats:bold>Background<\/jats:bold>\u2003Age-related changes (both normal and pathological), and health literacy are relevant to audiological practice. Changes associated with the musculoskeletal, vascular, and nervous systems drive manual, visual, and cognitive function. These in\n turn affect the capabilities required for effective hearing aid (HA) skill acquisition, use, and management. Meanwhile, health literacy influences the ability to gain access to, understand, and use information, which is important for promoting and maintaining HA use and management. Understanding\n the interindividual variability of these variables can help audiologists characterize those individuals who might have suboptimal HA outcomes. This knowledge can then inform better clinical practices and guide implementation of processes to improve care quality and outcomes. <jats:bold>Purpose<\/jats:bold>\u2003The\n aim of the study is to assess the variation in manual, visual, and cognitive function, and health literacy, among community-dwelling older individuals, and to determine whether and which of these variables are associated with reported HA outcome and\/or the knowledge and skill to manage HAs.\n <jats:bold>Research Design<\/jats:bold>\u2003Data presented here were collected as part of an efficacy trial of four variants of HA orientation. The data were collected at baseline (prior to HA fitting) and after 4 to 8 weeks of HA use. <jats:bold>Study Sample<\/jats:bold>\u2003The study sample consists of 265 U.S. Veterans\n aged 51 to 87 years with no previous HA experience who were scheduled to receive their first pair of HAs from the Veterans Administration. <jats:bold>Data Collection and Analysis<\/jats:bold>\u2003We assessed baseline measures of hand function, vision, cognition, and health literacy just prior to participants\n receiving their first pair of HAs. HA management skills and knowledge, and HA outcome were measured after 4 to 8 weeks of HA use using the Hearing Aid Skills and Knowledge (HASK) and International Outcomes Inventory for Hearing Aids (IOI-HA), respectively. Data collected here was compared\n with published norms to assess variation in baseline measures. Associations between baseline performance and outcomes data were examined using <jats:italic>t<\/jats:italic>-tests comparing participants who performed at or above age-based norms with those who performed below age-based norms. <jats:bold>Results<\/jats:bold>\u2003Participants'\n performance on the baseline measures was highly variable, with the proportions of individuals performing below norms varying by test measure. When combining data across the nine baseline measures, approximately 10% of participants performed below published norms on five or more measures, and\n 85% performed below norms on at least one measure. Poor manual dexterity, ability to learn a new task, and ability to draw inferences from spoken information negatively impacted HA management and outcome. <jats:bold>Conclusion<\/jats:bold>\u2003There was a considerable heterogeneity among a community-dwelling\n sample of first time HA users in terms of sensory, cognitive, and motor function. Clinicians should consider modifying their clinical practice to account for such heterogeneity and best support their patients in adapting to new HAs.<\/jats:p>","DOI":"10.1055\/s-0041-1728800","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T00:47:34Z","timestamp":1622594854000},"page":"355-365","source":"Crossref","is-referenced-by-count":2,"title":["Heterogeneity in Vision, Hand Function, Cognition, and Health Literacy Among Older Veterans: Impacts, Outcomes, and Clinical Recommendations for First-Time Hearing Aid Users"],"prefix":"10.3766","volume":"32","author":[{"given":"Gabrielle H.","family":"Saunders","sequence":"first","affiliation":[{"name":"VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Grush","sequence":"additional","affiliation":[{"name":"VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Vachhani","sequence":"additional","affiliation":[{"name":"VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina V.","family":"Echt","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Birmingham\/Atlanta Geriatric Research, Education and Clinical Center (GRECC), Birmingham, Alabama and Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Griest","sequence":"additional","affiliation":[{"name":"VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Samantha","family":"Lewis","sequence":"additional","affiliation":[{"name":"VA Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2087","reference":[{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1093\/gerona\/glt162","article-title":"Heterogeneity in healthy aging","volume":"69","author":"D J Lowsky","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"e0120077","DOI":"10.1371\/journal.pone.0120077","article-title":"Age-related variation in health status after age 60","volume":"10","author":"G Santoni","year":"2015","journal-title":"PLoS One"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/gerona\/58.2.M146","article-title":"The aging hand","volume":"58","author":"E Carmeli","year":"2003","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1146\/annurev-vision-111815-114550","article-title":"Vision and aging","volume":"2","author":"C Owsley","year":"2016","journal-title":"Annu Rev Vis Sci"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.cger.2013.07.002","article-title":"Normal cognitive aging","volume":"29","author":"C N Harada","year":"2013","journal-title":"Clin Geriatr Med"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1097\/AUD.0000000000000980","article-title":"Electronic health records as a platform for audiological research: data validity, patient characteristics and hearing-aid use persistence among 731,213 US Veterans","volume":"42","author":"G H Saunders","year":"2021","journal-title":"Ear Hear"},{"issue":"08","key":"ref8","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1258\/0022215001906480","article-title":"Manual dexterity and successful hearing aid use","volume":"114","author":"M Kumar","year":"2000","journal-title":"J Laryngol Otol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/AUD.0b013e31825f9bba","article-title":"The aging hand and the ergonomics of hearing aid controls","volume":"34","author":"G Singh","year":"2013","journal-title":"Ear Hear"},{"issue":"10","key":"ref10","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00405-002-0495-5","article-title":"Identifying the needs of elderly, hearing-impaired persons: the importance and utility of hearing aid attributes","volume":"259","author":"H Meister","year":"2002","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"ref11","first-page":"871","volume-title":"Aging and vision loss","author":"G Watson","year":"2010"},{"issue":"01","key":"ref12","first-page":"45","article-title":"Harnessing technology to enhance health literacy in aging","volume":"12","author":"K V Echt","year":"2007","journal-title":"Cogn Technol"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/1084713807308365","article-title":"An overview of dual sensory impairment in older adults: perspectives for rehabilitation","volume":"11","author":"G H Saunders","year":"2007","journal-title":"Trends Amplif"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.ophtha.2017.11.003","article-title":"Nationwide prevalence of self-reported serious sensory Impairments and their associations with self-reported cognitive and functional difficulties","volume":"125","author":"S D Fuller","year":"2018","journal-title":"Ophthalmology"},{"issue":"04","key":"ref15","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/arclin\/acs041","article-title":"Variability in Wechsler Adult Intelligence Scale-IV subtest performance across age","volume":"27","author":"N M Wisdom","year":"2012","journal-title":"Arch Clin Neuropsychol"},{"issue":"05","key":"ref16","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1037\/a0023835","article-title":"Chronological age and age-related cognitive deficits are associated with an increase in multiple types of driving errors in late life","volume":"25","author":"K J Anstey","year":"2011","journal-title":"Neuropsychology"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-0035-1555115","article-title":"The impact of age on cognition","volume":"36","author":"D L Murman","year":"2015","journal-title":"Semin Hear"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1044\/2018_AJA-17-0118","article-title":"The effect of memory span and manual dexterity on hearing aid handling skills in new and experienced hearing aid users","volume":"28","author":"J L Desjardins","year":"2019","journal-title":"Am J Audiol"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3109\/14992027.2013.773407","article-title":"Hearing-aid assembly management among adults from culturally and linguistically diverse backgrounds: toward the feasibility of self-fitting hearing aids","volume":"52","author":"E Convery","year":"2013","journal-title":"Int J Audiol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1044\/2018_JSLHR-H-ASCC7-18-0140","article-title":"The circle of care for older adults with hearing loss and comorbidities: a case study of a geriatric audiology clinic","volume":"62","author":"K Dupuis","year":"2019","journal-title":"J Speech Lang Hear Res"},{"volume-title":"Skills of U.S. Unemployed, Young, and Older Adults in Sharper Focus: Results From the Program for the International Assessment of Adult Competencies (PIAAC) 2012\/2014: First Look (NCES 2016\u2013039rev)","year":"2016","author":"B D Rampey","key":"ref21"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/heapro\/13.4.349","article-title":"Health promotion glossary","volume":"13","author":"D Nutbeam","year":"1998","journal-title":"Health Promot Int"},{"issue":"199","key":"ref23","first-page":"1","article-title":"Health literacy interventions and outcomes: an updated systematic review","volume":"199","author":"N D Berkman","year":"2011","journal-title":"Evid Rep Technol Assess (Full Rep)"},{"issue":"06","key":"ref24","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1177\/0272989X16638330","article-title":"Self-management skills in chronic disease management: what role does health literacy have?","volume":"36","author":"L M Mackey","year":"2016","journal-title":"Med Decis Making"},{"volume-title":"The Health Literacy of America's Adults Results From the 2003 National Assessment of Adult Literacy","year":"2006","author":"M Kutner","key":"ref25"},{"issue":"06","key":"ref26","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1093\/eurpub\/ckv043","article-title":"Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU)","volume":"25","author":"K S\u00f8rensen","year":"2015","journal-title":"Eur J Public Health"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00006416-200701000-00014","article-title":"Health literacy in geriatric patients: an integrative review of the literature","volume":"26","author":"C C Cutilli","year":"2007","journal-title":"Orthop Nurs"},{"volume-title":"Hearing Health Care for Adults: Priorities for Improving Access and Affordability","year":"2016","author":"National Academies of Sciences, Engineering, and Medicine","key":"ref29"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3109\/14992020903280161","article-title":"The impact of health literacy on patient understanding of counseling and education materials","volume":"49","author":"E L Nair","year":"2010","journal-title":"Int J Audiol"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1044\/2017_AJA-16-0061","article-title":"Exploring audiologists' language and hearing aid uptake in initial rehabilitation appointments","volume":"26","author":"A Sciacca","year":"2017","journal-title":"Am J Audiol"},{"issue":"17","key":"ref32","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1080\/09638288.2018.1457091","article-title":"Predictors of hearing loss self-management in older adults","volume":"41","author":"E Convery","year":"2019","journal-title":"Disabil Rehabil"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/AUD.0000000000000770","article-title":"Health literacy and self-reported hearing aid use in the Health and Retirement Study","volume":"41","author":"N A Munson Klyn","year":"2020","journal-title":"Ear Hear"},{"volume-title":"Instruction Manual for the Adult Neuropsychology Test Battery","year":"1964","author":"C G Matthews","key":"ref34"},{"volume-title":"J.V.P. Domes for Cutaneous Spatial Resolution Measurement","year":"1997","author":"Stoelting Co","key":"ref35"},{"key":"ref36","first-page":"43S","article-title":"Validation of an algofunctional index for osteoarthritis of the hand","volume":"62","author":"R L Dreiser","year":"1995","journal-title":"Rev Rhum Engl Ed"},{"issue":"S 11","key":"ref37","doi-asserted-by":"crossref","first-page":"S189","DOI":"10.1002\/acr.20631","article-title":"Measures of hand function: Arthritis Hand Function Test (AHFT), Australian Canadian Osteoarthritis Hand Index (AUSCAN), Cochin Hand Function Scale, Functional Index for Hand Osteoarthritis (FIHOA), Grip Ability Test (GAT), Jebsen Hand Function Test (JHFT), and Michigan Hand Outcomes Questionnaire (MHQ)","volume":"63","author":"J L Poole","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"issue":"01","key":"ref39","first-page":"207","article-title":"The SKILL card. An acuity test of reduced luminance and contrast","volume":"38","author":"G Haegerstrom-Portnoy","year":"1997","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/00041327-200106000-00015","article-title":"The SKILL card test in optic neuritis: experience of the Optic Neuritis Treatment Trial","volume":"21","author":"D T Long","year":"2001","journal-title":"J Neuroophthalmol"},{"key":"ref41","volume-title":"Rivermead Behavioural Memory Test","author":"B A Wilson","year":"2008","edition":"3rd ed."},{"edition":"2nd ed.","volume-title":"The Discourse Comprehension Test","author":"R H Brookshire","key":"ref42"},{"issue":"01","key":"ref43","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/S0738-3991(98)00116-5","article-title":"Development of a brief test to measure functional health literacy","volume":"38","author":"D W Baker","year":"1999","journal-title":"Patient Educ Couns"},{"issue":"06","key":"ref44","doi-asserted-by":"crossref","first-page":"S368","DOI":"10.1093\/geronb\/55.6.S368","article-title":"The association between age and health literacy among elderly persons","volume":"55","author":"D W Baker","year":"2000","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"01","key":"ref45","doi-asserted-by":"crossref","first-page":"30","DOI":"10.3109\/14992020209101309","article-title":"The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version","volume":"41","author":"R M Cox","year":"2002","journal-title":"Int J Audiol"},{"issue":"03","key":"ref46","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3766\/jaaa.16153","article-title":"Description, normative data and utility of the Hearing Aid Skills and Knowledge test","volume":"29","author":"G H Saunders","year":"2018","journal-title":"J Am Acad Audiol"},{"issue":"05","key":"ref47","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s11606-008-0520-5","article-title":"Validation of screening questions for limited health literacy in a large VA outpatient population","volume":"23","author":"L D Chew","year":"2008","journal-title":"J Gen Intern Med"},{"issue":"03","key":"ref49","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/AUD.0000000000000641","article-title":"Time from hearing aid candidacy to hearing aid adoption: a longitudinal cohort study","volume":"40","author":"A N Simpson","year":"2019","journal-title":"Ear Hear"},{"key":"ref50","doi-asserted-by":"crossref","first-page":"818","DOI":"10.3389\/fpsyg.2019.00818","article-title":"The Minnesota Haptic Function Test","volume":"10","author":"J Holst-Wolf","year":"2019","journal-title":"Front Psychol"},{"issue":"09","key":"ref51","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/01.HJ.0000582436.09398.32","article-title":"Photo-sharing as an audiological rehabilitation tool","volume":"72","author":"G H Saunders","year":"2019","journal-title":"Hear J"},{"issue":"01","key":"ref52","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1080\/10598650.2001.11510433","article-title":"Presenting information to older adults: considering age-related changes in vision and cognition","volume":"26","author":"R W Morrell","year":"2001","journal-title":"J Mus Educ"},{"issue":"02","key":"ref53","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/JCN.0b013e31824987bd","article-title":"Is \u201cteach-back\u201d associated with knowledge retention and hospital readmission in hospitalized heart failure patients?","volume":"28","author":"M White","year":"2013","journal-title":"J Cardiovasc Nurs"},{"issue":"07","key":"ref54","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.pec.2017.02.022","article-title":"Relationship between Teach-back and patient-centered communication in primary care pediatric encounters","volume":"100","author":"A Badaczewski","year":"2017","journal-title":"Patient Educ Couns"},{"issue":"01","key":"ref55","doi-asserted-by":"crossref","first-page":"210","DOI":"10.11124\/jbisrir-2016-2296","article-title":"The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review","volume":"14","author":"T T Ha Dinh","year":"2016","journal-title":"JBI Database Syst Rev Implement Reports"},{"issue":"05","key":"ref58","doi-asserted-by":"crossref","first-page":"594","DOI":"10.7205\/MILMED-D-11-00326","article-title":"Estimated incidence of multiple sclerosis among United States Armed Forces personnel using the Defense Medical Surveillance System","volume":"177","author":"E C Deussing","year":"2012","journal-title":"Mil Med"},{"key":"ref59","first-page":"E135","article-title":"Prevalence of and trends in diabetes among Veterans, United States, 2005-2014","volume":"14","author":"Y Liu","year":"2017","journal-title":"Prev Chronic Dis"}],"container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2021\/00000032\/00000006\/art00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T08:12:31Z","timestamp":1738829551000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.1055\/s-0041-1728800"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,1]]},"references-count":53,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021,6,1]]}},"alternative-id":["1050-0545(20210601)32:6L.355;1-"],"URL":"https:\/\/doi.org\/10.1055\/s-0041-1728800","relation":{},"ISSN":["1050-0545"],"issn-type":[{"type":"print","value":"1050-0545"}],"subject":[],"published":{"date-parts":[[2021,6,1]]}}}