{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:29:00Z","timestamp":1786120140752,"version":"build-2736575974"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"name":"Veterans Affairs Central Office"},{"name":"Health Outcomes of Military Exposures"},{"name":"Washington D.C. War Related Illness & Injury Study Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hearing loss and related impairments are among the most prevalent service-related disabilities affecting military Veterans. Yet, many of the cognitive and psychosocial implications related to auditory functioning remain insufficiently understood. Growing evidence suggests that hearing aid usage can alleviate cognitive symptoms and reduce psychological, social, and emotional burdens associated with hearing loss. The present study examined associations between hearing status, overall perceptions of health, and neurocognitive functioning in combat deployed Veterans. More specifically, this study assessed whether hearing status contributes to impaired neurocognitive function and, if hearing aid usage may serve as a protective factor for cognitive symptoms and neuropsychological performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This investigation was part of a larger observational study of traumatic brain injury in combat deployed Veterans. Analyses included 42 U.S. Veterans who completed a series of subjective surveys, and medical records were reviewed to assess current health conditions, lifetime blast exposure, neurocognitive functioning and auditory health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Lifetime blast exposure was significantly associated with neurobehavioral symptoms, particularly in the somatosensory and vestibular domains. Veterans using hearing aids reported fewer symptoms in these areas than those without hearing aids and hearing loss. Furthermore, hearing aid use was positively associated with neuropsychological performance, specifically with an improved learning slope, compared to Veterans without hearing aids and hearing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The relationships between hearing loss, hearing aid usage, and blast exposure remain important measures for consideration when examining neurological symptoms and cognitive health in Service Members and Veterans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usag059","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T12:44:55Z","timestamp":1769777095000},"page":"216-224","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Relationship Between Hearing Status, Cognitive Function, and Neurological Symptom Burden: The Impact of Hearing Aids on Veteran Health"],"prefix":"10.1093","volume":"191","author":[{"given":"Kyle","family":"Pietro","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charity B","family":"Breneman","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Henry M. Jackson Foundation (HJF) for the Advancement of Military Medicine, Inc, Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamila","family":"Pollin","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lily","family":"Reck","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Henry M. Jackson Foundation (HJF) for the Advancement of Military Medicine, Inc, Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie E","family":"Kuchinsky","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, National Audiology and Speech Pathology Center Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Davidson","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, National Audiology and Speech Pathology Center Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Brungart","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center, National Audiology and Speech Pathology Center Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen","family":"Killy","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Henry M. Jackson Foundation (HJF) for the Advancement of Military Medicine, Inc, Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Forsten","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Walter Reed National Military Medical Center, National Audiology and Speech Pathology Center Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Brewster","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Ortiz","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Uniformed Services University Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Reinhard","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Georgetown University Medical School Washington, DC 20007,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Costanzo","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Uniformed Services University Bethesda, MD 20814,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9754-2927","authenticated-orcid":false,"given":"Calvin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs, Complex Exposure Threats Center of Excellence (CETCE), Washington, DC 20422,","place":["United States"]},{"name":"Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC), Washington, DC 20422,","place":["United States"]},{"name":"Henry M. Jackson Foundation (HJF) for the Advancement of Military Medicine, Inc, Bethesda, MD 20817,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026080616020024700_usag059-B1","doi-asserted-by":"publisher","first-page":"1179069519872213","DOI":"10.1177\/\u20111179069519872213","article-title":"Blast-related traumatic brain injury: current concepts and research considerations","volume":"13","author":"Bryden","year":"2019","journal-title":"J Exp Neurosci"},{"key":"2026080616020024700_usag059-B2","doi-asserted-by":"publisher","first-page":"613","DOI":"10.3389\/fneur.2020.00613","article-title":"Objective and subjective auditory effects of traumatic brain injury and blast exposure in service members and veterans","volume":"11","author":"Kuchinsky","year":"2020","journal-title":"Front Neurol"},{"key":"2026080616020024700_usag059-B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S1355617708090036","article-title":"Cognitive sequelae of blast-related versus other mechanisms of brain trauma","volume":"15","author":"Belanger","year":"2009","journal-title":"J Int Neuropsychol Soc"},{"key":"2026080616020024700_usag059-B4","author":"Traumatic Brain Injury Center of Excellence","year":"2025"},{"key":"2026080616020024700_usag059-B5","doi-asserted-by":"publisher","first-page":"109183","DOI":"10.1016\/j.heares.2025.109183","article-title":"Not-so-normal hearing: temporary hearing changes lead to chronic difficulties for listeners with \u201cnormal\u201d audiometric thresholds","volume":"458","author":"Brungart","year":"2025","journal-title":"Hear Res"},{"key":"2026080616020024700_usag059-B6","author":"US Department of Veterans Affairs. Veterans Benefits Administration","year":"2024"},{"key":"2026080616020024700_usag059-B7","doi-asserted-by":"publisher","first-page":"14","DOI":"10.4103\/1463-1741.45308","article-title":"Hearing loss in veterans and the need for hearing loss prevention programs","volume":"11","author":"Saunders","year":"2009","journal-title":"Noise Health"},{"key":"2026080616020024700_usag059-B8","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1097\/AUD.0000000000001407","article-title":"Functional hearing difficulties in Blast-Exposed service members with normal to near-normal hearing thresholds","volume":"45","author":"Grant","year":"2024","journal-title":"Ear Hear"},{"key":"2026080616020024700_usag059-B9","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1044\/2025_PERSP-24-00098","article-title":"Exploring auditory processing abilities and the impact on response time and hearing aid benefit","volume":"10","author":"Davidson","year":"2025","journal-title":"Perspect ASHA Spec Interest Groups"},{"key":"2026080616020024700_usag059-B10","doi-asserted-by":"publisher","first-page":"578","DOI":"10.3390\/healthcare12050578","article-title":"Examining the use and benefits of low-\/mild-gain hearing aids in service members with normal hearing thresholds and self-reported hearing difficulties","volume":"12","author":"Davidson","year":"2024","journal-title":"Healthcare"},{"key":"2026080616020024700_usag059-B11","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1001\/jamainternmed.2013.1868","article-title":"Hearing loss and cognitive decline in older adults","volume":"173","author":"Lin","year":"2013","journal-title":"JAMA Intern Med"},{"key":"2026080616020024700_usag059-B12","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1038\/s43587-021-00065-z","article-title":"Neural circuits and behavioral pathways linking hearing loss to affective dysregulation in older adults","volume":"1","author":"Brewster","year":"2021","journal-title":"Nat Aging"},{"key":"2026080616020024700_usag059-B13","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1176\/appi.ajp.2017.17040423","article-title":"Sensation and psychiatry: linking age-related hearing loss to late-life depression and cognitive decline","volume":"175","author":"Rutherford","year":"2018","journal-title":"Am J Psychiatry"},{"key":"2026080616020024700_usag059-B14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1177\/0898264316634571","article-title":"Association of hearing impairment and anxiety in older adults","volume":"29","author":"Contrera","year":"2017","journal-title":"J Aging Health"},{"key":"2026080616020024700_usag059-B15","doi-asserted-by":"publisher","first-page":"102068","DOI":"10.1016\/j.eclinm.2023.102068","article-title":"Associations between hearing loss and clinical outcomes: population-based cohort study","volume":"61","author":"Tonelli","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026080616020024700_usag059-B16","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1001\/jamaoto.2017.2513","article-title":"Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia","volume":"144","author":"Loughrey","year":"2018","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"key":"2026080616020024700_usag059-B17","doi-asserted-by":"publisher","first-page":"838","DOI":"10.3109\/14992027.2015.1059503","article-title":"Hearing-aid use and long-term health outcomes: hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality","volume":"54","author":"Dawes","year":"2015","journal-title":"Int J Audiol"},{"key":"2026080616020024700_usag059-B18","doi-asserted-by":"publisher","first-page":"e0119616","DOI":"10.1371\/journal.pone.0119616","article-title":"Hearing loss and cognition: the role of hearing aids, social isolation and depression","volume":"10","author":"Dawes","year":"2015","journal-title":"PLoS One"},{"key":"2026080616020024700_usag059-B19","doi-asserted-by":"publisher","first-page":"151","DOI":"10.3766\/jaaa.18.2.7","article-title":"A systematic review of health-related quality of life and hearing aids: final report of the American academy of audiology task force on the health-related quality of life benefits of amplification in adults","volume":"18","author":"Chisolm","year":"2007","journal-title":"J Am Acad Audiol"},{"key":"2026080616020024700_usag059-B20","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/HTR.0b013e318230fb17","article-title":"Psychometric assessment of the neurobehavioral symptom inventory-22","volume":"27","author":"Meterko","year":"2012","journal-title":"J Head Trauma Rehabil"},{"key":"2026080616020024700_usag059-B21","doi-asserted-by":"publisher","first-page":"1860","DOI":"10.1212\/WNL.0b013e318258f744","article-title":"Neuro-QOL","volume":"78","author":"Cella","year":"2012","journal-title":"Neurology"},{"key":"2026080616020024700_usag059-B22","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1089\/neu.2020.7405","article-title":"Development of a blast exposure estimator from a department of defense-wide survey study on military service members","volume":"38","author":"Modica","year":"2021","journal-title":"Journal of Neurotrauma"},{"key":"2026080616020024700_usag059-B23","doi-asserted-by":"publisher","DOI":"10.1037\/t15169-000","article-title":"Wechsler adult intelligence scale\u2014fourth edition","author":"Wechsler","year":"2012","journal-title":"PsycTESTS Dataset"},{"key":"2026080616020024700_usag059-B24","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1002\/jts.22059","article-title":"The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation","volume":"28","author":"Blevins","year":"2015","journal-title":"J Trauma Stress"},{"key":"2026080616020024700_usag059-B25","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"2026080616020024700_usag059-B26","article-title":"California Verbal Learning Test\u2013Second Edition (CVLT-II) manual. San Antonio, TX: The Psychological Corporation","author":"Delis, DC, Kramer, JH, Kaplan, E, & Ober, BA.","year":"2000"},{"key":"2026080616020024700_usag059-B27","doi-asserted-by":"publisher","first-page":"2465","DOI":"10.1056\/NEJMra1616601","article-title":"Hearing loss in adults","volume":"377","author":"Cunningham","year":"2017","journal-title":"N Engl J Med"},{"key":"2026080616020024700_usag059-B28","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1089\/neu.2023.0133","article-title":"High lifetime blast exposure using the blast exposure threshold survey is associated with worse warfighter brain health following mild traumatic brain injury","volume":"41","author":"Lange","year":"2024","journal-title":"J Neurotrauma"},{"key":"2026080616020024700_usag059-B29","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.jpsychires.2021.09.021","article-title":"Effects of blast exposure on psychiatric and health symptoms in combat veterans","volume":"143","author":"Martindale","year":"2021","journal-title":"J Psychiatr Res"},{"key":"2026080616020024700_usag059-B30","doi-asserted-by":"publisher","first-page":"2411","DOI":"10.1007\/s11136-022-03092-4","article-title":"Clinical utility of PTSD, resilience, sleep, and blast as risk factors to predict poor neurobehavioral functioning following traumatic brain injury: a longitudinal study in U.S. military service members","volume":"31","author":"Lange","year":"2022","journal-title":"Qual Life Res"},{"key":"2026080616020024700_usag059-B31","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1097\/01.wad.0000213815.20177.19","article-title":"Cognitive reserve and Alzheimer disease","volume":"20","author":"Stern","year":"2006","journal-title":"Alzheimer Dis Assoc Disord"},{"key":"2026080616020024700_usag059-B32","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1037\/a0014802","article-title":"Aging, hearing acuity, and the attentional costs of effortful listening","volume":"24","author":"Tun","year":"2009","journal-title":"Psychol Aging"},{"key":"2026080616020024700_usag059-B33","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1097\/AUD.0000000000001067","article-title":"Estimated prevalence of functional hearing difficulties in blast-exposed service members with normal to near\u2013normal-hearing thresholds","volume":"42","author":"Grant","year":"2021","journal-title":"Ear Hear"},{"key":"2026080616020024700_usag059-B34","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1186\/s12889-020-08999-6","article-title":"Co-occurrence of hearing loss and posttraumatic stress disorder among injured military personnel: a retrospective study","volume":"20","author":"MacGregor","year":"2020","journal-title":"BMC Public Health"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/Supplement_1\/216\/70490089\/usag059.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/191\/Supplement_1\/216\/70490089\/usag059.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:02:13Z","timestamp":1786046533000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/191\/Supplement_1\/216\/8751646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":34,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2026,8,6]]},"published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usag059","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]}}}