# Effects of Environment Complexity on Listening Performance in Adult Hearing Aid Users

> **NIH NIH F32** · UNIVERSITY OF IOWA · 2020 · $69,810

## Abstract

PROJECT SUMMARY/ABSTRACT
Hearing loss is the second most common health condition among adults. Untreated hearing loss is associated
with an increased risk of depression, anxiety, social isolation, dementia, and all-cause mortality. Despite this,
only 14% of people who would benefit from hearing aids use them. The most common reason adults give for
not using hearing aids is that hearing aids do not help them in the very situations they struggle to hear in the
most—complex listening environments (CLEs). CLEs are places with many different sound sources, like
restaurants. Indeed, restaurants are the most difficult listening environments for the majority of adults with
hearing loss. Hearing aid technologies that are designed to improve speech perception in noise, such as noise
reduction and directional microphones, show some modest benefits when tested in a laboratory environment.
In the real world, however, these technologies show no benefits. Hearing aids can therefore demonstrate
efficacy (how well they can work in the best possible scenario, i.e., in a laboratory test), but fail to be effective
(how well they work in the real world). We propose that listening environment complexity differences between the
lab and the real world drives the hearing aid efficacy-effectiveness gap. We further propose that the effect of
environment complexity on listening performance is moderated by cognitive ability, and the benefit of hearing aid
features on listening performance is moderated by environment complexity. Our aims are designed to test these
hypotheses in the laboratory using controlled experimental paradigms, as well as in the real world using field
experiments. The proposed study is informed by information theory, which defines complexity as the amount of
information in a communication system. Under this theory, complexity can be measured using entropy to quantify
how much information is in the system. Our team will apply this framework to understanding communication in real
world CLEs. In Aim 1, we characterize the relationship between complexity, cognitive ability, and hearing aid feature
efficacy in the lab using a controlled experimental paradigm. In Aim 2, we characterize the relationship between
complexity, cognitive ability, and hearing aid feature effectiveness in the real world using smartphones to record real
world environments and deliver surveys to participants, as well as experimental hearing aids that record how
features process signals in real-time. The findings from this study will: enhance our understanding of how hearing
aid users perceive real world CLEs, extend information theory to quantify the complexity of real world CLEs and its
effect on listening performance, provide important insight into the factors that underlie the hearing aid efficacy-
effectiveness gap, and provide groundwork that may help guide developments to close the efficacy-effectiveness
gap through clinical and engineering approaches. The proposed study directly ...

## Key facts

- **NIH application ID:** 10139201
- **Project number:** 1F32DC018980-01A1
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Erik Jorgen Jorgensen
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $69,810
- **Award type:** 1
- **Project period:** 2020-09-10 → 2022-09-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10139201

## Citation

> US National Institutes of Health, RePORTER application 10139201, Effects of Environment Complexity on Listening Performance in Adult Hearing Aid Users (1F32DC018980-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10139201. Licensed CC0.

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