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Subjective Ratings of Fatigue and Vigor in Adults With Hearing Loss Are Driven by Perceived Hearing Difficulties Not Degree of Hearing Loss

Hornsby, Benjamin W. Y.1; Kipp, Aaron M.2

doi: 10.1097/AUD.0000000000000203
e-Research Articles

Objectives: Anecdotal reports and qualitative research suggests that fatigue is a common, but often overlooked, accompaniment of hearing loss which negatively affects quality of life. However, systematic research examining the relationship between hearing loss and fatigue is limited. In this study, the authors examined relationships between hearing loss and various domains of fatigue and vigor using standardized and validated measures. Relationships between subjective ratings of multidimensional fatigue and vigor and the social and emotional consequences of hearing loss were also explored.

Design: Subjective ratings of fatigue and vigor were assessed using the profile of mood states and the multidimensional fatigue symptom inventory-short form. To assess the social and emotional impact of hearing loss participants also completed, depending on their age, the hearing handicap inventory for the elderly or adults. Responses were obtained from 149 adults (mean age = 66.1 years, range 22 to 94 years), who had scheduled a hearing test and/or a hearing aid selection at the Vanderbilt Bill Wilkerson Center Audiology clinic. These data were used to explore relationships between audiometric and demographic (i.e., age and gender) factors, fatigue, and hearing handicap scores.

Results: Compared with normative data, adults seeking help for their hearing difficulties in this study reported significantly less vigor and more fatigue. Reports of severe vigor/fatigue problems (ratings exceeding normative means by ±1.5 standard deviations) were also increased in the study sample compared with that of normative data. Regression analyses, with adjustments for age and gender, revealed that the subjective percepts of fatigue, regardless of domain, and vigor were not strongly associated with degree of hearing loss. However, similar analyses controlling for age, gender, and degree of hearing loss showed a strong association between measures of fatigue and vigor (multidimensional fatigue symptom inventory-short form scores) and the social and emotional consequences of hearing loss (hearing handicap inventory for the elderly/adults scores).

Conclusions: Adults seeking help for hearing difficulties are more likely to experience severe fatigue and vigor problems; surprisingly, this increased risk appears unrelated to degree of hearing loss. However, the negative psychosocial consequences of hearing loss are strongly associated with subjective ratings of fatigue, across all domains, and vigor. Additional research is needed to define the pathogenesis of hearing loss-related fatigue and to identify factors that may modulate and mediate (e.g., hearing aid or cochlear implant use) its impact.

This study examined associations between objective and subjective measures of hearing difficulties and subjective fatigue in a sample (n=149) of adults seeking help for their hearing difficulties. Better-ear, pure tone average, hearing thresholds, and the Hearing Handicap Inventory for the Elderly (or Adults) were used to quantify objective and subjective hearing difficulties, respectively. Compared to normative data, severe fatigue and severely low vigor were more common in adults seeking help for hearing difficulties. Surprisingly, no association between degree of hearing loss and fatigue was observed. In contrast, there were strong positive associations between subjective hearing difficulties and all fatigue domains.

1Department of Hearing and Speech Science, Vanderbilt Bill Wilkerson Center, Dan Maddox Hearing Aid Research Laboratory, Vanderbilt University, Nashville, Tennessee, USA; and 2Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

This work was supported, in part, by the Dan Maddox Foundation and by CTSA award No. UL1TR000445 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent official views of the National Center for Advancing Translational Sciences or the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Received March 25, 2015; accepted June 22, 2015.

Address for correspondence: Benjamin W. Y. Hornsby, Vanderbilt Bill Wilkerson Center, Room 8310 Medical Center East, South Tower, 1215 21st Ave. South, Nashville, TN 37232, USA. E-mail:

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