PP312 - Factors Predicting Subjective Hearing Disability in Latino Older Adults

Abstract:
This cross-sectional study explores predictors of subjective hearing disability (HHIE) among older Latino adults. Among 103 participants (average age 76 years, SD = 9), audiometric hearing loss (pure-tone average, PTA) and education level were significant predictors of HHIE scores, but only 13% of the variance in HHIE was explained by PTA. Stratified analyses by hearing aid use and sensitivity and specificity of the HHIE in predicting hearing loss will also be presented. Findings highlight the role of non-audiometric factors, including potentially cultural and linguistic variables, in shaping perceptions of hearing loss and emphasize the need for culturally responsive hearing care.

Summary:
Objectives
Disparities in hearing healthcare have been well documented. For example, less than 5% of Latino adults with hearing loss use hearing aids, compared to approximately 20% of the general U.S. population. These disparities are driven by multiple factors, including the high cost of devices and services, limited insurance coverage, and a shortage of hearing healthcare providers—especially those proficient in Spanish. There are also known barriers of stigma and misconceptions about hearing health, potentially driven by language and health literacy differences with hearing healthcare providers. This study aims to understand the predictors of subjective hearing disability among older Latino adults. Outcomes can help contribute to improved access to, and equity of hearing care for this population.We hypothesize that objective audiometric hearing will not strongly predict subjective hearing difficulty. We anticipate that this disconnect may be influenced by cultural and linguistic factors shaping self-perceptions of hearing loss within Latino culture.

Design
Data collection included objective pure-tone hearing loss (pure-tone average) and subjective personal perceptions of hearing disability (Hearing Handicap Inventory for the Elderly, HHIE). Data collection took place at all-day elder care facilities in San Diego County. This cross-sectional study evaluated predictors of HHIE among primarily Latino older adults. Data was collected through a demographic questionnaire (age, sex, income, education), the Hearing Handicap Inventory for the Elderly (HHIE), and pure-tone air-conduction audiometry using a MAICO portable audiometer. All assessments were administered in either English or Spanish, depending on participant preference, and Spanish was the most common preferred language (n= 93, 94%).

Results
A total 103 older primarily Latino adults participated (mean age = 76 years, SD = 9). The mean pure-tone average (PTA) was 32 dB HL (SD = 18), with a mean HHIE score of 14 (SD = 14). The main predictors of HHIE were PTA (p < 0.001) and education level (p = 0.04). Although PTA was a statistically significant predictor, it only explained 13% of the variance in HHIE. We will also present stratified analyses based on hearing aid experience and evaluate the sensitivity and specificity of the HHIE in predicting PTA outcomes.

Conclusion
Findings highlight the role of non-audiometric factors, including potentially cultural and linguistic variables, in shaping the social and emotional consequences of hearing loss, and emphasize the need for culturally responsive hearing care. Future research will explore aspects of Latino culture that influence the uptake of hearing rehabilitation.