An Exploratory Study of the Impact of Hearing Handicap on Listening Fatigue During Health Care Encounters Among Older Adults.

Publication date: Sep 08, 2025

This exploratory study examined if hearing handicap in older adults affected listening-related fatigue during health care interactions and explored whether different face mask types worn during the coronavirus disease 2019 (COVID-19) pandemic influenced this association. A cross-sectional observational study among community-dwelling adults aged 60 years and older receiving care at an academic health care system outpatient audiology or otolaryngology clinics was conducted. Eligible participants completed and returned a mail-in self-reported packet including the Hearing Handicap Inventory for the Elderly (Screener Version; HHIE-S) and the 10-item Vanderbilt Fatigue Scale for Adults (VFS-A-10). Face masks were institutionally required during the COVID-19 pandemic, with options including (a) standard surgical face mask, (b) clear face mask, or (c) standard surgical face mask with face shield. General linear models assessed differences in VFS-A-10 by HHIE-S score. Among the 104 participants, the HHIE-S mean was 15. 3 (SD = 10. 4); 34. 3% experienced no hearing handicap, 45. 5% experienced mild to moderate handicap, and 20. 2% experienced severe handicap. Higher hearing handicap scores correlated with increased listening-related fatigue (β = 0. 66, SE = 0. 06, p ≤ .0001). Clear masks were linked to less listening-related fatigue, especially for individuals with higher degrees of hearing handicap, compared to standard surgical masks (β = -0. 30, SE = 0. 10, p ≤ .01). Findings from this exploratory study underscore the need for tailored communication strategies and accommodations to enhance the health care experience for individuals with hearing handicap. Future research could explore listening-related fatigue in other health care settings.

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