title: Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users, the n200 study.
abstract: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model.
  
  
  
  Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4 dB HL.
  
  
  
  LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables.
  
  
  
  The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R(2) = 0.40).
  
  
  
  All LEVEL 2 factors are important theoretically as well as for clinical assessment.
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Jerker
authors: J
authors: Rönnberg
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|c Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden .|d Eriksholm Research Centre , Oticon A/S, Rørtangvej 20, 3070 Snekkersten , Denmark .
authors: Thomas
authors: T
authors: Lunner
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Elaine Hoi Ning
authors: EH
authors: Ng
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .
authors: Björn
authors: B
authors: Lidestam
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|e Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute, VU University Medical Center , Amsterdam , The Netherlands .
authors: Adriana Agatha
authors: AA
authors: Zekveld
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|f Department of Building, Energy and Environmental Engineering , University of Gävle , Gävle , Sweden .
authors: Patrik
authors: P
authors: Sörqvist
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Björn
authors: B
authors: Lyxell
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .
authors: Ulf
authors: U
authors: Träff
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Wycliffe
authors: W
authors: Yumba
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Elisabet
authors: E
authors: Classon
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|c Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden .
authors: Mathias
authors: M
authors: Hällgren
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|c Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden .
authors: Birgitta
authors: B
authors: Larsby
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Carine
authors: C
authors: Signoret
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|g Department of Psychology , University of Toronto , Toronto , Ontario , Canada .|h The Toronto Rehabilitation Institute, University Health Network , Toronto , Ontario , Canada , and.|i The Rotman Research Institute, Baycrest Hospital , Toronto , Ontario , Canada.
authors: M Kathleen
authors: MK
authors: Pichora-Fuller
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Mary
authors: M
authors: Rudner
authors: a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden .|b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .
authors: Henrik
authors: H
authors: Danielsson
authors: b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden .|c Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden .
authors: Stefan
authors: S
authors: Stenfelt
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D003071:Cognition; D032882:Comprehension; D012048:Correction of Hearing Impairment / Q000295:instrumentation* / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006309:Hearing; D006310:Hearing Aids; D006311:Hearing Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D009622:Noise / Q000009:adverse effects; D010470:Perceptual Masking; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D013065:Speech Intelligibility; D013067:Speech Perception
keywords: Hearing impairment; cognition; context; executive functions; outcome; phonology; temporal fine structure; working memory capacity