Hearing Aid Use is Associated with Faster Visual Lexical Decision

Ning, Ruijing; Signoret, Carine; Holmer, Emil; Danielsson, Henrik · 2025 · Crossref

DOI: 10.1177/23312165251375892

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Summary

This study investigates whether hearing aid (HA) use improves visual lexical decision (LD) performance in individuals with hearing loss (HL), hypothesizing that enhanced auditory input stabilizes phonological representations and facilitates faster word recognition. The research addresses the gap in understanding how HA use impacts cognitive functions beyond auditory perception, specifically focusing on the speed and accuracy of visual word recognition. The researchers analyzed data from the n200 database, comprising 244 participants with mild-to-severe bilateral sensorineural HL. Participants were categorized into three groups: non-HA users (NoHA, n=54), short-term HA users (<5 years, n=92), and long-term HA users (≥5 years, n=98). All participants completed a visual LD task involving judgments on words, pseudowords, and nonwords, with reaction times and accuracy recorded. The study controlled for covariates including age, hearing level, years of education, working memory capacity, and fluid intelligence. Generalized linear mixed models were employed to analyze accuracy and reaction times, treating group and stimulus type as fixed effects. Results indicated no significant differences in LD accuracy across the three groups, suggesting a potential ceiling effect. However, HA users demonstrated significantly faster reaction times than non-users across all stimulus types. Specifically, long-term HA use was associated with a significantly smaller difference in reaction time between pseudowords and nonwords compared to the NoHA group, indicating enhanced processing efficiency for phonologically complex stimuli. Short-term HA users also showed faster reaction times than non-users, but no significant difference existed between short-term and long-term users. Pseudowords generally elicited longer reaction times and lower accuracy than words and nonwords, consistent with their reliance on phonological processing. The findings suggest that HA use is associated with faster visual word recognition, potentially reflecting enhanced cognitive functions and stabilized phonological representations in long-term memory. This supports the Development Ease of Language Understanding (D-ELU) model, which posits that consistent auditory input aids in maintaining efficient lexical access. The study highlights cognitive advantages linked to HA use, particularly in processing speed, though it does not support improvements in accuracy. Limitations include the cross-sectional design, which precludes causal inference, and the inability to distinguish between short- and long-term HA effects, suggesting that benefits may emerge within five years or be influenced by the duration of hearing loss. Future research should explore longitudinal designs and interactions between cognitive factors and HA use.

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