Hearing impairment and hearing aid usage in Singapore

Objective: To examine the epidemiological and audiological profile, pattern of hearing aid (HA) fitting and usage among HA users in Singapore. Design: Retrospective cross-sectional study. Study sample: Cohort of 1068 subjects issued with HAs at a tertiary hospital between 2001 and 2013. Results: Mean age was 70years with 50.8% male. Mean hearing loss (HL) was 63.1dB and 69.5% had at least moderate-severe HL. Sensorineural HL was present in 66.4% and 69.8% had symmetrical HL. Behind-the-Ear HAs were cheaper than In-Ear HAs. Standard Behind-The-Ear HAs were also cheaper than Receiver-in-Canal HAs. Among In-Ear HAs, In-the-Canal and Completely-in-Canal were more popular than In-the-Ear HAs despite costing more. HA was used 4days/week by 85.6% but >7h per day by only 35.7%. Only 18% received bilateral first HA fitting. In multivariate analysis, younger age and symmetrical HL were predictors of bilateral HA uptake while better Pure-Tone-Audiometry of aided ear and >7h of daily HA usage were predictors of successive HA fitting. Conclusions: HA users in Singapore were elderly and presented with advanced HL. Bilateral HA adoption and average daily use were low compared to other developed countries. Future research on understanding the suboptimal HA usage should explore patients' motivation, hearing disability, and HA effectiveness.