Preference and Outcomes for Fast Versus Slow Compression in Hearing Aids for Older Adults: A Randomized Control Trial

Participants with a greater degree of hearing loss tended to prefer slow-acting compression. The optimum boundary between the preference for "fast" versus "slow" compression speed was a four-frequency average hearing threshold of 35 dB HL in the better ear. When the default compression speed was set to "fast" for those with an average hearing threshold below 35 dB HL, and to "slow" for those with a greater degree of hearing loss, this setting correctly reflected a user's preference in about four in five cases. Neither compression speed offered a significant benefit for speech recognition in noise and quiet. Likewise, neither cognitive performance nor previous experience with hearing aids predicted the amount of reported benefit or preference. Limitations to the study included a positive association between hearing threshold and experience with hearing aids. The study also demonstrated a strong association between the preference and the order of compression speed provided, with users tending to prefer the second fitting.