Hearing Loss and Brain Health Study

• Over-The-Counter (OTC) hearing aid (Device): Over-The-Counter (OTC) hearing aid

Primary outcomes

• Feasibility- Proportion of enrolled participants who complete all study periods [Baseline, 3 months, and 6 months follow-up]: Feasibility- Proportion of enrolled participants who complete all study periods
• Feasibility - Enrollment rate (% eligible who consent) [Baseline]: Feasibility - Enrollment rate (% eligible who consent)
• Feasibility - Study visit completion rate (% of planned visits completed) [Baseline, 3 months, and 6 months follow-up]: Feasibility - Study visit completion rate (% of planned visits completed)
• Feasibility - Frequency of device troubleshooting encounters [Baseline, 3 months, and 6 months follow-up]: Feasibility - Frequency of device troubleshooting encounters
• Feasibility - Percentage achieving >= 6hours/day of objective wear time [Baseline, 3 months, and 6 months follow-up]: Feasibility - Percentage achieving >= 4hours/day of objective wear time
• Feasibility - Hearing aid use adherence (mean daily wear time from data-logging) [Baseline, 3 months, and 6 months follow-up]: Feasibility - Hearing aid use adherence (mean daily wear time from data-logging)
• Feasibility - Protocol adherence rate (% completing scheduled assessments) [Baseline, 3 months, and 6 months follow-up]: Feasibility - Protocol adherence rate (% completing scheduled assessments)
• Feasibility - Retention rate (% completing follow-up visits) [Baseline, 3 months, and 6 months follow-up]: Feasibility - Retention rate (% completing follow-up visits)
• Acceptability - International Outcome Inventory for Hearing Aids [Baseline, 3 months, and 6 months follow-up]: International Outcome Inventory for Hearing Aids (IOI-HA) The IOI-HA is a 7-item self-report questionnaire assessing hearing aid outcomes across domains including daily use, benefit, residual activity limitation, satisfaction, residual participation restriction, impact on others, and quality of life. Each item is scored on a 5-point Likert scale, with total scores ranging from 7 to 35. Higher scores indicate better hearing aid outcomes and greater perceived benefit/satisfaction.
• Acceptability - Intention to continue use after study completion [Baseline, 3 months, and 6 months follow-up]: Acceptability - Intention to continue use after study completion Participant-reported intention to continue hearing aid use after study completion will be assessed using a Likert-scale questionnaire. Responses are scored on a 5-point scale ranging from 1 to 5, with higher scores indicating greater willingness and acceptability for continued hearing aid use. Minimum score: 1; maximum score: 5. Higher scores represent better outcomes (greater intention to continue use).

Secondary outcomes

• Hearing Handicap Inventory - Screening Version [Baseline, 3 months, and 6 months follow-up]: Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S) The HHIE-S is a 10-item self-report questionnaire assessing the emotional and social/situational effects of hearing loss in older adults. Total scores range from 0 to 40, with higher scores indicating greater perceived hearing handicap and worse hearing-related quality of life. Minimum score: 0; maximum score: 40. Higher scores represent worse outcomes.
• Vanderbilt fatigue scale [Baseline, 3 months, and 6 months follow-up]: Vanderbilt Fatigue Scale - Adult Hearing Loss (VFS-AHL) The Vanderbilt Fatigue Scale - Adult Hearing Loss (VFS-AHL) is a self-report measure assessing listening-related fatigue in adults with hearing loss. Scores are derived using item-response theory-based scoring and are typically transformed to a standardized scale ranging from approximately -2 to +2 logits, with higher scores indicating greater fatigue and worse outcomes. Higher scores represent worse listening-related fatigue.

Sex: All, ages: 50 Years to any

Inclusion Criteria:

* Age >= 50 years
* Known APOE status
* Bilateral mild to moderate sensorineural hearing loss
* No current use of hearing aids or cochlear implants
* No diagnosis of dementia and able to provide informed consent
* Able to complete questionnaires and follow instructions in English
* Willing and able to comply with study procedures, follow-up visits, and hearing-aid use

Exclusion Criteria:

* Clinical diagnosis of dementia
* Severe or profound hearing loss
* Self-reported congenital hearing loss
* Absence of an ear canal due to medical conditions or prior surgical procedures
* unwillingness to wear OTC hearing aids regularly (>=4 hours/day)
* medical contraindication to use hearing aids (e.g., actively draining ear)
* Known retrocochlear pathology
* Severe uncorrected visual impairment or significant manual dexterity limitations that prevent handling the device