Background/Aims: Stroke survivors are at elevated risk of hearing difficulties, including higher rates of pre-existing and more severe peripheral hearing loss than the general population. Many also experience central auditory processing difficulties that are not detected by standard audiometric assessment and may be compounded by cognitive and linguistic impairment. Despite substantial downstream consequences for communication, participation, and quality of life, these difficulties remain poorly recognised within stroke rehabilitation.
Methods: We characterised hearing and listening difficulties in 40 stroke survivors aged 18–85 years using a co-designed online survey incorporating standardised self-report measures and qualitative responses.
Results: Most respondents were in the chronic phase of recovery (>2 years post-stroke, 77%), 44% reported having aphasia, and 28% reported a clinically identified hearing loss. Almost half of all respondents reported that their hearing had worsened following stroke. Listening difficulties were common in everyday environments: 80% reported difficulty in cafes/restaurants and 59% in group communication, while no participant reported difficulty in one-to-one conversation. More than half (57.5%) reported reduced well-being associated with listening difficulties, most commonly stress/anxiety, frustration, and reduced social confidence. Increased sound sensitivity was reported by 62.5%. Standardised measures indicated hearing and listening difficulties comparable to those reported by adults with mild-to-moderate hearing loss. Qualitative responses described listening as effortful, overwhelming, and socially restrictive. People with aphasia reported worse outcomes across all measures.
Conclusion: These findings highlight the need for better recognition, assessment, and intervention-focused research targeting post-stroke hearing and listening difficulties across the stroke care and rehabilitation pathway.