Table S1.

Self-assessment for Hearing Screening of the Elderly

Item	Statement	Never (0%)	Occasionally (25%)	Half the time (50%)	Almost always (70%)	Always (100%)
1	Do you have difficulty understanding when someone talks in a whisper?	➀	➁	➂	➃	➄
2	Do you have difficulty hearing environmental sounds such as birds singing or water flowing?	➀	➁	➂	➃	➄
3	Do you have difficulty understanding speech because a partner murmurs or the speech is not clear?	➀	➁	➂	➃	➄
4	Do you have difficulty understanding the speech of an unfamiliar person when compared to a familiar person?	➀	➁	➂	➃	➄
5	Do you often misunderstand what someone says?	➀	➁	➂	➃	➄
6	Do you wish to increase the TV’s volume level when watching it with your family?	➀	➁	➂	➃	➄
7	Does a partner tell you that your voice is too loud when you speak?	➀	➁	➂	➃	➄
8	Do you have trouble understanding announcements on a bus or subway?	➀	➁	➂	➃	➄
9	Do you have trouble talking with people in noisy environments such as restaurants or department stores?	➀	➁	➂	➃	➄
10	Do you have difficulty understanding speech in a concert hall or theater due to reverberation?	➀	➁	➂	➃	➄
11	Do you have difficulty understanding the conversation when several people talk at the same time?	➀	➁	➂	➃	➄
12	Do you miss hearing the sound of the doorbell when a guest visits your house?	➀	➁	➂	➃	➄
13	Do you have difficulty understanding speech on the phone?	➀	➁	➂	➃	➄
14	Do you have difficulty understanding speech in dark places?	➀	➁	➂	➃	➄
15	Do you feel that speech on the TV or radio is too fast?	➀	➁	➂	➃	➄
16	Do you ask a communication partner to speak slowly because you feel his or her speech is too fast?	➀	➁	➂	➃	➄
17	Do you have trouble remembering the introductory part after listening to a long lecture?	➀	➁	➂	➃	➄
18	Do you ask a partner to repeat what he or she said during a conversation?	➀	➁	➂	➃	➄
19	Do you forget the location of an object to be bought after asking for its location in a market?	➀	➁	➂	➃	➄
20	Do you have trouble remembering what you just said?	➀	➁	➂	➃	➄
Direction: Please circle the answer of each item that comes closest to your everyday experience while considering its percentage from 0% to 100%.