Relation between speech-in-noise threshold, hearing loss and cognition from 40-69 years of age (original) (raw)
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Frontiers in Neurology
BackgroundEstablished associations between hearing loss and cognitive decline were primarily defined by pure-tone audiometry, which reflects peripheral hearing ability. Speech-in-noise performance, which reflects central hearing ability, is more limited in prior literature. We examined the longitudinal associations of audiometric hearing and speech-in-noise performance with cognitive decline.MethodsWe studied 702 participants aged ≥60 years in the Baltimore Longitudinal Study of Aging 2012–2019. Global and domain-specific (language, memory, attention, executive function, visuospatial ability) cognitive performance were assessed by the cognitive assessment battery. Hearing thresholds at 0.5, 1, 2, and 4 kilohertz obtained from pure-tone audiometry were averaged to calculate better-ear pure-tone average (PTA) and participants were categorized as having hearing loss (>25 decibels hearing level [dB HL]) or normal hearing (≤25 dB HL). Speech-in-noise performance was assessed by the Qu...
American Journal of Audiology, 2019
Purpose The purpose of this study was to investigate associations between performance on a clinical speech-in-noise measure with a comprehensive neurocognitive battery of tests. Method A group of older adults ( N = 250, M age = 77 years, age range: 67.3–89.1 years) enrolled in the Atherosclerosis Risk in Communities Neurocognitive Study took part in the hearing pilot study (2013) that included testing for audiometric thresholds and speech-in-noise performance (Quick Speech-in-Noise Test; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004). This research study analyzed the associations between domain-specific cognitive function and speech-in-noise performance after adjusting for hearing thresholds and other demographic and cardiovascular factors. Results Multivariable-adjusted associations were found between all cognitive domains and speech-in-noise performance in the full sample, but the observed associations varied when participants with varying levels of moderate to moderately...
Auditory Processing Performance of the Middle-Aged and Elderly: Auditory or Cognitive Decline?
Journal of The American Academy of Audiology, 2018
Background: Despite the well-established relationship between aging and auditory processing decline, identifying the extent to which age effect is the main factor on auditory processing performance remains a great challenge due to the co-occurrence of age-related hearing loss and age-related cognitive decline as potential confounding factors. Purpose: To investigate the effects of age-related hearing loss and working memory on the clinical evaluation of auditory processing of middle-aged and elderly. Research Design: Cross-sectional study. Study Sample: A total of 77 adults between 50 and 70 yr of age were invited to participate in the study. Data Collection and Analysis: The participants were recruited from a larger study that focused on the assessment and management of sensory and cognitive skills in elderly participants. Only participants with normal hearing or mild-to-moderate age-related hearing loss, with no evidence of cognitive, psychological, or neurological conditions were included. Speech-in-noise, dichotic digit, and frequency pattern tests were conducted as well as a working memory test. The hearing loss effect was investigated using an audibility index, calculated from the audiometric threshold. The performance on the digit span test was used to investigate working memory effects. Both hearing loss and working memory effects were investigated via correlation and regression analyses, partialling out age effects. The significance level was set at p , 0.05. Results: The results demonstrated that, while hearing loss was associated to the speech-in-noise performance, working memory was associated to the frequency pattern and dichotic digit performances. Regression analyses confirmed the relative contribution of hearing loss to the variance in speech-in-noise and working memory test to the variance in frequency pattern and dichotic digit test performance. Conclusions: The performance decline of the elderly in auditory processing tests may be partially attributable to the working memory performance and, consequently, to the cognitive decline exhibited by this population. Mild-to-moderate hearing loss seems to affect performance on specific auditory processing tasks, such as speech in noise, reinforcing the idea that auditory processing disorder in the elderly might also be associated to auditory peripheral deficits.
Decline of speech understanding and auditory thresholds in the elderly
The Journal of the Acoustical Society of America, 2005
A group of 29 elderly subjects between 60.0 and 83.7 years of age at the beginning of the study, and whose hearing loss was not greater than moderate, was tested twice, an average of 5.27 years apart. The tests measured pure-tone thresholds, word recognition in quiet, and a set of tests of understanding speech with various types of distortion (low-pass filtering, time compression) or interference (single speaker, babble noise, reverberation). Performance declined consistently and significantly between the two testing phases. In addition, the variability of speech understanding measures increased significantly between testing phases, though the variability of audiometric measurements did not. A right-ear superiority was observed but this lateral asymmetry did not increase between testing phases. Using a group of young subjects with normal hearing to establish a baseline, we found that the decline of speech understanding measures accelerated significantly relative to the decline in audiometric measures in the seventh to ninth decades of life. On the assumption that speech understanding depends linearly on age and audiometric variables, there is evidence that this linear relationship changes with age, suggesting that not only the accuracy but also the nature of speech understanding evolves as we mature. I.INTRODUCTION From early adulthood on, but especially after age 60, auditory sensitivity and other aspects of hearing gradually deteriorate. More troubling for communication, and thus for quality of life, is the progressive degradation of speech understanding, especially when there is noise such as background speech or reverberation. The decline of auditory communication ability is interesting as basic science and for its clinical implications: understanding this loss would shed light on the relationship between hearing and speech comprehension and could lead to the development of devices to alleviate the deficit. The nature, degree, and rate of hearing deterioraion with age have been studied both diachronically, by testing a group of subjects longitudinally as they age, and synchronically, by comparing subjects of different ages. Longitudinal study is more direct and has fewer inherent ambiguities, but it is costly, difficult, and fraught with unpredictable obstacles, such as dropouts or illnesses affecting auditory functions. Cross-sectional study of subjects of different ages is easier and less expensive; however, it is more vulnerable to confounding.
Frontiers in Neuroscience
Epidemiological studies show increasing prevalence rates of cognitive decline and hearing loss with age, particularly after the age of 65 years. These conditions are reported to be associated, although conclusive evidence of causality and implications is lacking. Nevertheless, audiological and cognitive assessment among elderly people is a key target for comprehensive and multidisciplinary evaluation of the subject's frailty status. To evaluate the use of tools for identifying older adults at risk of hearing loss and cognitive decline and to compare skills and abilities in terms of hearing and cognitive performances between older adults and young subjects, we performed a prospective cross-sectional study using supraliminal auditory tests. The relationship between cognitive assessment results and audiometric results was investigated, and reference ranges for different ages or stages of disease were determined. Patients older than 65 years with different degrees of hearing function were enrolled. Each subject underwent an extensive audiological assessment, including tonal and speech audiometry, Italian Matrix Sentence Test, and speech audiometry with logatomes in quiet. Cognitive function was screened and then verified by experienced clinicians using the Montreal Cognitive Assessment Score, the Geriatric Depression Scale, and further investigations in some. One hundred twenty-three subjects were finally enrolled during 2016-2019: 103 were >65 years of age and 20 were younger participants (as controls). Cognitive functions showed a correlation with the audiological results in post-lingual hearing-impaired patients, in particular in those affected by slight to moderate hearing loss and aged more than 70 years. Audiological testing can thus be useful in clinical
Frontiers in aging neuroscience, 2014
Normal-hearing older adults often experience increased difficulties understanding speech in noise. In addition, they benefit less from amplitude fluctuations in the masker. These difficulties may be attributed to an age-related auditory temporal processing deficit. However, a decline in cognitive processing likely also plays an important role. This study examined the relative contribution of declines in both auditory and cognitive processing to the speech in noise performance in older adults. Participants included older (60-72 years) and younger (19-29 years) adults with normal hearing. Speech reception thresholds (SRTs) were measured for sentences in steady-state speech-shaped noise (SS), 10-Hz sinusoidally amplitude-modulated speech-shaped noise (AM), and two-talker babble. In addition, auditory temporal processing abilities were assessed by measuring thresholds for gap, amplitude-modulation, and frequency-modulation detection. Measures of processing speed, attention, working memo...
European Journal of Ageing
Age-related changes in auditory processing and speech perception: Cross-sectional and longitudinal analyses Age-related differences in speech perception has been shown in previous crosssectional studies to be related to auditory temporal processing. We examined this association in both cross-sectional and longitudinal designs, controlling for agerelated changes in hearing sensitivity and cognitive ability. Fifty-eight participants were tested in two phases. In phase 1, ages ranged between 22 and 82 years. Phase 2 occurred seven years later. In both phases, participants performed auditory processing tasks, speech perception tests, and cognitive tasks. In both phases, age correlated with hearing level, auditory temporal processing thresholds, word recognition accuracy in noise, and compressed speech. Auditory temporal processing thresholds were correlated with word recognition accuracy in narrowband noise and compressed speech. Longitudinal analysis showed significant decreases in performance from phase 1 to phase 2 in hearing level, dichotic TOJ thresholds, and word recognition accuracy. Steeper slopes were observed in phase 2 than in phase 1 for correlations between age, hearing level, and word recognition accuracy in narrowband noise, but not for age and dichotic TOJ thresholds. Generalized Estimating Equations revealed an overall decrease in word recognition accuracy from phase 1 to phase 2; this decrease was larger for older participants. Increases in dichotic TOJ and gap detection thresholds were associated with a decrease over time in speech in narrowband and broadband noise, and compressed speech, even when adjusted for age, hearing level and cognitive ability. These results show that both cross-sectional and longitudinal designs yield similar significant associations between temporal processing and speech perception, even when adjusted for hearing level and cognitive ability.
Korean Journal of Audiology, 2014
This study investigated the effect of ageing on speech perception in quiet and in noise, with noise directed from front, right and left. Subjects and Methods: Sixty Malay native adults with normal or near normal hearing comprising of 20 young adults (21 to 39 years old), 20 middle aged (40 to 59 years old) and 20 older adults (60 to 74 years old) participated in this study. Their speech perception ability was measured using the Malay Hearing in Noise Test (HINT) in four test conditions; 1) in quiet (HINT Q), 2) with noise from front (HINT NF), 3) with noise from right (HINT NR), and 4) with noise from left (HINT NL). Reception thresholds for sentences (RTSs) were measured in each of the aforementioned conditions using an adaptive method. Results: The results showed that, 1) genuine age-related decline was found in speech perception performance in HINT (NF), 2) hearing threshold was a major determinant differentiating speech perception performance for HINT (Q) and HINT (NL) conditions, and 3) speech perception performance for HINT (NR) was determined by both age and hearing threshold. Conclusions: This study suggests that, in older adults, while hearing thresholds affect speech perception in quiet, other factors such as central auditory processing and cognitive functions might be more important determinant factors for speech perception performance in noise.
Clinical Otolaryngology, 2017
Background: Age-related hearing loss (ARHL) is highly prevalent in older adults and more than two-thirds above age 70 years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment, however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in over-estimation of cognitive impairment in such individuals. This baseline cross-sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non-verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined.
Frontiers in Human Neuroscience
Noise-vocoded speech is commonly used to simulate the sensation after cochlear implantation as it consists of spectrally degraded speech. High individual variability exists in learning to understand both noise-vocoded speech and speech perceived through a cochlear implant (CI). This variability is partly ascribed to differing cognitive abilities like working memory, verbal skills or attention. Although clinically highly relevant, up to now, no consensus has been achieved about which cognitive factors exactly predict the intelligibility of speech in noise-vocoded situations in healthy subjects or in patients after cochlear implantation. We aimed to establish a test battery that can be used to predict speech understanding in patients prior to receiving a CI. Young and old healthy listeners completed a noise-vocoded speech test in addition to cognitive tests tapping on verbal memory, working memory, lexicon and retrieval skills as well as cognitive flexibility and attention. Partial-least-squares analysis revealed that six variables were important to significantly predict vocoded-speech performance. These were the ability to perceive visually degraded speech tested by the Text Reception Threshold, vocabulary size assessed with the Multiple Choice Word Test, working memory gauged with the Operation Span Test, verbal learning and recall of the Verbal Learning and Retention Test and task switching abilities tested by the Comprehensive Trail-Making Test. Thus, these cognitive abilities explain individual differences in noise-vocoded speech understanding and should be considered when aiming to predict hearing-aid outcome.