Manner of Speech and Its Influence on Speech Understanding in Older Patients with Impaired Hearing

Purpose Type 2 diabetes mellitus (DM2) is associated with impaired hearing. However, the evidence is less clear if DM2 can lead to difficulty understanding speech in complex acoustic environments, independently of age and hearing loss effects. The purpose of this study was to estimate the magnitude of DM2-related effects on speech understanding in the presence of competing speech after adjusting for age and hearing. Method A cross-sectional study design was used to investigate the relationship between DM2 and speech understanding in 190 Veterans ( M age = 47 years, range: 25–76). Participants were classified as having no diabetes ( n = 74), prediabetes ( n = 19), or DM2 that was well controlled ( n = 24) or poorly controlled ( n = 73). A test of spatial release from masking (SRM) was presented in a virtual acoustical simulation over insert earphones with multiple talkers using sentences from the coordinate response measure corpus to determine the target-to-masker ratio (TMR) required for 50% correct identification of target speech. A linear mixed model of the TMR results was used to estimate SRM and separate effects of diabetes group, age, and low-frequency pure-tone average (PTA-low) and high-frequency pure-tone average. A separate model estimated the effects of DM2 on PTA-low. Results After adjusting for hearing and age, diabetes-related effects remained among those whose DM2 was well controlled, showing an SRM loss of approximately 0.5 dB. Results also showed effects of hearing loss and age, consistent with the literature on people without DM2. Low-frequency hearing loss was greater among those with DM2. Conclusions In a large cohort of Veterans, low-frequency hearing loss and older age negatively impact speech understanding. Compared with nondiabetics, individuals with controlled DM2 have additional auditory deficits beyond those associated with hearing loss or aging. These results provide a potential explanation for why individuals who have diabetes and/or are older often report difficulty understanding speech in real-world listening environments. Supplemental Material https://doi.org/10.23641/asha.16746475

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Influence, Characteristics of Clear Speech for Older Patients with Impaired Hearing

The Hearing Journal ◽

10.1097/01.hj.0000795652.89298.f0 ◽

2021 ◽

Vol 74 (10) ◽

pp. 28,29

Author(s):

Raymond H. Hull

Keyword(s):

Older Patients ◽

Impaired Hearing ◽

Clear Speech

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Unilateral versus Bilateral Amplification for Adults with Impaired Hearing

Journal of the American Academy of Audiology ◽

10.3766/jaaa.16.8.6 ◽

2005 ◽

Vol 16 (08) ◽

pp. 574-584 ◽

Cited By ~ 33

Author(s):

Therese C. Walden ◽

Brian E. Walden

Keyword(s):

Speech Recognition ◽

Test Scores ◽

Background Noise ◽

Older Patients ◽

Deleterious Effect ◽

Impaired Hearing ◽

Speech In Noise ◽

Hearing Thresholds ◽

Noise Test ◽

The Right

This study compared unilateral and bilateral aided speech recognition in background noise in 28 patients being fitted with amplification. Aided QuickSIN (Quick Speech-in-Noise test) scores were obtained for bilateral amplification and for unilateral amplification in each ear. In addition, right-ear directed and left-ear directed recall on the Dichotic Digits Test (DDT) was obtained from each participant. Results revealed that the vast majority of patients obtained better speech recognition in background noise on the QuickSIN from unilateral amplification than from bilateral amplification. There was a greater tendency for bilateral amplification to have a deleterious effect among older patients. Most frequently, better aided QuickSIN performance was obtained in the right ear of participants, despite similar hearing thresholds in both ears. Finally, patients tended to perform better on the DDT in the ear that provided less SNR loss on the QuickSIN. Results suggest that bilateral amplification may not always be beneficial in every daily listening environment when background noise is present, and it may be advisable for patients wearing bilateral amplification to remove one hearing aid when difficulty is encountered understanding speech in background noise.

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Aging and Autism

Perspectives on Gerontology ◽

10.1044/gero17.2.69 ◽

2012 ◽

Vol 17 (2) ◽

pp. 69-75 ◽

Cited By ~ 1

Author(s):

Pamela A. Smith

Keyword(s):

Health Care ◽

Autism Spectrum Disorders ◽

Patient Group ◽

Older Patients ◽

Geriatric Patients ◽

Recent Literature ◽

Communication Disorders ◽

Autism Spectrum ◽

Need For Support ◽

Spectrum Disorders

In this article, I will review the available recent literature about the aging population with autism, a patient group that researchers know little about and a group that is experiencing a growing need for support from communication disorders professionals. Speech-language pathologists working with geriatric patients should become familiar with this issue, as the numbers of older patients with autism spectrum disorders is likely to increase. Our profession and our health care system must prepare to meet the challenge these patients and residents will present as they age.

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