scholarly journals Central Presbycusis: A Review and Evaluation of the Evidence

2012 ◽  
Vol 23 (08) ◽  
pp. 635-666 ◽  
Author(s):  
Larry E. Humes ◽  
Judy R. Dubno ◽  
Sandra Gordon-Salant ◽  
Jennifer J. Lister ◽  
Anthony T. Cacace ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Speech Perception ◽  
Auditory Processing ◽  
Temporal Discrimination ◽  
Speech Understanding ◽  
Negative Effects ◽  
Behavioral Measures ◽  
Compressed Speech ◽  
Competing Speech

Background: The authors reviewed the evidence regarding the existence of age-related declines in central auditory processes and the consequences of any such declines for everyday communication. Purpose: This report summarizes the review process and presents its findings. Data Collection and Analysis: The authors reviewed 165 articles germane to central presbycusis. Of the 165 articles, 132 articles with a focus on human behavioral measures for either speech or nonspeech stimuli were selected for further analysis. Results: For 76 smaller-scale studies of speech understanding in older adults reviewed, the following findings emerged: (1) the three most commonly studied behavioral measures were speech in competition, temporally distorted speech, and binaural speech perception (especially dichotic listening); (2) for speech in competition and temporally degraded speech, hearing loss proved to have a significant negative effect on performance in most of the laboratory studies; (3) significant negative effects of age, unconfounded by hearing loss, were observed in most of the studies of speech in competing speech, time-compressed speech, and binaural speech perception; and (4) the influence of cognitive processing on speech understanding has been examined much less frequently, but when included, significant positive associations with speech understanding were observed.For 36 smaller-scale studies of the perception of nonspeech stimuli by older adults reviewed, the following findings emerged: (1) the three most frequently studied behavioral measures were gap detection, temporal discrimination, and temporal-order discrimination or identification; (2) hearing loss was seldom a significant factor; and (3) negative effects of age were almost always observed.For 18 studies reviewed that made use of test batteries and medium-to-large sample sizes, the following findings emerged: (1) all studies included speech-based measures of auditory processing; (2) 4 of the 18 studies included nonspeech stimuli; (3) for the speech-based measures, monaural speech in a competing-speech background, dichotic speech, and monaural time-compressed speech were investigated most frequently; (4) the most frequently used tests were the Synthetic Sentence Identification (SSI) test with Ipsilateral Competing Message (ICM), the Dichotic Sentence Identification (DSI) test, and time-compressed speech; (5) many of these studies using speech-based measures reported significant effects of age, but most of these studies were confounded by declines in hearing, cognition, or both; (6) for nonspeech auditory-processing measures, the focus was on measures of temporal processing in all four studies; (7) effects of cognition on nonspeech measures of auditory processing have been studied less frequently, with mixed results, whereas the effects of hearing loss on performance were minimal due to judicious selection of stimuli; and (8) there is a paucity of observational studies using test batteries and longitudinal designs. Conclusions: Based on this review of the scientific literature, there is insufficient evidence to confirm the existence of central presbycusis as an isolated entity. On the other hand, recent evidence has been accumulating in support of the existence of central presbycusis as a multifactorial condition that involves age- and/or disease-related changes in the auditory system and in the brain. Moreover, there is a clear need for additional research in this area.

scholarly journals Study of Acute and Sub-Acute Effects of Auditory Training on the Central Auditory Processing in Older Adults with Hearing Loss—A Pilot Study

2020 ◽  
Vol 17 (14) ◽  
pp. 4944
Author(s):  
Carla Matos Silva ◽  
Carolina Fernandes ◽  
Clara Rocha ◽  
Telmo Pereira
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Speech Perception ◽  
Auditory Processing ◽  
Test Group ◽  
Auditory Training ◽  
Central Auditory Processing ◽  
Speech In Noise ◽  
Noise Test ◽  
Group 1

Background: Impairment in speech perception is a common feature of older adults. This study aimed at evaluating the acute and sub-acute (after three months) effects of auditory training on central auditory processing in older people with hearing loss. Methods: A nonrandomized study was conducted enrolling 15 older adults with hearing loss and an average age of 78.6 ± 10.9 years. All participants underwent a baseline otoscopy, tympanogram, audiogram and speech-in-noise test with a signal-noise ratio (SNR) of 10 and 15 dB. Afterwards, auditory training intervention was implemented consisting of 10 training sessions over 5 weeks. Participants were divided into two groups: group 1 (G1) underwent auditory training based on a speech-in-noise test; group 2 (G2) underwent a filtered-speech test. Auditory processing was evaluated at baseline (T0) immediately after the intervention (T1) and 3 months after the intervention (T2). Results: Group 1 were quite efficient regardless of the SNR in the right ear with statistically significant differences from T0 to T1 (p = 0.003 and p = 0.006 for 10 dB and 15 dB, respectively) and T0 to T2 (p = 0.011 and 0.015 for 10 dB and 15 dB, respectively). As for the left ear, the increase of success was statistically significant for the SNR of 10 dB and 15 dB from T0 to T1 (p = 0.001 and p = 0.014, respectively) and from T0 to T2 (p = 0.016 and p = 0.003). In G2, there was a significant variation only from T0 for T1 in the left ear for an SNR of 10 dB (p = 0.001). Conclusion: Speech perception in noise significantly improved after auditory training in old adults.

scholarly journals Speech Understanding in Modulated Noise and Speech Maskers as a Function of Cognitive Status in Older Adults

2021 ◽  
pp. 1-13
Author(s):  
Sara K. Mamo ◽  
Karen S. Helfer
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Speech Perception ◽  
Matched Control ◽  
Cognitive Status ◽  
Speech Understanding ◽  
Mild Dementia ◽  
Perception Task ◽  
Hearing Status ◽  
Competing Speech

Objectives The purpose of this study was to investigate the impact of different types of maskers on speech understanding as a function of cognitive status in older adults. The hypothesis tested was that individuals with a diagnosis of mild cognitive impairment (MCI) or mild dementia would perform like their age- and hearing status–matched control counterparts in modulated noise but would perform more poorly in the presence of competing speech. Design Participants ( n = 39; age range: 55–77 years old) performed a speech-in-noise task and completed two cognitive screening tests and a measure of working memory. Sentences were presented in the presence of two types of maskers (i.e., speech envelope–modulated noise and two-talker, same-sex competing speech). Two analyses were undertaken: (a) a between-groups comparison of individuals diagnosed with MCI/dementia, individuals who failed both cognitive screeners (possible MCI), and age- and hearing status–matched neurologically healthy control individuals and (b) a mixed-model analysis of variance of speech perception performance as a function of working memory capacity. Results The between-groups comparison yielded significant group differences for speech understanding in both masking conditions, with the MCI/dementia group performing more poorly than the neurologically healthy controls and possible MCI groups. A single measure of working memory (Size Comparison Span [SICSPAN]) was correlated with performance on the speech perception task in the competing speech conditions. Conclusions Adults with a diagnosis of MCI or mild dementia performed more poorly on a speech perception task than their age- and hearing status–matched control counterparts in the presence of both maskers, with larger group mean differences when the target speech was presented in a two-talker masker. This suggests increased difficulty understanding speech in the presence of distracting backgrounds for people with MCI/dementia. Future studies should consider how to target this potentially vulnerable population as they may be experiencing increased difficulty communicating in challenging environments.

scholarly journals Competing Speech Perception in Middle Age

2015 ◽  
Vol 24 (2) ◽  
pp. 80-83 ◽  
Author(s):  
Karen S. Helfer
Keyword(s):  
Older Adults ◽  
Speech Perception ◽  
Aging Process ◽  
Middle Age ◽  
Speech Understanding ◽  
Middle Aged ◽  
Listening Environments ◽  
Middle Aged Adults ◽  
Competing Speech

Purpose This research forum article summarizes research from our laboratory that assessed middle-aged adults' ability to understand speech in the presence of competing talkers. Method The performance of middle-aged adults on laboratory-based speech understanding tasks was compared to that of younger and older adults. Results Decline in the ability to understand speech in complex listening environments can be demonstrated in midlife. The specific auditory and cognitive contributors to these problems have yet to be established. Conclusion There is evidence that the ability to understand a target speech message in the presence of competing speech messages changes relatively early in the aging process. The nature and impact of these changes warrant further investigation.

The Effect of Conventional and Transparent Surgical Masks on Speech Understanding in Individuals with and without Hearing Loss

2017 ◽  
Vol 28 (01) ◽  
pp. 058-067 ◽  
Author(s):  
Samuel R. Atcherson ◽  
Lisa Lucks Mendel ◽  
Wesley J. Baltimore ◽  
Chhayakanta Patro ◽  
Sungmin Lee ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Impairment ◽  
Visual Input ◽  
Acoustic Properties ◽  
Speech Understanding ◽  
Profound Hearing Loss ◽  
Cross Sectional ◽  
Surgical Masks ◽  
Significant Difference

AbstractIt is generally well known that speech perception is often improved with integrated audiovisual input whether in quiet or in noise. In many health-care environments, however, conventional surgical masks block visual access to the mouth and obscure other potential facial cues. In addition, these environments can be noisy. Although these masks may not alter the acoustic properties, the presence of noise in addition to the lack of visual input can have a deleterious effect on speech understanding. A transparent (“see-through”) surgical mask may help to overcome this issue.To compare the effect of noise and various visual input conditions on speech understanding for listeners with normal hearing (NH) and hearing impairment using different surgical masks.Participants were assigned to one of three groups based on hearing sensitivity in this quasi-experimental, cross-sectional study.A total of 31 adults participated in this study: one talker, ten listeners with NH, ten listeners with moderate sensorineural hearing loss, and ten listeners with severe-to-profound hearing loss.Selected lists from the Connected Speech Test were digitally recorded with and without surgical masks and then presented to the listeners at 65 dB HL in five conditions against a background of four-talker babble (+10 dB SNR): without a mask (auditory only), without a mask (auditory and visual), with a transparent mask (auditory only), with a transparent mask (auditory and visual), and with a paper mask (auditory only).A significant difference was found in the spectral analyses of the speech stimuli with and without the masks; however, no more than ∼2 dB root mean square. Listeners with NH performed consistently well across all conditions. Both groups of listeners with hearing impairment benefitted from visual input from the transparent mask. The magnitude of improvement in speech perception in noise was greatest for the severe-to-profound group.Findings confirm improved speech perception performance in noise for listeners with hearing impairment when visual input is provided using a transparent surgical mask. Most importantly, the use of the transparent mask did not negatively affect speech perception performance in noise.

Speech Understanding Using Surgical Masks: A Problem in Health Care?

2008 ◽  
Vol 19 (09) ◽  
pp. 686-695 ◽  
Author(s):  
Lisa Lucks Mendel ◽  
Julie A. Gardino ◽  
Samuel R. Atcherson
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Speech Perception ◽  
Hearing Impairment ◽  
Deleterious Effect ◽  
Normal Hearing ◽  
Speech Understanding ◽  
Speech Stimuli ◽  
Dental Office ◽  
Significant Difference

Background: Successful communication is necessary in health-care environments. Yet the presence of noise in hospitals, operating rooms, and dental offices may have a deleterious effect on health-care personnel and patients understanding messages accurately. The presence of a surgical mask and hearing loss may further affect speech perception. Purpose: To evaluate whether a surgical mask had an effect on speech understanding for listeners with normal hearing and hearing impairment when speech stimuli were administered in the presence or absence of dental office noise. Research Design: Participants were assigned to one of two groups based on hearing sensitivity in this quasi-experimental, cross-sectional study. Study Sample: A total of 31 adults participated in this study (1 talker, 15 listeners with normal hearing, and 15 with hearing impairment). The normal hearing group had thresholds of 25 dB HL or better at the octave frequencies from 250 through 8000 Hz while the hearing loss group had varying degrees and configurations of hearing loss with thresholds equal to or poorer than 25 dB HL for the same octave frequencies. Data Collection And Analysis: Selected lists from the Connected Speech Test (CST) were digitally recorded with and without a surgical mask present and then presented to the listeners in four conditions: without a mask in quiet, without a mask in noise, with a mask in quiet, and with a mask in noise. Results: A significant difference was found in the spectral analyses of the speech stimuli with and without the mask. The presence of a surgical mask, however, did not have a detrimental effect on speech understanding in either the normal-hearing or hearing-impaired groups. The dental office noise did have a significant effect on speech understanding for both groups. Conclusions: These findings suggest that the presence of a surgical mask did not negatively affect speech understanding. However, the presence of noise did have a deleterious effect on speech perception and warrants further attention in health-care environments.

Physiological and Neurobiological Bases of Age-Related Hearing Loss: Biotherapeutic Implications

2013 ◽  
Vol 22 (2) ◽  
pp. 299-302 ◽  
Author(s):  
Robert D. Frisina ◽  
D. Robert Frisina
Keyword(s):  
Hearing Loss ◽  
Auditory Processing ◽  
Stria Vascularis ◽  
Positive Influence ◽  
Negative Effects ◽  
Age Related ◽  
Women And Aging ◽  
Auditory Tasks ◽  
And Function ◽  
Age Related Hearing Loss

Purpose The aim of this study was to highlight growing evidence of interactions between hormones and the structure and function of the auditory system. Method Recent studies implicating sex hormones and other natural hormones in the modulation of hearing status in age-related hearing loss were reviewed. Results Progesterone, a sex hormone, has been shown to have negative effects on the hearing of older women and aging mice, whereas, in contrast, estrogen was found in some cases to have a positive influence. Aldosterone, used in studies of animal models of autoimmune hearing loss, slowed the progression of hearing loss. Follow-up studies in humans revealed that auditory measures varied as serum aldosterone levels shifted within the normal range, in otherwise healthy older subjects. This was true for simple as well as complex auditory tasks (i.e., sound spatial processing), suggesting benefits of aldosterone to postperipheral auditory processing as well. In addition, evidence suggests that this functional hearing improvement occurred in association with anatomical improvements to the stria vascularis—an important site of anatomical change in presbycusis. Conclusions Audiology is now at the point where the search for biomedical interventions to modulate or prevent age-related hearing loss can move forward. Such interventions would require multidisciplinary collaborative initiatives by researchers in such areas as drug development, anatomy, auditory physiological and perceptual testing, and drug microdelivery systems.

Hearing Loss, Aging, and Speech Perception in Reverberation and Noise

1990 ◽  
Vol 33 (1) ◽  
pp. 149-155 ◽  
Author(s):  
Karen S. Helfer ◽  
Laura A. Wilber
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Speech Perception ◽  
Sensorineural Hearing Loss ◽  
Pure Tone ◽  
Nonsense Syllable ◽  
Normal Hearing ◽  
Four Levels ◽  
Reverberant Speech ◽  
Pure Tone Threshold

The present investigation examined the effect of reverberation and noise on the perception of nonsense syllables by four groups of subjects: younger (≤35 years of age) and older (>60 years of age) listeners with mild-to-moderate sensorineural hearing loss; younger, normal-hearing individuals; and older adults with minimal peripheral hearing loss. Copies of the Nonsense Syllable Test (Resnick, Dubno, Huffnung, & Levitt, 1975) were re-recorded under four levels of reverberation (0.0, 0.6, 0.9, 1.3 s) in quiet and in cafeteria noise at + 10 dB S:N. Results suggest that both age and amount of pure-tone hearing loss contribute to senescent changes in the ability to understand noisy, reverberant speech: pure-tone threshold and age were correlated negatively with performance in reverberation plus noise, although age and pure-tone hearing loss were not correlated with each other. Further, many older adults with minimal amounts of peripheral hearing loss demonstrated difficulty understanding distorted consonants.

scholarly journals Differences Between Young and Older Adults in Working Memory and Performance on the Test of Basic Auditory Capabilities†

2022 ◽  
Vol 12 ◽  
Author(s):  
Larry E. Humes ◽  
Gary R. Kidd ◽  
Jennifer J. Lentz
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Young Adults ◽  
Hearing Loss ◽  
Auditory Processing ◽  
Local Community ◽  
Age Groups ◽  
Age Group ◽  
Regression Analyses ◽  
Age Related

The Test of Basic Auditory Capabilities (TBAC) is a battery of auditory-discrimination tasks and speech-identification tasks that has been normed on several hundred young normal-hearing adults. Previous research with the TBAC suggested that cognitive function may impact the performance of older adults. Here, we examined differences in performance on several TBAC tasks between a group of 34 young adults with a mean age of 22.5 years (SD = 3.1 years) and a group of 115 older adults with a mean age of 69.2 years (SD = 6.2 years) recruited from the local community. Performance of the young adults was consistent with prior norms for this age group. Not surprisingly, the two groups differed significantly in hearing loss and working memory with the older adults having more hearing loss and poorer working memory than the young adults. The two age groups also differed significantly in performance on six of the nine measures extracted from the TBAC (eight test scores and one average test score) with the older adults consistently performing worse than the young adults. However, when these age-group comparisons were repeated with working memory and hearing loss as covariates, the groups differed in performance on only one of the nine auditory measures from the TBAC. For eight of the nine TBAC measures, working memory was a significant covariate and hearing loss never emerged as a significant factor. Thus, the age-group deficits observed initially on the TBAC most often appeared to be mediated by age-related differences in working memory rather than deficits in auditory processing. The results of these analyses of age-group differences were supported further by linear-regression analyses with each of the 9 TBAC scores serving as the dependent measure and age, hearing loss, and working memory as the predictors. Regression analyses were conducted for the full set of 149 adults and for just the 115 older adults. Working memory again emerged as the predominant factor impacting TBAC performance. It is concluded that working memory should be considered when comparing the performance of young and older adults on auditory tasks, including the TBAC.

scholarly journals Text captioning buffers against the effects of background noise and hearing loss on memory for speech

2020 ◽  
Author(s):  
Brennan Payne ◽  
Jack Silcox ◽  
Hannah Crandell ◽  
Amanda Lash ◽  
Sarah Hargus Ferguson ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Recognition Memory ◽  
Background Noise ◽  
Negative Effects ◽  
Memory Accuracy ◽  
Immediate Recall ◽  
Hearing Acuity ◽  
Delayed Recognition ◽  
Memory Confidence

AbstractObjectives. Everyday speech understanding frequently occurs in perceptually demanding environments, for example due to background noise and normal age-related hearing loss. The resulting degraded speech signals increase listening effort, which gives rise to negative downstream effects on subsequent memory and comprehension, even when speech is intelligible. In two experiments, we explored whether the presentation of realistic assistive text captioned speech offsets the negative effects of background noise and hearing impairment on multiple measures of speech memory.Design. In Experiment 1, young normal hearing adults (N = 48) listened to sentences for immediate recall and delayed recognition memory. Speech was presented in quiet or in two levels of background noise. Sentences were either presented as speech only or as text captioned speech. Thus, the experiment followed a 2 (caption vs no caption) x 3 (no noise, +7 dB SNR, +3 dB SNR) within-subjects design. In Experiment 2, a group of older adults (age range : 61 – 80, N = 31), with varying levels of hearing acuity completed the same experimental task as in Experiment 1. For both experiments, immediate recall, recognition memory accuracy, and recognition memory confidence were analyzed via general(ized) linear mixed effects models. In addition, we examined individual differences as a function of hearing acuity in Experiment 2.Results. In Experiment 1, we found that the presentation of realistic text-captioned speech in young normal-hearing listeners improved immediate recall, delayed recognition memory accuracy, and memory confidence compared to speech alone. Moreover, text captions attenuated the negative effects of background noise on all speech memory outcomes. In Experiment 2, we replicated the same pattern of results in a sample of older adults with varying levels of hearing acuity. Moreover, we showed that the negative effects of hearing loss on speech memory in older adulthood were attenuated by the presentation of text captions.Conclusion. Collectively, these findings suggest that listeners can rapidly integrate text and speech, and that the simultaneous presentation of text can offset the negative effects of effortful listening on speech memory.

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