\s=b\The performance intensity-phonetically balanced (PI-PB) and performance intensity-synthetic sentence identification (PI-SSI) functions were determined for 62 elderly patients (100 ears) with presbyacusis. A comparison of these functions was performed to determine whether patients older than 60 years exhibited peripheral or central PI-PB/PI-SSI patterning. Fifty-eight ears of the 100 ears examined showed central patterning. Furthermore, two diagnostically important central patterns were identified. The implications of the current data as well as the clinical application of PI \ x=r eq-\ PB/PI-SSI testing for the evaluation of peripheral and central auditory effects in aged listeners are described. (Arch Otolaryngol 1982;108:15-20) The use of performance intensity (PI) functions has expanded the scope of diagnostic speech audiometry in the last several years.San Francisco, CA 94121 (Dr Arnst).Hayes4 have advocated that complete PI functions for both phonetically bal¬ anced (PB) word lists and synthetic sentences be included as part of the routine audiologic test battery. The results of their investigation indi¬ cated that, when viewed together, spe¬ cific relationships exist between the PI-PB/PI-synthetic sentence identifi¬ cation (SSI) functions that differen¬ tiate cochlear, eighth nerve, and more central sites of auditory dysfunction.Jerger and Hayes4 also reported that aged listeners with presbyacusis demonstrated peculiar patterning when the PI-PB/PI-SSI functions were compared. Instead of producing the anticipated cochlear results, these listeners showed a central pattern with depressed PI-SSI performance relative to PI-PB performance. Simi¬ lar patterning has been observed in younger subjects with confirmed cen¬ tral auditory dysfunction. Jerger and Hayes4 attributed this PI-PB/PI-SSI discrepancy to a "central aging effect."To define the central aging effect more clearly, Jerger and Hayes4 ana¬ lyzed the PI-PB/PI-SSI test results of 204 subjects, ranging in age from 10 to 90 years, with sensorineural hearing loss. Their analysis disclosed the fol¬ lowing: (1) Performance on both sets of materials decreased as a function of increasing age. (2) The PI-SSI perfor¬ mance was more depressed than the PI-PB performance with increasing age. (3) Onset of the central aging effect was observed to occur at approximately 60 years of age. After the age of 60 years, the PI-PB/PI-SSI discrepancy was observed to increase. (4) The magnitude of the central aging effect was found to be greater for the right ear.The purpose of this study was to investigate the age-related effects and patterning with the PI-PB/PI-SSI functions in patients older than 60 years. The following questions were considered specifically: (1) Is there more than one age-related pattern?(2) Is the PI-PB/PI-SSI discrepancy observed in one or both ears? When it is observed in both ears, is the magni¬ tude of the discrepancy equal? SUBJECTS AND METHODS SubjectsThere were 62 subjects chosen from our clinic files, ranging in age from 60 to 85

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