Speech Perception in Older Adults: An Interplay of Hearing, Cognition, and Learning?

Abstract

Older adults with age-related hearing loss exhibit substantial individual differences in speech perception in adverse listening conditions. We propose that the ability to rapidly adapt to changes in the auditory environment (i.e., perceptual learning) is among the processes contributing to these individual differences, in addition to the cognitive and sensory processes that were explored in the past. Seventy older adults with age-related hearing loss participated in this study. We assessed the relative contribution of hearing acuity, cognitive factors (working memory, vocabulary, and selective attention), rapid perceptual learning of time-compressed speech, and hearing aid use to the perception of speech presented at a natural fast rate (fast speech), speech embedded in babble noise (speech in noise), and competing speech (dichotic listening). Speech perception was modeled as a function of the other variables. For fast speech, age [odds ratio (OR) = 0.79], hearing acuity (OR = 0.62), pre-learning (baseline) perception of time-compressed speech (OR = 1.47), and rapid perceptual learning (OR = 1.36) were all significant predictors. For speech in noise, only hearing and pre-learning perception of time-compressed speech were significant predictors (OR = 0.51 and OR = 1.53, respectively). Consistent with previous findings, the severity of hearing loss and auditory processing (as captured by pre-learning perception of time-compressed speech) was strong contributors to individual differences in fast speech and speech in noise perception. Furthermore, older adults with good rapid perceptual learning can use this capacity to partially offset the effects of age and hearing loss on the perception of speech presented at fast conversational rates. Our results highlight the potential contribution of dynamic processes to speech perception.

A review of auditory processing and cognitive change during normal ageing, and the implications for setting hearing aids for older adults

“…Inhibition, which a sub-domain of executive function ( Figure 1 ), and processing speed are also cognitive functions associated with reduced auditory performance ( 87–89 ). Different domains of cognition appear to be more strongly predictive of listening ability for more difficult listening tasks ( 90 , 91 ). A meta-analysis ( 92 ) provided an overview over various cognitive functions and their association with different SIN tasks.…”

Characteristics of the Summating Potential Measured Across a Cochlear Implant Array as an Indicator of Cochlear Function

“…It must be noted that while these differences are statistically significant, they are modest in size and clinical impact. It is also acknowledged that speech perception is affected by other factors apart from cochlear tissue states including etiology, age, cognition and level of education, which were not controlled for in this study ( Heutink et al 2021 ; Shechter Shvartzman et al 2022 ). No significant differences were seen in the most complex auditory task of speech-in noise (SRT); the lack of difference between groups here might reflect the low ceiling limit of this test.…”

Alpha and theta oscillations on a visual strategic processing task in age-related hearing loss

“…Value-directed strategic processing subsumes other attentional processes, including selective attention ( Anderson, 2013 ). In the context of ARHL, selective attention has been long examined ( Barr and Giambra, 1990 ; Craik, 2007 ; Shinn-Cunningham and Best, 2008 ; Van Gerven and Guerreiro, 2016 ; Dai et al, 2018 ), especially in the context of speech recognition ( Humes and Dubno, 2010 ; Nuesse et al, 2018 ; Fuglsang et al, 2020 ; Shechter Shvartzman et al, 2022 ). On various tasks, such as coordinate response measure ( Humes et al, 2006 , 2017 ), attentive matrices ( Bonmassar et al, 2022 ), n- back with distracting stimuli ( Guerreiro and Van Gerven, 2017 ), Stroop ( Guerreiro and Van Gerven, 2017 ; Gillingham et al, 2018 ; Ren et al, 2019 ; Huber et al, 2020 ; Chavant and Kapoula, 2022 ), and dichotic listening tasks ( Shinn-Cunningham and Best, 2008 ; Torrente et al, 2022 ), studies have found alterations in selective attention in older adults with ARHL relative to younger and older adults with normal hearing.…”