The Neural Consequences of Age-Related Hearing Loss

Abstract

During hearing, acoustic signals travel up the ascending auditory pathway from the cochlea to auditory cortex; efferent connections provide descending feedback. In human listeners, although auditory and cognitive processing have sometimes been viewed as separate domains, a growing body of work suggests they are intimately coupled. Here we review the effects of hearing loss on neural systems supporting spoken language comprehension, beginning with age-related physiological decline. We suggest that listeners recruit domain general executive systems to maintain successful communication when the auditory signal is degraded, but that this compensatory processing has behavioral consequences: even relatively mild levels of hearing loss can lead to cascading cognitive effects that impact perception, comprehension, and memory, leading to increased listening effort during speech comprehension.

Effort Not Speed Characterizes Comprehension of Spoken Sentences by Older Adults with Mild Hearing Impairment

“…Among the interventions available for age-associated performance declines, addressing the immediate (Wingfield and Lash, 2016) and long-term (Lin, 2011; Peelle and Wingfield, 2016) cognitive consequences of hearing impairment is among the most direct. The delay in seeking hearing healthcare thus remains a critical public health issue.…”

“…Yet, barring significant neuropathology or serious hearing impairment, comprehension of spoken language remains one of the best-preserved of our cognitive functions (Wingfield and Stine-Morrow, 2000; Peelle and Wingfield, 2016). Underlying this success, however, one may still ask: (1) whether such comprehension occurs as rapidly for older adults relative to younger adults; and (2) whether older adults’ success at speech comprehension requires more effort compared to younger adults.…”

Age-Related Deterioration of Perineuronal Nets in the Primary Auditory Cortex of Mice

“…In the auditory realm, this is exemplified by the relationship between age-related hearing loss (presbycusis), speech recognition problems, social isolation, depression and cognitive decline (Weinstein and Ventry, 1982; Gordon-Salant et al, 2006; Panza et al, 2015; Wayne and Johnsrude, 2015; Deal et al, 2016; Peelle and Wingfield, 2016). Presbycusis affects ~35% of humans older than 65 and ~45% of humans older than 75 years (Gates and Mills, 2005).…”

Neural decoding of attentional selection in multi-speaker environments without access to clean sources

“…To subjectively test the preference of users on the quality of the audio output of our system in a multi-speaker scenario, we performed a psychoacoustic experiment (see Methods). Because it is known that listening effort is increased for those with hearing impairments in multi-speaker scenarios [4, 5], we measured the subjective quality of the output of our system by asking listeners to rate (from 1 to 5) the difficulty of attending to the target speaker (Mean Opinion Score, MOS). All but one subject reported a larger MOS when the system was on, with a median MOS of 3.87 (25th percentile, 3.73; 75th percentile, 4.12) versus a median MOS of 3.5 (25th percentile, 2.9; 75th percentile, 3.8) when the system was off (figure 8(B)), which was a significant increase in MOS (Wilcoxon signed-rank test, p <0.001).…”