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Ashrafi M, Baghban AA. Dynamic Spatial Auditory Processing in the Elderly. Indian J Otolaryngol Head Neck Surg 2024; 76:3031-3036. [PMID: 39130326 PMCID: PMC11306474 DOI: 10.1007/s12070-024-04581-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/25/2024] [Indexed: 08/13/2024] Open
Abstract
Purpose One of the most obvious functional effects of aging on the cognitive and processing processes of spatial hearing is the localization problem and the disorder of speech perception in noise. The purpose of the present study is to investigate the performance of dynamic spatial auditory processing in the elderly. Methods This descriptive and analytical study was conducted on 60 young participants aged from18 to 25 years old and 60 elderly participants aged from 60 to 75 old years, using speech, spatial, and qualities of hearing scale (SSQ) questionnaire, binaural masking level difference (BMLD) and dynamic quick speech in noise (DS-QSIN) tests. Results Comparing the average scores of the tests and the questionnaire using the independent t test showed a significant difference between the two groups (p < 0.001). It was also found that gender had no effect on the results (p > 0.05). Conclusions Aging is accompanied by different structural and functional changes in the auditory central nervous system, which leads to a decrease in speech perception in challenging listening environments, as well as a decrease in sound localization abilities, due to the reduction of temporal and spectral information. This problem affects the determination of the source of sound and the spatial cognition of the elderly and leads to a disturbance in the awareness of the auditory environment. Therefore, auditory rehabilitation programs can cause the improvement of spatial auditory processing performance and improve speech perception in noise in the elderly.
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Affiliation(s)
- Majid Ashrafi
- Department of Audiology, Faculty of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Fitzgerald MB, Ward KM, Gianakas SP, Smith ML, Blevins NH, Swanson AP. Speech-in-Noise Assessment in the Routine Audiologic Test Battery: Relationship to Perceived Auditory Disability. Ear Hear 2024; 45:816-826. [PMID: 38414136 PMCID: PMC11175785 DOI: 10.1097/aud.0000000000001472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 12/07/2023] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Self-assessment of perceived communication difficulty has been used in clinical and research practices for decades. Such questionnaires routinely assess the perceived ability of an individual to understand speech, particularly in background noise. Despite the emphasis on perceived performance in noise, speech recognition in routine audiologic practice is measured by word recognition in quiet (WRQ). Moreover, surprisingly little data exist that compare speech understanding in noise (SIN) abilities to perceived communication difficulty. Here, we address these issues by examining audiometric thresholds, WRQ scores, QuickSIN signal to noise ratio (SNR) loss, and perceived auditory disability as measured by the five questions on the Speech Spatial Questionnaire-12 (SSQ12) devoted to speech understanding (SSQ12-Speech5). DESIGN We examined data from 1633 patients who underwent audiometric assessment at the Stanford Ear Institute. All individuals completed the SSQ12 questionnaire, pure-tone audiometry, and speech assessment consisting of ear-specific WRQ, and ear-specific QuickSIN. Only individuals with hearing threshold asymmetries ≤10 dB HL in their high-frequency pure-tone average (HFPTA) were included. Our primary objectives were to (1) examine the relationship between audiometric variables and the SSQ12-Speech5 scores, (2) determine the amount of variance in the SSQ12-Speech5 scores which could be predicted from audiometric variables, and (3) predict which patients were likely to report greater perceived auditory disability according to the SSQ12-Speech5. RESULTS Performance on the SSQ12-Speech5 indicated greater perceived auditory disability with more severe degrees of hearing loss and greater QuickSIN SNR loss. Degree of hearing loss and QuickSIN SNR loss were found to account for modest but significant variance in SSQ12-Speech5 scores after accounting for age. In contrast, WRQ scores did not significantly contribute to the predictive power of the model. Degree of hearing loss and QuickSIN SNR loss were also found to have moderate diagnostic accuracy for determining which patients were likely to report SSQ12-Speech5 scores indicating greater perceived auditory disability. CONCLUSIONS Taken together, these data indicate that audiometric factors including degree of hearing loss (i.e., HFPTA) and QuickSIN SNR loss are predictive of SSQ12-Speech5 scores, though notable variance remains unaccounted for after considering these factors. HFPTA and QuickSIN SNR loss-but not WRQ scores-accounted for a significant amount of variance in SSQ12-Speech5 scores and were largely effective at predicting which patients are likely to report greater perceived auditory disability on the SSQ12-Speech5. This provides further evidence for the notion that speech-in-noise measures have greater clinical utility than WRQ in most instances as they relate more closely to measures of perceived auditory disability.
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Affiliation(s)
- Matthew B. Fitzgerald
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Kristina M. Ward
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Steven P. Gianakas
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
- Department of Speech-Language-Hearing, Boys Town National Research Hospital, Omaha, Nebraska, USA
| | - Michael L. Smith
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN
| | - Nikolas H. Blevins
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
| | - Austin P. Swanson
- Department of Otolaryngology—Head and Neck Surgery, Stanford University, Palo Alto, California, USA
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Nisha KV, Uppunda AK, Konadath S. Effects of Maturation and Chronological Aging on Auditory Spatial Processing: A Cross-Sectional Study Across Life Span. Am J Audiol 2023; 32:119-134. [PMID: 36548963 DOI: 10.1044/2022_aja-22-00113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE The primary aim of the research was to document spatial acuity changes across the life span using a battery of psychoacoustical and perceptual tests. The secondary aim was to identify the optimal metric for measuring spatial processing changes across the life span (ages 10-70 years). DESIGN AND STUDY SAMPLE A cross-sectional study comprising 115 participants with clinically normal hearing was conducted. Purposive sampling was adopted to recruit participants in the study, who were divided into six groups based on their chronological age. METHOD Temporal, intensity, spectral, and composite correlates of spatial acuity were assessed using psychoacoustic measures and perceptual questionnaires. The temporal (interaural time difference [ITD]) and intensity correlates (interaural level difference [ILD]) of spatial perception were obtained using a MATLAB (v 2020a), whereas the composite correlate (virtual auditory space identification scores [VASIs]) and perceptual ratings of spatial processing were measured using Paradigm software and speech spatial and qualities in Kannada (SSQ-K). RESULTS Results across all tests (multivariate analyses variance: 6 age groups × 4 tests, followed by post hoc tests) consistently demonstrate poor ITD and ILD thresholds and overall lower spatial accuracy (VASI, SSQ-K) with increasing age. Discriminant function analyses (DFAs) revealed that VASI had a higher predictive power in capturing age-related changes in auditory spatial processing. The group segregation on spatial performance in DFA became evident after 50 years. CONCLUSION This study provides evidence of gradual change in all three correlates of spatial processing, with statistically demonstrable deficits appearing from fourth decade of life on VASI and fifth decade of life on binaural processing.
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Affiliation(s)
| | - Ajith Kumar Uppunda
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru
| | - Sreeraj Konadath
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru
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Skalleberg J, Myhrum M, Småstuen MC, Osnes TA, Fosså SD, Bunne M. Speech perception 30 years after cisplatin-based chemotherapy in adults: limited clinical relevance of long-term ototoxicity? Acta Oncol 2021; 60:426-433. [PMID: 33617403 DOI: 10.1080/0284186x.2021.1887514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Cisplatin-based chemotherapy (CBCT) can cause high-frequency hearing loss, but little is known about the development and clinical relevance of this hearing loss in survivors of adult-onset cancer with very long-term follow-up. This case-control study investigates hearing and speech perception both in quiet and with background noise 30-years after CBCT. PATIENTS AND METHODS One-hundred-and-one patients (Cases) who received CBCT for testicular cancer between 1980 and 1994 were assessed with pure-tone audiometry (.125 - 8 kHz) and speech perception tests including hearing in noise test (HINT). Self-reported hearing and tinnitus was scored by participants. Results were compared with 30 age-matched controls. RESULTS The median age of Cases and Controls was 60 (46 - 83) and 61 years (51 - 74), respectively. The median observation time for Cases was 30 years (22 - 37). Compared with Controls, Cases had 8 and 19 dB worse age-adjusted high-frequency hearing at 6 and 8 kHz, respectively (p <.05), while thresholds at lower frequencies did not differ. All but four Cases reached 100% speech perception with basic speech audiometry. There was no difference between Cases and Controls in speech perception neither in quiet nor with both speech and background noise from the front, although the within-group variance was greater among Cases. Cases scored slightly worse with speech from front and noise from either side. Self-reported hearing loss (both hearing loss in general and specifically with background noise), and tinnitus were about three times more common among Cases compared with Controls. CONCLUSIONS Cisplatin causes high-frequency hearing loss, but speech perception tests performed both in quiet and in background noise 30 years post-treatment indicate that the clinical relevance is limited for most patients. Few patients develop severe hearing loss that requires rehabilitation but it is important to identify these patients. Self-reported hearing loss and tinnitus were more common among Cases compared with Controls.
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Affiliation(s)
- J. Skalleberg
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - M. Myhrum
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - M. C. Småstuen
- Department of Health Science and Biostatistics, Oslo Metropolitan University, Oslo, Norway
| | - T. A. Osnes
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - S. D. Fosså
- National Resource Center for Late Effects After Cancer Treatment, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | - M. Bunne
- Department of Otolaryngology, Head and Neck Surgery, Oslo University Hospital, Oslo, Norway
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Kartal A, Konukseven O. Age-related altering temporal processing and binaural interaction functions in normal hearing individuals: Observational and cross-sectional study. Auris Nasus Larynx 2020; 48:615-621. [PMID: 33277137 DOI: 10.1016/j.anl.2020.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the temporal processing and binaural interaction functions of central auditory processing tests according to the anatomical localizations of young and elderly individuals. It also sought to evaluate the relationships between the same individuals' central auditory processing tests. METHODS This observational and cross-sectional study included individuals with normal hearing between 18 and 30 and 60-75 years of age, who were referred to as the young group and the elderly group, respectively. The evaluation of the central auditory processing tests was completed using the frequency pattern test, duration pattern test, masking level difference test, and random gap detection test. Furthermore, speech discrimination and speech in noise scores were analyzed for both groups. RESULTS Statistically significant differences were identified between the groups' scores for the speech in noise test, masking level difference test, random gap detection test, frequency pattern test, and duration pattern test (p < 0.05). A statistically significant relationship was observed between the age and the results of the central auditory processing tests (p < 0.05). CONCLUSION When compared to younger individuals, elderly individuals presented with declined temporal sequences, temporal resolutions, and binaural interaction skills.
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Affiliation(s)
- Ahsen Kartal
- University of Health Sciences, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey.
| | - Ozlem Konukseven
- Istanbul Aydin University, Faculty of Health Sciences, Department of Audiology, Istanbul, Turkey
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Cañete OM, Marfull D, Torrente MC, Purdy SC. The Spanish 12-item version of the Speech, Spatial and Qualities of Hearing scale (Sp-SSQ12): adaptation, reliability, and discriminant validity for people with and without hearing loss. Disabil Rehabil 2020; 44:1419-1426. [PMID: 32721200 DOI: 10.1080/09638288.2020.1795279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Because of the limited number of Spanish validated questionnaires available to assess auditory functionality in daily life situations in adults, the purpose of this study was to investigate the validity and the reliability of the Spanish version of the Speech, Spatial and Qualities of Hearing 12 items scale (sp-SSQ12), adapted from the published Spanish SSQ49, and to provide reference data for normal and hearing-impaired populations. METHODS The SSQ12 is a self-report questionnaire, consisting of 12 items assessing a range of daily life listening situations. One hundred fifty adults (101 female) with a mean age of 53.9 years (SD 20.3; range 20-88 years) took part in the study. Internal consistency, test-retest reliability, validity, and floor and ceiling effects were investigated. RESULTS The sp-SSQ12 questionnaire had high internal consistency (Cronbach's alpha = 0.95) and test-retest scores were highly correlated (ICC = 0.79). There was minimal evidence of floor and ceiling effects in our sample. Significant differences were observed overall and for the three subscales between normal and hearing-impaired groups. Although some significant differences in SSQ12 scores between groups of participants from different countries, these differences were minimal. CONCLUSIONS The sp-SSQ12 questionnaire is a valid and reliable tool that is easy to administer and requires a short time to answer. We recommend the use of this tool for the assessment of functional hearing in the Spanish-speaking population.Implication for rehabilitationHearing loss impacts people's lives in a number of ways that are captured in the SSQ.The sp-SSQ12 is a valid and reliable tool for assessing everyday listening abilities and limitations experienced by Spanish-speaking adults with hearing loss.The sp-SSQ12 can be incorporated in the hearing rehabilitation process as a tool for evaluating and improving hearing assessment and rehabilitation programs.The sp-SSQ12 can help to identify adults who require a comprehensive hearing assessment.
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Affiliation(s)
- Oscar M Cañete
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Daphne Marfull
- Escuela de Fonoaudiología, Universidad de Valparaíso, Valparaíso, Chile
| | - Mariela C Torrente
- Servicio de Otorrinolaringología, Hospital Padre Hurtado, Santiago, Chile.,Departamento de Otorrinolaringología, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Suzanne C Purdy
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand.,Eisdell Moore Centre for Research in Hearing and Balance, Auckland, New Zealand
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