Why do older adults have difficulty following conversations?

Spatial selective auditory attention is preserved in older age but is degraded by peripheral hearing loss

Interest in how ageing affects attention is long-standing, although interactions between sensory and attentional processing in older age are not fully understood. Here, we examined interactions between peripheral hearing and selective attention in a spatialised cocktail party listening paradigm, in which three talkers spoke different sentences simultaneously and participants were asked to report the sentence spoken by a talker at a particular location. By comparing a sample of older (N = 61; age = 55-80 years) and younger (N = 58; age = 18-35 years) adults, we show that, as a group, older adults benefit as much as younger adults from preparatory spatial attention. Although, for older adults, this benefit significantly reduces with greater age-related hearing loss. These results demonstrate that older adults with excellent hearing retain the ability to direct spatial selective attention, but this ability deteriorates, in a graded manner, with age-related hearing loss. Thus, reductions in spatial selective attention likely contribute to difficulties communicating in social settings for older adults with age-related hearing loss. Overall, these findings demonstrate a relationship between mild perceptual decline and attention in older age.

Tech vs. Tradition: ChatGPT and Mindfulness in Enhancing Older Adults' Emotional Health

To improve older adults' mental health, this study compared the effects of AI chatbots, such as ChatGPT 3.0, with traditional mindfulness therapies on loneliness and depression in older adults. Despite interest in AI as a complementary tool, empirical evidence on its impact remains limited. For an eight-week intervention, older adult participants from two nursing homes in Hangzhou were assigned to groups focused on mindfulness (group sessions) and chatting (one-on-one ChatGPT). Following the intervention, participants engaged in a researcher-led focus group discussion. After 8 weeks, tension had decreased significantly (p < 0.05) in the Mindfulness group of older adults, and there was no significant difference between the effects of ChatGPT and mindfulness on the emotional intervention of older adults. Findings indicated three themes, including (1) personal experience, reflecting older adults' use of AI technology and mindfulness; (2) attitudes and perspectives on the experiment's desirability and insufficiencies; and (3) needs and expectations for future AI and mindfulness developments, including usability and functional preferences. Similar to mindfulness practice, ChatGPT interactions helped older adults feel less depressed and might eventually reduce costs by replacing mindfulness. In the future, AI can be integrated with conventional techniques to improve interaction by giving AI a more human-like appearance.

Pragmatic Skills in Late Adulthood

Research investigating pragmatic abilities in healthy aging suggests that both production and comprehension might be compromised; however, it is not clear how pragmatic abilities evolve in late adulthood, as well as when difficulties are more likely to arise. The aim of this study is to investigate the decline of pragmatic skills in aging, and to explore what cognitive and demographic factors support pragmatic competence. We assessed pragmatic production skills, including discourse abilities such as speech, informativeness, information flow, paralinguistic aspects, as well as the ability to produce informative descriptions of pictures, and pragmatic comprehension skills, which encompassed the ability to understand discourse and the main aspects of a narrative text, to infer non-literal meanings and to comprehend verbal humor in a group of elderly individuals and in a sample of younger participants. Moreover, specific cognitive functions (short-term memory, verbal and visuospatial working memory, inhibition Theory of Mind, and Cognitive Reserve) were assessed in both groups. Pragmatic difficulties seem to occur in late adulthood, likely around 70 years, and emerge more prominently when participants are asked to understand verbal humor. Age was the only predictor of general pragmatic performance in a sample of cognitively unimpaired older adults; conversely, when elderly individuals with less intact inhibitory control are considered, a general role of inhibition emerged, in addition to working memory and ToM in specific tasks.

Interactions between acoustic challenges and processing depth in speech perception as measured by task-evoked pupil response

Speech perception under adverse conditions is a multistage process involving a dynamic interplay among acoustic, cognitive, and linguistic factors. Nevertheless, prior research has primarily focused on factors within this complex system in isolation. The primary goal of the present study was to examine the interaction between processing depth and the acoustic challenge of noise and its effect on processing effort during speech perception in noise. Two tasks were used to represent different depths of processing. The speech recognition task involved repeating back a sentence after auditory presentation (higher-level processing), while the tiredness judgment task entailed a subjective judgment of whether the speaker sounded tired (lower-level processing). The secondary goal of the study was to investigate whether pupil response to alteration of dynamic pitch cues stems from difficult linguistic processing of speech content in noise or a perceptual novelty effect due to the unnatural pitch contours. Task-evoked peak pupil response from two groups of younger adult participants with typical hearing was measured in two experiments. Both tasks (speech recognition and tiredness judgment) were implemented in both experiments, and stimuli were presented with background noise in Experiment 1 and without noise in Experiment 2. Increased peak pupil dilation was associated with deeper processing (i.e., the speech recognition task), particularly in the presence of background noise. Importantly, there is a non-additive interaction between noise and task, as demonstrated by the heightened peak pupil dilation to noise in the speech recognition task as compared to in the tiredness judgment task. Additionally, peak pupil dilation data suggest dynamic pitch alteration induced an increased perceptual novelty effect rather than reflecting effortful linguistic processing of the speech content in noise. These findings extend current theories of speech perception under adverse conditions by demonstrating that the level of processing effort expended by a listener is influenced by the interaction between acoustic challenges and depth of linguistic processing. The study also provides a foundation for future work to investigate the effects of this complex interaction in clinical populations who experience both hearing and cognitive challenges.

The psychology of the internet fraud victimization of older adults: A systematic review

Criminals targeting and exploiting older adults in online environments are of great concern. This study systematically retrieved and analyzed articles on the psychological characteristics of older adult victims of online fraud. First, we found that there was no evidence that older adults were more prevalent than other individuals of other ages among online fraud victims, and current researchers have focused more on why older adults are easy targets for fraud (susceptibility to being cheated). Second, research on psychological factors of older adults' susceptibility to online fraud has mainly focused on cognitive function, trust traits, and other personality traits, such as social loneliness, the Big Five personality traits, and self-control. Among them, most researchers claim that the cyber-cheating of older adults may be due to a decline in their cognitive function. However, there has not been a consensus on how cognitive function and physical and mental conditions affect older people who are cheated. Third, techniques (i.e., methods and techniques used by fraudsters) and experience (i.e., familiarity with internet technology or fraud) may be related to the susceptibility of older adults to fraud, and these studies have also not yet generated a consensus supported by reliable data. Based on the above research uncertainties, we propose that fraud prevention and control strategies for older adults should be applied with caution.

A cross-sectional study to assess pragmatic strengths and weaknesses in healthy ageing

Background

Ageing refers to the natural and physiological changes that individuals experience over the years. This process also involves modifications in terms of communicative-pragmatics, namely the ability to convey meanings in social contexts and to interact with other people using various expressive means, such as linguistic, extralinguistic and paralinguistic aspects of communication. Very few studies have provided a complete assessment of communicative-pragmatic performance in healthy ageing.

Methods

The aim of this study was to comprehensively assess communicative-pragmatic ability in three samples of 20 (N = 60) healthy adults, each belonging to a different age range (20–40, 65–75, 76–86 years old) and to compare their performance in order to observe any potential changes in their ability to communicate. We also explored the potential role of education and sex on the communicative-pragmatic abilities observed. The three age groups were evaluated with a between-study design by means of the Assessment Battery for Communication (ABaCo), a validated assessment tool characterised by five scales: linguistic, extralinguistic, paralinguistic, contextual and conversational.

Results

The results indicated that the pragmatic ability assessed by the ABaCo is poorer in older participants when compared to the younger ones (main effect of age group: F(2,56) = 9.097; p < .001). Specifically, significant differences were detected in tasks on the extralinguistic, paralinguistic and contextual scales. Whereas the data highlighted a significant role of education (F(1,56) = 4.713; p = .034), no sex-related differences were detected.

Conclusions

Our results suggest that the ageing process may also affect communicative-pragmatic ability and a comprehensive assessment of the components of such ability may help to better identify difficulties often experienced by older individuals in their daily life activities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03304-z.

Sound Localization of Listeners With Normal Hearing, Impaired Hearing, Hearing Aids, Bone-Anchored Hearing Instruments, and Cochlear Implants: A Review

PURPOSE

This review article reviews the contemporary studies of localization ability for different populations in different listening environments and provides possible future research directions.

CONCLUSIONS

The ability to accurately localize a sound source relying on three cues (interaural time difference, interaural level difference, and spectral cues) is important for communication, learning, and safety. Confounding effects including noise and reverberation, which exist in common listening environments, mask or alter localization cues and negatively affect localization performance. Hearing loss, a common public health issue, also affects localization accuracy. Although hearing devices have been developed to provide excellent audibility of speech signals, less attention has been paid to preserving and replicating crucial localization cues. Unique challenges are faced by users of various hearing devices, including hearing aids, bone-anchored hearing instruments, and cochlear implants. Hearing aids have failed to consistently improve localization performance and, in some cases, significantly impair sound localization. Bone-conduction hearing instruments show little to no benefit for sound localization performance in most cases, although some improvement is seen in binaural users. Although cochlear implants provide great hearing benefit to individuals with severe-to-profound sensorineural hearing loss, cochlear implant users have significant difficulty localizing sound, even with two implants. However, technologies in each of these areas are advancing to reduce interference with desired sound signals and preserve localization cues to help users achieve better hearing and sound localization in real-life environments.

Do Age and Linguistic Status Alter the Effect of Sound Source Diffuseness on Speech Recognition in Noise?

One aspect of auditory scenes that has received very little attention is the level of diffuseness of sound sources. This aspect has increasing importance due to growing use of amplification systems. When an auditory stimulus is amplified and presented over multiple, spatially-separated loudspeakers, the signal's timbre is altered due to comb filtering. In a previous study we examined how increasing the diffuseness of the sound sources might affect listeners' ability to recognize speech presented in different types of background noise. Listeners performed similarly when both the target and the masker were presented via a similar number of loudspeakers. However, performance improved when the target was presented using a single speaker (compact) and the masker from three spatially separate speakers (diffuse) but worsened when the target was diffuse, and the masker was compact. In the current study, we extended our research to examine whether the effects of timbre changes with age and linguistic experience. Twenty-four older adults whose first language was English (Old-EFLs) and 24 younger adults whose second language was English (Young-ESLs) were asked to repeat non-sense sentences masked by either Noise, Babble, or Speech and their results were compared with those of the Young-EFLs previously tested. Participants were divided into two experimental groups: (1) A Compact-Target group where the target sentences were presented over a single loudspeaker, while the masker was either presented over three loudspeakers or over a single loudspeaker; (2) A Diffuse-Target group, where the target sentences were diffuse while the masker was either compact or diffuse. The results indicate that the Target Timbre has a negligible effect on thresholds when the timbre of the target matches the timbre of the masker in all three groups. When there is a timbre contrast between target and masker, thresholds are significantly lower when the target is compact than when it is diffuse for all three listening groups in a Noise background. However, while this difference is maintained for the Young and Old-EFLs when the masker is Babble or Speech, speech reception thresholds in the Young-ESL group tend to be equivalent for all four combinations of target and masker timbre.

Cortical Tracking of Speech in Delta Band Relates to Individual Differences in Speech in Noise Comprehension in Older Adults

OBJECTIVES

Understanding speech in adverse listening environments is challenging for older adults. Individual differences in pure tone averages and working memory are known to be critical indicators of speech in noise comprehension. Recent studies have suggested that tracking of the speech envelope in cortical oscillations <8 Hz may be an important mechanism related to speech comprehension by segmenting speech into words and phrases (delta, 1 to 4 Hz) or phonemes and syllables (theta, 4 to 8 Hz). The purpose of this study was to investigate the extent to which individual differences in pure tone averages, working memory, and cortical tracking of the speech envelope relate to speech in noise comprehension in older adults.

DESIGN

Cortical tracking of continuous speech was assessed using electroencephalography in older adults (60 to 80 years). Participants listened to speech in quiet and in the presence of noise (time-reversed speech) and answered comprehension questions. Participants completed Forward Digit Span and Backward Digit Span as measures of working memory, and pure tone averages were collected. An index of reduction in noise (RIN) was calculated by normalizing the difference between raw cortical tracking in quiet and in noise.

RESULTS

Comprehension question performance was greater for speech in quiet than for speech in noise. The relationship between RIN and speech in noise comprehension was assessed while controlling for the effects of individual differences in pure tone averages and working memory. Delta band RIN correlated with speech in noise comprehension, while theta band RIN did not.

CONCLUSIONS

Cortical tracking by delta oscillations is robust to the effects of noise. These findings demonstrate that the magnitude of delta band RIN relates to individual differences in speech in noise comprehension in older adults. Delta band RIN may serve as a neural metric of speech in noise comprehension beyond the effects of pure tone averages and working memory.

The Effect of Hearing Aid Use on Cognition in Older Adults: Can We Delay Decline or Even Improve Cognitive Function?

Hearing loss is a modifiable risk factor for dementia in older adults. Whether hearing aid use can delay the onset of cognitive decline is unknown. Participants in this study (aged 62–82 years) were assessed before and 18 months after hearing aid fitting on hearing, cognitive function, speech perception, quality of life, physical activity, loneliness, isolation, mood, and medical health. At baseline, multiple linear regression showed hearing loss and age predicted significantly poorer executive function performance, while tertiary education predicted significantly higher executive function and visual learning performance. At 18 months after hearing aid fitting, speech perception in quiet, self-reported listening disability and quality of life had significantly improved. Group mean scores across the cognitive test battery showed no significant decline, and executive function significantly improved. Reliable Change Index scores also showed either clinically significant improvement or stability in executive function for 97.3% of participants, and for females for working memory, visual attention and visual learning. Relative stability and clinically and statistically significant improvement in cognition were seen in this participant group after 18 months of hearing aid use, suggesting that treatment of hearing loss with hearing aids may delay cognitive decline. Given the small sample size, further follow up is required.

The Effects of Age and Hearing Loss on Dual-Task Balance and Listening

Objectives

Among older adults (OA), hearing loss is associated with an increased risk for falls. The aim of the present study was to experimentally investigate the cognitive compensation hypothesis, wherein decreased auditory and motor functioning are compensated by the recruitment of cognitive resources.

Method

Twenty-nine younger adults (YA), 26 OA, and 32 OA with age-related hearing loss (ARHL) completed a dual-task paradigm consisting of cognitive and balance recovery tasks performed singly and concurrently. The auditory stimuli were presented with or without background noise.

Results

Both older adult groups performed significantly worse than YA on the cognitive task in noisy conditions and ARHL also demonstrated disproportionate negative effects of dual-tasking and noise. The kinematic data indicated that OA and ARHL demonstrated greater plantarflexion when compared with YA. Conversely, YA showed greater hip extension in response to dual-tasking.

Discussion

The cognitive and balance results suggest that YA were able to flexibly allocate their attention between tasks, whereas ARHL exhibited prioritization of posture over cognitive performance.

Spatial Release From Masking Under Different Reverberant Conditions in Young and Elderly Subjects: Effect of Moving or Stationary Maskers at Circular and Radial Conditions

Purpose Normal-hearing and hard-of-hearing listeners suffer from reduced speech intelligibility in noisy and reverberant environments. Although daily listening environments are in constant motion, most researchers have only studied speech-in-noise perception for stationary masker locations. The aim of this study was to investigate the spatial release from masking (SRM) of circularly and radially moving maskers under different room acoustic conditions for young and elderly subjects. Method Twelve young subjects with normal hearing and 12 elderly subjects with normal hearing or mild hearing loss were tested. Several different room acoustic conditions were simulated and reproduced via headphones using binaural synthesis. The target speech stream consisted of German digit triplets, and masker stream consisted of quasistationary noise with matched long-term averaged speech spectra. During the experiment, the position of the masker was changed to be in different stationary positions, or varied continuously. In the latter case, it was moved either on a circular trajectory spanning a 90° azimuth angle or on a radial trajectory linearly increasing the distance to the receiver from 0.5 m to 1.8 m. Absorption characteristics of the virtual room's surfaces were changed, recreating an anechoic room, a treated room with mean reverberation times (RT60) = 0.48 s, and an untreated room with mean RT60 = 1.26 s. Results For the circular condition, a significant difference was found between moving and stationary maskers, F(4, 44) = 20.91, p < .001, with a bigger SRM for stationary maskers than moving masker conditions. Also, both age groups displayed a significant decrease in SRM over the reverberation conditions: F(2, 22) = 12.24, p < .001. For the radial condition, both age groups showed a significant decrease in SRM over the reverberation conditions, F(2, 22) = 13.62, p < .001, as well as the moving and stationary masker conditions, F(8, 88) = 29.23, p < .001. In general, the SRM of a moving masker decreased when the reverberation increased, especially for elderly subjects. Conclusions A radially moving masker led to improved SRM in an anechoic environment for both age groups, whereas a circularly moving masker caused degraded SRM, especially for elderly subjects in the highly reverberant environment. Supplemental Material https://doi.org/10.23641/asha.9795371.

The Effect of Cochlear Implants on Cognitive Function in Older Adults: Initial Baseline and 18-Month Follow Up Results for a Prospective International Longitudinal Study

In older adults, hearing loss is independently associated with an increased rate of cognitive decline, and has been identified to be a modifiable risk factor for dementia. The mechanism underlying the cognitive decline associated with hearing loss is not understood, but it is known that the greater the hearing loss, the faster the rate of decline. It is unknown whether remediation of hearing loss with hearing devices can delay cognitive decline. This 5-year international longitudinal study is investigating the impact of cochlear implants on cognitive function in older people with severe-profound hearing loss, and whether remediation of hearing loss could delay the onset of cognitive impairment. This is the first study to examine the major primary risk factors associated with dementia in the same cohort. Participants were assessed before cochlear implantation and 18 months later using an identical battery including a visually presented cognitive assessment tool (Cogstate battery) that is highly sensitive to small changes in cognition and suitable for use with people with hearing loss. Hearing and speech perception ability were assessed in sound-treated conditions by an audiologist, and a range of questionnaire tools was administered to assess self-perceived ease of listening, quality of life, physical activity, diet, social and emotional loneliness, isolation, anxiety, and depression. A detailed medical health history was taken. Pre-operatively, despite the small initial sample size (n = 59), increased hearing loss and age predicted significantly poorer executive function and visual attention, while tertiary education predicted better executive function. Better self-reported quality of life was correlated with better visual learning performance, and engaging in frequent vigorous physical activity was correlated with poorer visual learning performance. At 18 months, for the first 20 participants, significant benefits of cochlear implants were seen in terms of speech perception, communication ability, and quality of life. Multiple linear regression modeling showed executive function improved significantly for non-tertiary educated males, while cognitive function remained stable for other participants. Further follow-up at 18 month intervals with a larger sample will reveal the effects of cochlear implant intervention on all outcomes, and whether this can delay cognitive decline.

Defining organizational contributions to sustaining an ageing workforce: a bibliometric review

The ageing of populations worldwide has implications for workforces in developed countries, and labour shortages have increasingly become a political concern. Governments in developed countries have responded by increasing the retirement age as a strategy for overcoming the fall in labour supply. Using bibliometric techniques, we reviewed 122 articles published between 1990 and 2018 to examine the effectiveness of the strategy in addressing the labour shortages and, in particular, to identify the factors that contribute positively to maintaining worker participation within an ageing workforce at an organizational level. The results identified five organizational factors that support continued participation: health, institutions, human resource management, human capital and technology tools. Employers will increasingly need to develop "age-friendly" workplaces and practices if they are to recruit and retain older workers.

Effect of improving audibility on better-ear glimpsing using non-linear amplification

Better-ear glimpsing (BEG) utilizes interaural level differences (ILDs) to improve speech intelligibility in noise. This spatial benefit is reduced in most hearing-impaired (HI) listeners due to their increased hearing loss at high frequencies. Even though this benefit can be improved by providing increased amplification, the improvement is limited by loudness discomfort. An alternative solution therefore extends ILDs to low frequencies, which has been shown to provide a substantial benefit from BEG. In contrast to previous studies, which only applied linear stimulus manipulations, wide dynamic range compression was applied here to improve the audibility of soft sounds while ensuring loudness comfort for loud sounds. Performance in both speech intelligibility and BEG was measured in 13 HI listeners at three different masker levels and for different interaural stimulus manipulations. The results revealed that at low signal levels, performance substantially improved with increasing masker level, but this improvement was reduced by the compressive behaviour at higher levels. Moreover, artificially extending ILDs by applying infinite (broadband) ILDs provided an extra spatial benefit in speech reception thresholds of up to 5 dB on top of that already provided by natural ILDs and interaural time differences, which increased with increasing signal level.

On Dynamic Pitch Benefit for Speech Recognition in Speech Masker

Previous work demonstrated that dynamic pitch (i.e., pitch variation in speech) aids speech recognition in various types of noises. While this finding suggests dynamic pitch enhancement in target speech can benefit speech recognition in noise, it is of importance to know what noise characteristics affect dynamic pitch benefit, and who will benefit from enhanced dynamic pitch cues. Following our recent finding that temporal modulation in noise influences dynamic pitch benefit, we examined the effect of speech masker characteristics on dynamic pitch benefit. Specifically, the first goal of the study was to test the hypothesis that dynamic pitch benefit varies depending on the availability of pitch cues in the masker and the intelligibility of masker. The second goal of this study was to investigate whether older listeners as a group can benefit from dynamic pitch for speech recognition in speech maskers. In addition, individual factors of hearing loss and working memory capacity were examined for their impact on older listeners' dynamic pitch benefit. Twenty-three younger listeners with normal hearing and 37 older listeners with varying levels of hearing sensitivity participated the study, in which speech reception thresholds were measured with sentences in speech maskers. While we did not find an effect of masker characteristics on dynamic pitch benefit, the results showed older listeners can benefit from dynamic pitch for recognizing speech in speech maskers. The data also suggest that among those older listeners with hearing loss, dynamic pitch benefit is stronger for individuals with higher working memory capacity. This can be attributed to their ability to exploit facilitated lexical access in processing of degraded speech signal.

Older Adults Experiences of Learning to Use Tablet Computers: A Mixed Methods Study

Background: We wanted to understand older adults’ experiences of learning how to use a tablet computer in the context of an intervention trial, including what they found helpful or unhelpful about the tablet training, to guide future intervention studies.

Methods: Mixed methods study using questionnaire and focus group approaches. Forty-three participants aged between 65 and 76 years old from the “Tablet for Healthy Ageing” study (comprising 22 in the intervention group and 21 controls) completed a post-intervention tablet experience questionnaire. Those who completed the tablet training intervention were invited to share their experiences of engaging with new technology in post-intervention focus groups. We conducted three separate focus groups with 14 healthy older adults (10 females).

Results: Questionnaire data suggested that the overall experience of the 22 participants who participated in the tablet training intervention was positive. The majority of participants said that it was likely or very likely they would use a tablet in the future. The focus group themes that emerged were related to the perception of tablet training, the experience of using tablets, and suggestions for future studies. Participants mentioned that their confidence was increased, that they enjoyed being part of a social group and downloading applications, but they also felt challenged at times. Advantages of using tablets included the ability to keep in touch with family and friends, a motivation to contribute to the community, and the potential for tablets to improve mental abilities and overall health and wellbeing. Participants made suggestions that would enable tablet usage, including improvement of features, and suggestions that would improve future tablet training studies, including smaller classes.

Conclusion: Our findings have implications for the development of interventions utilizing new technologies that might promote the health and wellbeing of older adults.

The impact of different background noises on the Production Effect

The presence of background noise has been previously shown to disrupt cognitive performance, especially memory. The amount of interference is derived from the acoustic characteristics of the noise; energetic vs. informational, steady-state vs. fluctuating. However, the literature is inconsistent concerning the effects of different types of noise on long-term memory free recall. In the present study, we tested the impact of different noises on recall of items that were learned under two conditions - silent or aloud reading, a Production Effect (PE) paradigm. As the PE represents enhanced memory for words read aloud relative to words read silently during study, we focused on the effect of noise on this robust memory phenomenon. The results showed that (a) steady-state energetic noise did not affect memory, with a recall advantage for aloud words (PE), comparable to a no-noise condition, (b) fluctuating-energetic noise and fluctuating-informational (eight-talkers babble) noise eliminated the PE, with similar recall for aloud and silent items. These results are discussed in light of their theoretical implications, stressing the role of attention in the PE. Ecological implications regarding studying in noisy environments are suggested.

Age-Related Changes in Objective and Subjective Speech Perception in Complex Listening Environments

PURPOSE

A frequent complaint by older adults is difficulty communicating in challenging acoustic environments. The purpose of this work was to review and summarize information about how speech perception in complex listening situations changes across the adult age range.

METHOD

This article provides a review of age-related changes in speech understanding in complex listening environments and summarizes results from several studies conducted in our laboratory.

RESULTS

Both degree of high frequency hearing loss and cognitive test performance limit individuals' ability to understand speech in difficult listening situations as they age. The performance of middle-aged adults is similar to that of younger adults in the presence of noise maskers, but they experience substantially more difficulty when the masker is 1 or 2 competing speech messages. For the most part, middle-aged participants in studies conducted in our laboratory reported as much self-perceived hearing problems as did older adult participants.

CONCLUSIONS

Research supports the multifactorial nature of listening in real-world environments. Current audiologic assessment practices are often insufficient to identify the true speech understanding struggles that individuals experience in these situations. This points to the importance of giving weight to patients' self-reported difficulties.

PRESENTATION VIDEO

http://cred.pubs.asha.org/article.aspx?articleid=2601619.

Continued search for better prediction of aided speech understanding in multi-talker environments

To better understand issues of hearing-aid benefit during natural listening, this study examined the added demand placed by the goal of understanding speech over the more typically studied goal of simply recognizing speech sounds. The study compared hearing-aid benefit in two conditions, and examined factors that might account for the observed benefits. In the phonetic condition, listeners needed only identify the correct sound to make a correct response. In the semantic condition, listeners had to understand what they had heard to respond correctly, because the answer did not include any keywords from the spoken speech. Hearing aids provided significant benefit for listeners in the phonetic condition. In the semantic condition on the other hand, there were large inter-individual differences, with many listeners not experiencing any benefit of aiding. Neither a set of cognitive and linguistic tests, nor age, could explain this variability. Furthermore, analysis of psychometric functions showed that enhancement of the target speech fidelity through improvement of signal-to-noise ratio had a larger impact on listeners' performance in the phonetic condition than in the semantic condition. These results demonstrate the importance of incorporating naturalistic elements in the simulation of multi-talker listening for assessing the benefits of intervention in communication success.

Evaluation of the NAL Dynamic Conversations Test in older listeners with hearing loss

OBJECTIVE

The National Acoustic Laboratories Dynamic Conversations Test (NAL-DCT) is a new test of speech comprehension that incorporates a realistic environment and dynamic speech materials that capture certain features of everyday conversations. The goal of this study was to assess the suitability of the test for studying the consequences of hearing loss and amplification in older listeners.

DESIGN

Unaided and aided comprehension scores were measured for single-, two- and three-talker passages, along with unaided and aided sentence recall. To characterise the relevant cognitive abilities of the group, measures of short-term working memory, verbal information-processing speed and reading comprehension speed were collected.

STUDY SAMPLE

Participants were 41 older listeners with varying degrees of hearing loss.

RESULTS

Performance on both the NAL-DCT and the sentence test was strongly driven by hearing loss, but performance on the NAL-DCT was additionally related to a composite cognitive deficit score. Benefits of amplification were measurable but influenced by individual test SNRs.

CONCLUSIONS

The NAL-DCT is sensitive to the same factors as a traditional sentence recall test, but in addition is sensitive to the cognitive factors required for speech processing. The test shows promise as a tool for research concerned with real-world listening.

Normative Study of the Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES) Test in the French-Canadian Population

PURPOSE

The Functional Assessment of Verbal Reasoning and Executive Strategies (FAVRES; MacDonald, 2005) test was designed for use by speech-language pathologists to assess verbal reasoning, complex comprehension, discourse, and executive skills during performance on a set of challenging and ecologically valid functional tasks. A recent French version of this test was translated from English; however, it had not undergone standardization. The development of normative data that are linguistically and culturally sensitive to the target population is of importance. The present study aimed to establish normative data for the French version of the FAVRES, a commonly used test with native French-speaking patients with traumatic brain injury in Québec, Canada.

METHOD

The normative sample consisted of 181 healthy French-speaking adults from various regions across the province of Québec. Age and years of education were factored into the normative model.

RESULTS

Results indicate that age was significantly associated with performance on time, accuracy, reasoning subskills, and rationale criteria, whereas the level of education was significantly associated with accuracy and rationale.

CONCLUSION

Overall, mean scores on each criterion were relatively lower than in the original English version, which reinforces the importance of using the present normative data when interpreting performance of French speakers who have sustained a traumatic brain injury.

Envelope-based inter-aural time difference localization training to improve speech-in-noise perception in the elderly

Background: Many elderly individuals complain of difficulty in understanding speech in noise despite having normal hearing thresholds. According to previous studies, auditory training leads to improvement in speech-in-noise perception, but these studies did not consider the etiology, so their results cannot be generalized. The present study aimed at investigating the effectiveness of envelopebased interaural time difference (ITD ENV) localization training on improving ITD threshold and speech-in-noise perception. Methods: Thirty-two elderly males aged 55 to 65 years with clinically diagnosed normal hearing at 250-2000 Hertz, who suffered from speech-in-noise perception difficulty participated in this study. These individuals were randomly divided into training and control groups: 16 elderlies in the experimental group received envelope-based interaural time difference localization training in 9 sessions, but 16 matched elderlies in the control group did not receive any training. The ITD ENV threshold and spatial word recognition score (WRS) in noise were analyzed before and after the localization training. Results: Findings demonstrated that following the training program, the interaural time difference envelope threshold and spatial word recognition score (WRS) in noise were improved significantly in the experimental group (p≤ 0.001). Moreover, a significant difference was detected in interaural time difference envelope threshold and spatial word recognition score (WRS) in noise (p≤ 0.001) before and after the training in the experimental group. Conclusion: The results of the present study revealed the effectiveness of envelope- based interaural time difference localization training in localization ability and speech in noise perception in the elderlies with normal hearing up to 2000 Hz who suffered from speech-in-noise perception difficulty.

The Role of Cognition, Personality, and Trust in Fraud Victimization in Older Adults

Older adults are more at risk to become a victim of consumer fraud than any other type of crime (Carcach et al., 2001) but the research on the psychological profiles of senior fraud victims is lacking. To bridge this significant gap, we surveyed 151 (120 female, 111 Caucasian) community-dwelling older adults in Southern Ontario between 60 and 90 years of age about their experiences with fraud. Participants had not been diagnosed with cognitive impairment or a neurological disorder by their doctor and looked after their own finances. We assessed their self-reported cognitive abilities using the MASQ, personality on the 60-item HEXACO Personality Inventory, and trust tendencies using a scale from the World Values Survey. There were no demographic differences between victims and non-victims. We found that victims exhibit lower levels of cognitive ability, lower honesty-humility, and lower conscientiousness than non-victims. Victims and non-victims did not differ in reported levels of interpersonal trust. Subsequent regression analyses showed that cognition is an important component in victimization over and above other social factors. The present findings suggest that fraud prevention programs should focus on improving adults’ overall cognitive functioning. Further investigation is needed to understand how age-related cognitive changes affect vulnerability to fraud and which cognitive processes are most important for preventing fraud victimization.

A Flexible Question-and-Answer Task for Measuring Speech Understanding

This report introduces a new speech task based on simple questions and answers. The task differs from a traditional sentence recall task in that it involves an element of comprehension and can be implemented in an ongoing fashion. It also contains two target items (the question and the answer) that may be associated with different voices and locations to create dynamic listening scenarios. A set of 227 questions was created, covering six broad categories (days of the week, months of the year, numbers, colors, opposites, and sizes). All questions and their one-word answers were spoken by 11 female and 11 male talkers. In this study, listeners were presented with question-answer pairs and asked to indicate whether the answer was true or false. Responses were given as simple button or key presses, which are quick to make and easy to score. Two preliminary experiments are presented that illustrate different ways of implementing the basic task. In the first experiment, question-answer pairs were presented in speech-shaped noise, and performance was compared across subjects, question categories, and time, to examine the different sources of variability. In the second experiment, sequences of question-answer pairs were presented amidst competing conversations in an ongoing, spatially dynamic listening scenario. Overall, the question-and-answer task appears to be feasible and could be implemented flexibly in a number of different ways.

Better-ear glimpsing at low frequencies in normal-hearing and hearing-impaired listeners

Better-ear glimpsing is an auditory process that takes advantage of short-term interaural level differences (ILDs) to improve the understanding of speech in spatial fluctuating noise. Since ILDs are mainly present at high frequencies, where most hearing-impaired (HI) listeners have the strongest hearing loss, HI individuals cannot fully utilize ILDs for better-ear glimpsing, which may lead to poorer understanding of speech in noise. This problem may be alleviated by hearing aids that artificially generate ILDs at low frequencies where hearing is typically less impaired. The present study therefore investigated the spatial benefit in speech intelligibility that is provided by better-ear glimpsing with low-frequency extended ILDs in a symmetric two-distractor speech background. Speech reception thresholds were measured in a spatially co-located and separated condition as a function of frequency region in ten normal-hearing (NH) and ten mild-to-moderate sensorineural HI subjects. In both groups the extended ILDs provided a substantial spatial advantage on top of the advantage already provided by natural ILDs. Moreover, the spatial advantage was largely independent of frequency region, suggesting that both NH and HI subjects can utilize low-frequency ILDs for improving speech understanding in noise. Overall performance as well as spatial advantage was reduced in the HI group.

Noise Affects Performance on the Montreal Cognitive Assessment

L’objectif était d’investiguer l’impact de la présence d’un bruit de fond sur la performance au Montreal Cognitive Assessment (MoCA). Deux versions du MoCA ont été administrées, utilisant écouteurs, avec des niveaux bas et élevés de bruit de fond à deux groupes de personnes âgées (un groupe présentant une audition cliniquement normale, le second présentant une perte d’audition) ainsi qu’à un groupe de jeunes adultes. Les niveaux d’intensité utilisés pour présenter la parole et le bruit étaient personnalisés en fonction des habiletés des participants présentant une perte de l’ouïe, et ce en vue de créer un niveau de difficulté uniforme à travers les participants dans la condition de bruit plus élevé. Les deux groupes de personnes âgées ont obtenu des scores plus faibles au MoCA en comparaison aux jeunes adultes. Il est également important de souligner que tous les participants ont obtenu des scores plus faibles au MoCA lorsque le test était administré dans un contexte de bruit élevé (M = 22,7/30), en comparaison à un contexte de bruit faible (M = 25,7/30, p < .001). Ces résultats suggèrent que le bruit de fond présent dans un contexte d’évaluation devrait être pris en considération au moment de l’administration de tests cognitifs ainsi que dans l’interprétation des résultats, en particulier lors de l’essai des adultes plus âgés.

How Age and Linguistic Competence Affect Memory for Heard Information

The short-term memory performance of a group of younger adults, for whom English was a second language (young EL2 listeners), was compared to that of younger and older adults for whom English was their first language (EL1 listeners). To-be-remembered words were presented in noise and in quiet. When presented in noise, the listening situation was adjusted to ensure that the likelihood of recognizing the individual words was comparable for all groups. Previous studies which used the same paradigm found memory performance of older EL1 adults on this paired-associate task to be poorer than that of their younger EL1 counterparts both in quiet and in a background of babble. The purpose of the present study was to investigate whether the less well-established semantic and linguistic skills of EL2 listeners would also lead to memory deficits even after equating for word recognition as was done for the younger and older EL1 listeners. No significant differences in memory performance were found between young EL1 and EL2 listeners after equating for word recognition, indicating that the EL2 listeners' poorer semantic and linguistic skills had little effect on their ability to memorize and recall paired associates. This result is consistent with the hypothesis that age-related declines in memory are primarily due to age-related declines in higher-order processes supporting stream segregation and episodic memory. Such declines are likely to increase the load on higher-order (possibly limited) cognitive processes supporting memory. The problems that these results pose for the comprehension of spoken language in these three groups are discussed.

The Role of Inhibition in Age-related Off-Topic Verbosity: Not Access but Deletion and Restraint Functions

The speech of older adults is commonly described as verbose and off-topic, which is thought to influence their social communication. This study investigated the role of inhibition in age-related off-topic verbosity (OTV). Inhibition consists of three functions: access, deletion, and restraint. The access function is responsible for preventing irrelevant information from accessing the attention center (pre-mechanism of inhibition); The deletion function is responsible for deleting previously relevant but currently irrelevant information from working memory, and the restraint function is responsible for restraining strong but inappropriate responses (post-mechanisms of inhibition). A referential communication task was used to determine whether OTV was influenced by the pre-mechanism of inhibition. A self-involved event interview task was used to investigate the effect of the post-mechanisms of inhibition on OTV. Results showed that the OTV of the elderly participants was associated with an age-related decline in the post-mechanisms of inhibition, while the OTV exhibited by young adults was most likely due to deficits in the pre-mechanism function of inhibition. This research contributed to fill gaps in the existing knowledge about the potential relationship between specific functions of inhibition and age-related OTV.

Effect of audibility on spatial release from speech-on-speech masking

This study investigated to what extent spatial release from masking (SRM) deficits in hearing-impaired adults may be related to reduced audibility of the test stimuli. Sixteen adults with sensorineural hearing loss and 28 adults with normal hearing were assessed on the Listening in Spatialized Noise-Sentences test, which measures SRM using a symmetric speech-on-speech masking task. Stimuli for the hearing-impaired listeners were delivered using three amplification levels (National Acoustic Laboratories - Revised Profound prescription (NAL-RP) +25%, and NAL-RP +50%), while stimuli for the normal-hearing group were filtered to achieve matched audibility. SRM increased as audibility increased for all participants. Thus, it is concluded that reduced audibility of stimuli may be a significant factor in hearing-impaired adults' reduced SRM even when hearing loss is compensated for with linear gain. However, the SRM achieved by the normal hearers with simulated audibility loss was still significantly greater than that achieved by hearing-impaired listeners, suggesting other factors besides audibility may still play a role.

How Age, Linguistic Status, and the Nature of the Auditory Scene Alter the Manner in Which Listening Comprehension Is Achieved in Multitalker Conversations

PURPOSE

We investigated how age and linguistic status affected listeners' ability to follow and comprehend 3-talker conversations, and the extent to which individual differences in language proficiency predict speech comprehension under difficult listening conditions.

METHOD

Younger and older L1s as well as young L2s listened to 3-talker conversations, with or without spatial separation between talkers, in either quiet or against moderate or high 12-talker babble background, and were asked to answer questions regarding their contents.

RESULTS

After compensating for individual differences in speech recognition, no significant differences in conversation comprehension were found among the groups. As expected, conversation comprehension decreased as babble level increased. Individual differences in reading comprehension skill contributed positively to performance in younger EL1s and in young EL2s to a lesser degree but not in older EL1s. Vocabulary knowledge was significantly and positively related to performance only at the intermediate babble level.

CONCLUSION

The results indicate that the manner in which spoken language comprehension is achieved is modulated by the listeners' age and linguistic status.

Development and preliminary evaluation of a new test of ongoing speech comprehension

OBJECTIVE

The overall goal of this work is to create new speech perception tests that more closely resemble real world communication and offer an alternative or complement to the commonly used sentence recall test.

DESIGN

We describe the development of a new ongoing speech comprehension test based on short everyday passages and on-the-go questions. We also describe the results of an experiment conducted to compare the psychometric properties of this test to those of a sentence test.

STUDY SAMPLE

Both tests were completed by a group of listeners that included normal hearers as well as hearing-impaired listeners who participated with and without their hearing aids.

RESULTS

Overall, the psychometric properties of the two tests were similar, and thresholds were significantly correlated. However, there was some evidence of age/cognitive effects in the comprehension test that were not revealed by the sentence test.

CONCLUSIONS

This new comprehension test promises to be useful for the larger goal of creating laboratory tests that combine realistic acoustic environments with realistic communication tasks. Further efforts will be required to assess whether the test can ultimately improve predictions of real-world outcomes.

Spatial separation benefit for unaided and aided listening

OBJECTIVES

The benefit attributable to spatial separation of speech and noise was measured as a function of low-pass cutoff frequency with and without bilateral hearing aids.

DESIGN

Fourteen younger and 10 older adults with normal hearing and 12 older adults with mild-to-moderate sloping high frequency hearing loss were included to assess the effects of age and hearing loss. Subjects with hearing loss were provided commercially available bilateral hearing aids. Consonant recognition was measured at 70 dB SPL in a background of speech-shaped noise at 66 dB SPL. Speech and noise were low-pass filtered at 1.7, 3.4, and 7.1 kHz. Nonsense syllables were always at 0° and noise was at either 0° or 90°. Speech and noise spectra for all conditions were digitally recorded using a probe microphone placed in each ear canal of each subject. Spectra and levels of speech, and quiet thresholds for narrowband noises, were used to calculate the Articulation Index and provide predictions of unaided and aided (hearing-impaired only) consonant recognition, spatial benefit, and hearing aid benefit for each condition. Subjective ratings of workload (NASA Task Load Index) were obtained for all unaided and aided measures of speech recognition.

RESULTS

Consonant recognition in noise improved for all groups with speech and noise spatially separated and with the addition of high-frequency speech information. Scores were poorer overall for the older adults with hearing loss than for the other groups. For normal-hearing subjects, observed scores and spatial benefit were better than predicted. For hearing-impaired subjects, scores did not significantly improve with hearing aids, even with higher frequencies and spatial separation, and were poorer than predicted especially for aided listening. Similar to subjects with normal hearing, spatial benefit for hearing-impaired subjects was larger than predicted.

CONCLUSIONS

Younger and older adults with normal hearing benefited from spatial separation of speech and noise sources to a greater extent than predicted based on simple audibility. Thus, no age-related deficits in the use of interaural difference cues were observed. Although hearing aid benefit was negligible, perceived listening effort was lower aided than unaided, especially with spatial separation. Articulation Index predictions revealed that speech audibility was generally restored with hearing aids across a wide bandwidth of speech, especially in the far ear. Thus, reduced audibility was not a primary factor in limited hearing aid benefit, suggesting that peripheral, central-auditory and/or cognitive changes may have played a role. In contrast, unaided and aided spatial benefit was better than predicted, and spatial benefit was slightly larger with hearing aids than without. Thus, these older adults with hearing loss using bilateral hearing aids were able to take advantage of binaural cues to improve consonant recognition in noise.

Older adults do not notice their names: a new twist to a classic attention task

Although working memory spans are, on average, lower for older adults than young adults, we demonstrate in 5 experiments a way in which older adults paradoxically resemble higher capacity young adults. Specifically, in a selective-listening task, older adults almost always failed to notice their names presented in an unattended channel. This is an exaggeration of what high-span young adults show and the opposite of what low-span young adults show. This striking finding in older adults remained significant after controlling for working memory span and for noticing their names in an attended channel. The findings were replicated when presentation rate was slowed and when the ear in which the unattended name was presented was controlled. These results point to an account of older adults' performance involving not only an inhibition factor, which allows high-span young adults to suppress the channel to be ignored, but also an attentional capacity factor, with more unallocated capacity. This capacity allows low-span young adults to notice their names much more often than older adults with comparably low working memory spans do.

How age and linguistic competence alter the interplay of perceptual and cognitive factors when listening to conversations in a noisy environment

Multi-talker conversations challenge the perceptual and cognitive capabilities of older adults and those listening in their second language (L2). In older adults these difficulties could reflect declines in the auditory, cognitive, or linguistic processes supporting speech comprehension. The tendency of L2 listeners to invoke some of the semantic and syntactic processes from their first language (L1) may interfere with speech comprehension in L2. These challenges might also force them to reorganize the ways in which they perceive and process speech, thereby altering the balance between the contributions of bottom-up vs. top-down processes to speech comprehension. Younger and older L1s as well as young L2s listened to conversations played against a babble background, with or without spatial separation between the talkers and masker, when the spatial positions of the stimuli were specified either by loudspeaker placements (real location), or through use of the precedence effect (virtual location). After listening to a conversation, the participants were asked to answer questions regarding its content. Individual hearing differences were compensated for by creating the same degree of difficulty in identifying individual words in babble. Once compensation was applied, the number of questions correctly answered increased when a real or virtual spatial separation was introduced between babble and talkers. There was no evidence that performance differed between real and virtual locations. The contribution of vocabulary knowledge to dialog comprehension was found to be larger in the virtual conditions than in the real whereas the contribution of reading comprehension skill did not depend on the listening environment but rather differed as a function of age and language proficiency. The results indicate that the acoustic scene and the cognitive and linguistic competencies of listeners modulate how and when top-down resources are engaged in aid of speech comprehension.

Analysis of narrative discourse structure as an ecologically relevant measure of executive function in adults

This study examined the narrative discourse production and executive function (EF) abilities of 46 neuro-typical adults (18-98 years old). Two questions were addressed: Is the analysis of narrative structure sensitive to changes associated with aging? & What is the relationship between measures of narrative structure and EF? Narratives were elicited under two conditions and narrative structure was analyzed for the presence of organizing story grammar elements. Narrative structure was significantly correlated with age as well as linguistic and non-linguistic measures of EF. Factor analysis of story structure and EF variables yielded two factors reflecting constructs of output-fluidity and organizational-efficiency. These data suggest that narrative structure and EF represent aspects of goal-directed knowledge that are not bound by a traditional linguistic and non-linguistic division. Thus, narrative structure may represent a global and ecologically valid measure of goal-directed executive function knowledge that is also sensitive to changes associated with typical aging.

Are there age-related differences in social suggestibility to central and peripheral misinformation?

BACKGROUND/STUDY CONTEXT: Dalton and Daneman ( 2006 , Memory, 14, 486-501) showed that young adults can be induced to accept misinformation from a co-witness, even if it contradicts central features of a previously witnessed event. This study investigated whether older adults are also susceptible to social suggestion, and if so, whether to the same or different degree as their younger counterparts. The study also investigated whether participants were more likely to succumb to suggestions delivered by a peer or an older figure.

METHODS

Younger and older adults viewed an action video in the presence of a younger or older confederate co-witness. During a postevent discussion, the confederate introduced misinformation about central and peripheral features of the co-witnessed event. Finally, participants responded to true-false statements about the event and rated how confident they were in their decisions.

RESULTS

Older adults were able to correctly reject false statements about an event that had been mentioned during the discussion by the confederate less often than they were able to correctly reject false statements that had not been mentioned, even if the misstatements contradicted central features of the previously witnessed event. However, older adults were no more susceptible to a co-witness's misleading suggestions than were their younger counterparts, and the age of the confederate did not influence the size of the suggestibility effect for younger or older adults.

CONCLUSION

When baseline memory accuracy (correct rejection rates for unmentioned false information) is controlled, older adults are no more susceptible to misleading suggestions from a co-witness than are their younger counterparts. Age of the confederate did not influence the size of the suggestibility effect and thus provided no support for the predictions that participants are more likely to succumb to misleading suggestions delivered by a peer or by an older authority figure.