Senescent Changes in Sensitivity to Binaural Temporal Fine Structure

Immediate Effects of (Simulated) Age-Related Hearing Loss on Cognitive Processing and Performance for the Backward-Digit-Span Task

The recall of auditorily presented sequences of digits in reverse order (also known as the Backward Digit Span, BDS) is considered to reflect a person's information storage and processing abilities which have been linked to speech-in-noise intelligibility. However, especially in aging research and audiology, persons who are administered the BDS task are often affected by hearing loss (HL). If uncorrected, HL can have immediate assessment-format-related effects on cognitive-test performance and can result, in the long term, in neuroplastic changes impacting cognitive functioning. In the present study, an impairment-simulation approach, mimicking mild-to-moderate age-related HLs typical for persons aged 65, 75, and 85 years, was used in 19 young normal-hearing participants to evaluate the impact of HL on cognitive performance and the cognitive processes probed by the BDS task. Participants completed the BDS task in several listening conditions, as well as several commonly used visual tests of short-term and working memory. The results indicated that BDS performance was impaired by a simulated HL representing that of persons aged 75 years and above. In the normal-hearing condition, BDS performance correlated positively with both performance on tests of short-term memory and performance on tests of working memory. In the listening condition simulating moderate HL (as experienced by the average 85-year-old person), BDS performance only correlated with performance on working-memory tests. In conclusion, simulated (and, by extrapolation, actual) age-related HL negatively affects cognitive-test performance and may change the composition of the cognitive processes associated with the completion of a cognitive task.

The relationship between interaural delay in binaural gap detection and sensitivity to temporal fine structure in young adults with or without musical training experience

Humans can detect the presence of a break in interaural correlation (BIC, also called binaural gap) even if a large interaural time delay (ITD) is introduced, which is important for detecting, recognizing, and localizing sounds in everyday environments. To investigate the relationship between interaural delay in binaural gap detection and the sensitivity of temporal fine structure (TFS), 40 young college students with normal hearing took the BIC delay threshold test, the TFS1 test (the test of monaural TFS sensitivity), and the TFS-AF test (the test of binaural TFS sensitivity). All participants were asked whether they had any musical training experience in their childhood. Results showed that the BIC delay threshold was significantly correlated with the TFS1 test (r =-0.426, p = 0.006), but not with the TFS-AF performance (r =-0.005, p = 0.997). The correlation between BIC delay threshold and monaural TFS sensitivity was observed in the non-music training group (r =-0.508, p = 0.010), but not in the music training group (r =-0.290, p = 0.295). These findings suggest that the interaural delay in binaural gap detection is related to the monaural sensitivity of TFS, this significant correlation was mainly found in young adults without musical training experience.

Age-Related Changes in Interaural-Level-Difference-Based Across-Frequency Binaural Interference

Low-frequency interaural time differences and high-frequency interaural level differences (ILDs) are used to localize sounds in the horizontal plane. Older listeners appear to be worse at horizontal-plane sound localization to compared younger listeners, but little is understood about age-related changes to across-frequency binaural processing. This study investigated if the frequency dependence of across-frequency ILD processing is altered for older compared to younger listeners, which was done by using an across-frequency binaural interference task (when the interaural difference sensitivity for a target sound is decreased by a spectrally remote interfering sound with zero interaural differences). It was hypothesized that as listeners experience advancing age and age-related high-frequency hearing loss (i.e., presbycusis), they will demonstrate worse binaural performance and experience more across-channel binaural interference (because of age-related temporal processing deficits), and will increasingly be affected by interferers at lower frequencies (because of age-related hearing loss) when compared to younger listeners. There were 11 older (>65 yrs) and 20 younger (<30 yrs) listeners with normal to near-normal audiometric thresholds up to 2 kHz. They were tested using a left-right ILD lateralization discrimination task. Single-tone ILD discrimination thresholds and across-frequency binaural interference were measured at 0.5, 1, 2, 4, and 8 kHz. ILD thresholds and interference were about twice as large for older compared to younger listeners. Interferers ≤1 kHz produced 2-3 times as much across-frequency binaural interference for older compared to younger listeners. Hearing thresholds were significant predictors of single-tone ILD thresholds; in addition, both target and interferer hearing thresholds were significant predictors of binaural interference. The results suggest a reweighting of binaural information that occurs with advancing age and age-related high-frequency hearing loss. This evidence of plasticity may help explain some of the age-related changes in spatial-hearing abilities.

Threshold Equalizing Noise Test Reveals Suprathreshold Loss of Hearing Function, Even in the "Normal" Audiogram Range

Objectives:

The threshold equalizing noise (TEN(HL)) is a clinically administered test to detect cochlear “dead regions” (i.e., regions of loss of inner hair cell [IHC] connectivity), using a “pass/fail” criterion based on the degree of elevation of a masked threshold in a tone-detection task. With sensorineural hearing loss, some elevation of the masked threshold is commonly observed but usually insufficient to create a “fail” diagnosis. The experiment reported here investigated whether the gray area between pass and fail contained information that correlated with factors such as age or cumulative high-level noise exposure (>100 dBA sound pressure levels), possibly indicative of damage to cochlear structures other than the more commonly implicated outer hair cells.

Design:

One hundred and twelve participants (71 female) who underwent audiometric screening for a sensorineural hearing loss, classified as either normal or mild, were recruited. Their age range was 32 to 74 years. They were administered the TEN test at four frequencies, 0.75, 1, 3, and 4 kHz, and at two sensation levels, 12 and 24 dB above their pure-tone absolute threshold at each frequency. The test frequencies were chosen to lie either distinctly away from, or within, the 2 to 6 kHz region where noise-induced hearing loss is first clinically observed as a notch in the audiogram. Cumulative noise exposure was assessed by the Noise Exposure Structured Interview (NESI). Elements of the NESI also permitted participant stratification by music experience.

Results:

Across all frequencies and testing levels, a strong positive correlation was observed between elevation of TEN threshold and absolute threshold. These correlations were little-changed even after noise exposure and music experience were factored out. The correlations were observed even within the range of “normal” hearing (absolute thresholds ≤15 dB HL).

Conclusions:

Using a clinical test, sensorineural hearing deficits were observable even within the range of clinically “normal” hearing. Results from the TEN test residing between “pass” and “fail” are dominated by processes not related to IHCs. The TEN test for IHC-related function should therefore only be considered for its originally designed function, to generate a binary decision, either pass or fail.

Musical Training and Its Association With Age-Related Changes in Binaural, Temporal, and Spatial Processing

OBJECTIVE

This article aimed to assess the relationship between musical training and age-related changes in binaural, temporal, and spatial processing abilities.

DESIGN

A standard group comparison study was conducted involving both musicians and nonmusicians. The effect of musical training was assessed using a battery of psychoacoustical tests (interaural time and level difference thresholds: ITD & ILD, binaural gap detection threshold, and virtual auditory space identification test) and subjective ratings (Spatial-Hearing subsection of Speech, Spatial, and Quality of Hearing scale in Kannada).

STUDY SAMPLE

A total of 60 participants, between 41 and 70 years, were divided into three groups of 20 each, based on their age (41-50, 51-60, and 61-70 years). Each of these three groups was subdivided into two, one comprising 10 musicians (vocalists practicing South-Indian classical music) and the other comprising 10 nonmusicians.

RESULTS

Multivariate analyses of variance revealed that musicians performed significantly better (p < .001) than nonmusicians in all the tests. Analyses of variance showed that whereas age had no effect (p > .05) on performance in any of the tests in musicians, age affected the performance of nonmusicians significantly in terms of ITD (p = .02) and ILD (p = .01) thresholds.

CONCLUSION

Musical training appears to have the potential to slow down age-related decline in binaural, temporal, and spatial processing.

Relationships Among Temporal Fine Structure Sensitivity, Transient Storage Capacity, and Ultra-High Frequency Hearing Thresholds in Tinnitus Patients and Normal Adults of Different Ages

Background

Elderlies and tinnitus patients often find it challenging to process acoustic signals in noisy environments. The sensitivity to temporal fine structure (TFS), the transient storage capacity for TFS, and the ultra-high frequency (UHF) thresholds are all associated with aging-related damage, evidenced by speech-in-noise perception deficits. In the present study, we aimed to investigate the relationships among TFS sensitivity, transient storage capacity, and UHF thresholds in tinnitus patients and normal adults of different ages.

Methods

In the present study, 38 tinnitus patients (age ranging from 21 to 65) and 23 non-tinnitus adults (age ranging from 22 to 56) were enrolled, and some of their auditory indicators were examined, including the TFS-adaptive frequency (TFS-AF), break in interaural correlation (BIAC) delay threshold, and UHF thresholds.

Results

We found no significant difference in TFS-AF thresholds and BIAC delay thresholds between the tinnitus group and normal group, while their relationships with age were more evident in the tinnitus group. Moreover, these two tests were only significantly correlated in the tinnitus group. UHF thresholds were significantly correlated with TFS-AF thresholds only in the tinnitus group, suggesting that the UHF hearing was positively associated with the TFS sensitivity.

Conclusion

These findings indicated that the influencing factors, such as tinnitus and UHF thresholds, should be fully considered when examining age-related hearing decline, because the combination of tinnitus and poor UHF hearing might play a role in affecting hearing ability, such as TFS sensitivity.

Effects of age on psychophysical measures of auditory temporal processing and speech reception at low and high levels

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We found little evidence of greater age-related hearing declines at high sound levels.

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There are age-related temporal-processing declines independent of hearing loss.

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No evidence of age-related speech-reception deficits independent of hearing loss.

Age-related cochlear synaptopathy (CS) has been shown to occur in rodents with minimal noise exposure, and has been hypothesized to play a crucial role in age-related hearing declines in humans. It is not known to what extent age-related CS occurs in humans, and how it affects the coding of supra-threshold sounds and speech in noise. Because in rodents CS affects mainly low- and medium-spontaneous rate (L/M-SR) auditory-nerve fibers with rate-level functions covering medium-high levels, it should lead to greater deficits in the processing of sounds at high than at low stimulus levels. In this cross-sectional study the performance of 102 listeners across the age range (34 young, 34 middle-aged, 34 older) was assessed in a set of psychophysical temporal processing and speech reception in noise tests at both low, and high stimulus levels. Mixed-effect multiple regression models were used to estimate the effects of age while partialing out effects of audiometric thresholds, lifetime noise exposure, cognitive abilities (assessed with additional tests), and musical experience. Age was independently associated with performance deficits on several tests. However, only for one out of 13 tests were age effects credibly larger at the high compared to the low stimulus level. Overall these results do not provide much evidence that age-related CS, to the extent to which it may occur in humans according to the rodent model of greater L/M-SR synaptic loss, has substantial effects on psychophysical measures of auditory temporal processing or on speech reception in noise.

Senescent Decline in Verbal-Emotion Identification by Older Hearing-Impaired Listeners - Do Hearing Aids Help?

Purpose

To assess the ability of older-adult hearing-impaired (OHI) listeners to identify verbal expressions of emotions, and to evaluate whether hearing-aid (HA) use improves identification performance in those listeners.

Methods

Twenty-nine OHI listeners, who were experienced bilateral-HA users, participated in the study. They listened to a 20-sentence-long speech passage rendered with six different emotional expressions (“happiness”, “pleasant surprise”, “sadness”, “anger”, “fear”, and “neutral”). The task was to identify the emotion portrayed in each version of the passage. Listeners completed the task twice in random order, once unaided, and once wearing their own bilateral HAs. Seventeen young-adult normal-hearing (YNH) listeners were also tested unaided as controls.

Results

Most YNH listeners (89.2%) correctly identified emotions compared to just over half of the OHI listeners (58.7%). Within the OHI group, verbal emotion identification was significantly correlated with age, but not with audibility-related factors. The number of OHI listeners who were able to correctly identify the different emotions did not significantly change when HAs were worn (54.8%).

Conclusion

In line with previous investigations using shorter speech stimuli, there were clear age differences in the recognition of verbal emotions, with OHI listeners showing a significant reduction in unaided verbal-emotion identification performance that progressively declined with age across older adulthood. Rehabilitation through HAs did not provide compensation for the impaired ability to perceive emotions carried by speech sounds.

Age-Related Deficits in Electrophysiological and Behavioral Measures of Binaural Temporal Processing

Binaural processing, particularly the processing of interaural phase differences, is important for sound localization and speech understanding in background noise. Age has been shown to impact the neural encoding and perception of these binaural temporal cues even in individuals with clinically normal hearing sensitivity. This work used a new electrophysiological response, called the interaural phase modulation-following response (IPM-FR), to examine the effects of age on the neural encoding of interaural phase difference cues. Relationships between neural recordings and performance on several behavioral measures of binaural processing were used to determine whether the IPM-FR is predictive of interaural phase difference sensitivity and functional speech understanding deficits. Behavioral binaural frequency modulation detection thresholds were measured to assess sensitivity to interaural phase differences while spatial release-from-masking thresholds were used to assess speech understanding abilities in spatialized noise. Thirty adults between the ages of 35 to 74 years with normal low-frequency hearing thresholds were used in this study. Data showed that older participants had weaker neural responses to the interaural phase difference cue and were less able to take advantage of binaural cues for speech understanding compared to younger participants. Results also showed that the IPM-FR was predictive of performance on the binaural frequency modulation detection task, but not on the spatial release-from-masking task after accounting the effects of age. These results confirm previous work that showed that the IPM-FR reflects age-related declines in binaural temporal processing and provide further evidence that this response may represent a useful objective tool for assessing binaural function. However, further research is needed to understand how the IPM-FR is related to speech understanding abilities.

Sensitivity to Interaural Phase in Older Hearing-Impaired Listeners Correlates With Nonauditory Trail Making Scores and With a Spatial Auditory Task of Unrelated Peripheral Origin

Interaural phase difference (IPD) discrimination upper frequency limits and just-noticeable differences (JNDs), interaural level difference (ILD) JNDs, and diotic intensity JNDs were measured for 20 older hearing-impaired listeners with matched moderate sloping to severe sensorineural hearing losses. The JNDs were measured using tone stimuli at 500 Hz. In addition to these auditory tests, the participants completed a cognitive test (Trail Making Test). Significant performance improvements in IPD discrimination were observed across test sessions. Strong correlations were found between IPD and ILD discrimination performance. Very strong correlations were observed between IPD discrimination and Trail Making performance as well as strong correlations between ILD discrimination and Trail Making performance. These relationships indicate that interindividual variability in IPD discrimination performance did not exclusively reflect deficits specific to any auditory processing, including early auditory processing of temporal information. The observed relationships between spatial audition and cognition may instead be attributable to a modality-general spatial processing deficit and/or individual differences in global processing speed.

Robust Data-Driven Auditory Profiling Towards Precision Audiology

The sources and consequences of a sensorineural hearing loss are diverse. While several approaches have aimed at disentangling the physiological and perceptual consequences of different etiologies, hearing deficit characterization and rehabilitation have been dominated by the results from pure-tone audiometry. Here, we present a novel approach based on data-driven profiling of perceptual auditory deficits that attempts to represent auditory phenomena that are usually hidden by, or entangled with, audibility loss. We hypothesize that the hearing deficits of a given listener, both at hearing threshold and at suprathreshold sound levels, result from two independent types of "auditory distortions." In this two-dimensional space, four distinct "auditory profiles" can be identified. To test this hypothesis, we gathered a data set consisting of a heterogeneous group of listeners that were evaluated using measures of speech intelligibility, loudness perception, binaural processing abilities, and spectrotemporal resolution. The subsequent analysis revealed that distortion type-I was associated with elevated hearing thresholds at high frequencies and reduced temporal masking release and was significantly correlated with elevated speech reception thresholds in noise. Distortion type-II was associated with low-frequency hearing loss and abnormally steep loudness functions. The auditory profiles represent four robust subpopulations of hearing-impaired listeners that exhibit different degrees of perceptual distortions. The four auditory profiles may provide a valuable basis for improved hearing rehabilitation, for example, through profile-based hearing-aid fitting.

Predicting Speech Perception in Older Listeners with Sensorineural Hearing Loss Using Automatic Speech Recognition

The objective of this study was to provide proof of concept that the speech intelligibility in quiet of unaided older hearing-impaired (OHI) listeners can be predicted by automatic speech recognition (ASR). Twenty-four OHI listeners completed three speech-identification tasks using speech materials of varying linguistic complexity and predictability (i.e., logatoms, words, and sentences). An ASR system was first trained on different speech materials and then used to recognize the same speech stimuli presented to the listeners but processed to mimic some of the perceptual consequences of age-related hearing loss experienced by each of the listeners: the elevation of hearing thresholds (by linear filtering), the loss of frequency selectivity (by spectrally smearing), and loudness recruitment (by raising the amplitude envelope to a power). Independently of the size of the lexicon used in the ASR system, strong to very strong correlations were observed between human and machine intelligibility scores. However, large root-mean-square errors (RMSEs) were observed for all conditions. The simulation of frequency selectivity loss had a negative impact on the strength of the correlation and the RMSE. Highest correlations and smallest RMSEs were found for logatoms, suggesting that the prediction system reflects mostly the functioning of the peripheral part of the auditory system. In the case of sentences, the prediction of human intelligibility was significantly improved by taking into account cognitive performance. This study demonstrates for the first time that ASR, even when trained on intact independent speech material, can be used to estimate trends in speech intelligibility of OHI listeners.

Relationship Between Domain-Specific Cognitive Function and Speech-in-Noise Performance in Older Adults: The Atherosclerosis Risk in Communities Hearing Pilot Study

Purpose The purpose of this study was to investigate associations between performance on a clinical speech-in-noise measure with a comprehensive neurocognitive battery of tests. Method A group of older adults (N = 250, M _age = 77 years, age range: 67.3-89.1 years) enrolled in the Atherosclerosis Risk in Communities Neurocognitive Study took part in the hearing pilot study (2013) that included testing for audiometric thresholds and speech-in-noise performance (Quick Speech-in-Noise Test; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004). This research study analyzed the associations between domain-specific cognitive function and speech-in-noise performance after adjusting for hearing thresholds and other demographic and cardiovascular factors. Results Multivariable-adjusted associations were found between all cognitive domains and speech-in-noise performance in the full sample, but the observed associations varied when participants with varying levels of moderate to moderately severe hearing loss were excluded from the analysis. Conclusions The findings are discussed in terms considering the cognitive status of older adults in relation to their speech-in-noise performance during audiological evaluation and implications for aural rehabilitation.

Effect of age on envelope regularity discrimination

The ability to discriminate irregular from regular amplitude modulation was compared for young and older adults with audiometric thresholds within the normal range for frequencies from 250 to 8000 Hz, using the "envelope regularity discrimination" (ERD) test. The amount of irregularity was parametrically varied and quantified by an "irregularity index." The carrier frequency was 2000 Hz, the modulation rate was 8 Hz, and the baseline modulation index was 0.3. Stimuli were presented both at 80 dB sound pressure level (SPL) and at 20 dB sensation level (SL) in the presence of a threshold-equalizing noise. There was a significant effect of level, performance being better at 80 dB SPL than at 20 dB SL. There was also a significant effect of age, performance being worse for the older subjects. There was no significant interaction of level and age. The thresholds for the ERD test were not significantly correlated with absolute thresholds at the test carrier frequency of 2000 Hz, for either group, or for the two groups combined. The worse envelope regularity discrimination for the older group may be related to the age-related synaptopathy that has been established from recent studies of human temporal bones.

The Association Between the Processing of Binaural Temporal-Fine-Structure Information and Audiometric Threshold and Age: A Meta-Analysis

The ability to process binaural temporal fine structure (TFS) information, which influences the perception of speech in spatially distributed soundscapes, declines with increasing hearing loss and age. Because of the relatively small sample sizes used in previous studies, and the population-unrepresentative distribution of hearing loss and ages within study samples, it has been difficult to determine the relative and combined contributions of hearing loss and age. The aim of this study was to survey published and unpublished studies that assessed binaural TFS sensitivity using the TFS-low frequency (LF) test. Results from 19 studies were collated, yielding sample sizes of 147 to 648, depending on the test frequency. At least for the test frequency of 500 Hz, there were at least 67 listeners in each of four adult age groups and the distribution of audiometric thresholds at the test frequency within each group was similar to that for the population as a whole. Binaural TFS sensitivity declined with increasing age across the adult lifespan and with increasing hearing loss in old adulthood. For all test frequencies, both audiometric threshold and age were significantly negatively correlated with TFS-LF sensitivity (r ranging from −0.19 to −0.64) but the correlation was always significantly higher for age than for audiometric threshold. Regression analyses showed that the standardized regression coefficient was greater for age than for audiometric threshold, and that there was a significant interaction; the effect of increasing age among older listeners was greater when the hearing loss was ≥30 dB than when it was < 30 dB.

Temporal dynamics and uncertainty in binaural hearing revealed by anticipatory eye movements

Accurate perception of binaural cues is essential for left-right sound localization. Much literature focuses on threshold measures of perceptual acuity and accuracy. This study focused on supra-threshold perception using an anticipatory eye movement (AEM) paradigm designed to capture subtle aspects of perception that might not emerge in behavioral-motor responses, such as the accumulation of certainty, and rapid revisions in decision-making. Participants heard interaural timing differences (ITDs) or interaural level differences in correlated or uncorrelated narrowband noises, respectively. A cartoon ball moved behind an occluder and then emerged from the left or right side, consistent with the binaural cue. Participants anticipated the correct answer (before it appeared) by looking where the ball would emerge. Results showed quicker and more steadfast gaze fixations for stimuli with larger cue magnitudes. More difficult stimuli elicited a wider distribution of saccade times and greater number of corrective saccades before final judgment, implying perceptual uncertainty or competition. Cue levels above threshold elicited some wrong-way saccades that were quickly corrected. Saccades to ITDs were earlier and more reliable for low-frequency noises. The AEM paradigm reveals the time course of uncertainty and changes in perceptual decision-making for supra-threshold binaural stimuli even when behavioral responses are consistently correct.

Effects of Age and Hearing Loss on the Discrimination of Amplitude and Frequency Modulation for 2- and 10-Hz Rates

Detection of frequency modulation (FM) with rate = 10 Hz may depend on conversion of FM to amplitude modulation (AM) in the cochlea, while detection of 2-Hz FM may depend on the use of temporal fine structure (TFS) information. TFS processing may worsen with greater age and hearing loss while AM processing probably does not. A two-stage experiment was conducted to test these ideas while controlling for the effects of detection efficiency. Stage 1 measured psychometric functions for the detection of AM alone and FM alone imposed on a 1-kHz carrier, using 2- and 10-Hz rates. Stage 2 assessed the discrimination of AM from FM at the same modulation rate when the detectability of the AM alone and FM alone was equated. Discrimination was better for the 2-Hz than for the 10-Hz rate for all young normal-hearing subjects and for some older subjects with normal hearing at 1 kHz. Other older subjects with normal hearing showed no clear difference in AM-FM discrimination for the 2- and 10-Hz rates, as was the case for most older hearing-impaired subjects. The results suggest that the ability to use TFS cues is reduced for some older people and most hearing-impaired people.

Categorization of sentence recognition for older adults under noisy and time-altered conditions

Purpose

While evaluating the speech recognition ability of older adults, the present study aimed to analyze their error types in parts of speech and find error patterns under various conditions of background noise level and speed of speech.

Methods

Twenty older adults with normal hearing for their age (NHiA) and 20 older adults with sensorineural hearing loss (SNHL) participated. Their cognitive function was screened as within the normal range (mini-mental state examination scores >25). The SNHL listeners were divided into high performers (SNHL-H; n=12) and low performers (SNHL-L; n=8), based on their achieving word recognition scores above or below 70%, respectively. A sentence recognition test was conducted at four levels of signal-to-noise ratio (SNR; eg, no noise, +6, +3, 0 dB) and four conditions of time alteration (eg, 30% and 15% of compression and expansion) at the most comfortable level for each participant.

Results

As expected, the three groups showed that the error percentage increased in sentence recognition as either the SNR decreased or the speech rate became faster. Interestingly, a larger performance difference was found between the SNHL-H and SNHL-L groups in the condition of time alteration than in that of background noise. Among the parts of speech, nouns presented the highest error scores for all participants regardless of degree of listening difficulty. The noun errors of the three groups mainly consisted of no response and fail patterns, but substitution and omission were identified as the third pattern of noun error for background noise and fast speech, respectively.

Conclusion

Deterioration of speech recognition from the hearing threshold and supra-threshold auditory processing was seen in the elderly in difficult listening environments such as background noise and time alteration. Although different group performance ran across the eight experimental conditions, the robustness of noun errors and the error patterns were very similar, which might be extended to a possible clinical application of aural rehabilitation for the elderly population.