COGNITIVE CONTRIBUTIONS TO HEARING IN OLDER PEOPLE
 
More details
Hide details
1
MRC Institute for Hearing Research, Nottingham, NG7 2RD, U.K.
CORRESPONDING AUTHOR
David R. Moore
David R. Moore, MRC Institute for Hearing Research, Nottingham, NG7 2RD, U.K.
Publication date: 2020-04-20
 
J Hear Sci 2012;2(4):58–60
 
ABSTRACT
Background:
Hearing necessarily involves top-down influences on the sensory signals provided by bottom-up information from the ear. The top-down influences include elements of attention, memory, motivation, emotion, and learning, deriving from many regions of the cerebral cortex. They exert their influence via intra-cortical networks and auditory efferent pathways that extend back down the auditory system, right out to the ear. These ‘cognitive’ contributions to hearing affect sound detection, hearing-in-noise, and short- and long-term experiential modulation. Difficulty in speech perception in noisy environments (SiN) is the most common complaint that people of all ages and hearing levels make about their hearing. We review here aspects of those difficulties.

Methods:
Studies considered recruited children and older adults with normal audiograms. Tests included speech-in-noise, cognition, and remote delivery via the internet. Interventions included wireless devices and training.

Results:
For those with cochlear hearing loss, reduced sensitivity and broadened spectral and temporal processing contribute to poor speech perception in quiet and in noise. But for SiN, the nature of the noise is also important. Typically, able young adults can benefit from amplitude-modulated noise as it enables them to listen into the dips of the noise. They also benefit from a spatial separation between the target speech and the noise. However, those with reduced cognitive capabilities, notably children (especially those with learning difficulties), receive less benefit in these conditions. Older people have a high prevalence of both cochlear hearing loss and cognitive impairment. While these problems often occur together, and may be supraadditive and causally connected, they can also occur independently. We review studies showing that those (rare) older people with normal hearing sensitivity nevertheless have impaired SiN for both modulated and unmodulated noises, but older listeners show normal benefit from listening into the energetic minima of a fluctuating noise.

Discussion:
Effective interventions to improve SiN in older people are likely to include reduction of room reverberation, instruction on viewing important sound sources, improved signal to noise (e.g. Bluetooth, FM), onset enhancement, directional microphones on hearing devices, and auditory training. Training should emphasise engagement with the target sound and is best achieved through the use of highly motivating exercises. These may involve the use of social engagement and salient signals (e.g. talk radio) that are also likely to enhance general cognitive well-being.

Conclusions:
The reviewed studies – of development of hearing in children, of SiN perception in older adults, and of intervention – emphasise the role of top-down, cognitive factors in hearing, hearing impairment, and rehabilitation.

 
REFERENCES (29)
1.
Amitay S, Irwin A, Moore DR: Discrimination learning induced by training with identical stimuli. Nature Neuroscience, 2006; 9: 1446–48.
 
2.
Briscoe J, Bishop DV, Norbury CF: Phonological processing, language, and literacy: a comparison of children with mildto-moderate sensorineural hearing loss and those with specific language impairment. J Child Psychol Psychiatry, 2001; 42(3): 329–40.
 
3.
BSA (2011). Practice Guidance: An overview of current management of auditory processing disorder (APD). http://www.thebsa.org.uk/image..., pp 1–60.
 
4.
Davis AC: Hearing in adults: the prevalence and distribution of hearing impairment and reported hearing disability in the MRC Institute of Hearing Research’s National Study of Hearing. London: Whurr, 1995.
 
5.
Füllgrabe C, Moore BCJ, Stone, MA: Speech-in-noise identification in elderly listeners with audiometrically normal hearing: Contributions of auditory temporal processing and cognition. British Society of Audiology annual conference abstracts. Nottingham, UK. Int J Audiol, 2011; (in press).
 
6.
Füllgrabe C: Age-dependent changes in temporal-fine-structure processing in the absence of peripheral hearing loss. Am J Audiol, 2013; (in press).
 
7.
Füllgrabe C, Berthommier F, Lorenzi C: Masking release for consonant features in temporally fluctuating background noise. Hear Res, 2006; 211: 74–84.
 
8.
Hagerman B, Kinnefors C: Efficient adaptive methods for measuring speech reception threshold in quiet and in noise. Scandinavian Audiology, 1995; 24(1): 71–77.
 
9.
Halliday LF, Taylor JL, Millward KE, Moore DR: Lack of generalization of auditory learning in typically developing children. J Speech Lang Hear Res, 2012; 55: 168–81.
 
10.
Henderson Sabes J, Sweetow RW: Variables predicting outcomes on listening and communication enhancement (LACE) training. Int J Audiol, 2007; 46(7): 374–83.
 
11.
Holmes J, Gathercole SE, Dunning DL: Adaptive training leads to sustained enhancement of poor working memory in children. Developmental Science, 2009; 12(4): F9–15.
 
12.
Holube I, Fredelake S, Vlaming M, Kollmeier B: Development and analysis of an International Speech Test Signal (ISTS). Int J Audiol, 2010; 49(12): 891–903.
 
13.
Levi DM, Li RW: Perceptual learning as a potential treatment for amblyopia: a mini-review. Vision Research, 2009; 49(21): 2535–49.
 
14.
Leigh-Pfaffenroth ED, Elangovan S: Temporal processing in low-frequency channels: Effects of age and hearing loss in middle-aged listeners. J Am Acad Audiol, 2011; 22: 393–404.
 
15.
Li RW, Ngo C, Nguyen J, Levi DM: Video-game play induces plasticity in the visual system of adults with amblyopia. PLoS Biology, 2011; 9: e1001135.
 
16.
Lin FR, Metter EJ, O’Brien RJ et al: Hearing loss and inciden dementia. Arch Neurol, 2011; 68(2): 214–20.
 
17.
Marshall L, Jesteadt W: Comparison of pure-tone audibility thresholds obtained with audiological and two-interval forcedchoice procedures. J Speech Hear Res, 1986; 29(1): 82–91.
 
18.
Moore BCJ: Perceptual Consequences of Cochlear Damage. Oxford: Oxford University Press, 1995.
 
19.
Moore DR: Listening difficulties in children: Bottom-up and top-down contributions. J Communi Disord, 2012; 45(6): 411–18.
 
20.
Moore DR, Cowan JA, Riley A et al: Development of auditory processing in 6- to 11-yr-old children. Ear Hear, 2011; 32(3): 269–85.
 
21.
Moore DR, Ferguson MA, Edmondson-Jones AM et al: Nature of auditory processing disorder in children. Pediatrics, 2010; 126(2): 382–90.
 
22.
Moore DR, Rosen S, Bamiou DE et al: Evolving concepts of developmental auditory processing disorder (APD): A British Society of Audiology APD Special Interest Group ‘white paper’. Int J Audiol, 2013; 52(1): 3–13.
 
23.
Nachtegaal J, Festen JM, Kramer SE: Hearing ability in working life and its relationship with sick leave and self-reported work productivity. Ear Hear, 2012; 33(1): 94–103.
 
24.
Oba SI, Fu QJ, Galvin JJ III: Digit training in noise can improve cochlear implant users; speech understanding in noise. Ear Hear, 2011; 32(5): 573–81.
 
25.
Singh-Manoux A, Kivimaki M, Glymour M et al: Timing of onset of cognitive decline: results from Whitehall II prospective cohort study. BMJ, 2012; 344: d7622.
 
26.
Smits C, Houtgast T: Results from the Dutch speech-in-noise screening test by telephone. Ear and Hearing, 2005; 26: 89–95.
 
27.
Vlaming MSMG, Kollmeier B, Dreschler WA et al: HearCom: Hearing in the Communication Society. Acta Acustica United with Acustica, 2011; 97(2): 175–92.
 
28.
Xiao LQ, Zhang JY, Wang R et al: Complete transfer of perceptual learning across retinal locations enabled by double training. Curr Biol, 2008; 18(24): 1922–26.
 
29.
Zwislocki JJ, Maire F, Feldman AS, Rubin H: On the effect of practice and motivation on the threshold of audibility. J Acoust Soc Am, 1958; 30: 254–62.
 
eISSN:2084-3127
ISSN:2083-389X