Hearing loss is prevalent in nearly two thirds of adults aged 70 years and older in the U.S. population. Additional research is needed to determine the epidemiological and physiological basis for the protective effect of black race against hearing loss and to determine the role of hearing aids in those with a mild hearing loss.

This study investigated factors that contribute to deficits of elderly listeners in recognizing speech that is degraded by temporal waveform distortion. Young and elderly listeners with normal hearing sensitivity and with mild-to-moderate, sloping sensorineural hearing losses were evaluated. Low-predictability (LP) sentences from the Revised Speech Perception in Noise test (R-SPIN) (Bilger, Nuetzel, Rabinowitz, & Rzeczkowski, 1984) were presented to subjects in undistorted form and in three forms of distortion: time compression, reverberation, and interruption. Percent-correct recognition scores indicated that age and hearing impairment contributed independently to deficits in recognizing all forms of temporally distorted speech. In addition, subjects’ auditory temporal processing abilities were assessed on duration discrimination and gap detection tasks. Canonical correlation procedures showed that some of the suprathreshold temporal processing measures, especially gap duration discrimination, contributed to the ability to recognize reverberant speech. The overall conclusion is that age-related factors other than peripheral hearing loss contribute to diminished speech recognition performance of elderly listeners.

Background The authors reviewed the evidence regarding the existence of age-related declines in central auditory processes and the consequences of any such declines for everyday communication. Purpose This report summarizes the review process and presents its findings. Data Collection and Analysis The authors reviewed 165 articles germane to central presbycusis. Of the 165 articles, 132 articles with a focus on human behavioral measures for either speech or nonspeech stimuli were selected for further analysis. Results For 76 smaller-scale studies of speech understanding in older adults reviewed, the following findings emerged: (1) the three most commonly studied behavioral measures were speech in competition, temporally distorted speech, and binaural speech perception (especially dichotic listening); (2) for speech in competition and temporally degraded speech, hearing loss proved to have a significant negative effect on performance in most of the laboratory studies; (3) significant negative effects of age, unconfounded by hearing loss, were observed in most of the studies of speech in competing speech, time-compressed speech, and binaural speech perception; and (4) the influence of cognitive processing on speech understanding has been examined much less frequently, but when included, significant positive associations with speech understanding were observed. For 36 smaller-scale studies of the perception of nonspeech stimuli by older adults reviewed, the following findings emerged: (1) the three most frequently studied behavioral measures were gap detection, temporal discrimination, and temporal-order discrimination or identification; (2) hearing loss was seldom a significant factor; and (3) negative effects of age were almost always observed. For 18 studies reviewed that made use of test batteries and medium-to-large sample sizes, the following findings emerged: (1) all studies included speech-based measures of auditory processing; (2) 4 of the 18 studies included nonspeech stimuli; (3) for the speech-based measures, monaural speech in a competing-speech background, dichotic speech, and monaural time-compressed speech were investigated most frequently; (4) the most frequently used tests were the Synthetic Sentence Identification (SSI) test with Ipsilateral Competing Message (ICM), the Dichotic Sentence Identification (DSI) test, and time-compressed speech; (5) many of these studies using speech-based measures reported significant effects of age, but most of these studies were confounded by declines in hearing, cognition, or both; (6) for nonspeech auditory-processing measures, the focus was on measures of temporal processing in all four studies; (7) effects of cognition on nonspeech measures of auditory processing have been studied less frequently, with mixed results, whereas the effects of hearing loss on performance were minimal due to judicious selection of stimuli; and (8) there is a paucity of observational studies using test batteries and longitudinal designs. Conclusions Based on this review of ...

Current studies are inconclusive regarding specific patterns of gender differences in age-associated hearing loss. This paper presents results from the largest and longest longitudinal study reported to date of changes in pure-tone hearing thresholds in men and women screened for otological disorders and noise-induced hearing loss. Since 1965, the Baltimore Longitudinal Study of Aging has collected hearing thresholds from 500 to 8000 Hz using a pulsed-tone tracking procedure. Mixed-effects regression models were used to estimate longitudinal patterns of change in hearing thresholds in 681 men and 416 women with no evidence of otological disease, unilateral hearing loss, or noise-induced hearing loss. The results show (1) hearing sensitivity declines more than twice as fast in men as in women at most ages and frequencies, (2) longitudinal declines in hearing sensitivity are detectable at all frequencies among men by age 30, but the age of onset of decline is later in women at most frequencies and varies by frequency in women, (3) women have more sensitive hearing than men at frequencies above 1000 Hz but men have more sensitive hearing than women at lower frequencies, (4) learning effects bias cross-sectional and short-term longitudinal studies, and (5) hearing levels and longitudinal patterns of change are highly variable, even in this highly selected group. These longitudinal findings document gender differences in hearing levels and show that age-associated hearing loss occurs even in a group with relatively low-noise occupations and with no evidence of noise-induced hearing loss.

This review provides an overview of recent research that addressed hearing loss and auditory processing problems among elderly people. It focuses on research from the University of Maryland on problems in auditory temporal processing by elderly listeners as assessed in speech perception experiments using temporally altered signals and in psychoacoustic experiments of duration and rhythm discrimination for simple and complex signals. Some recent studies of perceived hearing disability are also reviewed. The clinical implications of the research findings are discussed in relation to hearing aid performance and use by elderly people as well as potential signal processing strategies that may prove to be beneficial for this population.Abbreviations: DL = difference limen, FCC = Federal Communications Commission, FM = frequency modulation, IOI = interonset interval, SNR = signal-to-noise ratio, SPL = sound pressure level, WPM = words per minute.

This paper presents age-specific reference ranges for hearing level and change in hearing level for men and women at 500, 1000, 2000, and 4000 Hz. The percentiles are constructed from data obtained from persons in the Baltimore Longitudinal Study of Aging who were rigorously screened for otological disorders and evidence of noise-induced hearing loss. The resulting percentile curves represent norms for changes in hearing level in the absence of any known otologic disease. These percentile curves provide a reference for detecting when a person deviates from a normal pattern of change, thus helping in diagnosing problems with hearing or in monitoring hearing in occupational settings. The smoothed means and standard deviations of the hearing levels were used to construct the longitudinal percentiles. The percentiles for cross-sectional change were constructed using the skew normal distribution to allow for the percentiles to be asymmetric on either side of the median level. These percentiles are the first reference curves that (1) provide standards for hearing level changes over periods of up to 15 years, (2) account for age differences in the distribution of hearing levels, and (3) are based on data from persons who have been systematically screened for otological disorders and evidence of noise-induced hearing loss.

This investigation examined age-related performance differences on a range of speech and nonspeech measures involving temporal manipulation of acoustic signals and variation of stimulus complexity. The goal was to identify a subset of temporally mediated measures that effectively distinguishes the performance patterns of younger and older listeners, with and without hearing loss. The nonspeech measures included duration discrimination for simple tones and gaps, duration discrimination for tones and gaps embedded within complex sequences, and discrimination of temporal order. The speech measures were undistorted speech, time-compressed speech, reverberant speech, and combined time-compressed + reverberant speech. All speech measures were presented both in quiet and in noise. Strong age effects were observed for the nonspeech measures, particularly in the more complex stimulus conditions. Additionally, age effects were observed for all time-compressed speech conditions and some reverberant speech conditions, in both quiet and noise. Effects of hearing loss were observed also for the speech measures only. Discriminant function analysis derived a formula, based on a subset of these measures, for classifying individuals according to temporal performance consistent with age and hearing loss categories. The most important measures to accomplish this goal involved conditions featuring temporal manipulations of complex speech and nonspeech signals.

The influence of selected cognitive factors on age-related changes in speech recognition was examined by measuring the effects of recall task, speech rate, and availability of contextual cues on recognition performance by young and elderly listeners. Stimuli were low and high context sentences from the R-SPIN test presented at normal and slowed speech rates in noise. Response modes were final word recall and sentence recall. The effects of hearing loss and age were examined by comparing performances of young and elderly listeners with normal hearing and young and elderly listeners with hearing loss. Listeners with hearing loss performed more poorly than listeners with normal hearing in nearly every condition. In addition, elderly listeners exhibited poorer performance than younger listeners on the sentence recall task, but not on the word recall task, indicating that added memory demands have a detrimental effect on elderly listeners' performance. Slowing of speech rate did not have a differential effect on performance of young and elderly listeners. All listeners performed well when stimulus contextual cues were available. Taken together, these results support the notion that the performance of elderly listeners with hearing loss is influenced by a combination of auditory processing factors, memory demands, and speech contextual information.