RESUMO
PURPOSE: Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. METHOD: We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. RESULTS: Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. CONCLUSIONS: Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26237060.
Assuntos
Disfunção Cognitiva , Interação Social , Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Adulto , Idoso , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Adulto Jovem , Percepção da Fala , Ruído , Presbiacusia/psicologia , Presbiacusia/diagnóstico , Audiometria de Tons Puros , Envelhecimento/psicologia , Envelhecimento/fisiologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: This study aimed to investigate the effects of neurofeedback training (NFT) on alpha activity in quantitative electroencephalography (QEEG), cognitive function, and speech perception in elderly with presbycusis. METHODS: This study was conducted from June 15 to November 30, 2020. The experimental group (n = 28) underwent NFT, while the control group (n = 31) was instructed to continue with their routine daily life. The NFT conducted for 40 min, two times a week, for a total of 16 sessions and was performed using Neuroharmony S and BrainHealth 2.7. The alpha activity was measured as alpha waves using QEEG. The cognitive function was measured using the Korean version of Mini-Mental Status Examination, digit span forward and backward (DSF and DSB). The speech perception was measured using the word and sentence recognition score (WRS and SRS) using an audiometer with the Korean Standard Monosyllabic Word Lists for Adults. RESULTS: The experimental group demonstrated improvement in the alpha wave of the left frontal lobe measured as alpha activity (t=-2.521, p = .018); MMSE-K (t=-3.467, p < .01), and DSF (t=-2.646, p < .05) measured as cognitive function; and WRS (t=-3.255, p = .003), and SRS (t=-2.851, p = .008) measured as speech perception compared to the control group. CONCLUSIONS: This study suggests that NFT could be considered an effective cognitive and auditory rehabilitation method based on brain and cognitive science for improving alpha activity, cognitive function, and speech perception.
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Cognição , Eletroencefalografia , Neurorretroalimentação , Presbiacusia , Percepção da Fala , Humanos , Masculino , Feminino , Idoso , Cognição/fisiologia , Percepção da Fala/fisiologia , Eletroencefalografia/métodos , Presbiacusia/fisiopatologia , Presbiacusia/reabilitação , Presbiacusia/diagnóstico , Presbiacusia/psicologia , Presbiacusia/terapia , Neurorretroalimentação/métodos , Ritmo alfa/fisiologiaRESUMO
Older adults with hearing loss may experience difficulty recognizing speech in noise due to factors related to attenuation (e.g., reduced audibility and sensation levels, SLs) and distortion (e.g., reduced temporal fine structure, TFS, processing). Furthermore, speech recognition may improve when the amplitude modulation spectrum of the speech and masker are non-overlapping. The current study investigated this by filtering the amplitude modulation spectrum into different modulation rates for speech and speech-modulated noise. The modulation depth of the noise was manipulated to vary the SL of speech glimpses. Younger adults with normal hearing and older adults with normal or impaired hearing listened to natural speech or speech vocoded to degrade TFS cues. Control groups of younger adults were tested on all conditions with spectrally shaped speech and threshold matching noise, which reduced audibility to match that of the older hearing-impaired group. All groups benefitted from increased masker modulation depth and preservation of syllabic-rate speech modulations. Older adults with hearing loss had reduced speech recognition across all conditions. This was explained by factors related to attenuation, due to reduced SLs, and distortion, due to reduced TFS processing, which resulted in poorer auditory processing of speech cues during the dips of the masker.
Assuntos
Estimulação Acústica , Limiar Auditivo , Sinais (Psicologia) , Ruído , Mascaramento Perceptivo , Percepção da Fala , Humanos , Percepção da Fala/fisiologia , Idoso , Ruído/efeitos adversos , Adulto , Adulto Jovem , Masculino , Feminino , Pessoa de Meia-Idade , Fatores Etários , Reconhecimento Psicológico , Fatores de Tempo , Envelhecimento/fisiologia , Presbiacusia/fisiopatologia , Presbiacusia/diagnóstico , Presbiacusia/psicologia , Pessoas com Deficiência Auditiva/psicologia , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Inteligibilidade da FalaRESUMO
Age-Related Hearing Loss (ARHL) is a common problem in aging. Numerous longitudinal cohort studies have revealed that ARHL is closely related to cognitive function, leading to a significant risk of cognitive decline and dementia. This risk gradually increases with the severity of hearing loss. We designed dual auditory Oddball and cognitive task paradigms for the ARHL subjects, then obtained the Montreal Cognitive Assessment (MoCA) scale evaluation results for all the subjects. Multi-dimensional EEG characteristics helped explore potential biomarkers to evaluate the cognitive level of the ARHL group, having a significantly lower P300 peak amplitude coupled with a prolonged latency. Moreover, visual memory, auditory memory, and logical calculation were investigated during the cognitive task paradigm. In the ARHL groups, the alpha-to-beta rhythm energy ratio in the visual and auditory memory retention period and the wavelet packet entropy value within the logical calculation period were significantly reduced. Correlation analysis between the above specificity indicators and the subjective scale results of the ARHL group revealed that the auditory P300 component characteristics could assess attention resources and information processing speed. The alpha and beta rhythm energy ratio and wavelet packet entropy can become potential indicators to determine working memory and logical cognitive computation-related cognitive ability.
Assuntos
Disfunção Cognitiva , Presbiacusia , Humanos , Estudos Longitudinais , Cognição , Presbiacusia/psicologia , Disfunção Cognitiva/diagnóstico , EletroencefalografiaRESUMO
BACKGROUND: Although inconsistency between objective and subjective hearing loss among older adults has been suggested, a systematic examination of the cognitive and physical functioning among such older adults is lacking. Our objective was to assess the cognitive, physical, and mental profiles associated with the discrepancy. METHODS: The auditory acuity of 696 community-dwelling older adults was evaluated using a pure-tone average of hearing thresholds at 1.0 and 4.0 kHz in the better-hearing ear. Participants were then stratified as follows: normal hearing ≤ 25 dB, mild loss >25 dB and ≤40 dB, and moderate loss >40 dB and ≤70 dB. Global cognition, gait speed, and depressive symptoms were also assessed. RESULTS: Among older adults, 63.5% of those with mild hearing loss and 22.2% of those with moderate hearing loss did not recognize hearing difficulties. Significantly lower cognition and gait performance were observed in those with moderate hearing loss without subjective hearing loss (i.e., overestimation of hearing acuity) than in those with subjective hearing loss. Furthermore, older adults with subjective hearing loss showed a higher tendency toward depression than those without subjective hearing loss, irrespective of objective hearing loss. CONCLUSIONS: Our results suggest that failure to recognize a high level of age-related hearing loss may be related to impaired cognition and gait performance among older adults. Subjective hearing loss may indicate a tendency toward depression.
Assuntos
Disfunção Cognitiva , Presbiacusia , Humanos , Idoso , Audiometria de Tons Puros , Autoavaliação Diagnóstica , Presbiacusia/diagnóstico , Presbiacusia/psicologia , Cognição , Disfunção Cognitiva/diagnósticoRESUMO
OBJECTIVES: Sensorineural hearing loss (presbycusis) affects up to half of the adults, is associated with cognitive decline. Whether this association reflects the cause, the consequence, or parallel processes driven by other factors remains unclear. Both presbycusis and cognition are linked to elevated metabolic risk, which in turn raises with age. METHOD: In a multioccasion longitudinal design, we used latent change score models with strong factorial invariance to assess the change in pure-tone threshold auditory function, fluid intelligence, metabolic risk, variability therein, and the dynamic relationships among the 3 domains. We examined, up to 4 times over more than 7 years, a sample of relatively healthy 687 adults (aged 18.17-83.25 years). RESULTS: We found that levels of auditory and cognitive functioning at time t-1 influence each other's subsequent change between times t-1 and t, even when controlling for the reciprocal effects of metabolic risk on both. Thus, auditory and cognitive functioning do not only decline in parallel in healthy adults, but also affect each other's trajectories. To the best of our knowledge, this is the first long-term study with such evidence. DISCUSSION: Our results are in accord with extant hypotheses about auditory-cognitive associations in old age (e.g., social isolation, cognitive load, increased inflammation, reduced gene expression, and other microvascular or neuropathological factors). They also echo previous reports underscoring the need for improving access to hearing aids and other rehabilitative services aimed at reducing hearing loss. If applied early in the aging process, such interventions may mitigate cognitive decline.
Assuntos
Presbiacusia , Humanos , Presbiacusia/psicologia , Envelhecimento/psicologia , Estudos Longitudinais , Audição , CogniçãoRESUMO
Age-related hearing loss has been associated with increased recruitment of frontal brain areas during speech perception to compensate for the decline in auditory input. This additional recruitment may bind resources otherwise needed for understanding speech. However, it is unknown how increased demands on listening interact with increasing cognitive demands when processing speech in age-related hearing loss. The current study used a full-sentence working memory task manipulating demands on working memory and listening and studied untreated mild to moderate hard of hearing (n = 20) and normal-hearing age-matched participants (n = 19) with functional MRI. On the behavioral level, we found a significant interaction of memory load and listening condition; this was, however, similar for both groups. Under low, but not high memory load, listening condition significantly influenced task performance. Similarly, under easy but not difficult listening conditions, memory load had a significant effect on task performance. On the neural level, as measured by the BOLD response, we found increased responses under high compared to low memory load conditions in the left supramarginal gyrus, left middle frontal gyrus, and left supplementary motor cortex regardless of hearing ability. Furthermore, we found increased responses in the bilateral superior temporal gyri under easy compared to difficult listening conditions. We found no group differences nor interactions of group with memory load or listening condition. This suggests that memory load and listening condition interacted on a behavioral level, however, only the increased memory load was reflected in increased BOLD responses in frontal and parietal brain regions. Hence, when evaluating listening abilities in elderly participants, memory load should be considered as it might interfere with the assessed performance. We could not find any further evidence that BOLD responses for the different memory and listening conditions are affected by mild to moderate age-related hearing loss.
Assuntos
Esforço de Escuta/fisiologia , Memória de Curto Prazo/fisiologia , Presbiacusia/psicologia , Aprendizagem Verbal/fisiologia , Idoso , Mapeamento Encefálico , Cognição , Feminino , Lobo Frontal/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Testes Neuropsicológicos , Lobo Parietal/fisiologiaRESUMO
OBJECTIVES/HYPOTHESIS: To analyze the association between early audiometric age-related hearing loss and brain ß-amyloid, the pathologic hallmark of Alzheimer's disease (AD). STUDY DESIGN: Cross-sectional analysis of a prospective cohort study. METHODS: A cross-sectional analysis was performed on 98 participants in a cohort study of hearing and brain biomarkers of AD. The primary outcome was whole brain ß-amyloid standardized uptake value ratio (SUVR) on positron emission tomography (PET). The exposure was hearing, as measured by either pure-tone average or word recognition score in the better ear. Covariates included age, gender, education, cardiovascular disease, and hearing aid use. Linear regression was performed to analyze the association between ß-amyloid and hearing, adjusting for potentially confounding covariates. RESULTS: The mean age ± standard deviation was 64.6 ± 3.5 years. In multivariable regression, adjusting for demographics, education, cardiovascular disease, and hearing aid use, whole brain ß-amyloid SUVR increased by 0.029 (95% confidence interval [CI]: 0.003-0.056) for every 10 dB increase in pure-tone average (P = .030). Similarly, whole brain ß-amyloid SUVR increased by 0.061 (95% CI: 0.009-0.112) for every 10% increase in word recognition score (P = .012). CONCLUSIONS: Worsening hearing was associated with higher ß-amyloid burden, a pathologic hallmark of AD, measured in vivo with PET scans. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:633-638, 2021.
Assuntos
Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Tomografia por Emissão de Pósitrons , Presbiacusia/metabolismo , Idoso , Doença de Alzheimer/complicações , Audiometria de Tons Puros , Biomarcadores/metabolismo , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Presbiacusia/psicologia , Estudos Prospectivos , Análise de RegressãoRESUMO
As the proportion of older people increases, it is important to investigate hearing acuity in older individuals and to calculate hearing decline for older ages, using standardised test protocols. The main aim of this study was to determine pure-tone hearing thresholds in an unscreened birth cohort of 85-year-olds born in 1930, living in an industrial Swedish city. A further aim was to describe hearing decline in men and women from 75 to 85 years of age with the aid of longitudinal data. The study was part of the Gothenburg H70 Birth Cohort Studies in Sweden. Hearing thresholds (0.25-8â¯kHz) were measured using automated pure-tone audiometry for 286 85-year-old participants. A subsample (nâ¯=â¯182) was hearing examined at 75 years of age and studied longitudinally from 75 to 85 years. At age 85 years, men had better hearing at low frequencies but poorer hearing at high frequencies than women. The longitudinal study showed a considerable decline between 75 and 85â¯yearsâ¯at mid-high frequencies (>1â¯kHz) and the amount of decline was similar between sexes. The results contribute to the estimation of the future need for hearing health services.
Assuntos
Audiometria de Tons Puros , Limiar Auditivo , Audição , Presbiacusia/diagnóstico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Valor Preditivo dos Testes , Presbiacusia/fisiopatologia , Presbiacusia/psicologia , SuéciaRESUMO
Speech-in-noise (SIN) comprehension deficits in older adults have been linked to changes in both subcortical and cortical auditory evoked responses. However, older adults' difficulty understanding SIN may also be related to an imbalance in signal transmission (i.e., functional connectivity) between brainstem and auditory cortices. By modeling high-density scalp recordings of speech-evoked responses with sources in brainstem (BS) and bilateral primary auditory cortices (PAC), we show that beyond attenuating neural activity, hearing loss in older adults compromises the transmission of speech information between subcortical and early cortical hubs of the speech network. We found that the strength of afferent BSâPAC neural signaling (but not the reverse efferent flow; PACâBS) varied with mild declines in hearing acuity and this "bottom-up" functional connectivity robustly predicted older adults' performance in a SIN identification task. Connectivity was also a better predictor of SIN processing than unitary subcortical or cortical responses alone. Our neuroimaging findings suggest that in older adults (i) mild hearing loss differentially reduces neural output at several stages of auditory processing (PACâ¯>â¯BS), (ii) subcortical-cortical connectivity is more sensitive to peripheral hearing loss than top-down (cortical-subcortical) control, and (iii) reduced functional connectivity in afferent auditory pathways plays a significant role in SIN comprehension problems.
Assuntos
Córtex Auditivo/fisiopatologia , Tronco Encefálico/fisiopatologia , Compreensão , Ruído/efeitos adversos , Mascaramento Perceptivo , Pessoas com Deficiência Auditiva/psicologia , Presbiacusia/psicologia , Inteligibilidade da Fala , Percepção da Fala , Fatores Etários , Idoso , Envelhecimento/psicologia , Vias Auditivas/fisiopatologia , Vias Eferentes/fisiopatologia , Eletroencefalografia , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Presbiacusia/diagnóstico , Presbiacusia/fisiopatologiaRESUMO
Hearing loss is common in the geriatric population. Most hearing loss is associated with presbycusis or age-related hearing loss, impacting one-third of individuals over 65 years and increasing in prevalence with age. Hearing loss impacts quality of life, psychological health, and cognition. Implantable auditory devices are an exceptional option to improve hearing and quality of life. Various implantable auditory devices have been implemented safely with significant improvement in communication and performance on auditory tasks. Counseling is essential to establishing realistic expectations. Rehabilitation may be required to optimize outcomes and auditory performance with use.
Assuntos
Prótese Ancorada no Osso , Presbiacusia/psicologia , Presbiacusia/reabilitação , Qualidade de Vida , Idoso , Avaliação Geriátrica , Auxiliares de Audição , Humanos , Presbiacusia/epidemiologia , Desenho de Prótese , Percepção da FalaRESUMO
Polyphenols are promising nutritional bioactives exhibiting beneficial effect on age-related cognitive decline. This study evaluated the effect of a polyphenol-rich extract from grape and blueberry (PEGB) on memory of healthy elderly subjects (60-70 years-old). A bicentric, randomized, double-blind, placebo-controlled trial was conducted with 215 volunteers receiving 600 mg/day of PEGB (containing 258 mg flavonoids) or a placebo for 6 months. The primary outcome was the CANTAB Paired Associate Learning (PAL), a visuospatial learning and episodic memory test. Secondary outcomes included verbal episodic and recognition memory (VRM) and working memory (SSP). There was no significant effect of PEGB on the PAL on the whole cohort. Yet, PEGB supplementation improved VRM-free recall. Stratifying the cohort in quartiles based on PAL at baseline revealed a subgroup with advanced cognitive decline (decliners) who responded positively to the PEGB. In this group, PEGB consumption was also associated with a better VRM-delayed recognition. In addition to a lower polyphenol consumption, the urine metabolomic profile of decliners revealed that they excreted more metabolites. Urinary concentrations of specific flavan-3-ols metabolites were associated, at the end of the intervention, with the memory improvements. Our study demonstrates that PEGB improves age-related episodic memory decline in individuals with the highest cognitive impairments.
Assuntos
Envelhecimento , Mirtilos Azuis (Planta)/química , Memória Episódica , Polifenóis/administração & dosagem , Presbiacusia , Reconhecimento Psicológico/efeitos dos fármacos , Navegação Espacial/efeitos dos fármacos , Vitis/química , Idoso , Envelhecimento/efeitos dos fármacos , Envelhecimento/fisiologia , Suplementos Nutricionais , Feminino , Flavonoides/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Extratos Vegetais/administração & dosagem , Presbiacusia/diagnóstico , Presbiacusia/tratamento farmacológico , Presbiacusia/psicologia , Resultado do TratamentoRESUMO
Hearing impairment in older people is thought to arise from impaired temporal processing in auditory circuits. We used a systems-level (scalp recordings) and a microcircuit-level (extracellular recordings) approach to investigate how aging affects the sensitivity to temporal envelopes of speech-like sounds in rats. Scalp-recorded potentials suggest an age-related increase in sensitivity to temporal regularity along the ascending auditory pathway. The underlying cellular changes in the midbrain were examined using extracellular recordings from inferior colliculus neurons. We observed an age-related increase in sensitivity to the sound's onset and temporal regularity (i.e., periodicity envelope) in the spiking output of inferior colliculus neurons, relative to their synaptic inputs (local field potentials). This relative enhancement for aged animals was most prominent for multi-unit (relative to single-unit) spiking activity. Spontaneous multi-unit, but not single-unit, activity was also enhanced in aged compared with young animals. Our results suggest that aging is associated with altered sensitivity to a sound's temporal regularities, and that these effects may be due to increased gain of neural network activity in the midbrain.
Assuntos
Estimulação Acústica , Envelhecimento/fisiologia , Envelhecimento/psicologia , Percepção Auditiva/fisiologia , Encéfalo/fisiopatologia , Colículos Inferiores/fisiopatologia , Neurônios/fisiologia , Presbiacusia/fisiopatologia , Presbiacusia/psicologia , Som , Fala , Animais , Estudos Transversais , Modelos Animais de Doenças , Fenômenos Eletrofisiológicos , Potenciais Evocados Auditivos do Tronco Encefálico , Masculino , Ratos Endogâmicos F344RESUMO
OBJECTIVE: This review evaluated the data from five datasets having pure-tone thresholds and functional measures of speech communication from relatively large groups of older adults to evaluate the validity of the proposed new World Health Organisation (WHO) hearing-impairment grading system, referred to here as WHO-proposed. DESIGN: This was a review of studies identified from the literature having both pure-tone audiometry and functional measures of speech communication from relatively large samples of older adults. STUDY SAMPLE: Three population or population-sample datasets and two clinical datasets were identified with access provided to de-identified data for five of these six studies. RESULTS: As the WHO-proposed hearing-impairment grade progressed from "normal" to "severe" (insufficient data from older adults were available for the "profound" category), each step in this progression led to a significant difference in functional communication relative to the preceding step. Cohen's d effect sizes were moderate to very large between each successive step on the WHO-proposed hearing-impairment grading scale, with some exceptions for the step from "normal" to "mild/slight" grades. CONCLUSIONS: The WHO-proposed hearing-impairment grading system, recently developed through expert opinion and adopted by WHO, is validated here with evidence from studies of functional communication in older adults.
Assuntos
Audiometria de Tons Puros , Audiometria da Fala , Limiar Auditivo , Avaliação da Deficiência , Pessoas com Deficiência Auditiva/psicologia , Presbiacusia/diagnóstico , Percepção da Fala , Organização Mundial da Saúde , Idoso , Idoso de 80 Anos ou mais , Feminino , Audição , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Presbiacusia/classificação , Presbiacusia/fisiopatologia , Presbiacusia/psicologia , Reconhecimento Psicológico , Índice de Gravidade de Doença , Terminologia como AssuntoRESUMO
BACKGROUND: Dual-task procedures are commonly implemented to examine cognitive load and listening effort as individual differences in cognition often determine successful listening. However, which methods are most efficacious is unclear. Specifically, standardized, targeted assessment procedures for establishing cognitive function, and age-related changes that might account for changes in dual-task performance have yet to be established. Additional data are needed across aging populations, including middle-aged adults and older adults to establish the trend of performance changes throughout the aging process. Investigations of the relationship between cognitive function and dual-task performance may better inform clinical decisions. OBJECTIVE: The purpose of this study was to investigate if cognitive function predicts dual-task performance across adults with and without hearing loss. METHODS: Participants were divided into two groups based on age. Group 1: 14 listeners (Female = 11), 30-50 years old, with normal hearing. Group 2: 12 listeners (Female = 9), 60-80 years old, with normal hearing to near-normal hearing, including typical age-related hearing loss. Participants were administered four of the Woodcock-Johnson III cognitive subtests and standard hearing threshold procedures. All participants were tested in each of three experimental conditions, including two perceptual-cognitive dual-tasks: (1) Auditory word recognition + visual processing, (2) Auditory working memory (sentence) + visual processing in noise, and (3) Auditory working memory (word) + visual processing. RESULTS: Results indicated that cognitive function does predict dual-task performance regardless of age and hearing function. CONCLUSION: Cognitive function may predict dual-task performance during speech-in-noise tasks. Further research investigating the predictive value of related cognitive subtests to listening effort is warranted.
Assuntos
Envelhecimento/psicologia , Percepção Auditiva , Cognição , Pessoas com Deficiência Auditiva/psicologia , Presbiacusia/psicologia , Estimulação Acústica , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Limiar Auditivo , Estudos de Casos e Controles , Feminino , Audição , Humanos , Masculino , Memória de Curto Prazo , Pessoa de Meia-Idade , Ruído/efeitos adversos , Mascaramento Perceptivo , Estimulação Luminosa , Presbiacusia/diagnóstico , Presbiacusia/fisiopatologia , Percepção VisualRESUMO
This investigation assessed the impact of hearing loss and lateralized auditory attention on spatiotemporal parameters of gait during overground dual-tasking by the use of the dichotic listening task. Seventy-eight right-handed, healthy older adults between 60 and 88â¯years were assigned to a Young-Old (<70â¯years) or an Old-Old (>71â¯years) group. Cognitive assessment and pure tone audiometry were conducted. Spatiotemporal parameters of gait quantified by mean (M), and coefficient of variations (CoV) were evaluated with the OptoGait system during 3 dichotic listening conditions: Non-Forced, Forced-Right and Forced-Left. Factorial analyses of variance and covariance were used to assess group differences and the moderating effects of hearing status, respectively. Results demonstrated that three of the gait parameters assessed were affected asymmetrically by the dual-task paradigm after controlling for hearing status. Asymmetries existed on step width, gait speed and variability of stride length. Finally, correlations between gait outcomes and dichotic listening results showed that M and CoVs in gait parameters during right-ear responses were longer compared with left-ear. Left-ear responses were related to increased variability on stride length, which indicates higher difficulty level. Hearing status varying from normal to mild levels of hearing loss modulates spatiotemporal gait outcomes measured during dichotic listening execution. Findings suggest that attending to left side stimuli relates to increased gait variability, while focusing on right-side assures a safe walk. Results demonstrated that attending to right-ear stimuli is an adaptive strategy for older adults that compensates for limited sensorimotor and cognitive resources during walking.
Assuntos
Envelhecimento/fisiologia , Atenção , Marcha , Presbiacusia/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/psicologia , Audiometria de Tons Puros , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Presbiacusia/psicologiaRESUMO
This study investigated the relation between the intelligibility of conversational and clear speech produced by older and younger adults and (a) the acoustic profile of their speech (b) communication effectiveness. Speech samples from 30 talkers from the elderLUCID corpus were used: 10 young adults (YA), 10 older adults with normal hearing (OANH) and 10 older adults with presbycusis (OAHL). Samples were extracted from recordings made while participants completed a problem-solving cooperative task (diapix) with a conversational partner who could either hear them easily (NORM) or via a simulated hearing loss (HLS), which led talkers to naturally adopt a clear speaking style. In speech-in-noise listening experiments involving 21 young adult listeners, speech samples by OANH and OAHL were rated and perceived as less intelligible than those of YA talkers. HLS samples were more intelligible than NORM samples, with greater improvements in intelligibility across conditions seen for OA speech. The presence of presbycusis affected (a) the clear speech strategies adopted by OAHL talkers and (b) task effectiveness: OAHL talkers showed some adaptations consistent with an increase in vocal effort, and it took them significantly longer than the YA group to complete the diapix task. The relative energy in the 1-3â¯kHz frequency region of the long-term average spectrum was the feature that best predicted: (a) the intelligibility of speech samples, and (b) task transaction time in the HLS condition. Overall, our study suggests that spontaneous speech produced by older adults is less intelligible in babble noise, probably due to less energy present in the 1-3â¯kHz frequency range rich in acoustic cues. Even mild presbycusis in 'healthy aged' adults can affect the dynamic adaptations in speech that are beneficial for effective communication.
Assuntos
Envelhecimento/psicologia , Audição , Pessoas com Deficiência Auditiva/psicologia , Presbiacusia/psicologia , Acústica da Fala , Inteligibilidade da Fala , Percepção da Fala , Qualidade da Voz , Adulto , Fatores Etários , Feminino , Humanos , Masculino , Ruído/efeitos adversos , Mascaramento Perceptivo , Presbiacusia/diagnóstico , Presbiacusia/fisiopatologia , Adulto JovemRESUMO
Age-related hearing loss is a multifactorial condition that affects more than one-third of the aging population. Left untreated it can increase the risk of cognitive decline, dementia, social isolation, depression, and falls. Hearing augmentation devices exhibit improved digital sound processing and Smartphone connectivity. Stigma remains one of the prominent barriers and todays devices offer in the canal models, miniature sizes, and camouflage with the hair or skin color. Although rigorous scientific efforts are made in the research field of inner ear regeneration and some clinical early phase studies do exist, to date, the clinical availability is still some time away.
Assuntos
Auxiliares de Audição , Invenções/tendências , Presbiacusia/psicologia , Presbiacusia/reabilitação , Acidentes por Quedas , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/psicologia , Demência/psicologia , Depressão/psicologia , Humanos , Isolamento SocialRESUMO
Reductions in sound-evoked activity in the auditory nerve due to hearing loss have been shown to cause pathological changes in central auditory structures. Hearing loss due strictly to the aging process are less well documented. In this study of CBA/CaH mice, we provide evidence for age-related pathology in the endbulb of Held, a large axosomatic ending arising from myelinated auditory nerve fibers. Endbulbs are known to be involved in the processing of temporal cues used for sound localization and speech comprehension. Hearing thresholds as measured by auditory brainstem response (ABR) thresholds remained stable up to one year, whereas suprathreshold amplitudes of early ABR waves decreased by up to 50% in older mice, similar to that reported for age-related cochlear synaptopathy (Sergeyenko et al., 2013). The reduction of ABR response magnitude with age correlated closely in time with the gradual atrophy of endbulbs of Held, and is consistent with the hypothesis that endbulb integrity is dependent upon normal levels of spike activity in the auditory nerve. These results indicate that central auditory pathologies emerge as consequence of so-called "hidden" hearing loss and suggest that such brain changes require consideration when devising therapeutic interventions.
Assuntos
Doenças Auditivas Centrais/fisiopatologia , Limiar Auditivo , Nervo Coclear/fisiopatologia , Potenciais Evocados Auditivos do Tronco Encefálico , Presbiacusia/fisiopatologia , Estimulação Acústica , Fatores Etários , Animais , Doenças Auditivas Centrais/patologia , Doenças Auditivas Centrais/psicologia , Comportamento Animal , Nervo Coclear/patologia , Modelos Animais de Doenças , Feminino , Masculino , Camundongos Endogâmicos CBA , Presbiacusia/patologia , Presbiacusia/psicologiaRESUMO
BACKGROUND: Previous research has suggested that speech perception in elderly adults is influenced not only by age-related hearing loss or presbycusis but also by declines in cognitive abilities, by background noise and by the syntactic complexity of the message. AIMS: To gain further insight into the influence of these cognitive as well as acoustic and linguistic factors on speech perception in elderly adults by investigating inhibitory control as a listener characteristic and background noise type and syntactic complexity as input characteristics. METHODS & PROCEDURES: Phoneme identification was measured in different noise conditions and in different linguistic contexts (single words, sentences with varying syntactic complexity). Additionally, inhibitory control was measured using a visual stimulus-response matching task. Fifty-one adults participated in this study, including elderly adults with age-related hearing loss (n = 9) and with normal hearing (n = 17), and a control group of normal hearing younger adults (n = 25). OUTCOMES & RESULTS: The analysis revealed that elderly adults with normal hearing and with hearing loss were less likely to identify successfully phonemes in single words than younger normal hearing controls. In the context of sentences, only elderly adults with hearing loss had a lower odds of correct phoneme perception than the control group. Additionally, in elderly adults with hearing loss, phoneme-in-sentence perception was linked to age-related declines in inhibitory control. In all participants, phoneme identification in sentences was influenced by both noise type and syntactic complexity. CONCLUSIONS & IMPLICATIONS: Inhibitory control and syntactic complexity might play a significant role in speech perception, especially in elderly listeners. These factors might also influence the results of clinical assessments of speech perception. Testing procedures thus need to be selected and their results interpreted carefully with these influences in mind.