Individual and Age Differences in Item and Context Memory.

We investigated whether individuals who are good at recognizing previously presented items are also good at recognizing the context in which items were presented. We focused specifically on whether the relation between item recognition and context recognition abilities differs in younger and older adults. It has been hypothesized that context memory declines more rapidly in older adults due to an age-related deficit in associative binding or recollection. To test this hypothesis, younger and older adults were asked to remember lists of names and objects, as well as the context (i.e. their size, location, and color) that accompanied those items. Following presentation of each list, recognition tests for items and context were administered. Confirmatory factor analysis (CFA) models analyzing both item and context scores together provided no evidence of separate factors for item and context memory. Instead, the best-fitting model separated performance by item-type, regardless of context, and no differences were found in the structure of these abilities in younger and older adults. These findings are consistent with the limited previous latent variable research on context memory in aging suggesting that there is no context recognition memory ability separable from item memory in younger nor older adults. Instead, individual differences in recognition memory abilities may be specific to the domain of the studied stimulus.

Increased Connectivity among Sensory and Motor Regions during Visual and Audiovisual Speech Perception.

In everyday conversation, we usually process the talker's face as well as the sound of the talker's voice. Access to visual speech information is particularly useful when the auditory signal is degraded. Here, we used fMRI to monitor brain activity while adult humans (n = 60) were presented with visual-only, auditory-only, and audiovisual words. The audiovisual words were presented in quiet and in several signal-to-noise ratios. As expected, audiovisual speech perception recruited both auditory and visual cortex, with some evidence for increased recruitment of premotor cortex in some conditions (including in substantial background noise). We then investigated neural connectivity using psychophysiological interaction analysis with seed regions in both primary auditory cortex and primary visual cortex. Connectivity between auditory and visual cortices was stronger in audiovisual conditions than in unimodal conditions, including a wide network of regions in posterior temporal cortex and prefrontal cortex. In addition to whole-brain analyses, we also conducted a region-of-interest analysis on the left posterior superior temporal sulcus (pSTS), implicated in many previous studies of audiovisual speech perception. We found evidence for both activity and effective connectivity in pSTS for visual-only and audiovisual speech, although these were not significant in whole-brain analyses. Together, our results suggest a prominent role for cross-region synchronization in understanding both visual-only and audiovisual speech that complements activity in integrative brain regions like pSTS.SIGNIFICANCE STATEMENT In everyday conversation, we usually process the talker's face as well as the sound of the talker's voice. Access to visual speech information is particularly useful when the auditory signal is hard to understand (e.g., background noise). Prior work has suggested that specialized regions of the brain may play a critical role in integrating information from visual and auditory speech. Here, we show a complementary mechanism relying on synchronized brain activity among sensory and motor regions may also play a critical role. These findings encourage reconceptualizing audiovisual integration in the context of coordinated network activity.

Predicting Audiovisual Word Recognition in Noisy Situations: Toward Precision Audiology.

OBJECTIVE: Spoken communication is better when one can see as well as hear the talker. Although age-related deficits in speech perception were observed, Tye-Murray and colleagues found that even when age-related deficits in audiovisual (AV) speech perception were observed, AV performance could be accurately predicted from auditory-only (A-only) and visual-only (V-only) performance, and that knowing individuals' ages did not increase the accuracy of prediction. This finding contradicts conventional wisdom, according to which age-related differences in AV speech perception are due to deficits in the integration of auditory and visual information, and our primary goal was to determine whether Tye-Murray et al.'s finding with a closed-set test generalizes to situations more like those in everyday life. A second goal was to test a new predictive model that has important implications for audiological assessment. DESIGN: Participants (N = 109; ages 22-93 years), previously studied by Tye-Murray et al., were administered our new, open-set Lex-List test to assess their auditory, visual, and audiovisual perception of individual words. All testing was conducted in six-talker babble (three males and three females) presented at approximately 62 dB SPL. The level of the audio for the Lex-List items, when presented, was approximately 59 dB SPL because pilot testing suggested that this signal-to-noise ratio would avoid ceiling performance under the AV condition. RESULTS: Multiple linear regression analyses revealed that A-only and V-only performance accounted for 87.9% of the variance in AV speech perception, and that the contribution of age failed to reach significance. Our new parabolic model accounted for even more (92.8%) of the variance in AV performance, and again, the contribution of age was not significant. Bayesian analyses revealed that for both linear and parabolic models, the present data were almost 10 times as likely to occur with a reduced model (without age) than with a full model (with age as a predictor). Furthermore, comparison of the two reduced models revealed that the data were more than 100 times as likely to occur with the parabolic model than with the linear regression model. CONCLUSIONS: The present results strongly support Tye-Murray et al.'s hypothesis that AV performance can be accurately predicted from unimodal performance and that knowing individuals' ages does not increase the accuracy of that prediction. Our results represent an important initial step in extending Tye-Murray et al.'s findings to situations more like those encountered in everyday communication. The accuracy with which speech perception was predicted in this study foreshadows a form of precision audiology in which determining individual strengths and weaknesses in unimodal and multimodal speech perception facilitates identification of targets for rehabilitative efforts aimed at recovering and maintaining speech perception abilities critical to the quality of an older adult's life.

Guilty, Innocent, or Just Not Proven? Bayesian Verdicts in the Case of Inhibitory Deficits.

Background: This study addresses two issues: Whether age-related differences in working memory (WM) can be studied in online samples, and whether such differences reflect an inhibitory deficit. Currently, the evidence is mixed, but the playing field was not level because traditional statistics cannot provide evidence for the null hypothesis.Experiment 1: MTurk workers (ages 19-74) performed simple and complex visuospatial WM tasks to determine whether a secondary task affected the rate of age-related decline. Performance on both tasks replicated previous laboratory studies, establishing that age-related differences in WM can be studied online. Bayesian analyses revealed it is ten times as likely that there is no inhibitory deficit on visuospatial WM tasks as that there is.Experiment 2: The effects of irrelevant location information on visuospatial WM were examined in older (Mage = 64.0) and younger (Mage = 25.0) MTurk workers. Irrelevant locations produced interference, but both groups were equally affected. Bayesian analyses provided support for the null hypothesis of no age difference.Conclusions: The results of both experiments on working memory not only revealed equivalent visuospatial inhibitory function in older and younger adults, they also demonstrated that age-related differences in visuospatial WM can be effectively studied online as well as in the laboratory.

Age Differences in the Effects of Speaking Rate on Auditory, Visual, and Auditory-Visual Speech Perception.

OBJECTIVES: This study was designed to examine how speaking rate affects auditory-only, visual-only, and auditory-visual speech perception across the adult lifespan. In addition, the study examined the extent to which unimodal (auditory-only and visual-only) performance predicts auditory-visual performance across a range of speaking rates. The authors hypothesized significant Age × Rate interactions in all three modalities and that unimodal performance would account for a majority of the variance in auditory-visual speech perception for speaking rates that are both slower and faster than normal. DESIGN: Participants (N = 145), ranging in age from 22 to 92, were tested in conditions with auditory-only, visual-only, and auditory-visual presentations using a closed-set speech perception test. Five different speaking rates were presented in each modality: an unmodified (normal rate), two rates that were slower than normal, and two rates that were faster than normal. Signal to noise ratios were set individually to produce approximately 30% correct identification in the auditory-only condition and this signal to noise ratio was used in the auditory-only and auditory-visual conditions. RESULTS: Age × Rate interactions were observed for the fastest speaking rates in both the visual-only and auditory-visual conditions. Unimodal performance accounted for at least 60% of the variance in auditory-visual performance for all five speaking rates. CONCLUSIONS: The findings demonstrate that the disproportionate difficulty that older adults have with rapid speech for auditory-only presentations can also be observed with visual-only and auditory-visual presentations. Taken together, the present analyses of age and individual differences indicate a generalized age-related decline in the ability to understand speech produced at fast speaking rates. The finding that auditory-visual speech performance was almost entirely predicted by unimodal performance across all five speaking rates has important clinical implications for auditory-visual speech perception and the ability of older adults to use visual speech information to compensate for age-related hearing loss.

Effects of Early Auditory Deprivation on Working Memory and Reasoning Abilities in Verbal and Visuospatial Domains for Pediatric Cochlear Implant Recipients.

OBJECTIVES: The overall goal of this study was to compare verbal and visuospatial working memory in children with normal hearing (NH) and with cochlear implants (CI). The main questions addressed by this study were (1) Does auditory deprivation result in global or domain-specific deficits in working memory in children with CIs compared with their NH age mates? (2) Does the potential for verbal recoding affect performance on measures of reasoning ability in children with CIs relative to their NH age mates? and (3) Is performance on verbal and visuospatial working memory tasks related to spoken receptive language level achieved by children with CIs? DESIGN: A total of 54 children ranging in age from 5 to 9 years participated; 25 children with CIs and 29 children with NH. Participants were tested on both simple and complex measures of verbal and visuospatial working memory. Vocabulary was assessed with the Peabody Picture Vocabulary Test (PPVT) and reasoning abilities with two subtests of the WISC-IV (Wechsler Intelligence Scale for Children, 4th edition): Picture Concepts (verbally mediated) and Matrix Reasoning (visuospatial task). Groups were compared on all measures using analysis of variance after controlling for age and maternal education. RESULTS: Children with CIs scored significantly lower than children with NH on measures of working memory, after accounting for age and maternal education. Differences between the groups were more apparent for verbal working memory compared with visuospatial working memory. For reasoning and vocabulary, the CI group scored significantly lower than the NH group for PPVT and WISC Picture Concepts but similar to NH age mates on WISC Matrix Reasoning. CONCLUSIONS: Results from this study suggest that children with CIs have deficits in working memory related to storing and processing verbal information in working memory. These deficits extend to receptive vocabulary and verbal reasoning and remain even after controlling for the higher maternal education level of the NH group. Their ability to store and process visuospatial information in working memory and complete reasoning tasks that minimize verbal labeling of stimuli more closely approaches performance of NH age mates.

Evaluation of an online communication skills training programme for oncology nurses working with patients from minority backgrounds.

OBJECTIVE: This study aimed to develop and assess the feasibility of an online communication skills training intervention to increase cultural competence amongst oncology nurses working with individuals from minority backgrounds. METHODS: The intervention provided examples of communication strategies using vignette-based, professionally produced videos, developed through an iterative process with input from a large multidisciplinary team. Fifty-three oncology nurses completed all three questionnaires at baseline, within 2 weeks and then 3 months after accessing the programme. RESULTS: The online intervention was well received by the majority of participants, and was endorsed as clearly presented, informative, relevant and useful by more than 90% of participants. Eighty-seven percent of participants reported increased confidence in communicating with patients via an interpreter, and 93% agreed that skills they gained would be useful in providing better patient care. Participants reported significant improvements in practice while interacting with people with limited English proficiency 2 weeks and 3 months after accessing the website (X2 = 13.66, P < 0.001). CONCLUSION: This online communication training programme can now be tested for its utility in improving patient care for oncology nurses working with patients from minority backgrounds.

Culturally and linguistically diverse oncology patients' perspectives of consultation audio-recordings and question prompt lists.

OBJECTIVE: Ethnicity and migrant status result in disparities with cancer burden and survival, with communication difficulties cited as the main barrier to access. Our research team tested a communication intervention package comprising consultation audio-recordings (ARs) and question prompt lists (QPLs) for low English-speaking (LES) patients with cancer. This study explored LES patient experiences, preferences, and recommendations regarding the communication package. METHODS: Participants completed a questionnaire and qualitative interview regarding ARs and QPLs. Eligibility criteria comprised aged ≥18 years old; a consultation with an oncologist between June 1, 2015 and April 1, 2016; an Arabic, Cantonese, Greek, or Mandarin professional interpreter booked for that consultation; and randomised to receive the communication intervention. RESULTS: Eighteen patients completed the qualitative interview and 17 completed the questionnaire. Fifteen reported listening to the AR at least once. Participants reported that QPLs and ARs provide support and assistance with remembering and understanding medical information. Both resources were seen as having applicability beyond the oncology setting in regards to improving health service delivery and continuity of care. However, patients felt that individual tailoring of the resources should be considered. Patients also found it useful to share ARs with family. CONCLUSIONS: The LES participants in this study considered the ARs and QPLs useful for most, but not all contexts. Recommendations regarding delivery and use highlight that these resources should be tailored and patient-driven. Further, patients foresaw a range of additional uses for consultation ARs within the broader healthcare context.

Measuring recall of medical information in non-English-speaking people with cancer: A methodology.

BACKGROUND: Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients' memory of medical information. OBJECTIVES: This study aimed to develop a method for eliciting and coding recall of medical information in non-English-speaking patients. DESIGN: This method, called Patient-Interpreter-Clinician coding (PICcode), was developed in the context of a phase II trial conducted in two outpatient oncology clinics in Melbourne, Australia, and was refined iteratively through consultation with an expert panel and piloting. Between-coder differences in early versions of the coding system were resolved through discussion and consensus resulting in refinements to PICcode. RESULTS: The final version of PICcode involved transcribing, translating and coding of audio-recorded consultations and semi-structured interviews (SSI). The SSIs were designed to elicit patients' free-recall of medical information. Every unit of medical information in the consultation was identified and categorized in a coding tree. SSIs were coded to identify the extent to which information was recalled from the consultation. DISCUSSION: The iterative changes involved in developing PICcode assisted in clarifying precise details of the process and produced a widely applicable coding system. PICcode is the most comprehensively described method of determining the amount of information that patients who use an interpreter recall from their medical consultations. PICcode can be adapted for English-speaking patients and other healthcare populations.

Effects of environmental support on overt and covert visuospatial rehearsal.

People can rehearse to-be-remembered locations either overtly, using eye movements, or covertly, using only shifts of spatial attention. The present study examined whether the effectiveness of these two strategies depends on environmental support for rehearsal. In Experiment 1, when environmental support (i.e., the array of possible locations) was present and participants could engage in overt rehearsal during retention intervals, longer intervals resulted in larger spans, whereas in Experiment 2, when support was present but participants could only engage in covert rehearsal, longer intervals resulted in smaller spans. When environmental support was absent, however, longer retention intervals resulted in smaller memory spans regardless of which rehearsal strategies were available. In Experiment 3, analyses of participants' eye movements revealed that the presence of support increased participants' fixations of to-be-remembered target locations more than fixations of non-targets, and that this was associated with better memory performance. Further, although the total time fixating targets increased, individual target fixations were actually briefer. Taken together, the present findings suggest that in the presence of environmental support, overt rehearsal is more effective than covert rehearsal at maintaining to-be-remembered locations in working memory, and that having more time for overt rehearsal can actually increase visuospatial memory spans.

Individuals with low working memory spans show greater interference from irrelevant information because of poor source monitoring, not greater activation.

Although individuals with high and low working memory (WM) span appear to differ in the extent to which irrelevant information interferes with their performance on WM tasks, the locus of this interference is not clear. The present study investigated whether, when performing a WM task, high- and low-span individuals differ in the activation of formerly relevant, but now irrelevant items, and/or in their ability to correctly identify such irrelevant items. This was done in two experiments, both of which used modified complex WM span tasks. In Experiment 1, the span task included an embedded lexical decision task designed to obtain an implicit measure of the activation of both currently and formerly relevant items. In Experiment 2, the span task included an embedded recognition judgment task designed to obtain an explicit measure of both item and source recognition ability. The results of these experiments indicate that low-span individuals do not hold irrelevant information in a more active state in memory than high-span individuals, but rather that low-span individuals are significantly poorer at identifying such information as irrelevant at the time of retrieval. These results suggest that differences in the ability to monitor the source of information, rather than differences in the activation of irrelevant information, are the more important determinant of performance on WM tasks.

The effects of environmental support and secondary tasks on visuospatial working memory.

In the present experiments, we examined the effects of environmental support on participants' ability to rehearse locations and the role of such support in the effects of secondary tasks on memory span. In Experiment 1, the duration of interitem intervals and the presence of environmental support for visuospatial rehearsal (i.e., the array of possible memory locations) during the interitem intervals were both manipulated across four tasks. When support was provided, memory spans increased as the interitem interval durations increased, consistent with the hypothesis that environmental support facilitates rehearsal. In contrast, when environmental support was not provided, spans decreased as the duration of the interitem intervals increased, consistent with the hypothesis that visuospatial memory representations decay when rehearsal is impeded. In Experiment 2, the ratio of interitem interval duration to intertrial interval duration was kept the same on all four tasks, in order to hold temporal distinctiveness constant, yet forgetting was still observed in the absence of environmental support, consistent with the decay hypothesis. In Experiment 3, the effects of impeding rehearsal were compared to the effects of verbal and visuospatial secondary processing tasks. Forgetting of locations was greater when presentation of to-be-remembered locations alternated with the performance of a secondary task than when rehearsal was impeded by the absence of environmental support. The greatest forgetting occurred when a secondary task required the processing visuospatial information, suggesting that in addition to decay, both domain-specific and domain-general effects contribute to forgetting on visuospatial working memory tasks.

Age-related differences in delay discounting: Income matters.

Although the authors of a recent meta-analysis concluded there were no age-related differences in the discounting of delayed rewards, they did not examine the effects of income (Seaman et al., 2022). Accordingly, the present study compared discounting by younger and older adults (Ages 35-50 and 65-80) differing in household income. Two procedures were used: the Monetary Choice Questionnaire and the Adjusting-Amount procedure. Whereas no age difference was observed between the higher income (> $80,000) age groups, a significant difference was observed between younger and older adults with lower incomes (< $50,000): The younger adults discounted more steeply than the older adults. These findings, which were observed with both discounting procedures, support our buffering hypothesis, which assumes that the scarcity associated with a lower income is a stressor that can lead to steeper discounting, but that age-related increases in emotional stability can buffer such stressors, leading to age-related differences between lower income age groups. In contrast, no age difference was observed in higher income adults who experience much less scarcity. Further support for the buffering hypothesis comes from the finding that there was no age-related difference in discounting by the lower income groups when distress was statistically controlled. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Distress Signals: Age Differences in Psychological Distress before and during the COVID-19 Pandemic.

Psychological distress reached historically high levels in 2020, but why, and why were there pronounced age differences? We address these questions using a relatively novel, multipronged approach, part narrative review and part new data analyses. We first updated previous analyses of national surveys that showed distress was increasing in the US and Australia through 2017 and then re-analyzed data from the UK, comparing periods with and without lockdowns. We also analyzed the effects of age and personality on distress in the US during the pandemic. Results showed distress levels and age differences in distress were still increasing through 2019 in the US, UK, and Australia. The effects of lockdowns in 2020 revealed the roles of social deprivation and fear of infection. Finally, age-related differences in emotional stability accounted for the observed age differences in distress. These findings reveal the limitations of analyses comparing pre-pandemic and pandemic periods without accounting for ongoing trends. They also suggest that differences in personality traits such as emotional stability modulate responses to stressors. This could explain age and individual differences in both increases and decreases in distress in response to changes in the level of stressors such as those occurring prior to and during the COVID-19 pandemic.

An Eye-Movement Analysis of Overt Visual Attention During Consecutive and Simultaneous Interpreting Modes in a Remotely Interpreted Investigative Interview.

Remote interpreting via video-link is increasingly being employed in investigative interviews chiefly due to its apparent increased accessibility and efficiency. However, risks of miscommunication have been shown to be magnified in remote interpreting and empirical research specifically on video-link remote interpreting is in its infancy which greatly limits the evidence base available to inform and direct evidence-based policy and best practice, particularly in the identification of the optimal mode(s) of interpreting to be used, namely consecutive and simultaneous. Consecutive interpreting refers to a process in which the interpreter transfers short segments of speech from one language into the other as each person speaks in managed turn-taking, while simultaneous interpreting refers to the transfer of natural speech from one language into another in a concurrent manner without the need for speakers to segment their speech. This study provides novel empirical evidence by using eye tracking to compare the overt visual attention of interpreters working in a remote setting in which an English-speaking Interviewer interacts with a non-English-speaking Suspect in person, for whom interpretation is provided via video-link in real time. Using a within-subject design, we analyze eye-movement data from 28 professionally accredited interpreters who interpreted via video-link an investigative interview in which consecutive and simultaneous interpreting modes were counterbalanced. Taking interpreting performance into account, our results showed that, the consecutive mode yielded significantly less gaze time and therefore significantly less on-screen overt visual attention due to off-screen notetaking, an essential component of the consecutive interpreting mode. Relative to gaze time, the consecutive mode also resulted in significantly more and longer fixations and shifts of attention. Participants also allocated significantly more overt visual attention to the Interviewer than the Suspect, particularly in the consecutive mode. Furthermore, we found informative significant correlations between eye tracking measures and interpreting performance: accuracy, verbal rapport, and management. Finally, we found no significant differences between the three language pairs tested. We conclude with a discussion of limitations and the contributions of the study and an outline for future work on this topic of growing importance.

Differential effects of psychological distress on mitigation and vaccination: A public health conundrum.

CDC-recommended mitigation behaviors and vaccination status were assessed in an online sample (N = 810; ages 18-80). Results were consistent with a differential distress hypothesis positing that whereas psychological distress, which is induced in part by social deprivation, interferes with mitigation behaviors involving social distancing, it motivates vaccination, in part because it, in turn, can increase social interaction. Age modulated these effects. Despite the greater risk of severe consequences, older adults not only showed less distress, but compared to younger participants with equivalent levels of distress, the older adults showed less effect of distress on both social distancing and vaccination status. Together these findings highlight a conundrum faced in public health messaging. Traditional "fear messages" may be less effective for older adults, who are most in danger, whereas in younger adults, the distress induced by fear messages may motivate vaccination but diminish mitigation behaviors needed to prevent subsequent "breakthrough" infections.

Including migrant oncology patients in research: A multisite pilot randomised controlled trial testing consultation audio-recordings and question prompt lists.

Background: Oncology patients who are migrants or refugees face worse outcomes due to language and communication barriers impacting care. Interventions such as consultation audio-recordings and question prompt lists may prove beneficial in mediating communication challenges. However, designing robust research inclusive of patients who do not speak English is challenging. This study therefore aimed to: a) pilot test and assess the appropriateness of the proposed research design and methods for engaging migrant populations, and b) determine whether a multi-site RCT efficacy assessment of the communication intervention utilising these methods is feasible. Methods: This study is a mixed-methods parallel-group, randomised controlled feasibility pilot trial. Feasibility outcomes comprised assessment of: i) screening and recruitment processes, ii) design and procedures, and iii) research time and costing. The communication intervention comprised audio-recordings of a key medical consultation with an interpreter, and question prompt lists and cancer information translated into Arabic, Greek, Traditional, and Simplified Chinese. Results: Assessment of feasibility parameters revealed that despite barriers, methods utilised in this study supported the inclusion of migrant oncology patients in research. A future multi-site RCT efficacy assessment of the INFORM communication intervention using these methods is feasible if recommendations to strengthen screening and recruitment are adopted. Importantly, hiring of bilingual research assistants, and engagement with community and consumer advocates is essential. Early involvement of clinical and interpreting staff as key stakeholders is likewise recommended. Conclusion: Results from this feasibility RCT help us better understand and overcome the challenges and misconceptions about including migrant patients in clinical research.

Listening comprehension across the adult lifespan.

OBJECTIVES: Although age-related declines in perceiving spoken language are well established, the primary focus of research has been on perception of phonemes, words, and sentences. In contrast, relatively few investigations have been directed at establishing the effects of age on the comprehension of extended spoken passages. Moreover, most previous work has used extreme-group designs in which the performance of a group of young adults is contrasted with that of a group of older adults and little if any information is available regarding changes in listening comprehension across the adult lifespan. Accordingly, the goals of the current investigation were to determine whether there are age differences in listening comprehension across the adult lifespan and, if so, whether similar trajectories are observed for age-related changes in auditory sensitivity and listening comprehension. DESIGN: This study used a cross-sectional lifespan design in which approximately 60 individuals in each of 7 decades, from age 20 to 89 yr (a total of 433 participants), were tested on three different measures of listening comprehension. In addition, we obtained measures of auditory sensitivity from all participants. RESULTS: Changes in auditory sensitivity across the adult lifespan exhibited the progressive high-frequency loss typical of age-related hearing impairment. Performance on the listening comprehension measures, however, demonstrated a very different pattern, with scores on all measures remaining relatively stable until age 65 to 70 yr, after which significant declines were observed. Follow-up analyses indicated that this same general pattern was observed across three different types of passages (lectures, interviews, and narratives) and three different question types (information, integration, and inference). Multiple regression analyses indicated that low-frequency pure-tone average was the single largest contributor to age-related variance in listening comprehension for individuals older than 65 yr, but that age accounted for significant variance even after controlling for auditory sensitivity. CONCLUSIONS: Results suggest that age-related reductions in auditory sensitivity account for a sizable portion of individual variance in listening comprehension that was observed across the adult lifespan. Other potential contributors including a possible role for age-related declines in perceptual and cognitive abilities are discussed. Clinically, the results suggest that amplification is likely to improve listening comprehension but that increased audibility alone may not be sufficient to maintain listening comprehension beyond age 65 and 70 yr. Additional research will be needed to identify potential target abilities for training or other rehabilitation procedures that could supplement sensory aids to provide additional improvements in listening comprehension.