Auditory and cognitive function in older adults living with and without HIV.

OBJECTIVES: To evaluate the peripheral hearing sensitivity and central auditory processing in persons with HIV (PWH) and persons without HIV (PWoH); and the association between cognitive function and central auditory processing in PWH and PWoH. DESIGN: Cross-sectional, observational study. METHODS: Participants included 67 PWH {70.2% men; mean age = 66.6 years [standard deviation (SD) = 4.7 years]} and 35 PWoH [51.4% men; mean age = 72.9 years (SD = 7.0 years)]. Participants completed a hearing assessment and a central auditory processing assessment that included dichotic digits testing (DDT). Pure-tone air-conduction thresholds were obtained at octave frequencies from 0.25 through 8 kHz. A pure-tone average (PTA) was calculated from 0.5, 1, 2, and 4 kHz thresholds for each ear. Participants also completed a neuropsychological battery assessing cognition in seven domains. RESULTS: PWH had slightly lower (i.e. better) PTAs compared with PWoH, but this was not statistically significant. Conversely, PWH and PWoH had similar DDT results for both ears. Poorer verbal fluency, learning, and working memory performance was significantly related to lower DDT scores, and those defined as having verbal fluency, learning, and working memory impairment had significantly poorer DDT scores (8-18% lower) in both ears. CONCLUSION: Hearing and DDT results were similar in PWH and PWoH. The relationship between verbal fluency, learning, and working memory impairment and poorer DDT results did not differ by HIV serostatus. Clinicians, particularly audiologists, should be mindful of cognitive functioning abilities when evaluating central auditory processing.

Auditory Processing of Older Adults With Probable Mild Cognitive Impairment.

Purpose: Studies suggest that deficits in auditory processing predict cognitive decline and dementia, but those studies included limited measures of auditory processing. The purpose of this study was to compare older adults with and without probable mild cognitive impairment (MCI) across two domains of auditory processing (auditory performance in competing acoustic signals and temporal aspects of audition). Method: The Montreal Cognitive Assessment (Nasreddine et al., 2005) was used to classify participants as with or without probable MCI. In this cross-sectional study, participants (n = 79) completed 4 measures of auditory processing: Synthetic Sentence Identification with Ipsilateral Competing Message (Gates, Beiser, Rees, D'Agostino, & Wolf, 2002), Dichotic Sentence Identification (Fifer, Jerger, Berlin, Tobey, & Campbell, 1983), Adaptive Tests of Temporal Resolution (ATTR; Lister & Roberts, 2006; across-channel and within-channel subtests), and time-compressed speech (Wilson, 1993; Wilson, Preece, Salamon, Sperry, & Bornstein, 1994). Audiometry was also conducted. Results: Those with probable MCI had significantly poorer performance than those without MCI on Synthetic Sentence Identification with Ipsilateral Competing Message, Dichotic Sentence Identification, and the ATTR within-channel subtest. No group differences were found for time-compressed speech, ATTR across-channel, or audiometric measures. Conclusions: Older adults with cognitive impairment not only have difficulty with competing acoustic signals but may also show poor temporal processing. The profile of auditory processing deficits among older adults with cognitive impairment may include multiple domains.