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OBJECTIVE: The aim of this study was to identify risk factors for self-reported balance problems, and to analyse associations between hearing and balance. DESIGN: A battery of tests was administered to assess hearing and balance performance, as well as additional health-related factors indicative of frailty and fall risk. In a retrospective analysis, logistic regression was used to identify risk factors for self-reported balance problems and linear regression was used to identify associations between hearing ability and functional balance. STUDY SAMPLE: For the risk factor analysis, 199 volunteers aged 55-81 years (mean:67) were divided into two groups according to their self-reported balance problems. Only participants lacking self-reported balance problems (n = 157) were included in the second analysis. RESULTS: Female gender, frailty, and fine-motor skills were statistically significant predictors of self-reported balance problems. Functional balance performance was related to hearing impairment for dynamic, but not for static, balance tasks. CONCLUSION: For a holistic approach to healthcare and regardless of age, individuals with multiple comorbidities and/or phenotypic signs of frailty should be considered at risk for falls. For further research, it was shown that dynamic, rather than static, balance tasks may be needed to gain deeper insights into the relationship between hearing and balance.
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A multi-talker paradigm is introduced that uses different attentional processes to adjust speech-recognition scores with the goal of conducting measurements at high signal-to-noise ratios (SNR). The basic idea is to simulate a group conversation with three talkers. Talkers alternately speak sentences of the German matrix test OLSA. Each time a sentence begins with the name "Kerstin" (call sign), the participant is addressed and instructed to repeat the last words of all sentences from that talker, until another talker begins a sentence with "Kerstin". The alternation of the talkers is implemented with an adjustable overlap time that causes an overlap between the call sign "Kerstin" and the target words to be repeated. Thus, the two tasks of detecting "Kerstin" and repeating target words are to be done at the same time. The paradigm was tested with 22 young normal-hearing participants (YNH) for three overlap times (0.6â s, 0.8â s, 1.0â s). Results for these overlap times show significant differences, with median target word recognition scores of 88%, 82%, and 77%, respectively (including call-sign and dual-task effects). A comparison of the dual task with the corresponding single tasks suggests that the observed effects reflect an increased cognitive load.
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Percepção da Fala , Fala , Testes Auditivos , Humanos , Idioma , Razão Sinal-RuídoRESUMO
OBJECTIVE: The aim of this study was to predict outcomes of the HHI questionnaire (Hearing Handicap Inventory) using individual variables beyond pure-tone hearing thresholds. DESIGN: An extensive health-related test battery was applied including a general anamnesis, questionnaires, audiological measures, examination of visual acuity, balance, and cognition, as well as tactile- and motor skills. Based on the self-assessment of health variables and different sensory and cognitive performance measures, a frailty index was calculated to describe the health status of the participants. A stepwise linear regression analysis was conducted to predict HHI scores. STUDY SAMPLE: A mixed sample (N = 212) of 55- to 81-year-old, participants with different hearing and aiding status completed the test battery. RESULTS: The regression analysis showed statistically significant contributions of pure-tone hearing thresholds, speech recognition in noise, age, frailty, mental health, and the willingness to use hearing aids on HHIE outcomes. CONCLUSIONS: Self-reported hearing handicap assessed with the HHI questionnaire reflects various individual variables additionally to pure-tone hearing loss and speech recognition in noise. It is necessary to be aware of the influences of age and health-related variables on HHI scores when using it in research as well as in clinical settings.
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Fragilidade , Auxiliares de Audição , Adulto , Idoso , Idoso de 80 Anos ou mais , Audiometria de Tons Puros , Audição , Humanos , Saúde Mental , Pessoa de Meia-Idade , AutorrelatoRESUMO
Speech audiometry is an essential part of audiological diagnostics and clinical measurements. Development times of speech recognition tests are rather long, depending on the size of speech corpus and optimization necessity. The aim of this study was to examine whether this development effort could be reduced by using synthetic speech in speech audiometry, especially in a matrix test for speech recognition. For this purpose, the speech material of the German matrix test was replicated using a preselected commercial system to generate the synthetic speech files. In contrast to the conventional matrix test, no level adjustments or optimization tests were performed while producing the synthetic speech material. Evaluation measurements were conducted by presenting both versions of the German matrix test (with natural or synthetic speech), alternately and at three different signal-to-noise ratios, to 48 young, normal-hearing participants. Psychometric functions were fitted to the empirical data. Speech recognition thresholds were 0.5 dB signal-to-noise ratio higher (worse) for the synthetic speech, while slopes were equal for both speech types. Nevertheless, speech recognition scores were comparable with the literature and the threshold difference lay within the same range as recordings of two different natural speakers. Although no optimization was applied, the synthetic-speech signals led to equivalent recognition of the different test lists and word categories. The outcomes of this study indicate that the application of synthetic speech in speech recognition tests could considerably reduce the development costs and evaluation time. This offers the opportunity to increase the speech corpus for speech recognition tests with acceptable effort.
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Audiometria da Fala , Psicometria , Percepção da Fala , Teste do Limiar de Recepção da Fala , Adulto , Audiometria da Fala/métodos , Limiar Auditivo , Feminino , Humanos , Idioma , Masculino , Reconhecimento Psicológico , Reprodutibilidade dos Testes , Razão Sinal-Ruído , Inteligibilidade da FalaRESUMO
Elderly listeners are known to differ considerably in their ability to understand speech in noise. Several studies have addressed the underlying factors that contribute to these differences. These factors include audibility, and age-related changes in supra-threshold auditory processing abilities, and it has been suggested that differences in cognitive abilities may also be important. The objective of this study was to investigate associations between performance in cognitive tasks and speech recognition under different listening conditions in older adults with either age appropriate hearing or hearing-impairment. To that end, speech recognition threshold (SRT) measurements were performed under several masking conditions that varied along the perceptual dimensions of dip listening, spatial separation, and informational masking. In addition, a neuropsychological test battery was administered, which included measures of verbal working and short-term memory, executive functioning, selective and divided attention, and lexical and semantic abilities. Age-matched groups of older adults with either age-appropriate hearing (ENH, n = 20) or aided hearing impairment (EHI, n = 21) participated. In repeated linear regression analyses, composite scores of cognitive test outcomes (evaluated using PCA) were included to predict SRTs. These associations were different for the two groups. When hearing thresholds were controlled for, composed cognitive factors were significantly associated with the SRTs for the ENH listeners. Whereas better lexical and semantic abilities were associated with lower (better) SRTs in this group, there was a negative association between attentional abilities and speech recognition in the presence of spatially separated speech-like maskers. For the EHI group, the pure-tone thresholds (averaged across 0.5, 1, 2, and 4 kHz) were significantly associated with the SRTs, despite the fact that all signals were amplified and therefore in principle audible.