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Means and standard errors of air-conduction audiometric thresholds for returnees (circles) and nonreturnees (triangles) from original baseline (T1) study. Threshold data for the right ear are provided in the top panel and left ear in the bottom panel. The asterisk for the hearing threshold at 8000 Hz in the left ear marks the only significant (p < .05) difference in thresholds between the two groups.
Source publication
Purpose
This article aimed to document longitudinal changes in auditory function, including measures of temporal processing, and to examine the associations between observed changes in auditory and cognitive function in middle-aged and older adults.
Method
This was a prospective longitudinal study of 98 adults (66 women) with baseline ages ranging...
Context in source publication
Context 1
... convenience, the latter group of 105 have been designated here as "nonreturnees." Figure 1 shows the baseline audiograms for right and left ears for these two groups, and the only significant difference between the two groups occurred at 8000 Hz in the left ear. Similarly, the two groups did not differ significantly ( p > .05) in age at baseline evaluation, with the returnees having a mean age at baseline of 62.6 years and the nonreturnees at 65.3 years. ...
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Citations
... There is limited research on how ARHL affects WM. Some studies suggest a negative correlation between hearing ability and WM [17][18][19][20][21][22][23][24][25], but others using N-back tasks have had mixed results [22,23,26,27]. Event-related potentials (ERPs) help understand sensory and cognitive processing. ...
... These differences persisted even after controlling for age, education, and general slowing. These findings align with previous studies on WM deficits in ARHL [17][18][19][20][21][22][23][24][25], confirming the effect of ARHL on cognition. ...
... Significant connection between SFG and insula during the 1-back task. [23][24][25]. Considering SNR loss and PTA across four frequencies would further provide more insights into the functional deficits individuals with ARHL face. The results of the study suggest poor WM in ARHL, attributing the consequences of neural alterations and poor synchronization. ...
Introduction
Age-related hearing loss (ARHL) may affect working memory (WM), which impacts problem-solving, decision-making, language comprehension, and learning. Limited research exists on how ARHL affects WM using N-back tasks, but studying this is crucial for understanding neural markers and associated cognitive processes. Our study explores the impact of ARHL on WM using behavioral and electrophysiological measures and how it correlates with speech-in-noise scores in older individuals with ARHL.
Method
The study involved two groups, each with 20 participants aged 60–80. Group 1 had individuals with mild to moderate sensorineural hearing loss, while Group 2 had age- and education-matched controls with normal or near-normal hearing. Participants underwent audiological assessments and completed cognitive tests, including simple reaction time and N-back tests. During the performance of cognitive tasks, a simultaneous electroencephalography was recorded. Data analysis included behavioral and event-related potentials, source estimation, and functional connectivity analysis.
Results
The study revealed significantly poor accuracy, longer reaction time, and smaller P300 amplitude among individuals with ARHL, even after controlling for general slowing. Individuals with ARHL experience compromised neural activity, particularly in the temporal and parietal regions, which are vital for cognition and WM. Furthermore, individuals with ARHL exhibited poor communication between the superior temporal gyrus and insulae regions among the brain regions mediating WM during the 1-back task. Also, the study found a strong correlation between hearing measures and WM outcomes.
Conclusion
The study findings suggest that individuals with ARHL have impaired WM compared to those with normal hearing. This indicates a potential link between ARHL and cognitive decline, which could significantly affect daily life and quality of life. The widely used WM test with simultaneous EEG recording and source estimation analysis would further validate the usefulness of the study in assessing WM in this population.
... Typically, cognitive flexibility is studied by examining one's ability to shift between mental sets of information, or between two or more different tasks ( Cañas et al., 2003 ;Mayr and Keele, 2000 ;Miyake et al., 2000 ;Monsell, 1996 ). In the context of ARHL, studies have mostly explored associations between hearing ability and performance on cognitive flexibility measures ( Alattar et al., 2020 ;Armstrong et al., 2020 ;Birren et al., 1963 ;Golub et al., 2020a ;Granick et al., 1976 ;Harrison Bush et al., 2015 ;Huang et al., 2019 ;Humes, 2021 ;Lin, 2011 ;Lin et al., 2013 ;Samelli et al., 2022 ;Shende et al., 2021 ;Uchida et al., 2016 ), and a few have investigated group differences between individuals with ARHL and normal hearing controls ( Huang et al., 2019 ;Huber et al., 2020 ;Jayakody et al., 2018 ;Shende et al., 2021 ;Uchida et al., 2016 ). Visual measures, such as Digit Symbol Substitution Test (DSST; Armstrong et al., 2020 ;Golub et al., 2020aGolub et al., , 2020bHuang et al., 2019 ;Humes, 2021 ;Lin, 2011 ;Lin et al., 2013 ;Uchida et al., 2016 ) and the Trail Making Test-B (TMT-B; Alattar et al., 2020 ;Armstrong et al., 2020 ;Harrison Bush et al., 2015 ;Lin et al., 2011 ;Shende et al., 2021 ), have been the most frequently used measures to study cognitive flexibility in ARHL, while a few have used other measures, such as Letter Digit Substitution Test (LDST; Valentijn et al., 2005 ), the Concept Shifting Task-C (CST-C; Valentijn et al., 2005 ), and the Attention Switching Task ( Jayakody et al., 2018 ). ...
... In the context of ARHL, studies have mostly explored associations between hearing ability and performance on cognitive flexibility measures ( Alattar et al., 2020 ;Armstrong et al., 2020 ;Birren et al., 1963 ;Golub et al., 2020a ;Granick et al., 1976 ;Harrison Bush et al., 2015 ;Huang et al., 2019 ;Humes, 2021 ;Lin, 2011 ;Lin et al., 2013 ;Samelli et al., 2022 ;Shende et al., 2021 ;Uchida et al., 2016 ), and a few have investigated group differences between individuals with ARHL and normal hearing controls ( Huang et al., 2019 ;Huber et al., 2020 ;Jayakody et al., 2018 ;Shende et al., 2021 ;Uchida et al., 2016 ). Visual measures, such as Digit Symbol Substitution Test (DSST; Armstrong et al., 2020 ;Golub et al., 2020aGolub et al., , 2020bHuang et al., 2019 ;Humes, 2021 ;Lin, 2011 ;Lin et al., 2013 ;Uchida et al., 2016 ) and the Trail Making Test-B (TMT-B; Alattar et al., 2020 ;Armstrong et al., 2020 ;Harrison Bush et al., 2015 ;Lin et al., 2011 ;Shende et al., 2021 ), have been the most frequently used measures to study cognitive flexibility in ARHL, while a few have used other measures, such as Letter Digit Substitution Test (LDST; Valentijn et al., 2005 ), the Concept Shifting Task-C (CST-C; Valentijn et al., 2005 ), and the Attention Switching Task ( Jayakody et al., 2018 ). ...
... Similar findings have also been reported by Deal et al. (2015) , who found a dose-response relationship between hearing loss severity and DSST performance over 20 years such that worse DSST performance was related to greater severity of hearing loss. An exception is a study by Humes (2021) that found no significant association between rates of decline on pure tone thresholds and DSST performance over a nine-year period in older adults with ARHL. However, it is important to note that Humes (2021) examined partial correlations between hearing thresholds at 0.5, 1.4, and 4 kHz in the right ear and DSST performance while only controlling for age and followup time, whereas those who found worse DSST performance over years ( Deal et al., 2015 ;Lin et al., 2013 ;Uchida et al., 2016 ) typically used better ear PTA as a measure of hearing and some accounted for other health variables in addition to age when examining association (see Table 1 ). ...
Recent evidence suggests links between hearing loss and cognitive impairment in older adults with peripheral age-related hearing loss (ARHL). Earliest cognitive changes have been observed in cognitive control ; however, a cohesive account of cognitive control alterations in older adults with peripheral ARHL is lacking. Cognitive control refers to cognitive processes that manage and regulate one's behavior to achieve desired goals. This review summarizes behavioral evidence on alterations in three cognitive control processes , including cognitive flexibility, inhibitory control, and working memory updating, in individuals with ARHL. Of the three processes, cognitive flexibility and working memory updating have been most extensively studied, with relatively fewer studies examining inhibitory control. Most consistent evidence is observed for long-term changes in cognitive flexibility, particularly in individuals with greater severity of ARHL. Equivocal evidence is seen for alterations in inhibitory control and working memory updating, with various factors contributing to inconsistencies across studies. Our review summarizes the emerging body of research on cognitive control in individuals with ARHL to guide future work in this area and considerations related to the management of cognitive issues in this population.
... Among young normal-hearing (NH) listeners, differences in neither spectral nor temporal resolving power (measured with nonspeech stimuli) account for individual differences in speech understanding in Gaussian noise (Karlin, 1942;Surprenant and Watson, 2001;Watson and Kidd, 2002;Kidd et al., 2007). Among older listeners, the situation is less clear; age-related deficits in termporal sensitivity that may be linked to speech understanding are frequently found (e.g., Fitzgibbons and Gordon-Salant, 1994, 2004, 2011Schneider et al., 1994;Snell and Frisina, 2000;Gordon-Salant and Fitzgibbons, 2004;Lister and Tarver, 2004;Humes et al., 2009Humes et al., , 2013Gallego Hiroyasu and Yotsumoto, 2020;Humes, 2021), but the causal role of temporal-processing deficits is difficult to determine, due to correlations with other age-related factors, such as hearing loss, cognitive decline and a general perceptual slowing (see Schneider et al., 2005;Humes and Dubno, 2010;Humes et al., 2013). Notably, temporal processing deficits among the elderly tend to be greater when measured in the context of a temporal sequence than with isolated events (e.g., Fitzgibbons and Gordon-Salant, 1995;Gordon-Salant and Fitzgibbons, 1999;Fitzgibbons and Gordon-Salant, 2001), suggesting that the primary influence of temporal processing abilities on speech understanding may be related to the ability to attentionally track temporal patterns, rather than differences in basic temporal resolving power. ...
Sensitivity to the temporal properties of auditory patterns tends to be poorer in older listeners, and this has been hypothesized to be one factor contributing to their poorer speech understanding. This study examined sensitivity to speech rhythms in young and older normal-hearing subjects, using a task designed to measure the effect of speech rhythmic context on the detection of changes in the timing of word onsets in spoken sentences. A temporal-shift detection paradigm was used in which listeners were presented with an intact sentence followed by two versions of the sentence in which a portion of speech was replaced with a silent gap: one with correct gap timing (the same duration as the missing speech) and one with altered gap timing (shorter or longer than the duration of the missing speech), resulting in an early or late resumption of the sentence after the gap. The sentences were presented with either an intact rhythm or an altered rhythm preceding the silent gap. Listeners judged which sentence had the altered gap timing, and thresholds for the detection of deviations from the correct timing were calculated separately for shortened and lengthened gaps. Both young and older listeners demonstrated lower thresholds in the intact rhythm condition than in the altered rhythm conditions. However, shortened gaps led to lower thresholds than lengthened gaps for the young listeners, while older listeners were not sensitive to the direction of the change in timing. These results show that both young and older listeners rely on speech rhythms to generate temporal expectancies for upcoming speech events. However, the absence of lower thresholds for shortened gaps among the older listeners indicates a change in speech-timing expectancies with age. A further examination of individual differences within the older group revealed that those with better rhythm-discrimination abilities (from a separate study) tended to show the same heightened sensitivity to early events observed with the young listeners.
... Cognitive aging results in structural and functional changes throughout the central auditory pathway, 1-3 as well as declines in associated auditory processing skills necessary for effective speech comprehension. 4,5 Older adults demonstrate less precise and altered neural encoding of speech which has been attributed to slowed neural conduction times, poor neural synchrony, and reduced inhibitory processes. [6][7][8] Senescent neural changes parallel perceptual difficulties commonly reported by aging adults in clinical settings. ...
... [36][37][38][39][40] Although there is some evidence that FFRs contain cortical contributions at these low frequencies, 36 activity. 35,42 Behavioral data analysis Psychometric identification functions were created by calculating the proportion of trials identified as a single vowel class (i.e., /a/) for each token (i.e., vw [1][2][3][4][5]. Comparing the slope of the psychometric functions between groups allowed us to assess possible differences in the "steepness" (i.e., rate of change) of the categorical speech boundary as a function of musical experience. ...
Mild cognitive impairment (MCI) commonly results in more rapid cognitive and behavioral declines than typical aging. Individuals with MCI can exhibit impaired receptive speech abilities that may reflect neurophysiological changes in auditory‐sensory processing prior to usual cognitive deficits. Benefits from current interventions targeting communication difficulties in MCI are limited. Yet, neuroplasticity associated with musical experience has been implicated in improving neural representations of speech and offsetting age‐related declines in perception. Here, we asked whether these experience‐dependent effects of musical experience might extend to aberrant aging and offer some degree of cognitive protection against MCI. During a vowel categorization task, we recorded single‐channel electroencephalograms (EEGs) in older adults with putative MCI to evaluate speech encoding across subcortical and cortical levels of the auditory system. Critically, listeners varied in their duration of formal musical experience (0–21 years). Musical experience sharpened temporal precision in auditory cortical responses, suggesting that musical experience produces more efficient processing of acoustic features by counteracting age‐related neural delays. Additionally, robustness of brainstem responses predicted the severity of cognitive decline, suggesting that early speech representations are sensitive to preclinical stages of cognitive impairment. Our results extend prior studies by demonstrating positive benefits of musical experience in older adults with emergent cognitive impairments.
... More recently, Humes et al. (2013a), again making use of a study sample independent of that in the present study, found temporal-order processing in hearing, vision, and touch to be strongly associated with cognitive function in a cross-sectional study of 245 young, middle-age, and older adults. Recently, in longitudinal follow-up analyses of 98 of the original 195 middle-age and older adults included in the cross-sectional study of Humes et al. (2013a), independent from this study sample, auditory temporal-order identification for brief syllables emerged as the most significant auditory measure in regression analyses predicting cognitive function, both for brief clinical cognitive assessments (Humes, 2020) and for comprehensive cognitive assessments (Humes, 2021). Both monaural and dichotic temporal-order identification measures were found to decline longitudinally, dichotic longitudinal declines also having been observed by Babkoff and Fostick (2017). ...
... Both monaural and dichotic temporal-order identification measures were found to decline longitudinally, dichotic longitudinal declines also having been observed by Babkoff and Fostick (2017). Humes (2020Humes ( , 2021 found both temporal-order identification measures to be predictive of declines in cognitive function in older adults over a 9-year period. Temporal-order processing typically explained 10-20% of the variance in cognitive function among middle-age and older adults using either form of cognitive assessment. ...
... On the other hand, the concomitant decline in auditory abilities and cognition among older adults may offer insights into the factors underlying the well-established cognitive declines as adults advance in age (Humes et al., 2013a;Humes, 2020Humes, , 2021. That is, there may be shared underlying mechanisms that negatively impact both sensory and cognitive processing with increasing age either concomitantly or sequentially (Humes and Young, 2016). ...
The Test of Basic Auditory Capabilities (TBAC) is a battery of auditory-discrimination tasks and speech-identification tasks that has been normed on several hundred young normal-hearing adults. Previous research with the TBAC suggested that cognitive function may impact the performance of older adults. Here, we examined differences in performance on several TBAC tasks between a group of 34 young adults with a mean age of 22.5 years (SD = 3.1 years) and a group of 115 older adults with a mean age of 69.2 years (SD = 6.2 years) recruited from the local community. Performance of the young adults was consistent with prior norms for this age group. Not surprisingly, the two groups differed significantly in hearing loss and working memory with the older adults having more hearing loss and poorer working memory than the young adults. The two age groups also differed significantly in performance on six of the nine measures extracted from the TBAC (eight test scores and one average test score) with the older adults consistently performing worse than the young adults. However, when these age-group comparisons were repeated with working memory and hearing loss as covariates, the groups differed in performance on only one of the nine auditory measures from the TBAC. For eight of the nine TBAC measures, working memory was a significant covariate and hearing loss never emerged as a significant factor. Thus, the age-group deficits observed initially on the TBAC most often appeared to be mediated by age-related differences in working memory rather than deficits in auditory processing. The results of these analyses of age-group differences were supported further by linear-regression analyses with each of the 9 TBAC scores serving as the dependent measure and age, hearing loss, and working memory as the predictors. Regression analyses were conducted for the full set of 149 adults and for just the 115 older adults. Working memory again emerged as the predominant factor impacting TBAC performance. It is concluded that working memory should be considered when comparing the performance of young and older adults on auditory tasks, including the TBAC.
... Central auditory function, reflected in tests of speech perception in background noise, correlates with cognition (Watson, 1991;Hallgren et al., 2001;Anderson and Kraus, 2010;Hoover et al., 2017;Panza et al., 2018;Danielsson et al., 2019;Humes, 2020Humes, , 2021, including cognitive dysfunction due to mild cognitive impairment (MCI), Alzheimer's disease (Gates et al., 1996;Idrizbegovic et al., 2011), and HIV (Zhan et al., 2017b;Buckey et al., 2019;White-Schwoch et al., 2020;Niemczak et al., 2021). This suggests central auditory tests might be useful for tracking cognitive dysfunction in populations with disordered neuro-cognitive processing. ...
... These studies suggest worse performance on measures of speechin-noise identification may reflect damage to the central nervous system resulting in cognitive impairment (Buckey et al., 2019). Previous studies have shown a relationship between cognition and auditory processing ability such as speech perception in noise (Pichora-Fuller et al., 1995;Wong et al., 2009;Zekveld et al., 2011), auditory temporal ordering (Szymaszek et al., 2009;Danielsson et al., 2019;Humes, 2020;2021), and gap detection testing (Harris et al., 2010). In our previous work, we have shown a significant relationship between the ability to understand speech in noise and cognitive status in PLWH (Zhan et al., 2017b). ...
... By examining temporal acuity in an auditory gap detection paradigm, we found that age was significantly related to TOVA response time and Ex-Gaussian Mu with older adults having poorer response time compared to young adults. These observed age effects are consistent with previous studies that have suggested that age-related differences in complex measures of auditory temporal processing may be explained, in part, by age-related deficits in processing speed and attention (Snell, 1997;Humes et al., 2009Humes et al., , 2012Harris et al., 2010;Humes, 2021). Age has a large effect on cognitive speed, which declines earlier and at a higher rate than memory (Salthouse, 2009). ...
Objective: Tests requiring central auditory processing, such as speech perception-in-noise, are simple, time efficient, and correlate with cognitive processing. These tests may be useful for tracking brain function. Doing this effectively requires information on which tests correlate with overall cognitive function and specific cognitive domains. This study evaluated the relationship between selected central auditory focused tests and cognitive domains in a cohort of normal hearing adults living with HIV and HIV– controls. The long-term aim is determining the relationships between auditory processing and neurocognitive domains and applying this to analyzing cognitive function in HIV and other neurocognitive disorders longitudinally.
Method: Subjects were recruited from an ongoing study in Dar es Salaam, Tanzania. Central auditory measures included the Gap Detection Test (Gap), Hearing in Noise Test (HINT), and Triple Digit Test (TDT). Cognitive measures included variables from the Test of Variables of Attention (TOVA), Cogstate neurocognitive battery, and Kiswahili Montreal Cognitive Assessment (MoCA). The measures represented three cognitive domains: processing speed, learning, and working memory. Bootstrap resampling was used to calculate the mean and standard deviation of the proportion of variance explained by the individual central auditory tests for each cognitive measure. The association of cognitive measures with central auditory variables taking HIV status and age into account was determined using regression models.
Results: Hearing in Noise Tests and TDT were significantly associated with Cogstate learning and working memory tests. Gap was not significantly associated with any cognitive measure with age in the model. TDT explained the largest mean proportion of variance and had the strongest relationship to the MoCA and Cogstate tasks. With age in the model, HIV status did not affect the relationship between central auditory tests and cognitive measures. Age was strongly associated with multiple cognitive tests.
Conclusion: Central auditory tests were associated with measures of learning and working memory. Compared to the other central auditory tests, TDT was most strongly related to cognitive function. These findings expand on the association between auditory processing and cognitive domains seen in other studies and support evaluating these tests for tracking brain health in HIV and other neurocognitive disorders.
... These included measures of temporal gap-detection threshold at two different frequencies and several measures of temporal-order identification for short vowel sequences, both monaural and dichotic. These psychophysical measures had been obtained from 245 young, middle-aged, and older adults previously Busey et al., 2010) and more recently in a longitudinal follow-up of the original cross-sectional study (Humes, 2021b). In addition, two visual measures, one of temporal processing (flicker fusion) and one of text recognition akin to the auditory SRT, were also obtained here. ...
... A total of 137 adults (90 women, 47 men) with a mean age of 69.2 years (range of 47-94 years) participated in this study. Of the 137, 101 had completed the same cognitive and psychophysical measures included in this study 9 years earlier as part of a longitudinal study of sensory and cognitive changes (Humes, 2020b(Humes, , 2021b. As noted in Humes (2021b), there were no learning or practice effects for the measures considered here that resulted from this prior testing. ...
... Of the 137, 101 had completed the same cognitive and psychophysical measures included in this study 9 years earlier as part of a longitudinal study of sensory and cognitive changes (Humes, 2020b(Humes, , 2021b. As noted in Humes (2021b), there were no learning or practice effects for the measures considered here that resulted from this prior testing. The measures of SRT in noise, the dependent measures of interest in this study, had not been included in the evaluation 9 years earlier. ...
Many older adults have difficulty understanding speech in noisy backgrounds. In this study, we examined peripheral auditory, higher-level auditory, and cognitive factors that may contribute to such difficulties. A convenience sample of 137 volunteer older adults, 90 women, and 47 men, ranging in age from 47 to 94 years (M = 69.2 and SD = 10.1 years) completed a large battery of tests. Auditory tests included measures of pure-tone threshold, clinical and psychophysical, as well as two measures of gap-detection threshold and four measures of temporal-order identification. The latter included two monaural and two dichotic listening conditions. In addition, cognition was assessed using the complete Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III). Two monaural measures of speech-recognition threshold (SRT) in noise, the QuickSIN, and the WIN, were obtained from each ear at relatively high presentation levels of 93 or 103 dB SPL to minimize audibility concerns. Group data, both aggregate and by age decade, were evaluated initially to allow comparison to data in the literature. Next, following the application of principal-components factor analysis for data reduction, individual differences in speech-recognition-in-noise performance were examined using multiple-linear-regression analyses. Excellent fits were obtained, accounting for 60–77% of the total variance, with most accounted for by the audibility of the speech and noise stimuli and the severity of hearing loss with the balance primarily associated with cognitive function.
Speakers can place their prosodic prominence on any locations within a sentence, generating focus prosody for listeners to perceive new information. This study aimed to investigate age-related changes in the bottom-up processing of focus perception in Jianghuai Mandarin by clarifying the perceptual cues and the auditory processing abilities involved in the identification of focus locations. Young, middle-aged, and older speakers of Jianghuai Mandarin completed a focus identification task and an auditory perception task. The results showed that increasing age led to a decrease in listeners' accuracy rate in identifying focus locations, with all participants performing the worst when dynamic pitch cues were inaccessible. Auditory processing abilities did not predict focus perception performance in young and middle-aged listeners but accounted significantly for the variance in older adults' performance. These findings suggest that age-related deteriorations in focus perception can be largely attributed to declined auditory processing of perceptual cues. Poor ability to extract frequency modulation cues may be the most important underlying psychoacoustic factor for older adults' difficulties in perceiving focus prosody in Jianghuai Mandarin. The results contribute to our understanding of the bottom-up mechanisms involved in linguistic prosody processing in aging adults, particularly in tonal languages.
Purpose
The contributions from the central auditory and cognitive systems play a major role in communication. Understanding the relationship between auditory and cognitive abilities has implications for auditory rehabilitation for clinical patients. The purpose of this systematic review is to address the question, “In adults, what is the relationship between central auditory processing abilities and cognitive abilities?”
Method
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to identify, screen, and determine eligibility for articles that addressed the research question of interest. Medical librarians and subject matter experts assisted in search strategy, keyword review, and structuring the systematic review process. To be included, articles needed to have an auditory measure (either behavioral or electrophysiologic), a cognitive measure that assessed individual ability, and the measures needed to be compared to one another.
Results
Following two rounds of identification and screening, 126 articles were included for full analysis. Central auditory processing (CAP) measures were grouped into categories (behavioral: speech in noise, altered speech, temporal processing, binaural processing; electrophysiologic: mismatch negativity, P50, N200, P200, and P300). The most common CAP measures were sentence recognition in speech-shaped noise and the P300. Cognitive abilities were grouped into constructs, and the most common construct was working memory. The findings were mixed, encompassing both significant and nonsignificant relationships; therefore, the results do not conclusively establish a direct link between CAP and cognitive abilities. Nonetheless, several consistent relationships emerged across different domains. Distorted or noisy speech was related to working memory or processing speed. Auditory temporal order tasks showed significant relationships with working memory, fluid intelligence, or multidomain cognitive measures. For electrophysiology, relationships were observed between some cortical evoked potentials and working memory or executive/inhibitory processes. Significant results were consistent with the hypothesis that assessments of CAP and cognitive processing would be positively correlated.
Conclusions
Results from this systematic review summarize relationships between CAP and cognitive processing, but also underscore the complexity of these constructs, the importance of study design, and the need to select an appropriate measure. The relationship between auditory and cognitive abilities is complex but can provide informative context when creating clinical management plans. This review supports a need to develop guidelines and training for audiologists who wish to consider individual central auditory and cognitive abilities in patient care.
Supplemental Material
https://doi.org/10.23641/asha.24855174
Age-related hearing loss is difficult to study in humans because multiple genetic and environmental risk factors may contribute to pathology and cochlear function declines in older adults. These pathologies, including degeneration of the stria vascularis, are hypothesized to affect outer hair cells responsible for active cochlear amplification of low-level sounds. Otoacoustic emission (OAE) measures are used to quantify the energy added to the traveling wave in cochlear amplification, which typically weakens with increased pure-tone thresholds and for older individuals. Thus, the current study evaluated two OAE measures for individuals with different components of age-related hearing loss. We examined two retrospective adult lifespan datasets (18 to 89+ years of age) from independent sites (Medical University of South Carolina and Boys Town National Research Hospital), which included demographics, noise history questionnaires, distortion-product otoacoustic emissions (DPOAE), and cochlear reflectance (CR). Metabolic and sensory estimates of age-related hearing loss were derived from the audiograms in each dataset, and then tested for associations with DPOAE and CR. The results showed that metabolic estimates increased for older participants and were associated with lower overall DPOAE and CR magnitudes across frequency (i.e., lower fitted intercepts). Sensory estimates were significantly higher for males, who reported more positive noise histories compared to females and were associated with steeper negative across-frequency slopes for DPOAEs. Although significant associations were observed between OAE configurations, DPOAEs appeared uniquely sensitive to metabolic estimates. The current findings suggest that distortion-based measures may provide greater sensitivity than reflection-based measures to the components of age-related hearing loss.
