The Effects of Aging on Speech Perception in Noise: Comparison between Normal-Hearing and Cochlear-Implant Listeners

Abstract

Background: Speech understanding in noise is comparatively more problematic for older listeners with and without hearing loss, and age-related changes in temporal resolution might be associated with reduced speech recognition in complex noise. Purpose: The purpose of this study was to investigate the effects of aging on temporal processing and speech perception in noise for normal-hearing (NH) and cochlear-implant (CI) listeners. Research Design: All participants completed three experimental procedures: (1) amplitude modulation (AM) detection thresholds, (2) sentence recognition in quiet, and (3) speech recognition in steady or modulating noise. Study Sample: Four listener groups participated in the study: 11 younger (≤ 30 yr old, YNH) listeners and 12 older (> 60 yr old, ONH) listeners with NH and 7 younger (< 55 yr old, YCI) and 6 older (> 60 yr old, OCI) CI users. CI listeners have been wearing their device either monaurally or binaurally at least 1 yr. Data collection and Analysis: For speech recognition testing, there were eight listening conditions in noise (4 modulation frequencies × 2 signal-to-noise ratios) and one in quiet for each listener. For modulation detection testing, a broadband noise with a duration of 500 msec served as the stimuli at three temporal modulation frequencies of 2, 4, and 8 Hz, which were used to modulate the noise in the speech recognition experiment. We measured AM detection thresholds using a two-interval, two-alternative, forced-choice adaptive procedure. We conducted a series of analysis of variance tests to examine the effect of aging on each test result and measured the correlation coefficient between speech recognition in noise and modulation detection thresholds. Results: Although older NH and CI listeners performed similar to the younger listeners with the same hearing status for sentence recognition in quiet, there was a significant aging effect on speech recognition in noise. Regardless of modulation frequency and signal-to-noise ratio, speech recognition scores of the older listeners were poorer than those of the younger listeners when hearing status was matched. We also found a significant effect of aging on AM detection at each modulating frequency and a strong correlation between speech recognition in modulating noise and AM detection thresholds at 2 and 4 Hz. Conclusions: Regardless of differences in hearing status, the degree and pattern of aging effect on auditory processing of the NH listener groups were similar to those of the CI listener groups. This result suggests that age-related declines in speech understanding are likely multifactorial, including peripheral and central factors. Although the age cutoff of the current older age group was 10 yr less than in previous studies (Dubno et al, 2002; Lin et al, 2011), we still found the age-related differences on two auditory tasks. This study extends the knowledge of age-related auditory perception difficulties to CI listeners.