Relationship among Speech Perception in Noise, Age-related Hearing Loss and Cognition in Putonghua / 中国康复理论与实践

Objective:To explore the relationship between age-related hearing loss, cognitive level and speech perception in noise in Putonghua. Methods:From January to October 2018, 31 outpatients who visited the department of otolaryngology (aged 52-75) were divided into hearing normal (HN) group and hearing loss (HL) group according to the results of the average threshold measured with pure-tone audiometry. They were assessed with the computer-aided Chinese Speech Test Platform and the Cambridge Neuropsychological Test Automated Battery, which respectively evaluated the speech perception ability in noise, and the episodic memory, working memory and executive ability under non-verbal stimulation. Results:There were significant differences in speech perception ability, episodic memory and executive ability between the two groups (U < 68, P < 0.05). The hearing level correlated to the speech perception in noise, whatever the speech and noise were separated, as well as the episodic memory, working memory and executive ability (r > 0.360, P < 0.05). The more difficult the speech perception task was, the more significant the correlation between signal-noise ratio and cognitive ability was. Conclusion:Under the condition of Putonghua, age-related hearing loss is one of the main reasons for the decline of speech perception in noise in the old adults. Hearing loss leads to the decline of episodic memory and executive ability, which in turn affects speech perception in noise. The more difficulty it is to recognize speech in noise, the greater the dependence on cognitive level.

Factors Influencing Speech Perception in Noise, and Auditory and Cognitive Training in the Elderly (review) / 中国康复理论与实践

The elderly are more likely to have difficulty in communicating in noise, regardless of hearing loss. The decline of speech perception ability in noise is the main manifestation of the decline of central auditory processing ability. Hearing and cognition are significantly correlated with central auditory processing. The mechanisms of interaction among them are common cause, reduction-compensation hypothesis, information degradation hypothesis, sensory deprivation hypothesis and cognitive load hypothesis. In short, central auditory processing is clearly related with cognition, which decreases with age. The sensory input of degradation (hearing loss or communication in noise) brings more loads to the cognitive system, occupies more cognitive resources and affects the immediate processing of cognition. Over time, chronic sensory deprivation causes an overall decline in cognitive ability. Cognitive decline in turn affects the compensatory effect on perception from top to down, thereby affecting central auditory processing ability. After confirming the mutual relations between them, the effects of auditory and cognitive training on speech resolution in noise were explored. A number of studies have confirmed that the hearing training programs can improve central auditory processing and cognitive function in patients with hearing loss, and cognitive training can be trained part of the cognitive domain (memory) to improve cognition and auditory perception.

Speech Perception and Gap Detection Performance of Single-Sided Deafness under Noisy Conditions

BACKGROUND AND OBJECTIVES: Many studies have reported no benefit of sound localization, but improved speech understanding in noise after treating patients with single-sided deafness (SSD). Furthermore, their performances provided a large individual difference. The present study aimed to measure the ability of speech perception and gap detection in noise for the SSD patients to better understand their hearing nature.

Error Patterns Analysis of Hearing Aid and Cochlear Implant Users as a Function of Noise

BACKGROUND AND OBJECTIVES: Not all impaired listeners may have the same speech perception ability although they will have similar pure-tone threshold and configuration. For this reason, the present study analyzes error patterns in the hearing-impaired compared to normal hearing (NH) listeners as a function of signal-to-noise ratio (SNR). SUBJECTS AND METHODS: Forty-four adults participated: 10 listeners with NH, 20 hearing aids (HA) users and 14 cochlear implants (CI) users. The Korean standardized monosyllables were presented as the stimuli in quiet and three different SNRs. Total error patterns were classified into types of substitution, omission, addition, fail, and no response, using stacked bar plots. RESULTS: Total error percent for the three groups significantly increased as the SNRs decreased. For error pattern analysis, the NH group showed substitution errors dominantly regardless of the SNRs compared to the other groups. Both the HA and CI groups had substitution errors that declined, while no response errors appeared as the SNRs increased. The CI group was characterized by lower substitution and higher fail errors than did the HA group. Substitutions of initial and final phonemes in the HA and CI groups were limited by place of articulation errors. However, the HA group had missed consonant place cues, such as formant transitions and stop consonant bursts, whereas the CI group usually had limited confusions of nasal consonants with low frequency characteristics. Interestingly, all three groups showed /k/ addition in the final phoneme, a trend that magnified as noise increased. CONCLUSIONS: The HA and CI groups had their unique error patterns even though the aided thresholds of the two groups were similar. We expect that the results of this study will focus on high error patterns in auditory training of hearing-impaired listeners, resulting in reducing those errors and improving their speech perception ability.