Sex-Related Differences in the Associations Between Montreal Cognitive Assessment Scores and Pure-Tone Measures of Hearing.

PURPOSE: Hearing loss (HL) is associated with cognitive performance in older adults, including performance on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening test. Yet, despite well-established sex-related differences in both hearing and cognition, very few studies have tested whether there are sex-related differences in auditory-cognitive associations. METHOD: In the current cross-sectional retrospective analysis, we examined sex-related differences in hearing and cognition in 193 healthy older adults (M = 69 years, 60% women). Hearing was measured using audiometry (pure-tone average [PTA] of thresholds at 500, 1000, 2000, and 4000 Hz in the worse ear). Cognition was assessed using the MoCA. Additionally, we calculated MoCA scores with hearing-dependent subtests excluded from scoring (MoCA-Modified). RESULTS: Men and women did not differ in age, education, or history of depression. Women had better hearing than men. Women with normal hearing were more likely to pass the MoCA compared with their counterparts with HL. In contrast, the likelihood of passing the MoCA did not depend on hearing status in men. Linear regression analysis showed an interaction between sex and PTA in the worse ear. PTAs were significantly correlated with both MoCA and MoCA-Modified scores in women, whereas this was not observed in the men. CONCLUSIONS: This study is one of the first to demonstrate significant sex-related differences in auditory-cognitive associations even when hearing-related cognitive test items are omitted. Potential mechanisms underlying these female-specific effects are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19233297.

The Effects of Age and Hearing Loss on Dual-Task Balance and Listening.

Objectives: Among older adults (OA), hearing loss is associated with an increased risk for falls. The aim of the present study was to experimentally investigate the cognitive compensation hypothesis, wherein decreased auditory and motor functioning are compensated by the recruitment of cognitive resources. Method: Twenty-nine younger adults (YA), 26 OA, and 32 OA with age-related hearing loss (ARHL) completed a dual-task paradigm consisting of cognitive and balance recovery tasks performed singly and concurrently. The auditory stimuli were presented with or without background noise. Results: Both older adult groups performed significantly worse than YA on the cognitive task in noisy conditions and ARHL also demonstrated disproportionate negative effects of dual-tasking and noise. The kinematic data indicated that OA and ARHL demonstrated greater plantarflexion when compared with YA. Conversely, YA showed greater hip extension in response to dual-tasking. Discussion: The cognitive and balance results suggest that YA were able to flexibly allocate their attention between tasks, whereas ARHL exhibited prioritization of posture over cognitive performance.

The effect of simultaneously and sequentially delivered cognitive and aerobic training on mobility among older adults with hearing loss.

BACKGROUND: Older adults exhibit declines in auditory and motor functioning, which are compensated for through the recruitment of cognitive resources. Cognitive or physical training alone has been shown to improve cognitive functioning and transfer to motor tasks, but results are mixed when these are combined in studies of healthy older adults, and few studies have included those with age-related hearing loss (ARHL), who are at a higher risk of falls. RESEARCH QUESTION: To examine format effects in mixed training, we used a repeated measures intervention design to compare the efficacy of Simultaneous and Sequential multimodal training formats. METHODS: 42 older adults (Mage = 68.05, SDage = 4.65, females = 26) with (ARHL) and without hearing loss (OAH) completed an intervention study consisting of 12 sessions of multimodal training (computerized cognitive dual-task and recumbent aerobic cycling). Participants were randomly assigned to either the Simultaneous (concurrent cognitive and aerobic) or Sequential training group (cognitive followed by aerobic) and completed assessments of single- and dual-task mobility concurrent with an auditory working memory task. Training gains were assessed with repeated measures ANOVAs using magnitude of improvement from pre- to post-training on primary outcome measures as the dependent variable. RESULTS: Gains in auditory working memory were greater in the Sequential group than Simultaneous particularly among OAH. ARHL participants were unaffected by format. While all participants improved on a measure of chair rises, there was no benefit to standing balance. The results demonstrate an advantage to Sequential training, suggesting a benefit to focusing on each task in isolation. SIGNIFICANCE: The gains noted in the ARHL indicate the potential benefit of incorporating cognitive remediation into traditional audiological rehabilitation. Moreover, it is important to consider the cost of dividing attention when combining training.

Improving older adults' experience with interactive voice response systems.

BACKGROUND: Interactive voice response (IVR) systems use computer-based voice recognition and software algorithms to conduct human/computer interactions. In recent years, there has been a proliferation of IVR applications in business and healthcare. The available evidence suggests that older people have negative attitudes towards IVR and experience significant difficulties using these systems. OBJECTIVE: The goal of this project was to identify areas of difficulties in IVR use by older people and propose strategies for improvement. MATERIALS AND METHODS: During two focus groups, we examined older people's perceptions of IVR systems and the most common difficulties experienced by seniors in interacting with these systems. We also recorded their suggestions for improvement of IVR. RESULTS: Frequency and chi square analyses were performed on the focus groups data. Some of the difficulties reported by participants in this study were congruent with previous findings, but we also uncovered some additional problems, such as frustration for not being able to reach an operator, being asked to wait too long on hold, being unable to recover from mistakes, and an absence of shortcuts in the systems. In addition, significant number of participants indicated that they prefer a system that adjusts to them automatically as opposed to a system that allows for adjustment. CONCLUSION: Generally, our findings suggest that the poor acceptability of IVR systems by older people could be improved by designing IVR algorithms that detect difficulties during an ongoing IVR exchange and direct people to different algorithms adapted for each person.