Age-Related Changes in Objective and Subjective Speech Perception in Complex Listening Environments

Abstract

Purpose: A frequent complaint by older adults is difficulty communicating in challenging acoustic environments. The purpose of this work was to review and summarize information about how speech perception in complex listening situations changes across the adult age range.

Method: This article provides a review of age-related changes in speech understanding in complex listening environments and summarizes results from several studies conducted in our laboratory.

Results: Both degree of high frequency hearing loss and cognitive test performance limit individuals' ability to understand speech in difficult listening situations as they age. The performance of middle-aged adults is similar to that of younger adults in the presence of noise maskers, but they experience substantially more difficulty when the masker is 1 or 2 competing speech messages. For the most part, middle-aged participants in studies conducted in our laboratory reported as much self-perceived hearing problems as did older adult participants.

Conclusions: Research supports the multifactorial nature of listening in real-world environments. Current audiologic assessment practices are often insufficient to identify the true speech understanding struggles that individuals experience in these situations. This points to the importance of giving weight to patients' self-reported difficulties.

Presentation video: http://cred.pubs.asha.org/article.aspx?articleid=2601619.

Figure 1.

Prevalence of self-reported hearing difficulty to measured hearing difficulty in adults from 40 years to 85+ years of age. Figure adapted from Bainbridge & Wallhagen, 2014. Self-report data were taken from the National Health Interview Survey, and measured audiometric data are pure-tone audiometric thresholds averaged at 0.5 kHz, 1.0 kHz, 2.0 kHz, and 4.0 kHz gathered from the National Health and Nutrition Examination Survey. Reproduced with permission of Annual Review of Public Health, Volume © by Annual Reviews, http://www.annualreviews.org

Figure 2.

Percent correct speech recognition, averaged across studies, by listener group and masker condition (SSN = steady-state noise; SEM = speech envelope modulated noise; and competing speech).

Figure 3.

Average SSQ ratings by group averaged across four studies. Higher ratings indicate fewer problems related to the question topic (see the Appendix for the content of each question). SSQ = Speech, Spatial and Qualities of Hearing Scale Questionnaire.