Relationships Between Auditory Processing and Cognitive Abilities in Adults: A Systematic Review

Abstract

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.

Figure 1.

Central auditory processing schematic defining the six main categories used to evaluate auditory processing abilities.

Figure 2.

Flow diagram following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for identifying, screening, and including articles.

Figure 3.

Average quality ratings of studies with relationships between auditory behavioral (left) and electrophysiologic (right) and cognitive constructs measured in more than one study. SIN = Speech in Noise; MMN = mismatch negativity; Ex/Inhib = Executive/Inhibitory Processes; Fluid = Fluid Intelligence; Multi = Multiple-Domains; ProcS = Processing Speed; VisP = Visual Perception; WM = Working Memory.

Figure 4.

Clustered column chart of the percentage of significant relationships between auditory and cognitive constructs. Columns are separated by all quality ratings and ratings of 4 or more. MMN = mismatch negativity; QR = quality ratings.