Differences in Auditory Perception Between Young and Older Adults When Controlling for Differences in Hearing Loss and Cognition.
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ABSTRACT:
SUBMITTER: Lentz JJ
PROVIDER: S-EPMC8753078 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Objectives"Minimal" and "mild" hearing loss are the most common but least understood forms of hearing loss in children. Children with better ear hearing level as low as 30 dB HL have a global language impairment and, according to the World Health Organization, a "disabling level of hearing loss." We examined in a population of 6- to 11-year-olds how hearing level ≤40.0 dB HL (1 and 4 kHz pure-tone average, PTA, threshold) is related to auditory perception, cognition, and communication.DesignSchool children (n = 1638) were recruited in 4 centers across the United Kingdom. They completed a battery of hearing (audiometry, filter width, temporal envelope, speech-in-noise) and cognitive (IQ, attention, verbal memory, receptive language, reading) tests. Caregivers assessed their children's communication and listening skills. Children included in this study (702 male; 752 female) had 4 reliable tone thresholds (1, 4 kHz each ear), and no caregiver reported medical or intellectual disorder. Normal-hearing children (n = 1124, 77.1%) had all 4 thresholds and PTA <15 dB HL. Children with ≥15 dB HL for at least 1 threshold, and PTA <20 dB (n = 245, 16.8%) had minimal hearing loss. Children with 20 ≤PTA <40 dB HL (n = 88, 6.0%) had mild hearing loss. Interaural asymmetric hearing loss ( left PTA - right PTA ≥10 dB) was found in 28.9% of those with minimal and 39.8% of those with mild hearing loss.ResultsSpeech perception in noise, indexed by vowel-consonant-vowel pseudoword repetition in speech-modulated noise, was impaired in children with minimal and mild hearing loss, relative to normal-hearing children. Effect size was largest (d = 0.63) in asymmetric mild hearing loss and smallest (d = 0.21) in symmetric minimal hearing loss. Spectral (filter width) and temporal (backward masking) perceptions were impaired in children with both forms of hearing loss, but suprathreshold perception generally related only weakly to PTA. Speech-in-noise (nonsense syllables) and language (pseudoword repetition) were also impaired in both forms of hearing loss and correlated more strongly with PTA. Children with mild hearing loss were additionally impaired in working memory (digit span) and reading, and generally performed more poorly than those with minimal loss. Asymmetric hearing loss produced as much impairment overall on both auditory and cognitive tasks as symmetric hearing loss. Nonverbal IQ, attention, and caregiver-rated listening and communication were not significantly impaired in children with hearing loss. Modeling suggested that 15 dB HL is objectively an appropriate lower audibility limit for diagnosis of hearing loss.ConclusionsHearing loss between 15 and 30 dB PTA is, at ~20%, much more prevalent in 6- to 11-year-old children than most current estimates. Key aspects of auditory and cognitive skills are impaired in both symmetric and asymmetric minimal and mild hearing loss. Hearing loss <30 dB HL is most closely related to speech perception in noise, and to cognitive abilities underpinning language and reading. The results suggest wider use of speech-in-noise measures to diagnose and assess management of hearing loss and reduction of the clinical hearing loss threshold for children to 15 dB HL.
| S-EPMC7160041 | biostudies-literature
Project description:Presbycusis (PC) is associated with cognitive decline and incident dementia. Speech reception thresholds (SRT) are used to assess speech detection, which points toward a central component of PC. However, to the best of our knowledge, no previous study has reported the relationship between SRT and cognitive function in older adults in a Han Chinese cohort. Therefore, in this study, we investigate the association of hearing loss, indexed using pure tone average (PTA) and SRT, with cognitive function in a Han Chinese cohort using a standardized neurocognitive battery. Subjects (aged ≥60 years) with no history of psychiatric or neurological diseases were recruited. All subjects underwent a battery of neuropsychological and auditory tests. According to the PTA of the better ear, the subjects were further divided into PC and normal PTA (NP) groups. Regression analyses were performed to examine the relationship between cognitive function and hearing loss in the PC and NP groups and all subjects when controlling for age, sex, education level, diabetes, smoking, and hypertension. Cognitive function was significantly associated with PTA and SRT in all subjects. In all subjects, the correlations between non-verbal cognitive scores and SRT were stronger than those between non-verbal cognitive scores and PTA, whereas the correlations between verbal cognitive scores and PTA were stronger than those between verbal cognitive scores and SRT. Moreover, the correlations between PTA or SRT and cognitive function in the PC group were in principle stronger than those in the NP group. Our findings indicate that cognitive function is significantly associated with PTA and SRT in older adults in a Han Chinese cohort. Therefore, SRT could be an important auditory test for exploring cognitive decline in PC and could complement PTA.
| S-EPMC6603159 | biostudies-literature
Project description:When viewed cross-sectionally, aging seems to negatively affect speech comprehension. However, aging is a heterogeneous process, and variability among older adults is typically large. In this study, we investigated language comprehension as a function of individual differences in older adults. Specifically, we tested whether hearing thresholds, working memory, inhibition, and individual alpha frequency would predict event-related potential amplitudes in response to classic psycholinguistic manipulations at the sentence level. Twenty-nine healthy older adults (age range 61-76 years) listened to English sentences containing reduced relative clauses and object-relative clauses while their electroencephalogram was recorded. We found that hearing thresholds and working memory predicted P600 amplitudes early during reduced relative clause processing, while individual alpha frequency predicted P600 amplitudes at a later point in time. The results suggest that participants with better hearing and larger working memory capacity simultaneously activated both the preferred and the dispreferred interpretation of reduced relative clauses, while participants with worse hearing and smaller working memory capacity only activated the preferred interpretation. They also suggest that participants with a higher individual alpha frequency had a higher likelihood of successfully reanalysing the sentence toward the reduced relative clause reading than participants with a lower individual alpha frequency. By contrast, we found no relationship between object-relative clause processing and working memory or hearing thresholds. Taken together, the results support the view that older adults employ different strategies during auditory sentence processing dependent on their hearing and cognitive abilities and that there is no single ability that uniformly predicts sentence processing outcomes.
| S-EPMC7596743 | biostudies-literature
Project description:ObjectivesThe goal of this study was to identify the effects of auditory deprivation (age-related hearing loss) and auditory stimulation (history of hearing aid use) on the neural registration of sound across two stimulus presentation conditions: (1) equal sound pressure level and (2) equal sensation level.DesignWe used a between-groups design, involving three groups of 14 older adults (n = 42; 62 to 84 years): (1) clinically defined normal hearing (≤25 dB from 250 to 8000 Hz, bilaterally), (2) bilateral mild-moderate/moderately severe sensorineural hearing loss who have never used hearing aids, and (3) bilateral mild-moderate/moderately severe sensorineural hearing loss who have worn bilateral hearing aids for at least the past 2 years.ResultsThere were significant delays in the auditory P1-N1-P2 complex in older adults with hearing loss compared with their normal hearing peers when using equal sound pressure levels for all participants. However, when the degree and configuration of hearing loss were accounted for through the presentation of equal sensation level stimuli, no latency delays were observed. These results suggest that stimulus audibility modulates P1-N1-P2 morphology and should be controlled for when defining deprivation and stimulus-related neuroplasticity in people with hearing loss. Moreover, a history of auditory stimulation, in the form of hearing aid use, does not appreciably alter the neural registration of unaided auditory evoked brain activity when quantified by the P1-N1-P2.ConclusionsWhen comparing auditory cortical responses in older adults with and without hearing loss, stimulus audibility, and not hearing loss-related neurophysiological changes, results in delayed response latency for those with age-related hearing loss. Future studies should carefully consider stimulus presentation levels when drawing conclusions about deprivation- and stimulation-related neuroplasticity. Additionally, auditory stimulation, in the form of a history of hearing aid use, does not significantly affect the neural registration of sound when quantified using the P1-N1-P2-evoked response.
| S-EPMC6689468 | biostudies-literature
Project description:We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40-69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.
| S-EPMC8513843 | biostudies-literature
Project description:This systematic review and meta-analysis examined the efficacy of auditory training and cognitive training to improve cognitive function in adults with hearing loss. A literature search of academic databases (e.g., MEDLINE, Scopus) and gray literature (e.g., OpenGrey) identified relevant articles published up to January 25, 2018. Randomized controlled trials (RCTs) or repeated measures designs were included. Outcome effects were computed as Hedge's g and pooled using random-effects meta-analysis (PROSPERO: CRD42017076680). Nine studies, five auditory training, and four cognitive training met the inclusion criteria. Following auditory training, the pooled effect was small and statistically significant for both working memory ( g?=?0.21; 95% CI [0.05, 0.36]) and overall cognition ( g?=?0.19; 95% CI [0.07, 0.31]). Following cognitive training, the pooled effect for working memory was small and statistically significant ( g?=?0.34; 95% CI [0.16, 0.53]), and the pooled effect for overall cognition was large and significant ( g?=?1.03; 95% CI [0.41, 1.66]). However, this was dependent on the classification of training approach. Sensitivity analyses revealed no statistical difference between the effectiveness of auditory and cognitive training for improving cognition upon removal of a study that used a combined auditory-cognitive approach, which showed a very large effect. Overall certainty in the estimation of effect was "low" for auditory training and "very low" for cognitive training. High-quality RCTs are needed to determine which training stimuli will provide optimal conditions to improve cognition in adults with hearing loss.
| S-EPMC6088475 | biostudies-literature
Project description:This study represents the first attempt to perform a profiling analysis of the intergenerational differences in the microRNAs (miRNAs) of melanocytic neoplasms in young adult and older adult groups. Our comparative miRNA profiling provides a novel characterization of the miRnomes of melanocytic neoplasms and melanomas of different age groups and identifies a set of potential diagnostic and potential clinico-pathologic biomarkers that may serve as targets for development of novel miR-based modalities in cancer diagnosis and treatment. An exploratory miRNA analysis of 666 miRs was conducted on formalin fixed and paraffin embedded tissues from 10 adults and 10 young adults including conventional melanoma and melanocytic neoplasms of uncertain biological significance. Age-matched benign melanocytic nevi were used as controls. The comparative profiling was intentionally performed at two extremes of age, i.e., less than 30 years (Mel 30) and greater than 60 years (Mel 60). Primary melanoma in patients greater than 60 years old was characterized by the increased expression of miRs regulating TLR-MyD88-NF-kappaB pathway (hsa-miR -199a), RAS/RAB22A pathway (hsa-miR-204); growth differentiation and migration (hsa-miR337), epithelial mesenchymal transition EMT (let-7b, hsa-miR-10b/10bSTAR(*)), invasion and metastasis (hsa-miR-10b/10bSTAR(*), hsa-miR-30a/e*, hsa-miR-29c*; cellular matrix components (hsa-miR-29c*); invasion-cytokinesis (hsa-miR 99b*) compared to melanoma of younger patients. miR 211 was dramatically downregulated in primary melanoma compared to nevi controls, decreased with increasing age and was among the miRs linked to metastatic processes and potentially targeting the inflammatory receptor CCR10; Primary melanoma in young adult patients was characterized by the increased expression of hsa-miR-449a and decreased expression of hsa-miR146b, hsa-miR 214*. Among the miRs expressed at higher levels in control nevi, compared to adult or young adult melanoma, was hsa-miR 574-3p. Only 2 miRs distinguished adult from young adult-pediatric nevi, hsa-miR374a* and has-miR-566. MiR 30a* appeared to be a strong marker of differentiation in clinical stages I-II adult and pediatric melanoma, and could predict classification of melanoma tissue in the two age groups. Furthermore, lymph node status in the two age groups was characterized by the statistically significant expression of hsa-miR-30a* and hsa-miR-204 (F-test, p-value <0.001).
2010-03-20 | GSE19229 | GEO
Project description:Age-related hearing impairment (ARHI), or presbycusis, is a common condition of the elderly that results in significant communication difficulties in daily life. Clinically, it has been defined as a progressive loss of sensitivity to sound, starting at the high frequencies, inability to understand speech, lengthening of the minimum discernable temporal gap in sounds, and a decrease in the ability to filter out background noise. The causes of presbycusis are likely a combination of environmental and genetic factors. Previous research into the genetics of presbycusis has focused solely on hearing as measured by pure-tone thresholds. A few loci have been identified, based on a best ear pure-tone average phenotype, as having a likely role in susceptibility to this type of hearing loss; and GRM7 is the only gene that has achieved genome-wide significance. We examined the association of GRM7 variants identified from the previous study, which used an European cohort with Z-scores based on pure-tone thresholds, in a European-American population from Rochester, NY (N = 687), and used novel phenotypes of presbycusis. In the present study mixed modeling analyses were used to explore the relationship of GRM7 haplotype and SNP genotypes with various measures of auditory perception. Here we show that GRM7 alleles are associated primarily with peripheral measures of hearing loss, and particularly with speech detection in older adults.
| S-EPMC3705704 | biostudies-literature
Project description:ImportanceVisual dysfunction and poor cognition are highly prevalent among older adults; however, the relationship is not well defined.ObjectiveTo evaluate the association of measured and self-reported visual impairment (VI) with cognition in older US adults.Design, setting, and participantsCross-sectional analysis of 2 national data sets: the National Health and Nutrition Examination Survey (NHANES), 1999-2002, and the National Health and Aging Trends Study (NHATS), 2011-2015. The NHANES was composed of a civilian, noninstitutionalized community, and the NHATS comprised Medicare beneficiaries in the contiguous United States. Vision was measured at distance, near, and by self-report in the NHANES and by self-report alone in the NHATS. Sample weights were used to ensure result generalizability.Main outcomes and measuresThe NHANES measured Digit Symbol Substitution Test (DSST) score and relative DSST impairment (DSST score ≤28, lowest quartile in study cohort), and the NHATS measured probable or possible dementia, classified per NHATS protocol.ResultsThe NHANES comprised 2975 respondents aged 60 years and older who completed the DSST measuring cognitive performance. Mean (SD) age was 72 (8) years, 52% of participants were women (n = 1527), and 61% were non-Hispanic white (n = 1818). The NHATS included 30 202 respondents aged 65 years and older with dementia status assessment. The largest proportion (40%; n = 12 212) were between 75 and 84 years of age. Fifty-eight percent were women (n = 17 659), and 69% were non-Hispanic white (n = 20 842). In the NHANES, distance VI (β = -5.1; 95% CI, -8.6 to -1.6; odds ratio [OR], 2.8; 95% CI, 1.1-6.7) and subjective VI (β = -5.3; 95% CI, -8.0 to -2.6; OR, 2.7; 95% CI, 1.6-4.8) were both associated with lower DSST scores and higher odds of DSST impairment after full adjustment with covariates. Near VI was associated with lower DSST scores but not higher odds of DSST impairment. The NHATS data corroborated these results, with all vision variables associated with higher odds of dementia after full adjustment (distance VI: OR, 1.9; 95% CI, 1.6-2.2; near VI: OR, 2.6; 95% CI, 2.2-3.1; either distance or near VI: OR, 2.1; 95% CI, 1.8-2.4).Conclusions and relevanceIn a nationally representative sample of older US adults, vision dysfunction at distance and based on self-reports was associated with poor cognitive function. This was substantiated by a representative sample of US Medicare beneficiaries using self-reported visual function, reinforcing the value of identifying patients with visual compromise. Further study of longitudinal interactions between vision and cognition is warranted.
| S-EPMC5710542 | biostudies-literature
Project description:BackgroundSensorineural hearing loss is the most common sensory deficit among older adults. Some of the psychosocial consequences of this condition include difficulty in understanding speech, depression, and social isolation. Studies have shown that older adults with hearing loss show some age-related cognitive decline. Hearing aids have been proven as successful interventions to alleviate sensorineural hearing loss. In addition to hearing aid use, the positive effects of auditory training-formal listening activities designed to optimize speech perception-are now being documented among adults with hearing loss who use hearing aids, especially new hearing aid users. Auditory training has also been shown to produce prolonged cognitive performance improvements. However, there is still little evidence to support the benefits of simultaneous hearing aid use and individualized face-to-face auditory training on cognitive performance in adults with hearing loss.ObjectiveThis study will investigate whether using hearing aids for the first time will improve the impact of individualized face-to-face auditory training on cognition, depression, and social interaction for adults with sensorineural hearing loss. The rationale for this study is based on the hypothesis that, in adults with sensorineural hearing loss, using hearing aids for the first time in combination with individualized face-to-face auditory training will be more effective for improving cognition, depressive symptoms, and social interaction rather than auditory training on its own.MethodsThis is a crossover trial targeting 40 men and women between 50 and 90 years of age with either mild or moderate symmetric sensorineural hearing loss. Consented, willing participants will be recruited from either an independent living accommodation or via a community database to undergo a 6-month intensive face-to-face auditory training program (active control). Participants will be assigned in random order to receive hearing aid (intervention) for either the first 3 or last 3 months of the 6-month auditory training program. Each participant will be tested at baseline, 3, and 6 months using a neuropsychological battery of computer-based cognitive assessments, together with a depression symptom instrument and a social interaction measure. The primary outcome will be cognitive performance with regard to spatial working memory. Secondary outcome measures include other cognition performance measures, depressive symptoms, social interaction, and hearing satisfaction.ResultsData analysis is currently under way and the first results are expected to be submitted for publication in June 2018.ConclusionsResults from the study will inform strategies for aural rehabilitation, hearing aid delivery, and future hearing loss intervention trials.Trial registrationClinicalTrials.gov NCT03112850; https://clinicaltrials.gov/ct2/show/NCT03112850 (Archived by WebCite at http://www.webcitation.org/6xz12fD0B).
| S-EPMC5889491 | biostudies-literature