Perceptual Effort and Apparent Cognitive Decline: Implications for Audiologic Rehabilitation

ABSTRACT

Even when there is no significant threshold elevation in the speech range, age-related changes in auditory processing increase listening effort, especially in noisy situations. Increases in listening effort have deleterious effects on cognitive measures such as comprehension and memory. When young and older adults are tested under the same physical stimulus conditions, age differences on cognitive measures are common. However, when the conditions are equated for young and older adults so that listening effort is matched, many apparent age differences on cognitive measures are minimized. In general, for a given stimulus condition, listening is more effortful for older adults and their performance on cognitive measures resembles that of younger adults tested under more adverse stimulus conditions. Two approaches to equating for listening effort are described: adjustment of signal-to-noise ratio and simulations of the temporal aspects of auditory aging. Experimental findings relating perceptual test conditions to cognitive performance are discussed in light of recent findings that cognitive performance is related to benefit from complex hearing aid processing. A possible role of compensatory brain activation and plasticity is suggested and related to the importance of rehabilitative training.

KEYWORDS

Auditory aging - cognitive aging - information degradation - contextual support - listening effort

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