Linda Grugel

Cognitive resources related to speech recognition with a competing talker in young and older listeners

Speech recognition in a multi-talker situation poses high demands on attentional and other central resources. This study examines the relationship between age, cognition and speech recognition in tasks that require selective or divided attention in a multi-talker setting. Two groups of normal-hearing adults (one younger and one older group) were asked to repeat utterances from either one or two concurrent speakers. Cognitive abilities were then inspected by neuropsychological tests. Speech recognition scores approached its ceiling and did not significantly differ between age groups for tasks that demanded selective attention. However, when divided attention was required, performance in older listeners was reduced as compared to the younger group. When selective attention was required, speech recognition was strongly related to working memory skills, as determined by a regression model. In comparison, speech recognition for tests requiring divided attention could be more strongly determined by neuropsychological probes of fluid intelligence. The findings of this study indicate that - apart from hearing impairment - cognitive aspects account for the typical difficulties of older listeners in a multi-speaker setting. Our results are discussed in the context of evidence showing that frontal lobe functions in terms of working memory and fluid intelligence generally decline with age.

Untersuchungen zum Sprachverstehen und zu kognitiven Fähigkeiten im Alter

ZusammenfassungHintergrundÄltere Personen berichten häufig über Probleme beim Sprachverstehen, insbesondere in komplexen Kommunikationssituationen. Neben Hörstörungen können hierbei Einschränkungen kognitiver Leistungen eine Rolle spielen.MethodenMit 12 normalhörenden jüngeren Personen und 14 älteren Personen mit besonders gutem Hörvermögen wurden Sprachverständlichkeitsmessungen in unterschiedlich komplexen akustischen Situationen durchgeführt. Zur Beurteilung der kognitiven Fähigkeiten kamen verschiedene neuropsychologische Tests zum Einsatz.ErgebnisseDie älteren Probanden wiesen trotz vergleichbaren tonaudiometrischen Befunden in fast allen Messungen schlechtere Sprachverständlichkeitsergebnisse auf als die jüngeren Personen. Besonders große Unterschiede zeigten sich bei Verwendung von fluktuierenden Maskierern und konkurrierenden Sprechern. Es ergaben sich signifikante Korrelationen zu Befunden eines neuropsychologischen Tests, welcher das deklarative Verbalgedächtnis erfasst.SchlussfolgerungÄltere Personen weisen in komplexen akustischen Situationen schlechteres Sprachverstehen als jüngere Personen auf. Unterschiede im Sprachverstehen sind teilweise auf kognitive Leistungen zurückzuführen. Insbesondere das Arbeitsgedächtnis scheint eine wichtige Rolle zu spielen.AbstractBackgroundElderly persons frequently complain about problems with speech understanding especially in complex acoustic situations. Besides hearing impairment the decline of cognitive functions might explain these problems.MethodsIn 12 normal hearing young subjects and 14 elderly listeners with extraordinarily good hearing speech perception was measured in a broad range of different acoustic situations. Cognitive functioning was evaluated with different neuropsychological tests.ResultsDespite comparable pure tone thresholds the elderly listeners revealed worse speech discrimination than the young subjects in almost all test situations. Largest differences were found in situations with fluctuating maskers and competing talkers. Most of the speech perception results revealed significant correlations with the outcome from a neuropsychological test addressing declarative verbal memory.ConclusionsIn complex listening situations elderly persons reveal worse speech understanding than younger subjects. Differences in speech perception can partly be attributed to cognitive abilities. In particular, working memory seems to be an important factor.BACKGROUND Elderly persons frequently complain about problems with speech understanding especially in complex acoustic situations. Besides hearing impairment the decline of cognitive functions might explain these problems. METHODS In 12 normal hearing young subjects and 14 elderly listeners with extraordinarily good hearing speech perception was measured in a broad range of different acoustic situations. Cognitive functioning was evaluated with different neuropsychological tests. RESULTS Despite comparable pure tone thresholds the elderly listeners revealed worse speech discrimination than the young subjects in almost all test situations. Largest differences were found in situations with fluctuating maskers and competing talkers. Most of the speech perception results revealed significant correlations with the outcome from a neuropsychological test addressing declarative verbal memory. CONCLUSIONS In complex listening situations elderly persons reveal worse speech understanding than younger subjects. Differences in speech perception can partly be attributed to cognitive abilities. In particular, working memory seems to be an important factor.

Intention to use hearing aids: a survey based on the theory of planned behavior.

Objective To determine the intention to use hearing aids (HAs) by applying the theory of planned behavior (TPB). Design The TPB is a widely used decision-making model based on three constructs hypothesized to influence the intention to perform a specific behavior; namely, “attitude toward the behavior”, “subjective norm”, and “behavioral control”. The survey was based on a TPB-specific questionnaire addressing factors relevant to HA provision. Study sample Data from 204 individuals reporting hearing problems were analyzed. Different subgroups were established according to the stage of their hearing help-seeking. Results The TPB models’ outcome depended on the subgroup. The intention of those participants who had recognized their hearing problems but had not yet consulted an ear, nose, and throat specialist was largely dominated by the “subjective norm” construct, whereas those who had already consulted an ear, nose, and throat specialist or had already tried out HAs were significantly influenced by all constructs. The intention of participants who already owned HAs was clearly less affected by the “subjective norm” construct but was largely dominated by their “attitude toward HAs”. Conclusion The intention to use HAs can be modeled on the basis of the constructs “attitude toward the behavior”, “subjective norm”, and “behavioral control”. Individual contribution of the constructs to the model depends on the patient’s stage of hearing help-seeking. The results speak well for counseling strategies that explicitly consider the individual trajectory of hearing help-seeking.

Use of self-assessment inventories in hearing-aid provision: German versions of ECHO and SADL

Abstract Objective: This study presents German versions of the ECHO (expected consequences of hearing aid ownership) and SADL (satisfaction with amplification in daily life) self-assessment inventories (57). Study sample: The questionnaires were administered to a group of 290 hearing-aid candidates (ECHO) and 462 experienced hearing-aid users (SADL) recruited at different audiological centres in Germany. Design: The psychometric properties of the German versions and the original questionnaires were similar as confirmed by factor analysis and internal consistency analysis. Results: When comparing outcomes for the ECHO and SADL inventories from the two study groups it was found that satisfaction outperformed expectations. In addition, the relationships of the questionnaire subscales with personality traits as measured with the Big Five inventory were examined. Certain weak though statistically significant correlations were found revealing that personality in hearing-impaired persons does not greatly affect ECHO and SADL outcomes. In contrast, ECHO subscale scores were clearly associated with the motivation to use amplification and might thus help to detect non-adherents. Conclusion: These findings, along with the fact that pre-fitting expectations can be directly compared to post-fitting satisfaction, makes the application of the ECHO and SADL inventories highly valuable in rehabilitative audiology.

Utility and importance of hearing-aid features assessed by hearing-aid acousticians.

Modern hearing instruments include many features addressing situation-specific and user-related amplification. The main tasks of the acoustician are the appropriate choice of hearing instruments and fitting them to hearing impaired individuals. This study aims at investigating the utility and importance of several hearing-aid features as assessed by hearing-aid acousticians. For this purpose, eight different hearing-aid features with three levels each are addressed in a discrete-choice experiment. Preferences for systematically varied combinations of the features are assessed with 143 acousticians, using an adaptive conjoint analysis conducted via the Internet. Based on the preference data, utility and importance of the features are calculated. Highest utility and importance are found for noise cancellation and directional microphones. Outcome of these two features do not differ significantly. In contrast, data management functions, that is, self-learning options, show lowest importance. Though the acousticians’ professional experience reveal statistically significant influence on the assessment of some of the features’ utility and importance, a clear impact of sociodemographic or subject-specific factors on the outcome cannot be found. The study can be seen as a first approach to determine the estimation of basic hearing-aid features assessed by acousticians. Results show the outstanding utility and importance of features addressing speech perception in adverse listening situations. Furthermore, the outcome reveals reservations of the acousticians regarding self-learning options of the instruments.

Untersuchungen zum Sprachverstehen und zu kognitiven Fähigkeiten im Alter@@@Examination of speech perception and cognitive functioning in the elderly

ZusammenfassungHintergrundÄltere Personen berichten häufig über Probleme beim Sprachverstehen, insbesondere in komplexen Kommunikationssituationen. Neben Hörstörungen können hierbei Einschränkungen kognitiver Leistungen eine Rolle spielen.MethodenMit 12 normalhörenden jüngeren Personen und 14 älteren Personen mit besonders gutem Hörvermögen wurden Sprachverständlichkeitsmessungen in unterschiedlich komplexen akustischen Situationen durchgeführt. Zur Beurteilung der kognitiven Fähigkeiten kamen verschiedene neuropsychologische Tests zum Einsatz.ErgebnisseDie älteren Probanden wiesen trotz vergleichbaren tonaudiometrischen Befunden in fast allen Messungen schlechtere Sprachverständlichkeitsergebnisse auf als die jüngeren Personen. Besonders große Unterschiede zeigten sich bei Verwendung von fluktuierenden Maskierern und konkurrierenden Sprechern. Es ergaben sich signifikante Korrelationen zu Befunden eines neuropsychologischen Tests, welcher das deklarative Verbalgedächtnis erfasst.SchlussfolgerungÄltere Personen weisen in komplexen akustischen Situationen schlechteres Sprachverstehen als jüngere Personen auf. Unterschiede im Sprachverstehen sind teilweise auf kognitive Leistungen zurückzuführen. Insbesondere das Arbeitsgedächtnis scheint eine wichtige Rolle zu spielen.AbstractBackgroundElderly persons frequently complain about problems with speech understanding especially in complex acoustic situations. Besides hearing impairment the decline of cognitive functions might explain these problems.MethodsIn 12 normal hearing young subjects and 14 elderly listeners with extraordinarily good hearing speech perception was measured in a broad range of different acoustic situations. Cognitive functioning was evaluated with different neuropsychological tests.ResultsDespite comparable pure tone thresholds the elderly listeners revealed worse speech discrimination than the young subjects in almost all test situations. Largest differences were found in situations with fluctuating maskers and competing talkers. Most of the speech perception results revealed significant correlations with the outcome from a neuropsychological test addressing declarative verbal memory.ConclusionsIn complex listening situations elderly persons reveal worse speech understanding than younger subjects. Differences in speech perception can partly be attributed to cognitive abilities. In particular, working memory seems to be an important factor.BACKGROUND Elderly persons frequently complain about problems with speech understanding especially in complex acoustic situations. Besides hearing impairment the decline of cognitive functions might explain these problems. METHODS In 12 normal hearing young subjects and 14 elderly listeners with extraordinarily good hearing speech perception was measured in a broad range of different acoustic situations. Cognitive functioning was evaluated with different neuropsychological tests. RESULTS Despite comparable pure tone thresholds the elderly listeners revealed worse speech discrimination than the young subjects in almost all test situations. Largest differences were found in situations with fluctuating maskers and competing talkers. Most of the speech perception results revealed significant correlations with the outcome from a neuropsychological test addressing declarative verbal memory. CONCLUSIONS In complex listening situations elderly persons reveal worse speech understanding than younger subjects. Differences in speech perception can partly be attributed to cognitive abilities. In particular, working memory seems to be an important factor.