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      Differences in Auditory Perception Between Young and Older Adults When Controlling for Differences in Hearing Loss and Cognition

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          Abstract

          This study was designed to examine age effects on various auditory perceptual skills using a large group of listeners (155 adults, 121 aged 60–88 years and 34 aged 18–30 years), while controlling for the factors of hearing loss and working memory (WM). All subjects completed 3 measures of WM, 7 psychoacoustic tasks (24 conditions) and a hearing assessment. Psychophysical measures were selected to tap phenomena thought to be mediated by higher-level auditory function and included modulation detection, modulation detection interference, informational masking (IM), masking level difference (MLD), anisochrony detection, harmonic mistuning, and stream segregation. Principal-components analysis (PCA) was applied to each psychoacoustic test. For 6 of the 7 tasks, a single component represented performance across the multiple stimulus conditions well, whereas the modulation-detection interference (MDI) task required two components to do so. The effect of age was analyzed using a general linear model applied to each psychoacoustic component. Once hearing loss and WM were accounted for as covariates in the analyses, estimated marginal mean thresholds were lower for older adults on tasks based on temporal processing. When evaluated separately, hearing loss led to poorer performance on roughly 1/2 the tasks and declines in WM accounted for poorer performance on 6 of the 8 psychoacoustic components. These results make clear the need to interpret age-group differences in performance on psychoacoustic tasks in light of cognitive declines commonly associated with aging, and point to hearing loss and cognitive declines as negatively influencing auditory perceptual skills.

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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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            Hearing loss and cognitive decline in older adults.

            BACKGROUND Whether hearing loss is independently associated with accelerated cognitive decline in older adults is unknown. METHODS We studied 1984 older adults (mean age, 77.4 years) enrolled in the Health ABC Study, a prospective observational study begun in 1997-1998. Our baseline cohort consisted of participants without prevalent cognitive impairment (Modified Mini-Mental State Examination [3MS] score, ≥80) who underwent audiometric testing in year 5. Participants were followed up for 6 years. Hearing was defined at baseline using a pure-tone average of thresholds at 0.5 to 4 kHz in the better-hearing ear. Cognitive testing was performed in years 5, 8, 10, and 11 and consisted of the 3MS (measuring global function) and the Digit Symbol Substitution test (measuring executive function). Incident cognitive impairment was defined as a 3MS score of less than 80 or a decline in 3MS score of more than 5 points from baseline. Mixed-effects regression and Cox proportional hazards regression models were adjusted for demographic and cardiovascular risk factors. RESULTS In total, 1162 individuals with baseline hearing loss (pure-tone average >25 dB) had annual rates of decline in 3MS and Digit Symbol Substitution test scores that were 41% and 32% greater, respectively, than those among individuals with normal hearing. On the 3MS, the annual score changes were -0.65 (95% CI, -0.73 to -0.56) vs -0.46 (95% CI, -0.55 to -0.36) points per year (P = .004). On the Digit Symbol Substitution test, the annual score changes were -0.83 (95% CI, -0.94 to -0.73) vs -0.63 (95% CI, -0.75 to -0.51) points per year (P = .02). Compared to those with normal hearing, individuals with hearing loss at baseline had a 24% (hazard ratio, 1.24; 95% CI, 1.05-1.48) increased risk for incident cognitive impairment. Rates of cognitive decline and the risk for incident cognitive impairment were linearly associated with the severity of an individual's baseline hearing loss. CONCLUSIONS Hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults. Further studies are needed to investigate what the mechanistic basis of this association is and whether hearing rehabilitative interventions could affect cognitive decline.
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              When does age-related cognitive decline begin?

              Cross-sectional comparisons have consistently revealed that increased age is associated with lower levels of cognitive performance, even in the range from 18 to 60 years of age. However, the validity of cross-sectional comparisons of cognitive functioning in young and middle-aged adults has been questioned because of the discrepant age trends found in longitudinal and cross-sectional analyses. The results of the current project suggest that a major factor contributing to the discrepancy is the masking of age-related declines in longitudinal comparisons by large positive effects associated with prior test experience. Results from three methods of estimating retest effects in this project, together with results from studies comparing non-human animals raised in constant environments and from studies examining neurobiological variables not susceptible to retest effects, converge on a conclusion that some aspects of age-related cognitive decline begin in healthy educated adults when they are in their 20s and 30s.
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                Author and article information

                Journal
                Trends Hear
                Trends Hear
                TIA
                sptia
                Trends in Hearing
                SAGE Publications (Sage CA: Los Angeles, CA )
                2331-2165
                6 January 2022
                Jan-Dec 2022
                : 26
                : 23312165211066180
                Affiliations
                [1 ]Department of Speech, Language and Hearing Sciences, Ringgold 1771, universityIndiana University, Bloomington; , IN, USA
                Author notes
                [*]Jennifer J. Lentz, Department of Speech, Language and Hearing Sciences, Indiana University, 2631 East Discovery Parkway, Bloomington IN, 47408, USA. Email: jjlentz@ 123456indiana.edu
                Author information
                https://orcid.org/0000-0001-9883-7340
                https://orcid.org/0000-0002-9668-3744
                Article
                10.1177_23312165211066180
                10.1177/23312165211066180
                8753078
                34989641
                7dbe6735-442c-4f72-8677-bb4eae55db02
                © The Author(s) 2022

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: National Institute on Aging, FundRef https://doi.org/10.13039/100000049;
                Award ID: AG008293
                Categories
                Original Article
                Custom metadata
                ts19
                January-December 2022

                aging,psychoacoustics,cognition,working memory,principal component analysis

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