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The Egyptian Journal of Otolaryngology
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Central auditory functions in elderly individuals

The Egyptian Journal of Otolaryngology volume 29, pages 254–262 (2013)Cite this article

Abstract

Elderly individuals often have more difficulty in understanding speech than younger adults, particularly in noisy environments. Three models that attempt to explain this are as follows: (a) deterioration in peripheral hearing; (b) structural changes to the central auditory system; and (c) changes in normal cognitive processes. The aim of this study was to assess the central auditory functions in an elderly population and compare them with those of an adult population.

Participants and methods

The study group included 60 elderly individuals; they were older than 60 years of age and were divided into two subgroups: the first subgroup A included 24 elderly individuals with normal peripheral hearing and the second subgroup B included 36 elderly individuals with presbycusis with a mild degree of hearing loss. The control group included 30 individuals ranging in age from 18 to 30 years. Both the study and the control group were subjected to an otological examination, immittancemetry, pure tone audiometry, speech audiometry, and central auditory processing assessment using the following selected few behavioral central auditory tests: synthetic sentence identification test with ipsilateral competing message (SSI-ICM), dichotic digits test (DDT), auditory fusion test-revised (AFT-R), and pitch pattern sequences test (PPT).

Results

There were elevated hearing thresholds at mostly all frequencies with statistically significant differences on comparing both study subgroups A and B with the control group.

On using SSI-ICM, in the competition ratio (−15 dB), there were statistically significantly low scores in subgroups A and B compared with the control group. Results of DDT showed statistically significantly low scores on comparing the results between the left ear and the right ear in both subgroups A and B. There was a statistically significant elevated gap threshold for tonal stimuli in the AFT-R test on comparing both subgroups A and B with the control group. The results of PPT showed that subgroup B obtained a statistically significantly lower score compared with the control group.

There was a statistically significant negative correlation between age and the results of SSI-ICM in the competition ratio 0 dB when presented to the left ear, DDT, and PPT. There was a statistically significant positive correlation between age and the results of AFT-R when presented at 4000 Hz.

Conclusion

Age-related changes to auditory processing will occur in most adults 60 years of age and older that may or may not be concomitant with peripheral hearing loss. Aging decreases the capacity of digit recognition and also increases interaural asymmetries. Many older listeners show reduced temporal resolution even when potential influences of hearing loss are absent. Temporal ordering abilities decrease with age.

Recommendation

It is important to include central auditory tests in the audiologic assessment protocol of the elderly. The utilization of these tests in assessment of the elderly enables us to improve the quality of therapeutic-rehabilitative interventions.

References

  1. Pleis JR, Lethbridge-Çejku M. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2006 (Vital and Health Statistics 10, 235). Washington, DC:National Center for Health Statistics, US Government Printing Office; 2007.

    Google Scholar 

  2. Lavizzo-Mourey RJ, Siegler EL. Hearing impairment in the elderly. J Gen Intern Med 1992;7:191–198.

    Article  CAS  PubMed  Google Scholar 

  3. Dubno JR, Dirks DD, Morgan EE. Effects of age and mild hearing loss on speech recognition in noise. J Acoust Soc Am 1984;76:87–96.

    Article  CAS  PubMed  Google Scholar 

  4. Sommers MS. Speech perception in older adults: the importance of speech-specific cognitive abilities. J Am Geriatr Soc 1997;45:633–637.

    Article  CAS  PubMed  Google Scholar 

  5. Jerger J. Behavioral studies of auditory aging. Semin Hear 2006;27:243–263.

    Article  Google Scholar 

  6. Sanchez ML, Nunes FB, Barros F, Ganança MM, Caovilla HH. Auditory processing assessment in older people with no report of hearing disability. Braz J Otorhinolaryngol 2008;74:896–902.

    Article  PubMed  Google Scholar 

  7. Pichora-Fuller MK, Singh G. Effects of age on auditory and cognitive processing: implications for hearing aid fitting and audiologic rehabilitation. Trends Amplif 2006;10:29–59.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Jerger J, Chmiel R, Allen J, Wilson A. Effects of age and gender on dichotic sentence identification. Ear Hear 1994;15:274–286.

    Article  CAS  PubMed  Google Scholar 

  9. Martin JS, Jerger JF. Some effects of aging on central auditory processing. J Am Acad Audiol 2005;42 (Suppl 12): 25–44.

    Google Scholar 

  10. Cruickshanks KJ, Zhan W, Zhong W. Epidemiology of age-related hearing impairment (chapter 9). In: Gordon-Salant S, Frisina RD, Popper AN, Fay RR, editors. The aging auditory system. Berlin:Springer; 2010. pp. 259–274.

    Chapter  Google Scholar 

  11. Humes LE, Christopherson L, Cokely CG. Central auditory processing disorders in the elderly: fact or fiction? In: Katz J, Stecker N, Henderson D, editors. Central auditory processing: a transdisciplinary view. St Louis:Mosby Year Book; 1992. pp. 141–149.

    Google Scholar 

  12. Webster DB. Neuroscience of communication. 2nd ed. San Diego:Singular Publishing Group; 1999.

    Google Scholar 

  13. Beasley DS, Forman BS, Rintelmann WF. Perception of time-compressed CNC monosyllables by normal listeners. J Aud Res 1972;12:71–75.

    Google Scholar 

  14. Kelly DA. Central auditory processing disorders: strategies for use with children and adolescents. San Antonio, TX:Communication Skill Builders;1995.

    Google Scholar 

  15. Almedia CIR, Cumpos MI, Almedia RR. Logoaudiometria pediatrica (PSI). Otorrinolaryngol 1988;54:73–76.

    Google Scholar 

  16. Pichora-Fuller MK. Cognitive aging and auditory information processing. Int J Audiol 2003;42 (Suppl 2): S26–S32.

    Article  Google Scholar 

  17. Cruz O, Kasse C, Sanchez M, Barbosa F, Barros F. Serotonin reuptake inhibitors in auditory processing disorders in elderly patients: preliminary results. Laryngoscope 2004;114:1656–1659.

    Article  CAS  PubMed  Google Scholar 

  18. Gordon-Salant S. Hearing loss and aging: new research findings and clinical implications. J Rehab Res Dev 2005;42:9–24.

    Article  Google Scholar 

  19. Carhart R, Tillman TW. Interaction of competing speech signals with hearing losses. Arch Otolaryngol 1970;91:273–279.

    Article  CAS  PubMed  Google Scholar 

  20. Bosatra A, Russolo M. Comparison between central tonal tests and central speech tests in elderly subjects. Audiology 1982;21:334–341.

    Article  CAS  PubMed  Google Scholar 

  21. Carter AS, Noe CM, Wilson RH. Listeners who prefer monaural to binaural hearing aids. J Am Acad Audiol 2001;12:261–272.

    CAS  PubMed  Google Scholar 

  22. Zenker F, Mora Espino MR, Cosialls MS, Carmona De Lucas G, Belda FR, Barajas JJ. The effect of age over the dichotic digit test. 2007; 8th EFAS Congress/10th Congress of the German Society of Audiology, 6–9 June 2007 Heidelberg/Germany; 2007.

  23. Strouse A, Wilson RH. Stimulus length uncertainty with dichotic digit recognition. J Am Acad Audiol 1999;10:219–229.

    CAS  PubMed  Google Scholar 

  24. Keith R. Auditory fusion test-revised. Audiology Online. 2001. Available at: http://www.audiologyonline.com [Accessed 16 April 2001].

  25. Moore B, Shailer M, Schooneveldt G. Temporal modulation transfer functions for band-limited noise in subjects with cochlear hearing loss. Br J Audiol 1992;26:229–237.

    Article  CAS  PubMed  Google Scholar 

  26. Schneider BA, Pichora-Fuller MK, Kowalchuk D, Lamb M. Gap detection and the precedence effect in young and old adults. J Acoust Soc Am 1994;95:980–991.

    Article  CAS  PubMed  Google Scholar 

  27. Strouse A, Ashmead DH, Ohde RN, Granthan DW. Temporal processing in the aging auditory system. J Acoust Soc Am 1998;104:2385–2399.

    Article  CAS  PubMed  Google Scholar 

  28. Schneider BA, Hamstra SJ. Gap detection thresholds as a function of tonal duration for younger and older listeners. J Acoust Soc Am 1999;106:371–380.

    Article  CAS  PubMed  Google Scholar 

  29. Snell KB. Age-related changes in temporal gap detection. J Acoust Soc Am 1997;101:2214–2220.

    Article  CAS  PubMed  Google Scholar 

  30. Musiek FE, Shinn JB, Jirsa R, Bamiou D-E, Baran JA, Zaida E. GIN (Gaps-in-Noise) test performance in subjects with confirmed central auditory nervous system involvement. Ear Hear 2005;26:608–618.

    Article  PubMed  Google Scholar 

  31. Gordon-Salant S, Frisina RD, Popper AN, Fay RRGordon-Salant S, Frisina RD, Popper AN, Fay RR. Behavioral studies with aging humans: hearing sensitivity and psychoacoustics (chapter 5). The aging auditory system 2010 Springer handbook of auditory research;125.

  32. Roberts RA, Lister JJ, Wilson RH. Effects of age and hearing loss on gap detection and the precedence effect: broadband stimuli. J Speech Lang Hear Res 2004;47:965–978.

    Article  PubMed  Google Scholar 

  33. Trainor LJ, Trehub SE. Aging and auditory temporal sequencing: ordering the elements of repeating tone patterns. Percept Psychophys 1989;45:417–426.

    Article  CAS  PubMed  Google Scholar 

  34. Fitzgibbons PJ, Gordon-Salant S. Auditory temporal order perception in younger and older adults. J Speech Lang Hear Res 1998;41:1052–1060.

    Article  CAS  PubMed  Google Scholar 

  35. Musiek FE, Pinheiro ML. Frequency patterns in cochlear, brainstem, and cerebral lesions. Audiology 1987;26:79–88.

    Article  CAS  PubMed  Google Scholar 

  36. Jerger J, Jerger S. Auditory findings n brainstem disorders. Arch Otolaryngol 1974;93:573–580.

    Article  Google Scholar 

  37. Jerger J, Jerger S. Clinical validity of central auditory tests. Scand Audiol 1975;4:147–163.

    Article  Google Scholar 

  38. Musiek FE, Gollegly K, Kibbe K, Verkest S. Current concepts on the use of ABR and auditory psychophysical tests in the evaluation of brainstem lesion. Am J Otol 1988;9(Suppl):25–35.

    PubMed  Google Scholar 

  39. Jerger J, Alford B, Lew HL, Rivera V, Chmiel R. Dichotic listening, event-related potentials, and interhemispheric transfer in the elderly. Ear Hear 1995;16:482–498.

    Article  CAS  PubMed  Google Scholar 

  40. Chmiel R, Jerger J, Murphy E, Pirozzolo F, Tooley-Young C. Unsuccessful use of binaural amplification by an elderly person. J Am Acad Audiol 1997;8:1–10.

    CAS  PubMed  Google Scholar 

  41. Horning J. The effects of age in dichotic listening [Master’s thesis]. San Diego, CA: San Diego State College; 1972.

    Google Scholar 

  42. Johnson RC, Cole RE, Bowers JK, Foiles SV, Nikaido AM, Patrick JW, Woliver RE. Hemispheric efficiency in middle and later adulthood. Cortex 1979;15:109–119.

    Article  CAS  PubMed  Google Scholar 

  43. Borod JC, Goodglass H. Lateralization of linguistic and melodic processing with age. Neuropsychologia 1980;18:79–83.

    Article  CAS  PubMed  Google Scholar 

  44. Martini A, Bovo R, Agnoletto M, Da Col M, Drusian A, Liddeo M, Morra B. Dichotic performance in elderly Italians with Italian stop consonant-vowel stimuli. Audiology 1988;27:1–7.

    Article  CAS  PubMed  Google Scholar 

  45. Pinheiro ML, Musiek FE. Sequencing and temporal ordering in the auditory system. In: Pinheiro ML, Musiek FE, editor. Assessment of central auditory dysfunction: foundations and clinical correlates. Baltimore:Williams & Wilkins; 1985. pp. 219–238.

    Google Scholar 

  46. Musiek FE, Pinheiro ML, Wilson DH. Auditory pattern perception in ‘split-brain’ patients. Arch Otolaryngol 1980;106:610–612.

    Article  CAS  PubMed  Google Scholar 

  47. Schneider BA, Speranza F, Pichora-Fuller MK. Age-related changes in temporal resolution: envelope and intensity effects. Can J Exp Psychol 1998;52:184–191.

    Article  CAS  PubMed  Google Scholar 

  48. Snell KB, Frisina DR. Relationships among age-related differences in gap detection and word recognition. J Acoust Soc Am 2000;107:1615–1626.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Audiology Unit, Department of Otolaryngology, Head and Neck Surgery, Assiut College of Medicine, Assiut University School of Medicine, Assiut University Hospitals, Assiut, Egypt, 71526

    Mohamed Salama Bakr, Eman Abdel-Fattah MD & Maha Abd El-Gaber Abd Ellah

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  1. Mohamed Salama Bakr
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  2. Eman Abdel-Fattah MD
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  3. Maha Abd El-Gaber Abd Ellah
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Correspondence to Eman Abdel-Fattah MD.

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Bakr, M.S., Abdel-Fattah, E. & El-Gaber Abd Ellah, M.A. Central auditory functions in elderly individuals. Egypt J Otolaryngol 29, 254–262 (2013). https://doi.org/10.7123/01.EJO.0000434107.38731.f3

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  • DOI: https://doi.org/10.7123/01.EJO.0000434107.38731.f3

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