Cochlear Implants, Aging, and Speech-in-Noise
Fullgrabe and Moore (2015) recently reported that (even) for older people with normal hearing, speech-in-noise ability does indeed, decline with age. Therefore, Fullgrabe and Moore recommended tests beyond the audiogram to assess older people and their hearing/listening ability, and they reported it is necessary to take age into account, when addressing the audiological needs of older patients.
Sladen and Zappler (2015) report that advanced age is associated with decreases in auditory function, beyond simple thresholds. Indeed, Gates et al (1990) stated that word recognition scores decrease some 12 percent per decade after age 60 years. Sladen and Zappler note that physiologic changes in the auditory system associated with aging may explain the “disproportionately poor speech recognition” experienced by older people. However, clearly CIs in older adults generally have excellent outcomes and CIs significantly improve speech understanding from pre-op to post-op. Sladen and Zappler evaluated 40 people with CIs. Twenty participants (the older group) were 60 to 83 years of age (mean age 71 years) and the younger group included people 21 to 58 years of age (mean age 40 years). Both groups were balanced for duration of deafness and length of use of their CIs.
Despite the excellent results in the older patients, when compared to younger CI patients, the older CI users performed worse than younger CI users with regard to speech understanding in quiet and in noise, and with regard to timbre recognition.
For More Information, References, and Recommendations
Fullgrabe C, Moore BCJ, Stone MA. (2015) Age-group Differences in Speech Identification Despite Matched Audiometrically Normal Hearing: Contributions from Auditory Temporal Processing and Cognition. Frontiers (January).
Gates GA, Cooper JC, Kannel WB, Miller NJ. (1990) Hearing in the Elderly: The Framingham Cohort 1983–1985. Part One. Basic Audiometric Test Results. Ear & Hearing 11(August):240–256.
Sladen DP, Zappler A. (2015) Older and Younger Adult Cochlear Implant Users—Speech Recognition in Quiet and Noise, Quality of Life, and Music Perception. American Journal of Audiology 24(March):31–39.