Approximately 10 million Americans over the age of 65 suffer from hearing impairment, making it the third most prevalent chronic medical condition among older adults. Hearing impairment not only impacts communicative effectiveness between older adults and health care and social service providers, but it can lead to withdrawal from social networks, loneliness and a declining sense of self-efficacy. This renewal application follows an interdisciplinary approach combining the perspectives of cognitive psychology and audiology to study the special challenge of comprehension and memory for meaningful speech by older adults with age-related hearing loss. A primary concern is that hearing loss may not only result in the inability to correctly identify words in a speech message. Our concern is also that when word recognition is successful, it may come at the cost of perceptual effort that consumes attentional resources that might otherwise be available for higher-level comprehension and memory operations. That is, even a mild hearing decline may be the source of subtle but significant contributions to declines in older adults'cognitive performance. Among our goals is to test the hypothesis that perceptual effort in the context of mild-to- moderate age-related hearing loss draws already limited attentional resources that older adults might ordinarily use for higher-level comprehension operations and encoding what has been heard in memory. The mechanism underlying the beneficial effects of linguistic context, to include the contribution of speech prosody, may be to reduce processing demands as the speech is being heard, with consequent mitigation of the effects of auditory declines and declines in working memory. It is our goal to use cognitive aging theory to inform our understanding of older adults'ability to comprehend and recall spoken information as well as using these findings to inform our understanding of cognitive aging. Successful outcome of this research will advance public health by providing guidelines for maximizing spoken communication with older adults who have reduced hearing acuity, as well as supplying data for those wishing to develop guidelines for testing older adults'hearing and testing hearing aid efficacy for a wider range of speech stimuli than is currently employed.
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