Many older adults have difficulty understanding speech in complex and demanding environments typical ofeveryday listening. Using laboratory outcome measures, speech-understanding difficulties of older hearingimpairedadults are accounted for primarily by reductions in speech audibility due to elevated thresholds.Given the importance of speech audibility, amplification provided by a hearing aid should restore importantspeech information and provide significant benefit to communication. Nevertheless, only a small fraction ofolder adults who could benefit from amplification own hearing aids and use them regularly. The lack ofsuccess and satisfaction with hearing aids suggests that a fundamental change in direction is needed. Thedesign and fitting of communication aids for older adults should be guided by their listening performance incomplex and demanding environments that contain the acoustic and perceptual variability inherent ineveryday situations. Thus, in Project 1, a series of experiments is planned to address key questionsconcerning older adults' perception of speech information as delivered in realistic environments. To relateage-related declines in auditory function to underlying mechanisms of age-related hearing loss, subjects willinclude older adults with and without characteristics of metabolic presbyacusis.
Aim 1. 1 tests the hypothesisthat, even when audible, limited use of interaural level and timing cues reduces the binaural advantage forspeech for older adults with and without hearing loss and that binaural advantages vary according to thephenotype of age-related hearing loss.
Aim 1. 2 tests the hypothesis that benefit of hearing aids forprocessing spatial, binaural, and temporal information underlies hearing-aid use and success by older adultsand differs according to the phenotype of age-related hearing loss. Three hearing-aid trials are conducted todetermine the extent to which adults with and without characteristics of metabolic presbyacusis who arepredicted by laboratory-based measures to benefit from amplification ultimately benefit from using hearingaids in everyday communication.
Aim 1. 3 tests the hypothesis that age-related changes in speech audibilityand in auditory attention increase the effects of stimulus similarity and uncertainty, especially in adverselistening conditions. A long-term goal is to extend our knowledge of mechanisms that account for reducedspeech understanding in noise by older adults and thus enhance benefit derived from amplification.
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