AO Journal Group: Hearing Loss In Older Adults Can Shrink Cognitive Resources

Do you want to stay up on the latest research related to hearing? Tune into the AO Journal Group where on a monthly basis our group of Contributing Editors will provide reviews of timely journal articles that relate to your clinical practice.

This article review was submitted Patricia B. Kricos, Ph.D., who is a Professor of Audiology from the University of Florida and a Contributing Editor for Audiology Online in the area of adult amplification.

Article:

McCoy, S. L., Tun, P., Cox, C. L., Colangelo, M., Stewart, R. A., Wingfield, A. (2005). Hearing loss and perceptual effort: Downstream effects on older adults' memory for speech. Quarterly Journal of Expermiental Psychology: Section A, 58, 22-33. Dr. McCoy's research lab website is: www.audiospeech.ubc.ca/research/hearinglab.htm The website for the Journal is www.ingentaconnect.com/content/psych/pqja

Review:

Through a series of research projects, Brandeis University researchers from the fields of audiology, psychology, and neuroscience have concluded that older adults with hearing loss expend precious cognitive resources when trying to comprehend spoken language, particularly in difficult listening situations. In an article by McCoy, Tun, Cox, Colangelo, Stewart, and Wingfield (2005), the downstream effects of hearing loss were clear: even when their older research participants could hear words clearly enough to repeat them, their ability to memorize and recall the words was poorer compared to participants in their age cohort who had normal hearing.

In the McCoy et al. study, participants listened to a 15-word list and then were asked to remember only the last three words of the list. Both good- and poor-hearing participants, who had been matched for age, education, and verbal ability, had near perfect recall of the final words of the three-word sets, suggesting that in all likelihood, all three words were heard correctly. However, the poor-hearing group recalled significantly fewer of the other two words in the three-word sets than did the better-hearing group. The authors concluded that their results provide support for the effortfulness hypothesis: that is, the extra effort that a listener with impaired hearing needs to make to achieve successful speech perception compromises the processing resources available for encoding the speech content in memory.

This is an important finding from a scientific viewpoint, because it highlights how changes in hearing and cognition are interrelated in older adults. From a practical viewpoint, the findings are even more important. Picture a health care provider providing instructions to an older adult with a mild-to-moderate hearing loss. The patient seems to have heard everything the practitioner was saying during their brief conversation. Depending on factors such as the complexity of the instructions and the listening environment, the older adult may nod her head but later not be able to recall all of the instructions.

The findings of this article underscore the importance of understanding how hearing loss may affect not only an older adult's speech perception, but also their memory and cognitive function. Further, the results underscore the importance of communication strategies such as clear speech, use of pauses to allow for extra processing time, assistive technology, and control of the listening environment when speaking to older individuals with hearing loss.