Elderly people with hearing loss and cognitive decline: speech perception performance in noise.
Maria Julia Ferreira Cardoso, Kátia de Freitas Alvarenga, Maria de Lourdes Merighi Tabaquim and 3 others
PMID 38896743WHAT IT FOUND
Cognitive decline did not worsen speech-in-noise perception in elderly people with hearing loss.
Instead, the degree of hearing loss and education level determined performance. Clinicians should prioritize audiological and educational factors over cognitive status when assessing these patients.
Key findings
01There was no significant difference in speech perception in noise between elderly with and without risk of cognitive impairment, except in the left-noise condition where the at-risk group performed better.
02Speech perception in noise was significantly influenced by the degree of hearing loss and education level, but not by cognitive resources.
03Higher education levels correlated with better speech perception scores (lower signal-to-noise ratio) in the group without risk of cognitive changes.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (36 participants), and the group at risk for cognitive impairment was particularly small (12 participants), which may have reduced the power to detect subtle differences. The groups were not balanced for education level; the at-risk group had significantly lower education, which is a known confounder for both cognitive test scores and hearing aid outcomes. The study used a specific cognitive measure (Verbal IQ) and may not reflect other cognitive domains like working memory or processing speed, which are often implicated in listening effort. The cross-sectional design prevents causal conclusions about whether hearing loss or education influences cognitive decline over time.
Declared interests
The study was approved by the Research Ethics Committee. Funding and conflict of interest declarations are not explicitly detailed in the provided text, but the study was conducted in a public-school clinic accredited by the Ministry of Health, suggesting public funding.
The easy way to misread this
Do not conclude that cognitive decline has no impact on daily listening effort or communication. This study only measured performance on a specific sentence recognition test in noise. The 'better' performance of the cognitively at-risk group in one condition may reflect test-taking strategies or the confounding effect of lower education levels, rather than a genuine preservation of auditory processing ability. Clinicians should not stop monitoring cognitive health in patients with hearing loss.