A perspective on brain-behavior relationships and effects of age and hearing using speech-in-noise stimuli

Understanding speech in background noise is often more difficult for individuals who are older and have
hearing impairment than for younger, normal-hearing individuals. In fact, speech-understanding abilities
among older individuals with hearing impairment varies greatly. Researchers have hypothesized that
some of that variability can be explained by how the brain encodes speech signals in the presence of
noise, and that brain measures may be useful for predicting behavioral performance in difficult-to-test
patients. In a series of experiments, we have explored the effects of age and hearing impairment in
both brain and behavioral domains with the goal of using brain measures to improve our understanding
of speech-in-noise difficulties. The behavioral measures examined showed effect sizes for hearing
impairment that were 6e10 dB larger than the effects of age when tested in steady-state noise, whereas
electrophysiological age effects were similar in magnitude to those of hearing impairment. Both age and
hearing status influence neural responses to speech as well as speech understanding in background
noise. These effects can in turn be modulated by other factors, such as the characteristics of the background
noise itself. Finally, the use of electrophysiology to predict performance on receptive speech-innoise
tasks holds promise, demonstrating root-mean-square prediction errors as small as 1e2 dB. An
important next step in this field of inquiry is to sample the aging and hearing impairment variables
continuously (rather than categorically) e across the whole lifespan and audiogram e to improve effect
estimates.