hearing

Hearing aid use linked to better cognition in hearing-impaired elderly

  • A study of older adults with impaired hearing supports the use of hearing aids to help fight the development of cognitive decline and dementia.

A study involving 100 older adults (aged 80-99) with hearing loss has found that those who used a hearing aid performed significantly better on a cognitive test (MMSE) than those who didn't use a hearing aid, despite having poorer hearing. Among non-users, participants with more hearing loss had lower MMSE scores than those with better hearing.

In the MMSE, participants give vocal responses to verbal commands. Executive function was also assessed with the Trail Making Test, Part B, which doesn't have a verbal or auditory component. On this test, although hearing aid users performed better than non-users, the difference was not statistically significant. Nor were scores correlated with hearing level.

The finding suggests that hearing loss is associated with sensory-specific cognitive decline rather than global cognitive impairment.

Of the 100 participants, 34 regularly used a hearing aid.

Previous studies have found hearing loss is associated with greater cognitive decline in older adults. A physician recently told the annual meeting of the American Association for the Advancement of Science (AAAS) that as much as 36% of dementia risk might be attributable to hearing impairment, and urged that doctors treat age-related hearing impairment more seriously.

The finding supports the view that use of hearing aids for the hearing impaired may help keep them more socially engaged, thus preventing or slowing the progression of cognitive decline and the development of dementia.

More than half of adults over age 75 have hearing loss, yet less than 15% of the hearing impaired use a hearing aid.

http://www.eurekalert.org/pub_releases/2016-04/cumc-hau042216.php

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Hearing

Older news items (pre-2010) brought over from the old website

Music training helps you hear better in noisy rooms

I’ve often talked about the benefits of musical training for cognition, but here’s a totally new benefit. A study involving 31 younger adults (19-32) with normal hearing has found that musicians (at least 10 years of music experience; music training before age 7; practicing more than 3 times weekly within previous 3 years) were significantly better at hearing and repeating sentences in increasingly noisy conditions, than the non-musicians. The number of years of music practice also correlated positively with better working memory and better tone discrimination ability. Hearing speech in noisy environments is of course difficult for everyone, but particularly for older adults, who are likely to have hearing and memory loss, and for poor readers.

[960] Parbery-Clark A, Skoe E, Lam C, Kraus N. Musician enhancement for speech-in-noise. Ear and Hearing [Internet]. 2009 ;30(6):653 - 661. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19734788

http://www.eurekalert.org/pub_releases/2009-08/nu-tum081709.php

Why it's hard to hear in a crowded room

New research helps explain why it’s difficult for those with impaired hearing to hear conversation involving several different people, particularly in a busy setting such as a restaurant or at a party. It appears that as you attend to a continuous auditory stream (such as one person speaking from one location), your attention gets refined and improved over time. However, if that person gets changing location, or if you have to focus on more than one speaker, then degradation occurs as attention gets switched and begins the process of building up performance again. It’s speculated that the same sort of attentional selectivity may occur with objects in a complex visual scene (think of “Where’s Wally”).

[1148] Best V, Ozmeral EJ, Kopco N, Shinn-Cunningham BG. Object continuity enhances selective auditory attention. Proceedings of the National Academy of Sciences [Internet]. 2008 ;105(35):13174 - 13178. Available from: http://www.pnas.org/content/early/2008/08/20/0803718105.abstract

http://www.eurekalert.org/pub_releases/2008-08/bu-mta082108.php

Memory impairment associated with sound processing disorder

Central auditory processing dysfunction refers to the situation where hearing in quiet settings is normal or near normal but is substantially impaired in the presence of competing noise or in other difficult listening situations. Such a problem is not helped by amplification and requires alternative rehabilitation strategies. Central auditory processing has been found to be impaired in those with dementia. Now a study comparing individuals with dementia, those with mild memory impairment but without a dementia diagnosis, and those without memory loss, has found that scores on central auditory processing tests were significantly lower in both the group with dementia and in the group with mild memory impairment, compared to controls.

[302] Gates GA, Anderson ML, Feeney PM, McCurry SM, Larson EB. Central auditory dysfunction in older persons with memory impairment or Alzheimer dementia. Archives of Otolaryngology--Head & Neck Surgery [Internet]. 2008 ;134(7):771 - 777. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18645130

http://www.eurekalert.org/pub_releases/2008-07/jaaj-mia071708.php

Hearing loss in older adults may compromise cognitive resources for memory

A study involving older adults with good hearing and a group with mild-to-moderate hearing loss has found that even when older adults could hear words well enough to repeat them, their ability to memorize and remember these words was poorer in comparison to other individuals of the same age with good hearing. The researchers suggest that the effect of expending extra effort comprehending words means there are fewer cognitive resources for higher level comprehension. Working memory capacity tends to diminish as we age.

[394] Wingfield A, Tun PA, McCoy SL. Hearing Loss in Older Adulthood. Current Directions in Psychological Science [Internet]. 2005 ;14(3):144 - 148. Available from: http://dx.doi.org/10.1111/j.0963-7214.2005.00356.x

http://www.eurekalert.org/pub_releases/2005-08/bu-hli082905.php

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Sense of rhythm linked to language skills

A study involving 124 teenagers has found that those who were most accurate at tapping along with a metronome also showed the most consistent brain responses to a synthesized speech sound "da". The finding is consistent with previous research showing links between reading ability and beat-keeping ability, and between reading ability and the consistency of the brain's response to sound. The finding also provides more support for the benefits of music training for both language skills and auditory processing.

09/2013

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It’s not the noise in the brain; it’s the noise in the input

A new study has found that errors in perceptual decisions occurred only when there was confused sensory input, not because of any ‘noise’ or randomness in the cognitive processing. The finding, if replicated across broader contexts, will change some of our fundamental assumptions about how the brain works.

05/2013

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Hearing loss accelerates cognitive decline in older adults

February, 2013

A large study finds that hearing loss significantly increases the rate of cognitive decline in old age.

I’ve written before about the gathering evidence that sensory impairment, visual impairment and hearing loss in particular, is a risk factor for age-related cognitive decline and dementia. Now a large long-running study provides more support for the association between hearing loss and age-related cognitive decline.

The study involved 1,984 older adults (aged 75-84) whose hearing and cognition was tested at the start of the study, with cognitive performance again assessed three, five, and six years later.

Those with hearing loss showed significantly faster cognitive decline than those with normal hearing — some 30-40% faster (41% on the MMSE; 32% on the Digit Symbol Substitution Test), with rate directly related to the amount of hearing loss.

On average, older adults with hearing loss developed significant cognitive impairment 3.2 years sooner than those with normal hearing — a very significant difference indeed.

It has been suggested that increasing social isolation and loneliness may underlie some, if not all, of this association. It may also be that difficulties in hearing force the brain to devote too much of its resources to processing sound, leaving less for cognition. A third possibility is that some common factor underlies both hearing loss and cognitive decline — however, the obvious risk factors, such as high blood pressure, diabetes and stroke, were taken account of in the analysis.

The findings emphasize the importance of getting help for hearing difficulties, rather than regarding them as ‘natural’ in old age.

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[3293] Lin FR, Yaffe K, Xia J, et al. Hearing loss and cognitive decline in older adults. JAMA Internal Medicine [Internet]. 2013 :1 - 7. Available from: http://dx.doi.org/10.1001/jamainternmed.2013.1868

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New direction for cognitive training in the elderly

October, 2012

A pilot study suggests declines in temporal processing are an important part of age-related cognitive decline, and shows how temporal training can significantly improve some cognitive abilities.

Here’s an exciting little study, implying as it does that one particular aspect of information processing underlies much of the cognitive decline in older adults, and that this can be improved through training. No, it’s not our usual suspect, working memory, it’s something far less obvious: temporal processing.

In the study, 30 older adults (aged 65-75) were randomly assigned to three groups: one that received ‘temporal training’, one that practiced common computer games (such as Solitaire and Mahjong), and a no-activity control. Temporal training was provided by a trademarked program called Fast ForWord Language® (FFW), which was developed to help children who have trouble reading, writing, and learning.

The training, for both training groups, occupied an hour a day, four days a week, for eight weeks.

Cognitive assessment, carried out at the beginning and end of the study, and for the temporal training group again 18 months later, included tests of sequencing abilities (how quickly two sounds could be presented and still be accurately assessed for pitch or direction), attention (vigilance, divided attention, and alertness), and short-term memory (working memory span, pattern recognition, and pattern matching).

Only in the temporal training group did performance on any of the cognitive tests significantly improve after training — on the sequencing tests, divided attention, matching complex patterns, and working memory span. These positive effects still remained after 18 months (vigilance was also higher at the end of training, but this improvement wasn’t maintained).

This is, of course, only a small pilot study. I hope we will see a larger study, and one that compares this form of training against other computer training programs. It would also be good to see some broader cognitive tests — ones that are less connected to the temporal training. But I imagine that, as I’ve discussed before, an effective training program will include more than one type of training. This may well be an important component of such a program.

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[3075] Szelag E, Skolimowska J. Cognitive function in elderly can be ameliorated by training in temporal information processing. Restorative Neurology and Neuroscience [Internet]. 2012 ;30(5):419 - 434. Available from: http://dx.doi.org/10.3233/RNN-2012-120240

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Childhood music training has enduring benefits for hearing

September, 2012

More evidence that learning a musical instrument in childhood, even for a few years, has long-lasting benefits for auditory processing.

Adding to the growing evidence for the long-term cognitive benefits of childhood music training, a new study has found that even a few years of music training in childhood has long-lasting benefits for auditory discrimination.

The study involved 45 adults (aged 18-31), of whom 15 had no music training, 15 had one to five years of training, and 15 had six to eleven years. Participants were presented with different complex sounds ranging in pitch while brainstem activity was monitored.

Brainstem response to the sounds was significantly stronger in those with any sort of music training, compared to those who had never had any music training. This was a categorical difference — years of training didn’t make a difference (although some minimal length may be required — only one person had only one year of training). However, recency of training did make a difference to brainstem response, and it does seem that some fading might occur over long periods of time.

This difference in brainstem response means that those with music training are better at recognizing the fundamental frequency (lowest frequency sound). This explains why music training may help protect older adults from hearing difficulties — the ability to discriminate fundamental frequencies is crucial for understanding speech, and for processing sound in noisy environments.

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[3074] Skoe E, Kraus N. A Little Goes a Long Way: How the Adult Brain Is Shaped by Musical Training in Childhood. The Journal of Neuroscience [Internet]. 2012 ;32(34):11507 - 11510. Available from: http://www.jneurosci.org/content/32/34/11507

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How piano tuning changes the brain

September, 2012

In another example of how expertise in a specific area changes the brain, brain scans of piano tuners show which areas grow, and which shrink, with experience — and starting age.

I’ve reported before on how London taxi drivers increase the size of their posterior hippocampus by acquiring and practicing ‘the Knowledge’ (but perhaps at the expense of other functions). A new study in similar vein has looked at the effects of piano tuning expertise on the brain.

The study looked at the brains of 19 professional piano tuners (aged 25-78, average age 51.5 years; 3 female; 6 left-handed) and 19 age-matched controls. Piano tuning requires comparison of two notes that are close in pitch, meaning that the tuner has to accurately perceive the particular frequency difference. Exactly how that is achieved, in terms of brain function, has not been investigated until now.

The brain scans showed that piano tuners had increased grey matter in a number of brain regions. In some areas, the difference between tuners and controls was categorical — that is, tuners as a group showed increased gray matter in right hemisphere regions of the frontal operculum, the planum polare, superior frontal gyrus, and posterior cingulate gyrus, and reduced gray matter in the left hippocampus, parahippocampal gyrus, and superior temporal lobe. Differences in these areas didn’t vary systematically between individual tuners.

However, tuners also showed a marked increase in gray matter volume in several areas that was dose-dependent (that is, varied with years of tuning experience) — the anterior hippocampus, parahippocampal gyrus, right middle temporal and superior temporal gyrus, insula, precuneus, and inferior parietal lobe — as well as an increase in white matter in the posterior hippocampus.

These differences were not affected by actual chronological age, or, interestingly, level of musicality. However, they were affected by starting age, as well as years of tuning experience.

What these findings suggest is that achieving expertise in this area requires an initial development of active listening skills that is underpinned by categorical brain changes in the auditory cortex. These superior active listening skills then set the scene for the development of further skills that involve what the researchers call “expert navigation through a complex soundscape”. This process may, it seems, involve the encoding and consolidating of precise sound “templates” — hence the development of the hippocampal network, and hence the dependence on experience.

The hippocampus, apart from its general role in encoding and consolidating, has a special role in spatial navigation (as shown, for example, in the London cab driver studies, and the ‘parahippocampal place area’). The present findings extend that navigation in physical space to the more metaphoric one of relational organization in conceptual space.

The more general message from this study, of course, is confirmation for the role of expertise in developing specific brain regions, and a reminder that this comes at the expense of other regions. So choose your area of expertise wisely!

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Music training protects against aging-related hearing loss

February, 2012

More evidence that music training protects older adults from age-related impairment in understanding speech, adding to the potential benefits of music training in preventing dementia.

I’ve spoken before about the association between hearing loss in old age and dementia risk. Although we don’t currently understand that association, it may be that preventing hearing loss also helps prevent cognitive decline and dementia. I have previously reported on how music training in childhood can help older adults’ ability to hear speech in a noisy environment. A new study adds to this evidence.

The study looked at a specific aspect of understanding speech: auditory brainstem timing. Aging disrupts this timing, degrading the ability to precisely encode sound.

In this study, automatic brain responses to speech sounds were measured in 87 younger and older normal-hearing adults as they watched a captioned video. It was found that older adults who had begun musical training before age 9 and engaged consistently in musical activities through their lives (“musicians”) not only significantly outperformed older adults who had no more than three years of musical training (“non-musicians”), but encoded the sounds as quickly and accurately as the younger non-musicians.

The researchers qualify this finding by saying that it shows only that musical experience selectively affects the timing of sound elements that are important in distinguishing one consonant from another, not necessarily all sound elements. However, it seems probable that it extends more widely, and in any case the ability to understand speech is crucial to social interaction, which may well underlie at least part of the association between hearing loss and dementia.

The burning question for many will be whether the benefits of music training can be accrued later in life. We will have to wait for more research to answer that, but, as music training and enjoyment fit the definition of ‘mentally stimulating activities’, this certainly adds another reason to pursue such a course.

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Deep male voice helps women remember

November, 2011

It seems that what is said by deeper male voices is remembered better by heterosexual women, while memory is impaired for higher male voices. Pitch didn’t affect the memorability of female voices.

I had to report on this quirky little study, because a few years ago I discovered Leonard Cohen’s gravelly voice and then just a few weeks ago had it trumped by Tom Waits — I adore these deep gravelly voices, but couldn’t say why. Now a study shows that woman are not only sensitive to male voice pitch, but this affects their memory.

In the first experiment, 45 heterosexual women were shown images of objects while listening to the name of the object spoken either by a man or woman. The pitch of the voice was manipulated to be high or low. After spending five minutes on a Sudoku puzzle, participants were asked to choose which of two similar but not identical versions of the object was the one they had seen earlier. After the memory test, participants were tested on their voice preferences.

Women strongly preferred the low pitch male voice and remembered objects more accurately when they have been introduced by the deeper male voice than the higher male voice (mean score for object recognition was 84.7% vs 77.8%). There was no significant difference in memory relating to pitch for the female voices (83.9% vs 81.7% — note that these are not significantly different from the score for the deeper male voice).

So is it that memory is enhanced for deeper male voices, or that it is impaired for higher male voices (performance on the female voices suggests the latter)? Or are both factors at play? To sort this out, the second experiment, involving a new set of 46 women, included unmanipulated male and female voices.

Once again, women were unaffected by the different variations of female voices. However, male voices produced a clear linear effect, with the unmanipulated male voices squarely in the middle of the deeper and higher versions. It appears, then, that both factors are at play: deepening a male voice enhances its memorability, while raising it impairs its memorability.

It’s thought that deeper voices are associated with more desirable traits for long-term male partners. Having a better memory for specific encounters with desirable men would allow women to compare and evaluate men according to how they might behave in different relationship contexts.

The voices used were supplied by four young adult men and four young adult women. Pitch was altered through software manipulation. Participants were told that the purpose of the experiment was to study sociosexual orientation and object preference. Contraceptive pill usage did not affect the women’s responses.

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