Effects of Age, Hearing Loss and Cognition on Discourse Comprehension and Speech Intelligibility Performance

Abstract

Discourse comprehension requires listeners to interpret the meaning of an incoming message, integrate the message into memory and use the information to respond appropriately. Discourse comprehension is a skill required to effectively communicate with others in real time. The overall goal of this research is to determine the relative impact of multiple environmental and individual factors on discourse comprehension performance for younger and older adults with and without hearing loss using a clinically feasible testing approach. Study 1 focused on the impact of rapid speech on discourse comprehension performance for younger and older adults with and without hearing loss. Study 2 focused on the impact of background noise and masker type on discourse comprehension performance for younger and older adults with and without hearing loss. The influences of cognitive function and speech intelligibility were also of interest. The impact of these factors was measured using a self-selection paradigm in both studies. Listeners were required to self-select a time-compression ratio or signal-to-noise ratio (SNR) where they could understand and effectively answer questions about the discourse comprehension passages. Results showed that comprehension accuracy performance was held relatively constant across groups and conditions, but the time-compression ratios and SNRs varied significantly. Results in both studies demonstrated significant effects of age and hearing loss on the self-selection of listening rate and SNR. This result suggests that older adults are at a disadvantage for rapid speech and in the presence of background noise during a discourse comprehension task compared to younger adults. Older adults with hearing loss showed an additional disadvantage compared to older normal-hearing listeners for both difficult discourse comprehension tasks. Cognitive function, specifically processing speed and working memory, was shown to predict self-selected time-compression ratio and SNR. Understanding the effects of age, hearing loss and cognitive decline on discourse comprehension performance may eventually help mitigate these effects in real world listening situations.