Selective hearing in the aged with regard to speech perception in quiet and in noise.

Most listening environments contain some noise which is mixed up with the speech. The effects of noise on speech perception depend on the parameters of the noise (long term spectrum, fluctuations of the intensity in time and average intensity relative to the intensity of speech) and on the speech material (sentences, monosyllables, CV-, CVC-, VC-syllables). The most effective at masking are noises with spectra similar to the speech spectrum, such as the speech simulating noise (CCITT-noise) or cocktail-party-noise. The cocktail-party situation is judged to be a difficult communication situation not only by the hearing impaired but also by patients with presbycusis. We examined different age-dependent changes of the speech discrimination in noise ability. Using sentences and CV-syllables (rhyme test) the critical signal-to-noise ratios (S/N-dB) for a speech discrimination of 35%-45% were investigated for monaural and binaural noise representations for different age groups. The results are compared to several types of hearing loss and to those of similar studies in literature. The data of this study prove that hearing impaired and elderly patients are greatly affected by noise. While younger patients with moderate high-tone hearing loss may profit from a special hearing aid device with an integrated noise suppression-system, an improvement of speech discrimination in noise for the elderly can be achieved only by enhancing the signal-to-noise ratio by more than 10 dB. This is possibly because of the reduced capacity for frequency-, intensity- and time-resolution in the peripheral and central pathways of the hearing organ of the aged.