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18至70岁成年人5年期间言语识别能力的衰退:荷兰在线噪声环境下言语测试的结果

Deterioration of Speech Recognition Ability Over a Period of 5 Years in Adults Ages 18 to 70 Years: Results of the Dutch Online Speech-in-Noise Test.

作者信息

Stam Mariska, Smits Cas, Twisk Jos W R, Lemke Ulrike, Festen Joost M, Kramer Sophia E

机构信息

1Department of Otolaryngology-Head and Neck Surgery, Section Audiology, VU University Medical Center and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; 2Department of Epidemiology and Biostatistics, VU University Medical Center and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands; and 3Phonak AG, Science and Technology, Stäfa, Switzerland.

出版信息

Ear Hear. 2015 May-Jun;36(3):e129-37. doi: 10.1097/AUD.0000000000000134.

Abstract

OBJECTIVES

The first aim of the present study was to determine the change in speech recognition in noise over a period of 5 years in participants ages 18 to 70 years at baseline. The second aim was to investigate whether age, gender, educational level, the level of initial speech recognition in noise, and reported chronic conditions were associated with a change in speech recognition in noise.

DESIGN

The baseline and 5-year follow-up data of 427 participants with and without hearing impairment participating in the National Longitudinal Study on Hearing (NL-SH) were analyzed. The ability to recognize speech in noise was measured twice with the online National Hearing Test, a digit-triplet speech-in-noise test. Speech-reception-threshold in noise (SRTn) scores were calculated, corresponding to 50% speech intelligibility. Unaided SRTn scores obtained with the same transducer (headphones or loudspeakers) at both test moments were included. Changes in SRTn were calculated as a raw shift (T1 - T0) and an adjusted shift for regression towards the mean. Paired t tests and multivariable linear regression analyses were applied.

RESULTS

The mean increase (i.e., deterioration) in SRTn was 0.38-dB signal-to-noise ratio (SNR) over 5 years (p < 0.001). Results of the multivariable regression analyses showed that the age group of 50 to 59 years had a significantly larger deterioration in SRTn compared with the age group of 18 to 39 years (raw shift: beta: 0.64-dB SNR; 95% confidence interval: 0.07-1.22; p = 0.028, adjusted for initial speech recognition level - adjusted shift: beta: 0.82-dB SNR; 95% confidence interval: 0.27-1.34; p = 0.004). Gender, educational level, and the number of chronic conditions were not associated with a change in SRTn over time. No significant differences in increase of SRTn were found between the initial levels of speech recognition (i.e., good, insufficient, or poor) when taking into account the phenomenon regression towards the mean.

CONCLUSIONS

The study results indicate that hearing deterioration of speech recognition in noise over 5 years can also be detected in adults ages 18 to 70 years. This rather small numeric change might represent a relevant impact on an individual's ability to understand speech in everyday life.

摘要

目的

本研究的首要目的是确定年龄在18至70岁之间、基线时无听力障碍的参与者在5年时间里噪声环境下言语识别能力的变化。第二个目的是调查年龄、性别、教育程度、初始噪声环境下言语识别水平以及所报告的慢性病是否与噪声环境下言语识别能力的变化相关。

设计

对参与全国听力纵向研究(NL-SH)的427名有或无听力障碍的参与者的基线数据和5年随访数据进行分析。使用在线国家听力测试(一种数字三联体噪声下言语测试)对噪声环境下的言语识别能力进行两次测量。计算噪声下言语接收阈值(SRTn)得分,对应于50%的言语可懂度。纳入在两个测试时刻使用相同换能器(耳机或扬声器)获得的未助听SRTn得分。SRTn的变化计算为原始变化(T1 - T0)以及向均值回归的调整变化。应用配对t检验和多变量线性回归分析。

结果

5年期间SRTn的平均增加(即恶化)为0.38分贝信噪比(SNR)(p < 0.001)。多变量回归分析结果显示,与18至39岁年龄组相比,50至59岁年龄组的SRTn恶化程度显著更大(原始变化:β:0.64分贝SNR;95%置信区间:0.07 - 1.22;p = 0.028,根据初始言语识别水平调整 - 调整变化:β:0.82分贝SNR;95%置信区间:0.27 - 1.34;p = 0.004)。性别、教育程度和慢性病数量与SRTn随时间的变化无关。考虑到向均值回归现象时,在言语识别初始水平(即良好、不足或较差)之间未发现SRTn增加的显著差异。

结论

研究结果表明,在18至70岁的成年人中也可以检测到5年期间噪声环境下言语识别的听力恶化情况。这种相对较小的数值变化可能对个体在日常生活中理解言语的能力产生相关影响。

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