Universiti Kebangsaan Malaysia, Institute of Ear, Hearing and Speech, Kuala Lumpur, Malaysia.
Universiti Kebangsaan Malaysia, Faculty of Heath Sciences, Kuala Lumpur, Malaysia; Ministry of Health, Putrajaya, Malaysia.
Braz J Otorhinolaryngol. 2020 Mar-Apr;86(2):149-156. doi: 10.1016/j.bjorl.2018.10.010. Epub 2018 Dec 10.
Hearing acuity, central auditory processing and cognition contribute to the speech recognition difficulty experienced by older adults. Therefore, quantifying the contribution of these factors on speech recognition problem is important in order to formulate a holistic and effective rehabilitation.
To examine the relative contributions of auditory functioning and cognition status to speech recognition in quiet and in noise.
We measured speech recognition in quiet and in composite noise using the Malay Hearing in noise test on 72 native Malay speakers (60-82 years) older adults with normal to mild hearing loss. Auditory function included pure tone audiogram, gaps-in-noise, and dichotic digit tests. Cognitive function was assessed using the Malay Montreal cognitive assessment.
Linear regression analyses using backward elimination technique revealed that had the better ear four frequency average (0.5-4kHz) (4FA), high frequency average and Malay Montreal cognitive assessment attributed to speech perception in quiet (total r=0.499). On the other hand, high frequency average, Malay Montreal cognitive assessment and dichotic digit tests contributed significantly to speech recognition in noise (total r=0.307). Whereas the better ear high frequency average primarily measured the speech recognition in quiet, the speech recognition in noise was mainly measured by cognitive function.
These findings highlight the fact that besides hearing sensitivity, cognition plays an important role in speech recognition ability among older adults, especially in noisy environments. Therefore, in addition to hearing aids, rehabilitation, which trains cognition, may have a role in improving speech recognition in noise ability of older adults.
听力敏锐度、中枢听觉处理和认知能力都会影响老年人的言语识别能力。因此，量化这些因素对言语识别问题的贡献对于制定全面有效的康复方案非常重要。
探讨听觉功能和认知状态对安静和噪声环境下言语识别的相对贡献。
我们对 72 名母语为马来语、年龄在 60-82 岁、听力正常或轻度听力损失的老年人进行了马来语听力噪声测试，以测量安静和复合噪声中的言语识别。听觉功能包括纯音听阈、噪声间隙和双耳分听测试。认知功能采用马来语蒙特利尔认知评估进行评估。
使用逐步回归分析方法，我们发现较好耳的四个频率平均（0.5-4kHz）（4FA）、高频平均和马来语蒙特利尔认知评估与安静环境下的言语感知相关（总 r=0.499）。另一方面，高频平均、马来语蒙特利尔认知评估和双耳分听测试对噪声环境下的言语识别有显著贡献（总 r=0.307）。虽然较好耳的高频平均主要测量安静环境下的言语识别能力，但噪声环境下的言语识别主要由认知功能决定。
这些发现强调了一个事实，即除了听力敏感度，认知在老年人的言语识别能力中起着重要作用，尤其是在嘈杂环境中。因此，除了助听器，认知训练康复可能在提高老年人的噪声环境下言语识别能力方面发挥作用。
