Divenyi P L, Haupt K M
Speech and Hearing Research Facility, Veterans Affairs Medical Center, Martinez, California, USA.
Ear Hear. 1997 Feb;18(1):42-61. doi: 10.1097/00003446-199702000-00005.
The study was conducted to answer two questions: 1) Which auditory measures detect impairments attributable to age rather than hearing loss? 2) Among the elderly, is there a lateral asymmetry of performance?
Audiological status and auditory performance of a group of elderly (60 to 81 yr old) and normal-hearing young (18 to 30 yr old) individuals were determined through a test battery. When present, the hearing loss of elderly subjects was symmetrical in the two ears and, at most, moderate. The battery included tests of speech intelligibility on the word and sentence levels, with and without the presence of interfering speech. In addition to pure-tone and speech reception thresholds, perception of spectrally or temporally distorted speech and auditory resolution of frequency, time, and space were tested. Two tests received special consideration: the Speech Perception In Noise Test and the Modified Rhyme Reverberation Test.
Results indicated that 1) hearing loss was a major factor differentiating auditory performance of elderly and young individuals, and 2) genuine age-related deficits were found in measures assessing auditory resolution and the ability to utilize spatial, temporal, and/or linguistic context information to perceptually separate a speech target from surrounding speech noise. Furthermore, the elderly group exhibited a right-ear advantage, caused by left-ear deficits, in tests measuring central auditory processing and a slight left-ear advantage in tests measuring peripheral auditory resolution.
The findings suggest that, after controlling for the effect of hearing loss, there are a number of test measures in which performance of elderly and young listeners differs. Regarding lateral asymmetry, a disproportionate decline in auditory processing in the left ear of elderly individuals has been demonstrated. The major clinical conclusion is that, when testing an elderly group's performance regarding any given auditory function, the influence of pure-tone threshold elevations, no matter how mild, cannot be disregarded.
开展本研究以回答两个问题：1）哪些听觉测量方法能够检测出由年龄而非听力损失导致的听觉损伤？2）在老年人中，是否存在表现上的左右不对称性？
通过一组测试确定了一组老年人（60至81岁）和听力正常的年轻人（18至30岁）的听力学状态和听觉表现。老年受试者若存在听力损失，则双耳对称，且至多为中度。该组测试包括有或无干扰语音情况下的单词和句子层面的言语清晰度测试。除了纯音和言语接受阈值外，还测试了对频谱或时间失真语音的感知以及频率、时间和空间的听觉分辨力。两项测试受到特别关注：噪声中的言语感知测试和改良韵律混响测试。
结果表明，1）听力损失是区分老年人和年轻人听觉表现的主要因素，2）在评估听觉分辨力以及利用空间、时间和/或语言上下文信息从周围语音噪声中感知分离语音目标的能力的测量中发现了与年龄相关的真正缺陷。此外，在测量中枢听觉处理的测试中，老年组由于左耳缺陷表现出右耳优势，而在测量外周听觉分辨力的测试中表现出轻微的左耳优势。
研究结果表明，在控制听力损失的影响后，老年和年轻听众在多项测试指标上表现不同。关于左右不对称性，已证明老年人左耳的听觉处理能力下降不成比例。主要临床结论是，在测试老年组在任何给定听觉功能方面的表现时，纯音阈值升高的影响，无论多么轻微，都不能忽视。
