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Decline in Older Persons Ability to Recognize Speech in Noise: The Influence of Demographic, Health-Related, Environmental, and Cognitive Factors

Pronk, Marieke1; Deeg, Dorly J. H.2,3; Festen, Joost M.1; Twisk, Jos W.2,4; Smits, Cas1; Comijs, Hannie C.3; Kramer, Sophia E.1

doi: 10.1097/AUD.0b013e3182994eee
Research Articles

Objectives: The first aim was to investigate whether the rate of decline in older persons’ ability to recognize speech in noise over time differs across age and gender. The second aim was to determine extent demographic, health-related, environmental, and cognitive factors influence the change in speech-in-noise recognition over time.

Design: Data covering 3 to 7 years of follow-up (mean: 4.9 years) of a large sample of the Longitudinal Aging Study Amsterdam were used (n = 1298; 3025 observations; baseline ages: 57 to 93 years). Hearing ability was measured by a digit triplet speech-in-noise test (SNT) yielding a speech reception threshold in noise (SRTn). Multilevel analyses were used to model the change in SRTn over time. First, interaction terms were used to test differences in rate of decline across subgroups. Second, for each of the following factors the authors determined the influence on the change in SRTn: age, gender, educational level, cardiovascular conditions, information processing speed, fluid intelligence, global cognitive functioning, smoking, and alcohol use. This was done by calculating the percentage change in Btime after adding the particular factor to the model.

Results: On average, respondents’ SRTn increased (i.e., deteriorated) significantly over time by 0.18 dB signal-to-noise ratio per annum. Rates were accelerated for older ages (Btime = 0.13, 0.14, 0.25, 0.27 for persons who were 57 to 65, 65 to 75, 75 to 85, and 85 to 93 years of age, respectively). Only information processing speed relevantly influenced the change in SRTn over time (17% decrease in Btime).

Conclusions: Decline in older persons’ speech-in-noise recognition over time accelerated for older ages. Decline in information processing speed explained a moderate proportion of the SRTn decline. This indicates the relevance of declining cognitive abilities in the ability of older persons to recognize speech in noisy environments.

This study reports on the decline in older persons’ ability to recognize speech in noise over time. Modeling speech reception threshold in noise (SRT) data of a large population-based sample (n = 1298; baseline ages 63 to 93 years) over 3 to 7 years of follow-up, on average, participants’ SRT increased by 0.18 dB SNR per annum. Faster increases appeared in relatively older participants. Further, a moderate amount of older adults’ increase in SRT over time was explained by their decline in information-processing speed over time.

Departments of 1Ear Nose Throat/Audiology, 2Epidemiology and Biostatistics, 3Psychiatry/GGZ inGeest, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, the Netherlands; and 4Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands

ACKNOWLEDGMENTS: This work was based on data collected in the context of the Longitudinal Aging Study Amsterdam, which is funded largely by the Dutch Ministry of Welfare, Health and Sports.

The authors declare no conflict of interest.

Address for correspondence: Marieke Pronk, Department of ENT/Audiology, VU University Medical Center Amsterdam, Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail:

© 2013 by Lippincott Williams & Wilkins