Evaluation of a method for determining binaural sensitivity to temporal fine structure (TFS-AF test) for older listeners with normal and impaired low-frequency hearing

The ability to process binaural temporal fine structure (TFS) information was assessed using the TFS-AF test (where AF stands for adaptive frequency) for 26 listeners aged 60 years or more with normal or elevated low-frequency audiometric thresholds. The test estimates the highest frequency at which a fixed interaural phase difference (IPD) of ϕ (varied here between 30° and 180°) can be discriminated from an IPD of 0°, with higher thresholds indicating better performance. A sensation level of 30 dB was used. All listeners were able to perform the task reliably, giving thresholds well above the lowest allowed frequency of 30 Hz. The duration of a run averaged 5 min. Repeated testing of the normal-hearing listeners showed no significant practice effects. Thresholds varied markedly across listeners, but their ranking was fairly consistent across values of ϕ. Thresholds decreased (worsened) with decreasing ϕ and were lower than for a group of young listeners tested in an earlier study. There were weak to moderate, negative correlations between TFS-AF thresholds and audiometric thresholds at low frequencies (125–1000 Hz) but not at high frequencies (4000–8000 Hz). In conclusion, the TFS-AF test yielded a graded measure of binaural TFS sensitivity for all listeners. This contrasts with the TFS-LF (low-frequency) test, which measures the smallest detectable shift in IPD for a fixed frequency. The absence of practice effects and a reasonably short administration time make the TFS-AF test a good candidate for the assessment of sensitivity to changes in binaural TFS for older listeners without or with hearing loss

Can older people remember medication reminders presented using synthetic speech?

Reminders are often part of interventions to help older people adhere to complicated medication regimes. Computer-generated (synthetic) speech is ideal for tailoring reminders to different medication regimes. Since synthetic speech may be less intelligible than human speech, in particular under difficult listening conditions, we assessed how well older people can recall synthetic speech reminders for medications. 44 participants aged 50-80 with no cognitive impairment recalled reminders for one or four medications after a short distraction. We varied background noise, speech quality, and message design. Reminders were presented using a human voice and two synthetic voices. Data were analyzed using generalized linear mixed models. Reminder recall was satisfactory if reminders were restricted to one familiar medication, regardless of the voice used. Repeating medication names supported recall of lists of medications. We conclude that spoken reminders should build on familiar information and be integrated with other adherence support measures. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: [email protected] numbered affiliations see end of article

Estimates of the number of adults in England, Wales, and Scotland with a hearing loss

No abstract available

Progressive auditory neuropathy in patients with Leber's hereditary optic neuropathy

Objective: To investigate auditory neural involvement in patients with Leber's hereditary optic neuropathy (LHON).Methods: Auditory assessment was undertaken in two patients with LHON. One was a 45 year old woman with Harding disease (multiple-sclerosis-like illness and positive 11778mtDNA mutation) and mild auditory symptoms, whose auditory function was monitored over five years. The other was a 59 year old man with positive 11778mtDNA mutation, who presented with a long standing progressive bilateral hearing loss, moderate on one side and severe to profound on the other. Standard pure tone audiometry, tympanometry, stapedial reflex threshold measurements, stapedial reflex decay, otoacoustic emissions with olivo-cochlear suppression, auditory brain stem responses, and vestibular function tests were undertaken.Results: Both patients had good cochlear function, as judged by otoacoustic emissions ( intact outer hair cells) and normal stapedial reflexes ( intact inner hair cells). A brain stem lesion was excluded by negative findings on imaging, recordable stapedial reflex thresholds, and, in one of the patients, olivocochlear suppression of otoacoustic emissions. The deterioration of auditory function implied a progressive course in both cases. Vestibular function was unaffected.Conclusions: The findings are consistent with auditory neuropathy - a lesion of the cochlear nerve presenting with abnormal auditory brain stem responses and with normal inner hair cells and the cochlear nucleus (lower brain stem). The association of auditory neuropathy, or any other auditory dysfunction, with LHON has not been recognised previously. Further studies are necessary to establish whether this is a consistent finding

Principal components analysis on audiograms from a hearing aid clinic

In this study we describe a Principal Components Analysis (PCA) of 11,462 audiograms recorded at the hearing aid clinic at James Cook University Hospital in Middlesbrough between 1992 and 2001. PCA is a multivariate statistical technique which starts with an n x p matrix in which n subjects are each evaluated on each of p variables (Woods et al, 1986). In our case the n subjects were represented by the 11,462 audiograms, and the p variables were the six air conduction thresholds and five bone conduction thresholds typically obtained in an audiogram. Although the patients were originally tested at 11 thresholds, the principle of PCA is that certain hearing thresholds tend to vary together, and thus can be grouped into a smaller number of underlying variables called principal components (PC). Each PC has a set of coefficients in the range -1 to +1, corresponding to the degree of influence of each of the original thresholds on that PC. The coefficients of the first PC were all negative and approximately equal. This suggests that the main source of variation between the patients was simply the overall degree of hearing loss. The coefficients of the second PC were negative for frequencies at or below 1000Hz, but positive for higher frequencies, for both air and bone conduction, and thus differentiate patients according to whether they have a predominanty high frequency or low frequency hearing loss. The coefficients of the third PC were negative for air conduction at all frequencies, but positive for bone conduction, showing a contrast between patients with and without an air-bone gap. The fourth component is similar to the second, but corresponds to a sensorineural hearing loss with a sharper dip at 2000 – 4000 Hz rather than a general high frequency hearing loss. No clear patterns were seen for the fifth or subsequent principal components. The percentage of the overall variability in the data explained by the first four principal components respectively was 59.5, 13.4, 9.7, and 5.2, giving a total of 87.8%. We performed PCA using the MATLAB statistical toolbox

The just meaningful difference in speech-to-noise ratio

The speech-to-noise ratio (SNR) in an environment plays a vital role in speech communication for both normal-hearing (NH) and hearing-impaired (HI) listeners. While hearing-assistance devices attempt to deliver as favorable an SNR as possible, there may be discrepancies between noticeable and meaningful improvements in SNR. Furthermore, it is not clear how much of an SNR improvement is necessary to induce intervention-seeking behavior. Here we report on a series of experiments examining the just-meaningful difference (JMD) in SNR. All experiments used sentences in same-spectrum noise, with two intervals on each trial mimicking examples of pre- and post-benefit situations. Different groups of NH and HI adults were asked (a) to rate how much better or worse the change in SNR was in a number of paired examples, (b) if they would swap the worse for the better SNR (e.g., their current device for another) or (c) if they would be willing to go to the clinic for the given increase in SNR. The mean SNR JMD based on better/worse ratings (one arbitrary unit) was similar to the just-noticeable difference, approximately 3 dB. However, the mean SNR JMD for the more clinically relevant tasks -- willingness (at least 50% of the time) to swap devices or attend the clinic for a change in SNR -- was 6-8 dB regardless of hearing ability. This SNR JMD of the order of 6 dB provides a new benchmark, indicating the SNR improvement necessary to immediately motivate participants to seek intervention

Screening methods for age-related hearing loss in older patients with cancer: A review of the literature

© 2018 by the authors. As people grow older, they may experience loss in hearing sensitivity. Age-related hearing loss may negatively affect the patient's quality of life as it may lead to social isolation. In older patients with cancer, hearing loss can seriously interfere with the patient's ability to deal properly with all aspects of their disease, and may have a cumulative effect on their already decreased quality of life. Therefore, the proper screening of those conditions is essential in order to optimise the patient's comfort during and after treatment. This review article aims at providing a concise image of the nature of age-related hearing loss, and provides an overview of the screening methods that could be used in older patients with cancer

The Sensitivity of Hearing-Impaired Adults to Acoustic Attributes in Simulated Rooms

In previous studies we have shown that older hearing-impaired individuals are relatively insensitive to changes in the apparent width of broadband noises when those width changes were based on differences in interaural coherence [W. Whitmer, B. Seeber and M. Akeroyd, J. Acoust. Soc. Am. 132, 369-379 (2012)]. This insensitivity has been linked to senescent difficulties in resolving binaural fine-structure differences. It is therefore possible that interaural coherence, despite its widespread use, may not be the best acoustic surrogate of spatial perception for the aged and impaired. To test this, we simulated the room impulse responses for various acoustic scenarios with differing coherence and lateral (energy) fraction attributes using room modelling software (ODEON). Bilaterally impaired adult participants were asked to sketch the perceived size of speech tokens and musical excerpts that were convolved with these impulse responses and presented to them in a sound-dampened enclosure through a 24-loudspeaker array. Participants' binaural acuity was also measured using an interaural phase discrimination task. Corroborating our previous findings, the results showed less sensitivity to interaural coherence in the auditory source width judgments of older hearing-impaired individuals, indicating that alternate acoustic measurements in the design of spaces for the elderly may be necessary