Description of the Baseline Audiologic Characteristics of the Participants Enrolled in the Aging and Cognitive Health Evaluation in Elders Study

Purpose:The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a randomized clinical trial designed to determine the effects of a best-practice hearing intervention versus a successful aging health education control intervention on cognitive decline among community-dwelling older adults with untreated mild-to-moderate hearing loss. We describe the baseline audiologic characteristics of the ACHIEVE participants.Method:Participants aged 70–84 years (N = 977; Mage = 76.8) were enrolled at four U.S. sites through two recruitment routes: (a) an ongoing longitudinal study and (b) de novo through the community. Participants underwent diagnostic evaluation including otoscopy, tympanometry, pure-tone and speech audiometry, speech-in-noise testing, and provided self-reported hearing abilities. Baseline characteristics are reported as frequencies (percentages) for categorical variables or medians (interquartiles, Q1–Q3) for continuous variables. Between-groups comparisons were conducted using chi-square tests for categorical variables or Kruskal–Wallis test for continuous variables. Spearman correlations assessed relationships between measured hearing function and self-reported hearing handicap.Results:The median four-frequency pure-tone average of the better ear was 39 dB HL, and the median speech-in-noise performance was a 6-dB SNR loss, indicating mild speech-in-noise difficulty. No clinically meaningful differences were found across sites. Significant differences in subjective measures were found for recruitment route. Expected correlations between hearing measurements and self-reported handicap were found.Conclusions:The extensive baseline audiologic characteristics reported here will inform future analyses examining associations between hearing loss and cognitive decline. The final ACHIEVE data set will be publicly available for use among the scientific community

Electrophysiological responses to lateral shifts are not consistent with opponent-channel processing of interaural level differences

Cortical encoding of auditory space relies on two major peripheral cues, interaural time difference (ITD) and interaural level difference (ILD) of the sounds arriving at a listener’s ears. In much of the precortical auditory pathway, ITD and ILD cues are processed independently, and it is assumed that cue integration is a higher order process. However, there remains debate on how ITDs and ILDs are encoded in the cortex and whether they share a common mechanism. The present study used electroencephalography (EEG) to measure evoked cortical potentials from narrowband noise stimuli with imposed binaural cue changes. Previous studies have similarly tested ITD shifts to demonstrate that neural populations broadly favor one spatial hemifield over the other, which is consistent with an opponent-channel model that computes the relative activity between broadly tuned neural populations. However, it is still a matter of debate whether the same coding scheme applies to ILDs and, if so, whether processing the two binaural cues is distributed across similar regions of the cortex. The results indicate that ITD and ILD cues have similar neural signatures with respect to the monotonic responses to shift magnitude; however, the direction of the shift did not elicit responses equally across cues. Specifically, ITD shifts evoked greater responses for outward than inward shifts, independently of the spatial hemifield of the shift, whereas ILD-shift responses were dependent on the hemifield in which the shift occurred. Active cortical structures showed only minor overlap between responses to cues, suggesting the two are not represented by the same pathway

Electrophysiological responses to lateral shifts are not consistent with opponent-channel processing of interaural level differences

Cortical encoding of auditory space relies on two major peripheral cues, interaural time difference (ITD) and interaural level difference (ILD) of the sounds arriving at a listener’s ears. In much of the precortical auditory pathway, ITD and ILD cues are processed independently, and it is assumed that cue integration is a higher order process. However, there remains debate on how ITDs and ILDs are encoded in the cortex and whether they share a common mechanism. The present study used electroencephalography (EEG) to measure evoked cortical potentials from narrowband noise stimuli with imposed binaural cue changes. Previous studies have similarly tested ITD shifts to demonstrate that neural populations broadly favor one spatial hemifield over the other, which is consistent with an opponent-channel model that computes the relative activity between broadly tuned neural populations. However, it is still a matter of debate whether the same coding scheme applies to ILDs and, if so, whether processing the two binaural cues is distributed across similar regions of the cortex. The results indicate that ITD and ILD cues have similar neural signatures with respect to the monotonic responses to shift magnitude; however, the direction of the shift did not elicit responses equally across cues. Specifically, ITD shifts evoked greater responses for outward than inward shifts, independently of the spatial hemifield of the shift, whereas ILD-shift responses were dependent on the hemifield in which the shift occurred. Active cortical structures showed only minor overlap between responses to cues, suggesting the two are not represented by the same pathway