title: Decline in older persons' ability to recognize speech in noise: the influence of demographic, health-related, environmental, and cognitive factors.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Marieke
authors.initials: M
authors.lastname: Pronk
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.forename: Joost M
authors.initials: JM
authors.lastname: Festen
authors.forename: Jos W
authors.initials: JW
authors.lastname: Twisk
authors.forename: Cas
authors.initials: C
authors.lastname: Smits
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.forename: Sophia E
authors.initials: SE
authors.lastname: Kramer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D000428:Alcohol Drinking / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D012737:Sex Factors; D059629:Signal-To-Noise Ratio; D012907:Smoking / Q000503:physiopathology*; D013067:Speech Perception / Q000502:physiology*