title: Relation between speech-in-noise threshold, hearing loss and cognition from 40-69 years of age.
abstract: BACKGROUND
  Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40-69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.
  
  
  RESULTS
  About half a million volunteers were recruited through NHS registers. Respondents completed 'whole-body' testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing.
  
  
  CONCLUSIONS
  Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.
authors.affiliation: NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom; MRC Institute of Hearing Research, University Park, Nottingham, United Kingdom; Cincinnati Children's Hospital Medical Center and Department of Otolaryngology, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
authors.forename: David R
authors.initials: DR
authors.lastname: Moore
authors.affiliation: NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Edmondson-Jones
authors.affiliation: School of Psychological Sciences, University of Manchester, Manchester, United Kingdom.
authors.forename: Piers
authors.initials: P
authors.lastname: Dawes
authors.affiliation: NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Heather
authors.initials: H
authors.lastname: Fortnum
authors.affiliation: NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom; MRC Institute of Hearing Research, University Park, Nottingham, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Abby
authors.initials: A
authors.lastname: McCormack
authors.affiliation: NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Pierzycki
authors.affiliation: School of Psychological Sciences, University of Manchester, Manchester, United Kingdom; Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Munro
mesh_terms: D000328:Adult; D000368:Aged; D001309:Auditory Threshold / Q000502:physiology*; D003071:Cognition; D005260:Female; D006309:Hearing / Q000502:physiology; D034381:Hearing Loss / Q000503:physiopathology*; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D012923:Social Class; D013060:Speech