title: Speech perception in noise in the elderly: interactions between cognitive performance, depressive symptoms, and education.
abstract: BACKGROUND
  The difficulty the elderly experience in understanding speech may be related to several factors including cognitive and perceptual performance.
  
  
  OBJECTIVE
  To evaluate the influence of cognitive performance, depressive symptoms, and education on speech perception in noise of elderly hearing aids users.
  
  
  METHODS
  The sample consisted of 25 elderly hearing aids users in bilateral adaptation, both sexes, mean age 69.7 years. Subjects underwent cognitive assessment using the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-cognitive and depressive symptoms evaluation using the Geriatric Depression Scale. The assessment of speech perception in noise (S/N ratio) was performed in free field using the Portuguese Sentence List test. Statistical analysis included the Spearman correlation calculation and multiple linear regression model, with 95% confidence level and 0.05 significance level.
  
  
  RESULTS
  In the study of speech perception in noise (S/N ratio), there was statistically significant correlation between education scores (p=0.018), as well as with the Mini-Mental State Examination (p=0.002), Alzheimer's Disease Assessment Scale-cognitive (p=0.003), and Geriatric Depression Scale (p=0.022) scores. We found that for a one-unit increase in Alzheimer's Disease Assessment Scale-cognitive score, the S/N ratio increased on average 0.15dB, and for an increase of one year in education, the S/N ratio decreased on average 0.40dB.
  
  
  CONCLUSIONS
  Level of education, cognitive performance, and depressive symptoms influence the speech perception in noise of elderly hearing aids users. The better the cognitive level and the higher the education, the better is the elderly communicative performance in noise.
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Programa Pós-graduação em Distúrbios da Comunicação Humana, São Paulo, SP, Brazil.
authors.forename: Laura Maria Araújo
authors.initials: LM
authors.lastname: de Carvalho
authors.affiliation: Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil. Electronic address: elisiane.miranda@fcmsantacasasp.edu.br.
authors.forename: Elisiane Crestani de Miranda
authors.initials: EC
authors.lastname: Gonsalez
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Departamento de Fonoaudiologia, São Paulo, SP, Brazil.
authors.forename: Maria Cecília Martineli
authors.initials: MC
authors.lastname: Iorio
mesh_terms: D000161:Acoustic Stimulation; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis; D003863:Depression / Q000150:complications / Q000175:diagnosis; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D006310:Hearing Aids; D034381:Hearing Loss / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D013067:Speech Perception / Q000502:physiology*
keywords: Cognition; Cognição; Depression; Depressão; Elderly; Idoso; Speech in noise test; Teste de fala em ruído