title: Effect of signal to noise ratio on the speech perception ability of older adults.
abstract: BACKGROUND
  Speech perception ability depends on auditory and extra-auditory elements. The signal- to-noise ratio (SNR) is an extra-auditory element that has an effect on the ability to normally follow speech and maintain a conversation. Speech in noise perception difficulty is a common complaint of the elderly. In this study, the importance of SNR magnitude as an extra-auditory effect on speech perception in noise was examined in the elderly.
  
  
  METHODS
  The speech perception in noise test (SPIN) was conducted on 25 elderly participants who had bilateral low-mid frequency normal hearing thresholds at three SNRs in the presence of ipsilateral white noise. These participants were selected by available sampling method. Cognitive screening was done using the Persian Mini Mental State Examination (MMSE) test.
  
  
  RESULTS
  Independent T- test, ANNOVA and Pearson Correlation Index were used for statistical analysis. There was a significant difference in word discrimination scores at silence and at three SNRs in both ears (p≤0.047). Moreover, there was a significant difference in word discrimination scores for paired SNRs (0 and +5, 0 and +10, and +5 and +10 (p≤0.04)). No significant correlation was found between age and word recognition scores at silence and at three SNRs in both ears (p≥0.386).
  
  
  CONCLUSIONS
  Our results revealed that decreasing the signal level and increasing the competing noise considerably reduced the speech perception ability in normal hearing at low-mid thresholds in the elderly. These results support the critical role of SNRs for speech perception ability in the elderly. Furthermore, our results revealed that normal hearing elderly participants required compensatory strategies to maintain normal speech perception in challenging acoustic situations.
authors.affiliation: PhD Candidate of Audiology, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. elaheshojaei49@gmail.com.
authors.forename: Elahe
authors.initials: E
authors.lastname: Shojaei
authors.affiliation: Professor, Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. ashayeri.neuroscientist@yahoo.com.
authors.forename: Hassan
authors.initials: H
authors.lastname: Ashayeri
authors.affiliation: Associate Professor, Department of Basic Sciences in Rehabilitation, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. jafari.z@iums.ac.ir.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jafari
authors.affiliation: Professor, Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran. zarinmr@tums.ac.ir.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Zarrin Dast
authors.affiliation: Associate Professor, Department of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran. kkamali71@yahoo.com.
authors.forename: Koorosh
authors.initials: K
authors.lastname: Kamali
keywords: Elderly; Signal to Noise Ratio; Word Discrimination Score