Project 452313

Approximately two in five individuals over 60 experience difficulty understanding speech with even mild background noise. Clinical diagnosis of hearing impairment, and remediation with hearing aids, typically comes decades after people first notice they are struggling. People with diminished ability to understand speech in the presence of background noise are at risk of social isolation, and poor quality of life and health outcomes as a consequence, possibly including cognitive decline. Although a major health problem, listening effort is poorly understood. It is measured in a variety of ways that make it impossible to compare across studies. Furthermore, listening effort is the product both of hearing impairment and of cognitive factors. For measures of listening effort to be more sensitive to hearing loss, we need to understand its relationship to these cognitive factors. Here, we leverage the tools and theories of cognitive neuroscience to explore listening effort, identify scientifically and clinically fruitful ways to measure it, and examine how it varies with individual differences in cognition. In this project, we test young normally hearing listeners, and middle aged and older listeners with and without diagnosed hearing loss. For each individual, we measure intelligibility and effort when speech is masked with different levels of background noise. We examine whether standardized cognitive tests can predict individual differences in performance on these listening tests. We use imaging to identify brain regions recruited when speech listening becomes challenging. The long-term goal is to develop a clearer understanding of the nature of listening effort, and its relation to cognition. We leverage findings from cognitive neuroscience to accelerate progress. The research proposed here will enable us to develop sensitive tests for more timely, and effective, diagnosis of hearing impairment, so people can be fitted with hearing aids when they need them,