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The frequency-following response with origin in the auditory brainstem represents the pitch contour of voice and can be recorded with electrodes from the scalp. MEG studies also revealed a cortical contribution to the high gamma oscillations at the fundamental frequency (f 0 ) of a vowel stimulus. Therefore, studying the cortical component of the frequency-following response could provide insights into how pitch information is encoded at the cortical level. Comparing how aging affects the different responses may help to uncover the neural mechanisms underlying speech understanding deficits in older age. We simultaneously recorded EEG and MEG responses to the syllable /ba/. MEG beamformer analysis localized sources in bilateral auditory cortices and the midbrain. Time-frequency analysis showed a faithful representation of the pitch contour between 106 Hz and 138 Hz in the cortical activity. A cross-correlation revealed a latency of 20 ms. Furthermore, stimulus onsets elicited cortical 40-Hz responses. Both the 40-Hz and the f 0 response amplitudes increased in older age and were larger in the right hemisphere. The effects of aging and laterality of the f 0 response were evident in the MEG only, suggesting that both effects were characteristics of the cortical response. After comparing f 0 and N1 responses in EEG and MEG, we estimated that approximately one-third of the scalp-recorded f 0 response could be cortical in origin. We attributed the significance of the cortical f 0 response to the precise timing of cortical neurons that serve as a time-sensitive code for pitch., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Here, we describe some of the ways in which aging negatively affects the way sensory input is transduced and processed within the aging brain and how cognitive work is involved when listening to a less-than-perfect signal. We also describe how audiologic rehabilitation, including hearing aid amplification and listening training, is used to reduce the amount of cognitive resources required for effective auditory communication and conclude with an example of how listening effort is being studied in research laboratories for the purpose(s) of informing clinical practice., Competing Interests: The authors have no conflicts of interest to disclose.

Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice., (© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Older adults, with or without normal peripheral hearing sensitivity, have difficulty understanding speech. This impaired speech perception may, in part, be due to desynchronization affecting the neural representation of acoustic features. Here we determine if phase-locked neural activity generating the brainstem frequency-following response (FFR) exhibits age-related desynchronization and how this degradation affects the neural representation of simple and complex sounds., Purpose: The objectives of this study were to (1) characterize the effects of age on the neural representation of simple tones and complex consonant-vowel stimuli, (2) determine if sustained and transient components of the FFR are differentially affected by age, and (3) determine if the inability to encode a simple signal predicts degradation in representation for complex speech signals., Research Design: Correlational., Study Sample: Thirty four adults (aged 22-77 yr) with hearing thresholds falling within normal limits., Data Collection and Analysis: Stimuli used to evoke FFRs were 1000 Hz tone bursts as well as a consonant-vowel /da/ sound., Results: The neural representation of simple (tone) and complex (/da/) stimuli declines with advancing age. Tone-FFR phase coherence decreased as chronological age increased. For the consonant-vowel FFRs, transient onset and offset response amplitudes were smaller, and offset responses were delayed with age. Sustained responses at the onset of vowel periodicity were prolonged in latency and smaller in amplitude as age increased. FFT amplitude of the consonant-vowel FFR fundamental frequency did not significantly decline with increasing age. The ability to encode a simple signal was related to degradation in the neural representation of a complex, speechlike sound. Tone-FFR phase coherence was significantly related to the later vowel response components but not the earlier vowel components., Conclusions: FFR components representing the tone and consonant-vowel /da/ stimulus were negatively affected by age, showing age-related reductions in response synchrony and amplitude, as well as prolonged latencies. These aging effects were evident in middle age, even in the absence of significant hearing loss., (American Academy of Audiology.)

Older adults, even with clinically normal hearing sensitivity, have auditory perceptual deficits relative to their younger counterparts. This difficulty may in part, be related to a decline in the neural representation of frequency. The purpose of this study was to examine the effect of age on behavioral and physiological measures of frequency representation. Thirty two adults (ages 22-77), with hearing thresholds 25 dB HL at octave frequencies 0.25-8.0 kHz, participated in this experiment. Frequency discrimination difference limens (FDLs) were obtained at 500 and 1000 Hz using a two-interval, two-alternative forced choice procedure. Linear regression analyses showed significant declines in FDLs at both frequencies as age increased. Frequency-following responses (FFRs) were elicited by 500 and 1000 Hz tonebursts, as well as at frequencies within and outside those FDLs. Linear regression of FFR phase coherence and FFR amplitude at frequencies at and slightly below 1000 Hz showed significant decreases as age increased. Therefore, pitch discrimination, as measured by FDLs, and neural representation of frequency, as reflected by FFR, declined as age increased. Although perception and neural representation concurrently declined, one was not predictive of the other., (Copyright 2009 Elsevier B.V. All rights reserved.)

Older adults often have difficulty understanding speech in a noisy environment or with multiple speakers. In such situations, binaural hearing improves the signal-to-noise ratio. How does this binaural advantage change with increasing age? Using magnetoencephalography, we recorded cortical activity evoked by changes in interaural phase differences of amplitude-modulated tones. These responses occurred for frequencies up to 1225 Hz in young subjects but only up to 940 Hz in middle-aged and 760 Hz in older adults. Behavioral thresholds also decreased with increasing age but were more variable, likely because some older adults make effective use of compensatory mechanisms. The reduced frequency range for binaural hearing became significant in middle age, before decline in hearing sensation and the morphology of cortical responses, which became apparent only in the older subjects. This study provides evidence from human physiological data for the early onset of biological aging in binaural hearing.

We examined the effects of stimulus complexity and stimulus presentation rate in ten younger and ten older normal-hearing adults. A 1 kHz tone burst as well as a speech syllable were used to elicit the N1 -P2 complex. Three different interstimulus intervals (ISI) were used (510, 910, and 1510 msec). When stimuli were presented at the medium presentation rate (910 msec ISI), N1 and P2 latencies were prolonged for older listeners in response to the speech stimulus but not the tone stimulus. These age effects were absent when stimuli were presented at a slower rate (1510 msec ISI). Results from this study suggest that rapidly occurring stimulus onsets, either within a stimulus or between stimuli, result in prolonged N1 and P2 responses in older adults. This is especially true when processing complex stimuli such as speech. One potential explanation for this age effect might be age-related refractory differences in younger and older auditory systems. Refractory issues might in turn affect synchronized neural activity underlying the perception of critical time-varying speech cues and may partially explain some of the difficulties older people experience understanding speech.

A recurring problem in aging research is separating the effects of age per se from the effects of high-frequency hearing loss. One approach is to present test stimuli in the presence of a high-pass masker to control confounding differences in high-frequency audibility across age groups. However, there is evidence that such maskers may affect older and younger listeners differently. In this study, pure-tone thresholds were measured for younger and older listeners in the presence of high-pass maskers. The age groups were carefully selected based on similar unmasked thresholds at each frequency. Thresholds were measured in quiet and in seven masker conditions. Both younger and older listeners showed increased threshold shift below the masker passband as the masker level increased. The degree of threshold shift was not greater for older versus younger listeners. Results suggest that high-pass maskers may be used to reduce high-frequency sensitivity differences between younger and older listeners without introducing differential masking effects.

Objective: To examine the effects of aging and age-related hearing loss on the perception and neural representation of a time-varying speech cue., Methods: P1, N1 and P2 cortical responses were recorded from younger and older normal-hearing adults, as well as older adults with age-related hearing loss. Synthetic speech tokens representing 10 ms increments along a /ba/-/pa/ voice-onset-time (VOT) continuum were used to evoke the responses. Each participant's ability to discriminate the speech tokens was also assessed., Results: Compared with younger participants, older adults with and without hearing loss had more difficulty discriminating 10 ms VOT contrasts. In addition, both older groups elicited abnormal neural response patterns. There were no significant age-related findings for P1 latency; however, N1 latencies were prolonged for both older groups in response to stimuli with increased VOT durations. Also, P2 latencies were delayed for both older groups. The presence of age-related hearing loss resulted in a significant increase in N1 amplitude in response to voiceless stimuli., Conclusions: Aging and age-related hearing loss alter temporal response properties in the central auditory system. Because both older groups had difficulty discriminating these same speech stimuli, we conclude that some of the perceptual difficulties described by older adults might be due to age-related changes regulating excitatory and inhibitory processes., Significance: Some of the speech understanding difficulties expressed by elderly adults may be related to impaired temporal precision in the aging auditory system. This might explain why older adults frequently complain that wearing a hearing aid makes speech louder, but does not necessarily improve their ability to understand speech.

Age-related deficits in speech understanding are well documented. Because speech is a complex signal, containing time-varying acoustic cues, it is frequently hypothesized that aging adversely affects the ability to process temporal cues. This study examined the neural representation and perception of voice-onset-time, a temporal cue that distinguishes voiced /b/ from voiceless /p/ sounds. We found that older adults had more difficulty than younger listeners discriminating voice-onset contrasts. In addition, these same speech stimuli evoked abnormal neural responses in older adults. That is, compared with younger listeners, N1 and P2 long-latency auditory evoked responses were prolonged for older adults. Collectively, these results suggest speech perception difficulties described by older adults may be related to age-related changes regulating excitatory and inhibitory processes.

Purpose: The purpose of this article is to review recent research from our laboratory on the topic of aging, and the ear-brain system, as it relates to hearing aid use and auditory rehabilitation. The material described here was presented as part of the forum on the brain and hearing aids, at the 2014 HEaling Across the Lifespan (HEAL) conference. Method: The method involves a narrative review of previously reported electroencephalography (EEG) and magnetoencephalography (MEG) data from our laboratory as they relate to the (a) neural detection of amplified sound and (b) ability to learn new sound contrasts. Conclusions: Results from our studies add to the mounting evidence that there are central effects of biological aging as well as peripheral pathology that affect a person's neural detection and use of sound. What is more, these biological effects can be seen as early as middle age. The accruing evidence has implications for hearing aid use because effective communication relies not only on sufficient detection of sound but also on the individual's ability to learn to make use of these sounds in ever-changing listening environments. [ABSTRACT FROM AUTHOR]

Background: The projected increase in the aging population raises concerns about how to manage the health-care needs in a cost-effective way. Within hearing health care, there are presently too few audiologists to meet the expected demand, and training more professionals may not be a feasible way of addressing this problem. For this reason, there is a need to develop different ways of assessing hearing sensitivity that can be conducted accurately and inexpensively when a certified audiologist and/or sound-attenuated booth is unavailable. More specifically, there is a need to determine if the Etymotic Home Hearing Test (HHT) can yield accurate and reliable data from older adults with varying degrees of hearing loss. Purpose: To compare audiometric thresholds obtained using the HHT, an automated pure-tone air-conduction test, to those obtained using manual audiometry (MA), among older adults with varying degrees of hearing loss. Study Sample: Participants were 112 English-speaking adults (58% Female), aged 60 yr and older. Participants were excluded from this study if otoscopy revealed cerumen impaction and/or suspected ear pathology. Intervention: All participants completed the HHT on tablet computers in a carpeted classroom and MA in a double-walled sound-attenuated booth using insert earphones for both measures. Both measures were completed in the same test session, and the order of testing (MA versus HHT) was counterbalanced. Data Collection and Analysis: Absolute differences in threshold measurements (in dB HL) were calculated across all ears (n = 224 ears) and for all frequencies (octave frequencies from 0.5 to 8 kHz). Correlation and multiple linear regression analyses were conducted to determine if thresholds obtained using the HHT significantly correlated with thresholds using MA. Mean thresholds for each method (HHT and MA) were compared using correlation analyses for each test frequency. Multiple linear regression analysis was used to examine the relationship between the four-frequency pure-tone average (PTA) (average threshold at 0.5, 1, 2, and 4 kHz) in the better-hearing ear measured using the HHT and a set of seven independent factors: four-frequency PTA in the better-hearing ear measured via MA, treatment group (HHT versus MA), age, gender, and degree of hearing loss (mild, moderate, and >moderate). Results: Correlation analyses revealed significant frequency-specific correlations, ranging from 0.91 to 0.97 (p < 0.001), for air-conduction thresholds obtained using the HHT and MA. Mean HHT thresholds were significantly correlated with mean MA thresholds in both ears across the frequency range. This relationship held true across different degrees of hearing loss. The regression model accounted for a significant amount of variance in the HHT better-ear PTA, with MA better-ear PTA being the only significant predictor in our final model, with no effect of degree of loss, age, or gender. Conclusions: The HHT is an accurate and cost-effective method of establishing pure-tone air-conduction thresholds, when compared with MA. Therefore, the HHT can be used as a tool to acquire accurate air-conduction hearing thresholds from older adults, in-group settings, without the use of a sound-attenuated booth or a certified audiologist. [ABSTRACT FROM AUTHOR]