Abstract
Aging is known to affect working memory and attention, automatic as well as intentional. Hearing impairment leads to central gain change, putatively a compensatory mechanism, aging increases the cognitive load in perceptual processes underlying speech understanding. Working memory span is the most important variable accounting for speech recognition performance. The effect of noise on cognitive spare capacity is related to working memory capacity, the effect of load is related to executive function. In elderly persons, reduced executive functioning is associated with central auditory processing, but not with primary auditory functioning. Aging affects especially those processes that are involved in stream segregation, the ability to isolate one sound source from competing ones, and episodic memory. The resulting decreased speech understanding and ease of communication may lead to social withdrawal and may enhance the onset of dementia.
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