Abstract
Auditory training (AT) has been used for auditory rehabilitation in elderly individuals and is an effective tool for optimizing speech processing in this population. However, it is necessary to distinguish training-related improvements from placebo and test–retest effects. Thus, we investigated the efficacy of short-term AT [acoustically controlled auditory training (ACAT)] in elderly subjects through behavioral measures and P300. Sixteen elderly individuals with auditory processing disorder (APD) received an initial evaluation (evaluation 1 – E1) consisting of behavioral and electrophysiological tests (P300 evoked by tone burst and speech sounds) to evaluate their auditory processing. The individuals were divided into two groups. The Active Control Group (n = 8) underwent placebo training. The Passive Control Group (n = 8) did not receive any intervention. After 12 weeks, the subjects were revaluated (evaluation 2 – E2). Then, all of the subjects underwent ACAT. Following another 12 weeks (eight training sessions), they underwent the final evaluation (evaluation 3 – E3). There was no significant difference between E1 and E2 in the behavioral test [F(9.6) = 0.06, p = 0.92, λ de Wilks = 0.65)] or P300 [F(8.7) = 2.11, p = 0.17, λ de Wilks = 0.29] (discarding the presence of placebo effects and test–retest). A significant improvement was observed between the pre- and post-ACAT conditions (E2 and E3) for all auditory skills according to the behavioral methods [F(4.27) = 0.18, p = 0.94, λ de Wilks = 0.97]. However, the same result was not observed for P300 in any condition. There was no significant difference between P300 stimuli. The ACAT improved the behavioral performance of the elderly for all auditory skills and was an effective method for hearing rehabilitation.
Highlights
The structural and functional changes in the auditory system due to aging can limit speech comprehension during difficult listening situations in elderly people (Corso, 1977; Jerger et al, 1989; Willott, 1991; Chisolm et al, 2003; Gates and Mills, 2005)
The subjects were recruited after an analysis of the medical records in a longitudinal study of elderly people conducted at the Department of Physical Therapy, Speech Therapy, and Occupational Therapy at the Medical School of USP in which language, hearing, cognition, and functional capacity were assessed in the elderly volunteers between 2010 and 2013
Placebo and Test–Retest Effects The repeated-measures multivariate analysis of variance (MANOVA) indicated no significant differences between the two assessments (E1 and E2) or between the groups (PCG and Active Control Group (ACG)) for the behavioral [F(9.6) = 0.36, p = 0.92, Wilks λ = 0.65] or electrophysiological tests [F(8.7) = 2.11, p = 0.17, Wilks λ = 0.29]
Summary
The structural and functional changes in the auditory system due to aging can limit speech comprehension during difficult listening situations in elderly people (Corso, 1977; Jerger et al, 1989; Willott, 1991; Chisolm et al, 2003; Gates and Mills, 2005). Previous studies have demonstrated poor performance of elderly people compared with young people during different auditory tasks, including temporal processing, listening in noisy environments, and dichotic listening, indicating that the difficulty in understanding speech among elderly people may be associated with auditory processing disorder (APD) (Dubno et al, 1984; Welsh et al, 1985; Jerger et al, 1989; Cooper and Gates, 1991; Snell, 1997; Phillips et al, 2000; Bellis and Wilber, 2001; Pichora-Fuller and Souza, 2003; Gates and Mills, 2005; Martin and Jerger, 2005; Kraus and Anderson, 2013). Despite the heterogeneity of these methods, AT is generally an effective tool for the auditory rehabilitation in adults (Sweetow and Palmer, 2005; Pichora-Fuller and Levitt, 2012; Henshaw and Ferguson, 2013)
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