There's no such thing as flexible training for GP trainees

Abstract

<h3>Abstract</h3> Many older adults are struggling with understanding spoken language, particularly when background noise interferes with comprehension. In the present study, we investigated a potential interaction between two well-known factors associated with greater speech-in-noise (SiN) reception thresholds in older adults, namely a) lower working memory capacity and b) age-related structural decline of frontal lobe regions. In a sample of older adults (N=25) and younger controls (N=13) with normal pure-tone thresholds, SiN reception thresholds and working memory capacity were assessed. Furthermore, T1-weighted structural MR-images were recorded to analyze neuroanatomical traits (i.e., cortical thickness (CT) and cortical surface area (CSA)) of the cortex. As expected, the older group showed greater SiN reception thresholds compared to the younger group. We also found consistent age-related atrophy (i.e., lower CT) in brain regions associated with SiN recognition namely the superior temporal lobe bilaterally, the right inferior frontal and precentral gyrus, as well as the left superior frontal gyrus. Those older participants with greater atrophy in these brain regions also showed greater SiN reception thresholds. Interestingly, the association between CT in the left superior frontal gyrus and SiN reception thresholds was moderated by individual working memory capacity. Older adults with greater working memory capacity benefitted more strongly from thicker frontal lobe regions when it comes to improve SiN recognition. Overall, our results fit well into the literature showing that age-related structural decline in auditory- and cognition-related brain areas is associated with greater SiN reception thresholds in older adults. However, we highlight that this association changes as a function of individual working memory capacity. We therefore believe that future interventions to improve SiN recognition in older adults should take into account the role of the frontal lobe as well as individual working memory capacity. <h3>Highlights</h3> Speech-in-noise (SiN) reception thresholds are significantly increased with higher age, independently of pure-tone hearing loss Greater SiN reception thresholds are associated with cortical thinning in several auditory-, linguistic-, and cognitive-related brain areas, irrespective of pure-tone hearing loss Greater cortical thinning in the left superior frontal lobe is detrimental for SiN recognition in older, but not younger adults Older adults with greater working memory capacity benefit more strongly from structural integrity of left superior frontal lobe for SiN recognition