Elderly Listeners Research Articles

Metalinguistic Discourse in an Emerging Sign Language

In this paper, I explore metalinguistic discourse in Zinacantec Family Homesign (‘Z sign’), an emergent sign language developed by three deaf siblings and their hearing family members. In particular, I examine how metalinguistic discourse unfolds between a hearing Z signer and various members of her family—including her deaf siblings, her elderly hearing father, and her young hearing son. I do so via a close examination of several snippets of conversation in which the Z signers talk about the “right” way to sign, paying close attention to how they mobilize various semiotic devices, including manual signs, eye gaze, facial expressions, and speech. I aim to understand not only the formal components of metalinguistic discourse in Z sign but also how it functions as a form of social action in this small linguistic community. How do members of this family position themselves and others as (in)competent, (non-)authoritative signers in light of existing social divisions among them? How do they reinforce or challenge those social divisions through metalinguistic discourse? How might metalinguistic discourse contribute to the propagation of emergent linguistic norms throughout the family? I find that a recurrent device for enacting metalinguistic critique among the Z signers is the partial re-production and transformation of others’ utterances and other visible actions, manifested in a way that exploits the availability of multiple, semi-independent manual and non-manual articulators in the visual modality.

A Study on Improving Speech Perception in Noise and Cognitive-Communication Abilities in Elderly Individuals Wearing Hearing Aids through Web-Based Auditory Training

Purpose: This study aimed to explore the impact of web-based auditory training on speech perception in noise and cognitive-communication abilities in elderly individuals wearing hearing aids. The focus was on addressing communication difficulties commonly experienced by this demographic.Methods: Twenty participants, with over 6 months of hearing aid use, were divided into a training group (undergoing 8 weeks of weekly 60-minute web-based auditory training) and a non-training group. The training program included tasks like listening to sentences in noise, short and long stories, sentence arrangement, and crossword quizzes. Various assessments, such as Korean Repeat and Recall Test and Brief test Cognitive-Communication Disorders evaluations, were conducted before and after training. The Korean version of Montreal Cognitive Assessment test served as a prescreening measure for cognitive impairments.Results: Significant improvements were observed in the training group’s speech perception in noise, recall, and cognitive-communicative abilities post-training. Conversely, the non-training group showed no statistically significant differences.Conclusion: The findings suggest that web-based auditory training holds promise for enhancing cognition and communication in elderly hearing aid users. Future studies could further explore the comparative effectiveness of auditory training by categorizing participants into face-to-face, remote, and hybrid groups. This research contributes valuable insights into addressing communication challenges in the aging population through innovative training methods.

Speech self-perception algorithm objective analysis with elderly hearing aids users

Speech self-perception algorithm objective analysis with elderly hearing aids users

Hearing Care, as part of basic care in a senior home.

Background: World wide, 1 in 6 people is hearing impaired. Age-related hearing loss is the most frequent cause. The number of deaf and hearing impaired persons increases as the population is getting older.
 Unfortunately, the impact on quality of life is underestimated. 
 Hearing is an important part of communication. Several studies of the World Health Organization show the consequences of bad hearing s.a. isolation, frustration, loneliness and even acceleration of the dementia process. A hearing disability is invisible and problems are often not recognized.
 A great part of the elderly people lives in a senior home. The prevalence of hearing problems there is estimated around 80% as average age is about 87 years. The ringing of the telephone, a knock on the door, the radio, the television, the alarm signals are difficult to hear. This absence of familiar sounds produces a feeling of confusion and anxiety instead of safety and recognition. Communication is often done ‘on the job’ ignoring some special needs of the hearing impaired. Facemasks may make things even more difficult. The elderly hearing impaired, their family and caretakers have often little or no knowledge about the risks of untreated hearing loss, about innovative technologies in hearing aids and other hearing devices and about some interactional adaptations to improve their quality of life.
 Aim: Installing high-quality hearing care in senior homes in order to stimulate the inclusion and participation of hearing impaired elderly.
 Method: A team of AHOSA vzw, a Flemish interest group for persons with a hearing loss who communicate in spoken language, developed a project to put into the spotlight the importance of hearing care in senior homes.
 Basic relevant information is given to all the persons who are involved in the care process, but also to the residents themselves and to their family. 
 Physical and digital workshops include a theoretical approach as well as practical information s.a. how wearing a hearing aid, changing a battery, seeing that the person didn’t understand the message… Tips and tricks are given to improve communication.
 The workshops use tools such as a PowerPointpresentation, an instruction film and leaflets.
 We started with a pilot study: a partnership between the association AHOSA VZW and the Senior Home Sint-Jozef, Assenede Belgium, with support of the Artevelde Highschool Ghent.
 During this trial period, the workshops and tools are adjusted by means of feedback of all participants, and the effects are measured by pre- and post questionnaires.
 Result: This participatory process with co-creation leads to a workable model of hearing care for all senior homes in Flanders, and can be a national or an international policy recommendation in a later stage.
 The scoop can be more durable by also aiming at integration of this model in the education programs of schools and departments that prepare students to work with elderly people.
 Conclusion: A well-developed Hearing Care model as part of basic care in a senior home leads to better quality of life.
 
 

Assessing the feasibility of a randomised controlled trial examining the effect of hearing aids on cognitive decline in elderly individuals: a study protocol

IntroductionHearing loss is one of the leading potentially modifiable risk factors for dementia. There is growing evidence suggesting that treating hearing loss with hearing aids could be a relatively low-cost...

Audiological benefit, quality of life, and factors associated with functional gain in elderly hearing aid users in a developing country between 2017 and 2020: a pre-post-study

BackgroundSensorineural hearing loss (SNHL) is the most common auditory deficit in older adults and may lead to quality-of-life deterioration. However, few studies have been performed in low/middle-income countries, particularly in Latin America. This study aimed to assess the audiological benefit, quality of life, and factors associated with functional gain in elderly hearing aid users in the Fundación Santa Fe de Bogotá and UNIMEQ-ORL, two otology referral centers in Colombia.DesignPre-post study that included hearing aid users at the otology consult of the Fundación Santa Fe de Bogotá and UNIMEQ-ORL between June 2017 and December 2020. Glasgow Benefit Inventory (GBI) and Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaires were applied. Audiometric (0,5 kHz to 4 kHz) and speech audiometry results were collected.ResultsA total of 75 participants (132 ears) were included. The mean age was 70.73 years (SD: 12.66). The median hearing aid use in years was 0.71 (IQR: 0.64–0.90). Mean change in speech audiometry was − 26.53dB (95%CI: -28.09, -24.97; p < 0.001), in functional gain was − 21.75dB (-23.81, -19.68; p < 0.001). The mean changes in the APHAB domains were Ease of Communication: -37.85 (95%CI: -43.01; -32.7), Background Noise: -3.51 (-6.06; -0.95), and Aversiveness of Sounds: -6.9 (-2.04; 11.77). The GBI assessment of quality of life showed improvement in 100% of the population after the use of hearing aids. The number of years of hearing aids use was associated with functional gain.ConclusionThe number of years of hearing aids use may impact on the functional gain in these populations. A significant clinical benefit was found in terms of quality of life, communication, and reverberation related to the use of hearing aids. Access to hearing aids should be granted, and public health strategies are needed to grant the access to hearing rehabilitation in these populations.Trial registrationFundación Santa Fe de Bogotá (Protocol Number: CCEI-12666-2020).

The Exploratory Study on the Development of Online Based Auditory Training Contents: Based on the Analysis of the Application for Auditory-Training for the Elderly in their 70s and Older

Purpose: Due to the recent COVID-19 pandemic, the importance of teleservices such as telemedicine and digital treatment is increasing. Interest in teleservice is also growing in the filed of audiology. The increase in the demand for remote hearing services will likely lead to the need for online-based auditory training programs. This study aims to investigate and analyze the usage behaviors and functions, the satisfaction of the developed online-based auditory training program, and to suggest the implications of development directions for the online-based auditory training program.Methods: Individual in-depth interviews were conducted. Eleven participants, including five 70s~80s elderly hearing aids users, two program developers, three audiologists, and one professor of audiology, were recruited.Results: Three themes emerged from the interviews were; analysis contents in online-based auditory training, maximized ease of voluntary auditory training, and individualized contents required for the auditory training.Conclusion: The study results highlighted that online-based auditory training needs familiar, easy, short, technology strategy for elderly users with hearing loss. First, familiar topics greatly benefit elderly users because they do not want to learn new and diverse issues. Also, there was a need to provide contents that could attract individual interest using advanced technology. Second, short sentences must be quickly visualized to encourage participantation in the auditory training. Third, ease accessibility to the system for auditory training program is needed. Lastly, the elderly users were proud to use new technology for auditory training, so the professionals must encourage them to continue it. In addition, professionals pointed out that qualified professionals provide the auditory training service and need government support, such as voucher service, for the auditory training. These outcomes will contribute to refining the devleoped online-based auditory training program.

Survey of Auditory Training Awareness for Hearing Professionals and Elderly Individuals Using Hearing Aids

Purpose: The purpose of this study was to identify the demand for auditory training provision and survey beneficiary experience.Methods: A total of 161 participants (80 hearing professionals and 81 elderly hearing aid users) were surveyed online or in-person. Both groups completed 26 questions related to their experience of providing or receiving auditory training, awareness of need, and preference.Results: The hearing professional group was strongly aware of the need to provide auditory training to improve communication problems in elderly individuals using hearing aids, and the absence of a systematic auditory training program was the biggest factor in not providing auditory training. The elderly hearing aid user group also recognized the need for auditory training to improve communication problems, but they responded that the hassle of visiting a clinic for training and lack of training time were factors that made participation in auditory training difficult.Conclusion: Hearing professionals should expand the scope of aural rehabilitation services to provide effective auditory training programs that fit the concept of rehabilitation, rather than simply providing hearing aid fitting management services to improve communication skills. Therefore, hearing professionals should conduct an intervention program after hearing aid fitting for elderly hearing aid users so that hearing rehabilitation can be comprehensively performed according to auditory and cognitive perceptual changes. In addition, efforts are required to solve limitations that make it difficult for elderly individuals who use hearing aids to participate in auditory training, such as the development of a web-based auditory training program.

Toward a clinically viable spectro-temporal modulation test for predicting supra-threshold speech reception in hearing-impaired listeners

The ability of hearing-impaired listeners to detect spectro-temporal modulation (STM) has been shown to correlate with individual listeners’ speech reception performance. However, the STM detection tests used in previous studies were overly challenging especially for elderly listeners with moderate-to-severe hearing loss. Furthermore, the speech tests considered as a reference were not optimized to yield ecologically valid outcomes that represent real-life speech reception deficits. The present study investigated an STM detection measurement paradigm with individualized audibility compensation, focusing on its clinical viability and relevance as a real-life supra-threshold speech intelligibility predictor. STM thresholds were measured in 13 elderly hearing-impaired native Danish listeners using four previously established (noise-carrier based) and two novel complex-tone carrier based STM stimulus variants. Speech reception thresholds (SRTs) were measured (i) in a realistic spatial speech-on-speech set up and (ii) using co-located stationary noise, both with individualized amplification. In contrast with previous related studies, the proposed measurement paradigm yielded robust STM thresholds for all listeners and conditions. The STM thresholds were positively correlated with the SRTs, whereby significant correlations were found for the realistic speech-test condition but not for the stationary-noise condition. Three STM stimulus variants (one noise-carrier based and two complex-tone based) yielded significant predictions of SRTs, accounting for up to 53% of the SRT variance. The results of the study could form the basis for a clinically viable STM test for quantifying supra-threshold speech reception deficits in aided hearing-impaired listeners.

Investigation of correlation between dichotic listening performance and speech in noise perception with hearing aid outcomes in the elderly

Background and purpose: Presbycusis, which occurs both in peripheral and central forms, is one of the most common disorders in the elderly. Presbycusis is generally characterized by decreased auditory sensitivity, poor speech comprehension and decreased speech recognition in noisy environments. This disease is also associated with a decrease of more than 20% of a person’s maximum speech perception in the presence of a competitive signal compared to silence. The inability of the central auditory systems of elderly hearing aid users to decode sounds, especially in the presence of peripheral hearing loss, can affect hearing aid outcomes. This study investigates the correlation between assessments related to auditory processing and hearing aid outcomes. Method: This cross-sectional study was performed on 39 elderly hearing aid users in two groups: behind-the-ear (BTE; n = 23) and in-the-ear (n = 16) hearing aid users. After pure tone audiometry, patients who met the inclusion criteria underwent assessments related to the central auditory system, including double dichotic digit (DDT) and quick noise speech (Q-SIN) tests. Then, the correlation between the tests and hearing aid outcomes was evaluated based on the international outcome inventory (IOI-HA), a comprehensive assessment of the outcomes in different aspects. Results: In the BTE and in-the-canal (ITC) hearing aid users, there was a significant correlation between DDT scores in the right ear (r = 0.60, 0.52) left ear (r = 0.43, 0.54), speech-to-noise ratio (SNR) loss (r = −0.50, −0.58) and IOI-HA questionnaire scores respectively. The stepwise regression analysis results indicated that unlike other variables such as age or peripheral hearing loss, the Q-SIN was the only variable that significantly (p < 0.001) participated in IOI-HA prediction with a correlation coefficient of 0.504, which simulates the conditions most closely related to hearing aid inefficiency and patient dissatisfaction. Conclusions: The Q-SIN test could be used partially to predict the outcomes of hearing aid use.

Auditory Spatial Training-Induced Changes in the Release of Informational Masking in Older Adults

Background and Aim: Generally, in noisy environments more informational masking occurs. Older adults benefit less than younger adults from spatial hearing and they have more problems of understanding speech in the presence of distracting speeches. This study was conducted to examine the effect of auditory spatial training on informational masking release in the elderly. Methods: Thirty-two 60-75-year-olds with normal hearing, who complain about difficulty in speech perception in noise, participated in control and intervention groups (16 people in each group). The intervention included fifteen sessions of auditory spatial training. The informational masking measurement test scores were compared before the intervention, one session after the intervention, and one month after between the two groups. Results: There was a significant improvement in informational masking measurement scores in the intervention group compared to the control (p&lt;0.02). The results showed no significant differences between the informational masking measurement scores before and after the intervention in the control group (p&gt;0.05) and a significant difference in most signal to noise ratio i.e. 0, -5 and -10, in the intervention group (p≤0.006). No significant difference was found between the results of the two assessments one session and one month after the intervention in any of the positions (p&gt;0.05), which suggests that both groups’ scores remained highly stable one month after the intervention Conclusion: This study introduced a spatial training program to improve speech perception in noise in normal-hearing elderly listeners. It was recommended that this kind of training be included in geriatric population auditory rehabilitation programs. Keywords: Informational masking; energetic masking; elderly; speech perception in noise

A Survey Study of Hearing Aid Satisfaction, Quality of Life, and Tinnitus of Elderly Hearing Aid Users

Purpose: The purpose of this study is to investigate hearing aid satisfaction, quality of life, and tinnitus of elderly hearing aid users to help hearing aid rehabilitation of the elderly. Methods: A total of 50 elderly hearing aid users (average age 75.7 years) with or without tinnitus participated in this study. We implemented pure tone audiometry and tinnitogram and conducted four questionnaires including Satisfaction with Amplification in Daily Life (SADL), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Visual Analogue Scale (VAS), and Tinnitus Handicap Inventory (THI).Results: Positive correlations were found between SADL and WHOQOL-BREF scores. The average total SADL scores and WHOQOL-BREF scores are 5 points and 3.4 points respectively. There were no significant differences in the average SADL and WHOQOL-BREF scores between the elderly with tinnitus and the elderly without tinnitus. About 90% of the elderly with tinnitus described high frequency tinnitus above 2,000 Hz. Eighty-eight percent of the respondents had an experience of tinnitus therapy and 67% of the elderly with tinnitus therapy experiences reported that tinnitus therapy was not helpful. Ninety-two percent of the respondents stated that wearing hearing aid was helpful to reduce their tinnitus. The emotional and catastrophic subscales of THI were correlated with VAS scores. Conclusion: Positive correlations were found between SADL and WHOQOL-BREF scores regardless of tinnitus presence. Tinnitus of elderly hearing users was not directly related to the quality of life and successful hearing aid intervention could be a key factor in improving the quality of life of the elderly.

Cochlear Implantation in Hearing-Impaired Elderly: Clinical Challenges and Opportunities to Optimize Outcome.

Cochlear implant (CI) overall provides a very good outcome, but speech comprehension outcome in the elderly is more variable. Several clinical factors play an important role. The management of residual hearing, the presence of comorbidities, and especially the progression of cognitive decline seem to be the clinical parameters that strongly determine the outcome of cochlear implantation and need to be discussed prospectively in the consultation process with the elderly hearing impaired. In the context of this review article, strategies for dealing with these will be discussed. Timely cochlear implantation should already be considered by hearing aid acousticians or practicing otolaryngologists and communicated or initiated with the patient. This requires intensive cooperation between hearing aid acousticians and experts in the clinic. In addition, residual hearing and comorbidities in the elderly need to be considered to make realistic predictions about speech comprehension with CI. Long-term aftercare and its different implementations should be discussed preoperatively, so that the elderly person with hearing impairments feels well taken care of together with his or her relatives. Elderly patients with hearing impairments benefit most from a CI in terms of speech comprehension if there is a large cochlear coverage (electrical or acoustic electrical) and the therapy is not hampered by comorbidities, especially cognitive decline.

Changes in cortical auditory evoked potentials in response to auditory training in elderly hearing aid users: A pilot study.

To compare the cortical auditory evoked potential responses pre-and post-Auditory Musical Training associated with hearing aid adaptation in elderly people with presbycusis. This is a pilot, prospective, randomized, single-blind study. Eight presbiacusis elderly people between 65 and 80 years, new hearing aid users, divided into two groups participated in the study: Hearing Aid Group: use of hearing aid; and Auditory Training Group: use of hearing aid in addition to musical auditory training for 16 sessions. All participants were submitted to cortical auditory evoked potential tests with verbal stimulation in two different moments: Initial assessment, carried out before hearing aid adaptation and auditory training, and after three months, final assessment at the end of the auditory training sessions. All participants were adapted bilaterally with digital mini hearing aids. There was a decrease in the P3a latency component for the Auditory Training Group when initial and final assessment were compared. There was a change in the cortical auditory evoked potential in elderly people with presbycusis in response to the Musical Auditory Training associated with the use of hearing aids in elderly people with presbycusis.

Evaluating the Effectiveness of a New Auditory Training Program on the Speech Recognition Skills and Auditory Event-Related Potentials in Elderly Hearing Aid Users

Introduction: The objective of this study was to evaluate the effectiveness of a new auditory training (AT) program on the speech recognition in the noise and on the auditory event-related potentials in elderly hearing aid users. Methods: Thirty-three elderly individuals using hearing aids aged from 60 to 80 years participated. A new AT program was developed for the study. AT program lasts for 8 weeks and includes sound discrimination exercises and cognitive exercises. Seventeen individuals (mean age 72.17 ± 6.94) received AT and 16 individuals (mean age 71.75 ± 6.81) did not receive AT. The mismatch negativity (MMN) test and matrix test were used to evaluate the effectiveness of AT. Tests were conducted for the study group before and after the AT. The tests were carried out for the control group at the same times with the study group and the results were compared. Results: In comparison with the first evaluation, the last evaluation of the study group demonstrated a significant difference regarding the decrease of mean latency in the MMN wave (p = 0.038), and regarding the improving score of matrix test (p = 0.004), there was no difference in the control group. Conclusion: The AT program prepared for the study was effective in improving speech recognition in noise in the elderly, and the efficiency of AT could be demonstrated with MMN and matrix test.

Influence of Tinnitus-Control Sound Stimuli on Auditory Spectral and Temporal Resolution and Speech Perception in Hearing Aid Users

Background and Objectives: Hearing aids (HAs) with built-in sound generators can alleviate the discomfort of tinnitus in individuals with tinnitus and impaired hearing. However, it is unknown how tinnitus-control sound (TCS) affects speech perception in HA users. Therefore, this study aimed to evaluate the effect of HA TCS on auditory spectral resolution, temporal resolution, and speech perception in individuals with tinnitus and impaired hearing. Materials and Methods: The subjects were 13 elderly listeners (62.38±8.44 years, seven males, six females) with tinnitus and impaired hearing who had been using a receiver-in-canal HA with a built-in sound generator in everyday life for more than 3 months. The following psychoacoustic measurements were performed: spectral-ripple discrimination (SRD), temporal modulation detection (TMD), and speech recognition threshold in noise. The results obtained with HA-only and HA plus TCS conditions were compared. Results: There were no significant differences in SRD and TMD between the HA-only and HA plus TCS conditions (p&gt;0.05). However, the HA plus TCS conditions were associated with worse speech recognition than the HA-only conditions (p=0.027). Conclusions: TCS constrains speech perception in noise in individuals with tinnitus and impaired hearing, implying that the TCS introduces additional noise to existing tinnitus. Therefore, we recommend that individuals with tinnitus who use a HA with a built-in sound generator should turn off the sound generator in daily life, especially in noisy environments. (J Clinical Otolaryngol 2021;32:202-211)

Predictability-Based Source Segregation and Sensory Deviance Detection in Auditory Aging.

When multiple sound sources are present at the same time, auditory perception is often challenged with disentangling the resulting mixture and focusing attention on the target source. It has been repeatedly demonstrated that background (distractor) sound sources are easier to ignore when their spectrotemporal signature is predictable. Prior evidence suggests that this ability to exploit predictability for foreground-background segregation degrades with age. On a theoretical level, this has been related with an impairment in elderly adults’ capabilities to detect certain types of sensory deviance in unattended sound sequences. Yet the link between those two capacities, deviance detection and predictability-based sound source segregation, has not been empirically demonstrated. Here we report on a combined behavioral-EEG study investigating the ability of elderly listeners (60–75 years of age) to use predictability as a cue for sound source segregation, as well as their sensory deviance detection capacities. Listeners performed a detection task on a target stream that can only be solved when a concurrent distractor stream is successfully ignored. We contrast two conditions whose distractor streams differ in their predictability. The ability to benefit from predictability was operationalized as performance difference between the two conditions. Results show that elderly listeners can use predictability for sound source segregation at group level, yet with a high degree of inter-individual variation in this ability. In a further, passive-listening control condition, we measured correlates of deviance detection in the event-related brain potential (ERP) elicited by occasional deviations from the same spectrotemporal pattern as used for the predictable distractor sequence during the behavioral task. ERP results confirmed neural signatures of deviance detection in terms of mismatch negativity (MMN) at group level. Correlation analyses at single-subject level provide no evidence for the hypothesis that deviance detection ability (measured by MMN amplitude) is related to the ability to benefit from predictability for sound source segregation. These results are discussed in the frameworks of sensory deviance detection and predictive coding.

Auditory Training for Spatial Hearing Loss: Two Case Reports of the Older Adults Who Wear Hearing Aids

The elderly with hearing loss have often experienced spatial hearing deficits when only wearing hearing aids. This case study aimed to investigate whether auditory training for spatial hearing loss could improve the spatial hearing ability of the elderly who wear hearing aids. Two older adults (males, aged 75 years and 78 years) who were wearing bilateral hearing aids participated. They had symmetric sensorineural hearing loss. A total of 16 auditory-training sessions (40 minutes, twice per week) for auditory training for spatial hearing ability provided. For outcome measurements, we assessed speech reception thresholds (SRTs) and spatial release from masking (SRM), using two types of noise, steady-state noise and speech-like noise at pre- and post-auditory training. Both subjects increased SRTs after the auditory training, but the SRM of only one participant improved. Also, there were no masking effects for SRM in terms of noise types. Both subjects reported that their trained hearing skills helped in communication with their families and friends. These results suggested that audiologists can consider auditory training for focusing on the spatial hearing loss for the elderly hearing aids users.

Hearing Screening Results of the Elderly in ○○ Nursing Home Hospital

Objective: The elderly hearing in nursing hospital is important for care giving and communication with their family. This study aims to investigate the elderly hearing in the nursing hospital with the otoacoustic emission (OAE). Participants & Method: 58 of whom aged from 65 to 91 were analyzed for the results. The signal-to- noise ratio (SNR) was used for transient evoked OAE (TEOAE) and distortion product OAE (DPOAE). OAE lower than 5 ㏈ SNR at speech and high frequency range was categorized to suspicious hearing loss. Results: It was impossible to evaluate 10.53 % and 13.16% of all participants because it was to have issues in the external and middle ear, and brain problems. The suspicious rate at TEOAE was 31.03, 8.62, 10.34, 48.28, 53.45 % at right ear and 39.66, 12.07, 13.79, 41.38, 67.24 % at left ear in 1000, 1414, 2000, 2828, and 4000 Hz. The mean of speech and high-frequency range were observed to be 15.52, 55.17 % at right ear, 15.52, 48.28 % at left ear. The dB SNR at speech range in the 60s, 70s, and 80s were significantly decreased to 16.1, 13.41, and 8.28 dB SNR, on average. Conclusion: The SNR of TEOAE was significantly lower in the high-pitched range than in the speech range according to frequency and showed a tendency to worsen with age. For hearing screening in the elderly, TEOAE is more useful than DPOAE with a higher referral rate of 81.03~98.28 %.

Emotional Reactions to Music in Dementia Patients and Healthy Controls: Differential Responding Depends on the Mechanism

Music is frequently regarded as a unique way to connect with dementia patients. Yet little is known about how persons with dementia respond emotionally to music. Are their responses different from those of healthy listeners? If so, why? The present study makes a first attempt to tackle these issues in a Portuguese context, with a focus on psychological mechanisms. In Experiment 1, featuring 20 young and healthy adults, we found that musical excerpts which have previously been shown to activate specific emotion induction mechanisms (brain stem reflex, contagion, episodic memory, musical expectancy) in Sweden were valid and yielded predicted emotions also in Portugal, as indexed by self-reported feelings, psychophysiology, and post hoc mechanism indices. In Experiment 2, we used the same stimuli to compare the responses of 20 elderly listeners diagnosed with Alzheimer’s disease (AD) with those of 20 healthy listeners. We controlled for cognitive functioning (Mini-Mental State Examination) and depression (Geriatric Depression Scale). Our predictions about how mechanisms would be differentially affected by decline in brain regions associated with AD received support in that AD patients reported significantly lower levels of (a) sadness in the contagion condition, (b) happiness and nostalgia in the episodic memory condition, and (c) anxiety in the musical expectancy condition. By contrast, no significant difference in reported surprise was found in the brain stem reflex condition. Implications for musical interventions aimed at dementia are discussed, highlighting the key role that basic research may play in developing applications.