Word recognition and the articulation index in older listeners with probable age-related auditory neuropathy

This retrospective analysis of existing data was derived from 957 members of a population-based cohort who participated in a prior study of the prevalence of central auditory dysfunction. Word recognition scores (WRS) at three intensity levels were compared to predicted scores based on the Articulation Index (AI) and the Thornton-Raffin 95 percent critical differences. In 112 (11.7 percent) participants, one or more word recognition scores were significantly below the predicted score, which we consider a subtle sign of possible auditory neuropathy. In contrast, classic signs of retrocochlear dysfunction were found in only three people (0.3 percent) using rollover of the performance-intensity function for phonetically balanced word lists, in two (0.2 percent) people using the guideline of Yellin et al (1989), and in 54 people (5.6%) using a 20-point difference between the AI (x 100) and the WRS. Subtle signs of possible auditory neuropathy were more frequent than the classic signs. Comparing WRS at several high presentation levels to the AI is suggested as a method to screen for subtle neuropathy. Elderly listeners whose WRS fall below the Thornton-Raffin 95 percent critical difference based on AI should be considered for further testing for age-related auditory neuropathy.