Speech recognition across the lifespan: Longitudinal changes from middle age to older adults

To provide an overview of evidence of age-related declines in speech recognition in middle-age to older adults, review contributions of pure-tone thresholds, age, and gender, and report preliminary results from a longitudinal study.

Pure-tone thresholds and word recognition in quiet and babble are being measured in a large sample of adults yearly or every 2-3 years. Analyses included >1,200 adults whose ages ranged from 40s to 90s, with >16,000 audiograms and speech recognition scores. A multivariable generalized linear repeated mixed model assessed changes in thresholds and speech recognition over time.

Word recognition in quiet declined significantly while controlling for threshold increases, and declines appeared to accelerate near age 65-70. Scores for males were poorer than for females even after controlling for gender differences in thresholds, but rates of decline did not differ by gender. Smaller declines in key word recognition in babble were observed and declines appeared to accelerate near age 75-80.

Additional evidence is needed from large-scale longitudinal cohort studies to determine rates of change of auditory function across the lifespan. These studies can identify associations with modifiable risk factors and potential mechanisms to reduce, prevent, or delay the onset of age-related hearing loss.