Binaural Interference and the Effects of Age and Hearing Loss

The existence of binaural interference, defined here as poorer speech recognition with both ears than with the better ear alone, is well documented. Studies have suggested that its prevalence may be higher in the elderly population. However, no study to date has explored binaural interference in groups of younger and older adults in conditions that favor binaural processing (i.e., in spatially separated noise). Also, the effects of hearing loss have not been studied.

To examine binaural interference through speech perception tests, in groups of younger adults with normal hearing, older adults with normal hearing for their age, and older adults with hearing loss.

A cross-sectional study.

Thirty-three participants with symmetric thresholds were recruited from the University of Iowa community. Participants were grouped as follows: younger with normal hearing (18-28 yr, n = 12), older with normal hearing for their age (73-87 yr, n = 9), and older with hearing loss (78-94 yr, n = 12). Prior noise exposure was ruled out.

The Connected Speech Test (CST) and Hearing in Noise Test (HINT) were administered to all participants bilaterally, and to each ear separately. Test materials were presented in the sound field with speech at 0° azimuth and the noise at 180°. The Dichotic Digits Test (DDT) was administered to all participants through earphones. Hearing aids were not used during testing. Group results were compared with repeated measures and one-way analysis of variances, as appropriate. Within-subject analyses using pre-established critical differences for each test were also performed.

The HINT revealed no effect of condition (individual ear versus bilateral presentation) using group analysis, although within-subject analysis showed that 27% of the participants had binaural interference (18% had binaural advantage). On the CST, there was significant binaural advantage across all groups with group data analysis, as well as for 12% of the participants at each of the two signal-to-babble ratios (SBRs) tested. One participant had binaural interference at each SBR. Finally, on the DDT, a significant right-ear advantage was found with group data, and for at least some participants. Regarding age effects, more participants in the pooled elderly groups had binaural interference (33.3%) than in the younger group (16.7%), on the HINT. The presence of hearing loss yielded overall lower scores, but none of the comparisons between bilateral and unilateral performance were affected by hearing loss.

Results of within-subject analyses on the HINT agree with previous findings of binaural interference in ≥17% of listeners. Across all groups, a significant right-ear advantage was also seen on the DDT. HINT results support the notion that the prevalence of binaural interference is likely higher in the elderly population. Hearing loss, however, did not affect the differences between bilateral and better unilateral scores. The possibility of binaural interference should be considered when fitting hearing aids to listeners with symmetric hearing loss. Comparing bilateral to unilateral (unaided) performance on tests such as the HINT may provide the clinician with objective data to support subjective preference for one hearing aid as opposed to two.