Speech discrimination skills in the elderly: a critical review

Traditionally, investigators have claimed that speech discrimination skills decline with increasing age more than would be expected, given hearing sensitivity. These effects are magnified under difficult listening conditions. Evidence is presented which both supports and refutes this claim of decreased speech discrimination ability in the elderly. Other possible explanations for this phenomenon including reaction time, response bias, hearing threshold, memory, learning, selective attention and social expectation are discussed. The question of whether this effect represents central or peripheral processing is explored. It is suggested that further evidence is necessary before conclusive statements can be made.