Psychometric function for speech-in-noise tests accounts for word-recognition deficits in older listeners

Speech-in-noise (SIN) understanding in older age is affected by hearing loss, impaired central auditory processing, and cognitive deficits. SIN-tests measure these factors' compound effects by a speech reception threshold, defined as the signal-to-noise ratio required for 50% word understanding (SNR50). This study compared two standard SIN tests, QuickSIN (n = 354) in young and older adults and BKB-SIN (n = 139) in older adults (>60 years). The effects of hearing loss and age on SIN understanding were analyzed to identify auditory and nonauditory contributions to SIN loss. Word recognition in noise was modelled with individual psychometric functions using a logistic fit with three parameters: the midpoint (SNRα), slope (β), and asymptotic word-recognition deficit at high SNR (λ). The parameters SNRα and λ formally separate SIN loss into two components. SNRα characterizes the steep slope of the psychometric function at which a slight SNR increase provides a considerable improvement in SIN understanding. SNRα was discussed as being predominantly affected by audibility and low-level central auditory processing. The parameter λ describes a shallow segment of the psychometric function at which a further increase in the SNR provides modest improvement in SIN understanding. Cognitive factors in aging may contribute to the SIN loss indicated by λ.