Speech recognition in younger and older adults: a dependency on low-level auditory cortex.

A common complaint of older adults is difficulty understanding speech, especially in challenging listening environments. In addition to well known declines in the peripheral auditory system that reduce audibility, age-related changes in central auditory and attention-related systems are hypothesized to have additive negative effects on speech recognition. We examined the extent to which functional and structural differences in speech- and attention-related cortex predicted differences in word recognition between 18 younger adults (19-39 years) and 18 older adults (61-79 years). Subjects performed a word recognition task in an MRI scanner where the intelligibility of words was parametrically varied. Older adults exhibited significantly poorer word recognition in a challenging listening condition compared with younger adults. An anteromedial Heschl's gyrus/superior temporal gyrus (HG/STG) region, engaged by the word recognition task, exhibited age group differences in gray matter volume and predicted word recognition in younger and older adults. Age group differences in anterior cingulate (ACC) activation were also observed. The association between HG gray matter volume, word recognition, and ACC activation was present after controlling for hearing loss. In younger and older adults, causal path modeling analyses demonstrated that individual variation in left HG/STG morphology affected word recognition performance, which was reflected by error monitoring activity in the dorsal ACC. These results have clinical implications for rehabilitation and suggest that some of the perceptual difficulties experienced by older adults are due to structural changes in HG/STG. More broadly, the results suggest the possibility that aging may exaggerate developmental limitations on the ability to recognize speech.