[Speech comprehension and cognitive performance in acoustically difficult situations].

Understanding speech strongly depends on sensory processes (bottom-up); however, especially in acoustically difficult situations, cognitive processes (top-down), such as attention and working memory also play a role. In older people both hearing and certain cognitive abilities typically decrease. This has consequences for everyday communication. In clinical practice it is relevant to improve the audibility of speech through appropriate rehabilitative measures and at the same time to reduce the cognitive burden during understanding speech. In this context, future audiometric methods will have to consider "listening effort" as an expression of cognitive load in addition to the improvement of speech intelligibility.