Speech Understanding in Modulated Noise and Speech Maskers as a Function of Cognitive Status in Older Adults.

Objectives The purpose of this study was to investigate the impact of different types of maskers on speech understanding as a function of cognitive status in older adults. The hypothesis tested was that individuals with a diagnosis of mild cognitive impairment (MCI) or mild dementia would perform like their age- and hearing status-matched control counterparts in modulated noise but would perform more poorly in the presence of competing speech. Design Participants (n = 39; age range: 55-77 years old) performed a speech-in-noise task and completed two cognitive screening tests and a measure of working memory. Sentences were presented in the presence of two types of maskers (i.e., speech envelope-modulated noise and two-talker, same-sex competing speech). Two analyses were undertaken: (a) a between-groups comparison of individuals diagnosed with MCI/dementia, individuals who failed both cognitive screeners (possible MCI), and age- and hearing status-matched neurologically healthy control individuals and (b) a mixed-model analysis of variance of speech perception performance as a function of working memory capacity. Results The between-groups comparison yielded significant group differences for speech understanding in both masking conditions, with the MCI/dementia group performing more poorly than the neurologically healthy controls and possible MCI groups. A single measure of working memory (Size Comparison Span [SICSPAN]) was correlated with performance on the speech perception task in the competing speech conditions. Conclusions Adults with a diagnosis of MCI or mild dementia performed more poorly on a speech perception task than their age- and hearing status-matched control counterparts in the presence of both maskers, with larger group mean differences when the target speech was presented in a two-talker masker. This suggests increased difficulty understanding speech in the presence of distracting backgrounds for people with MCI/dementia. Future studies should consider how to target this potentially vulnerable population as they may be experiencing increased difficulty communicating in challenging environments.