Speech perception in older adults: the importance of speech-specific cognitive abilities.

OBJECTIVE: To provide a critical evaluation of studies examining the contribution of changes in language-specific cognitive abilities to the speech perception difficulties of older adults.
DESIGN: A review of the literature on aging and speech perception.
CONCLUSIONS: The research considered in the present review suggests that age-related changes in absolute sensitivity is the principal factor affecting older listeners' speech perception in quiet. However, under less favorable listening conditions, changes in a number of speech-specific cognitive abilities can also affect spoken language processing in older people. Clinically, these findings suggest that hearing aids, which have been the traditional treatment for improving speech perception in older adults, are likely to offer considerable benefit in quiet listening situations because the amplification they provide can serve to compensate for age-related hearing losses. However, such devices may be less beneficial in more natural environments, (e.g., noisy backgrounds, multiple talkers, reverberant rooms) because they are less effective for improving speech perception difficulties that result from age-related cognitive declines. It is suggested that an integrative approach to designing test batteries that can assess both sensory and cognitive abilities needed for processing spoken language offers the most promising approach for developing therapeutic interventions to improve speech perception in older adults.