Age-Related Changes in Speech Understanding: Peripheral Versus Cognitive Influences

This chapter examines anatomical and physiological changes in the peripheral and central auditory system that contribute to speech understanding deficits observed in older adults, as well as how cognitive and linguistic abilities may modulate the impact of age-related limitations in hearing acuity and auditory processing. The focus is on considering auditory and cognitive mechanisms in some detail that help explain older listeners’ performance on a range of speech understanding tasks that capture the challenges of every day listening conditions. In particular, the roles of working memory, linguistic context, and listening effort on representative difficult speech understanding tasks are reviewed. Emerging areas of research that address age-related differences in speech understanding performance of adults who use cochlear implants and those who are native speakers of a foreign language are also discussed, particularly in relation to the theoretical constructs presented. The chapter culminates in recommendations for several key areas of research aimed at further elucidating mechanisms that can potentially effect positive change in speech understanding outcomes for older adults.