One of the universal findings in cognitive aging research is reduced speed of information (sensory and mental) processing with advancing age. 8 We observe this with changes in various forms of memory and attention. On the other hand, changes in the perceptual processing of auditory information can be influenced by declines in higher-order processes (i.e., cognition) in a top-down, concept-driven manner. 8 We observe this in the effects of sensorineural hearing loss and with direct insult (e.g., brain trauma) to specific auditory regions of the central nervous system. Changes in perceptual processing of auditory information can arise from changes within the cells, structures, fiber pathways, and processes specific to the peripheral and central auditory system in a bottom-up, data-driven manner. However, the challenge of separating the influence of auditory system-related changes from higher-order cognitive changes remains. 6 7 There is evidence that the aging brain fulfills this definition in terms of both behavioral and electrophysiologic findings that manifest within this population. 4 5 One of the most frequently cited definitions for central auditory processing disorder refers to difficulties in the perceptual processing of auditory information in the central nervous system and the neurobiologic activity that underlies that processing and gives rise to the electrophysiologic auditory potentials. 3 These changes can directly impact a broad range of auditory and cognitive processing abilities that are important for speech understanding. Physiologic changes with aging in both the peripheral and central auditory systems have been documented. Finally, we review some of the common rehabilitative approaches to reduce the effects of central auditory processing deficit in older adults.Īuditory Processing, Cognitive Processing, and Aging Next, we review the literature on various behavioral and electrophysiologic tests that exhibit some sensitivity to age-related central auditory processing declines. We first provide a brief contrast between our current understanding of auditory processing and how that differs from cognitive processing. The purpose of this article is to provide an overview of assessment and rehabilitative approaches for central auditory processing deficits in older adults. In contrast, when an older adult exhibits listening-related issues that are poorer than expected for age, hearing sensitivity, and physical and mental health, one cannot help but wonder if the central auditory system is affected. 2 When interventions such as hearing aids or auditory training demonstrate positive outcomes in older adults, it is not always apparent what mechanisms facilitated the change. What is less clear, however, is whether there is an isolated or pure form of central auditory processing decline in older adults (sometimes referred to as “central presbycusis”). 1 2 In general, many would agree that older adults are susceptible to a variety of age-related auditory declines, including changes in hearing sensitivity and changes in higher-order cognitive processes. The notion that a central auditory processing deficit (or disorder) is possible in older adults is not a novel one and is quite complex, often with many more questions than there are answers. Learning Outcomes: As a result of this activity, the participant will be able to (1) describe at least three behavioral and electrophysiologic manifestations of age-related central auditory processing deficit, and (2) list at least three common behavioral tests that may be used to assess central auditory processing in older adults.
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