Speech Recognition Across the Life Span: Longitudinal Changes From Middle-Age to Older Adults

Purpose: The purpose of this article is to provide an overview of evidence of age-related declines in speech recognition in middle age to older adulthood; to review contributions of pure-tone thresholds, age, and gender; and to report preliminary results from a longitudinal study. Method: Pure-tone thresholds and word recognition in quiet and babble are being measured in a large sample of adults yearly or every 2 to 3 years. Analyses included >16,000 audiograms and speech recognition scores from >1,200 adults whose ages ranged from the 40s to the 90s. A multivariable generalized linear repeated mixed model assessed changes in thresholds and speech recognition over time. Results: Word recognition in quiet declined significantly while controlling for threshold increases, and declines appeared to accelerate near ages 65 to 70 years. Scores for men were poorer than those for women even after controlling for gender differences in thresholds, but rates of decline did not differ by gender. Smaller declines in key word recognition in babble were observed, and declines appeared to accelerate near ages 75 to 80 years. Conclusions: Additional evidence is needed from large-scale longitudinal cohort studies to determine rates of change of auditory function across the life span. These studies can identify associations with modifiable risk factors and potential mechanisms to reduce, to prevent, or to delay the onset of age-related hearing loss.