Age and Measurement Time-of-Day Effects on Speech Recognition in Noise

Objectives: The purpose of this study was to determine the effect of measurement time of day on speech recognition in noise and the extent to which time-of-day effects differ with age. Older adults tend to have more difficulty understanding speech in noise than younger adults, even when hearing is normal. Two possible contributors to this age difference in speech recognition may be measurement time of day and inhibition. Most younger adults are evening-type, showing peak circadian arousal in the evening, whereas most older adults are morning-type, with circadian arousal peaking in the morning. Tasks that require inhibition of irrelevant information have been shown to be affected by measurement time of day, with maximum performance attained at one's peak time of day. The authors hypothesized that a change in inhibition will be associated with measurement time of day and therefore affect speech recognition in noise, with better performance in the morning for older adults and in the evening for younger adults. Design: Fifteen younger evening-type adults (20-28 years) and 15 older morning-type adults with normal hearing (66-78 years) listened to the Hearing in Noise Test (HINT) and the Quick Speech in Noise (QuickSIN) test in the morning and evening (peak and off-peak times). Time of day preference was assessed using the Morningness-Eveningness Questionnaire. Sentences and noise were presented binaurally through insert earphones. During morning and evening sessions, participants solved word-association problems within the visual-distraction task (VDT), which was used as an estimate of inhibition. After each session, participants rated perceived mental demand of the tasks using a revised version of the NASA Task Load Index. Results: Younger adults performed significantly better on the speech-in-noise tasks and rated themselves as requiring significantly less mental demand when tested at their peak (evening) than off-peak (morning) time of day. In contrast, time-of-day effects were not observed for the older adults on the speech recognition or rating tasks. Although older adults required significantly more advantageous signal-to-noise ratios than younger adults for equivalent speech-recognition performance, a significantly larger younger versus older age difference in speech recognition was observed in the evening than in the morning. Older adults performed significantly poorer than younger adults on the VDT, but performance was not affected by measurement time of day. VDT performance for misleading distracter items was significantly correlated with HINT and QuickSIN test performance at the peak measurement time of day. Conclusions: Although all participants had normal hearing, speech recognition in noise was significantly poorer for older than younger adults, with larger age-related differences in the evening (an off-peak time for older adults) than in the morning. The significant effect of measurement time of day suggests that this factor may impact the clinical assessment of speech recognition in noise for all individuals. It appears that inhibition, as estimated by a visual distraction task for misleading visual items, is a cognitive mechanism that is related to speech-recognition performance in noise, at least at a listener's peak time of day. (Ear & Hearing 2013;34;288-299)