Why do older people complain about difficulty hearing conversations, especially in noisy situations?

Why do older people complain about difficulty hearing conversations, especially in noisy situations?

Usually starting in our 40s, we often begin to notice problems understanding speech, especially in background noise. And, these problems usually increase gradually over the years. It should be noted, however, that people of any age have more difficulty understanding speech (by focusing attention, understanding and remembering) when they listen in noisy situations compared to quiet situations.¹ But, because the amount of noise required to make listening difficult for an older adult is less than what it takes for younger adults², we become more aware of our difficulties as we age.

Most people think that problems understanding speech in everyday conversations are only about our ears. But the ears are the doorway to the brain. It is much more complex than you think! Understanding speech in noisy situations involves the interaction of sensory (ears/hearing), central-auditory (brain areas required for hearing), and cognitive processes (higher-level functions of the brain). To follow a conversation, we use our ears to hear and we use our brain to focus attention on, understand and remember what is said.

When we try to follow and understand a group conversation, we need to process the words that we hear. We need to process the information fast and efficiently, which involves not only hearing, but also focusing attention, understanding and memory. Changes in the ear with age can make it more difficult to listen. In turn, difficulty hearing can reduce how efficient the brain can focus on, understand and remember the information that was heard.³

What is important and what is ‘noise’?

Imagine yourself in a noisy restaurant with a friend. You may find it interesting to eavesdrop on the conversation at the table next to you. That conversation is not ‘noise’ at that time. But when you redirect your attention to what your friend is saying, the conversation occurring at the table next to you becomes ‘noise’ you don’t want to hear. It is our brain that allows us to ignore ‘noise’ and pay attention to the sounds we want to hear. And, what we consider ‘noise’ depends on the situation and not simply which sounds are entering our ears.

What happens as we get older?

As we get older, there are changes in our ears and changes in our neural networks that connect our ears to the various parts of our brain.³ It is important to note that some changes in our hearing and memory are part of normal aging and some are not. Although hearing, focusing on and remembering information becomes progressively more difficult as we age, hope is not lost! Older adults can use their experience and knowledge to their advantage. Improved ability to use context and knowledge of the world helps older adults to compensate³ in those challenging listening environments.

Today’s hearing aids have begun to incorporate more complex operations that emulate aspects of higher-level auditory and cognitive processing such as attention, memory, and language. So, by solving some of the hearing problems by using hearing aids, you could make it easier for yourself to focus, understand and remember what you hear. Use hearing aids and take a load off your brain!

1. https://www.mcmasteroptimalaging.org/blog/detail/blog/2014/09/30/hearing-loss-part-1-is-it-my-hearing-or-is-it-my-memory-why-do-older-people-have-trouble-following-conversations-in-noisy-situations.

2. Ben-David BM, Tse VY, Schneider BA. (2012). Does it take older adults longer than younger adults to perceptually segregate a speech target from a background masker? Hear Res. 290, 55–63.

3. Pichora-Fuller M. K., Singh G. (2006). Effects of age on auditory and cognitive processing: Implications for hearing aid fitting and audiologic rehabilitation. Trends in Amplification, 10(1), 29-59.