The impact of early age-related hearing loss on working memory capacity and speech recognition in noise in middle-aged and older adults

• Published in: Experimental gerontology Vol. 208; p. 112823
• Main Authors: Chang, Chen-Wei, Chen, Yu-chun
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.09.2025; Elsevier
• Subjects: Adult; Age-related hearing loss; Aged; Aged, 80 and over; Aging - psychology; Audiometry, Pure-Tone; Auditory Threshold; Extended high-frequency; Female; Hearing Loss, High-Frequency - physiopathology; Hearing Loss, High-Frequency - psychology; Humans; Male; Memory, Short-Term; Middle Aged; Noise; Presbycusis - physiopathology; Presbycusis - psychology; Signal-To-Noise Ratio; Speech Perception; Speech recognition in noise; Taiwanese Mandarin; Working memory capacity; Young Adult; Taiwanese Mandarin; Speech recognition in noise; Extended high-frequency; Age-related hearing loss; Working memory capacity
• ISSN: 0531-5565; 1873-6815; 1873-6815
• DOI: 10.1016/j.exger.2025.112823

This study aimed to investigate the impact of age-related hearing loss (ARHL) on working memory capacity (WMC) and speech recognition in noise and their relationship in middle-aged and older adults. Participants were divided into three groups: young adults with normal hearing, middle-aged and older adults with normal hearing, and middle-aged and older adults with high-frequency hearing loss. Assessments included standard and extended high-frequency (EHF) audiometry, the Wechsler Memory Scale, and the Taiwanese Mandarin Quick Speech-in-Noise test. Sixty-two participants were recruited. Early ARHL were evident as elevated thresholds >1 kHz and in the EHF range. Conventional high-frequency hearing loss primarily impaired word recognition in quiet, whereas EHF loss significantly affected speech-in-noise recognition. Furthermore, ARHL was associated with reduced WMC, potentially accelerating cognitive decline. After controlling for age and hearing status, no significant associations were found between signal-to-noise-ratio (SNR) loss and hearing measures, including EHF hearing thresholds. However, WMC remained moderately and negatively correlated with SNR loss in middle-aged and older adults (r = −0.554, p = .002) but not in younger adults. Adults aged ≥50 years showed declines in EHF hearing sensitivity, WMC, and speech-in-noise recognition despite clinically normal hearing or well-preserved hearing. Speech-in-noise testing proved more sensitive than pure-tone audiometry or word recognition in detecting auditory and cognitive decline. To comprehensively evaluate the impact of ARHL on communication in middle-aged and older adults, it is recommended to incorporate assessments of EHF hearing sensitivity, cognitive function (e.g., WMC), and speech-in-noise perception. •Early age-related hearing changes were most obvious above 1 kHz and extending into the EHF range.•EHF hearing loss significantly impacts speech recognition in noisy environments.•Early age-related high-frequency hearing loss is associated with reduced WMC.•WMC showed a negative correlation with SNR loss in middle-aged and older adults.•Speech-in-noise tests more effectively reveal auditory and cognitive decline.