Hearing, Remembering, and Living Well: Paying Attention to Challenges that Older Adults Face in Noisy Environments

谈话对许多日常活动来说都是至关重要的，大多数人在进行谈话时没有困难，至少在他们年轻的时候，背景是安静的，他们的听力很好。然而，随着年龄的增长，人们会发现进行对话越来越困难，特别是在噪音背景下进行对话。即使他们没有临床上显著的听力损失也是如此。噪声中的言语感知困难往往与年龄相关的听力灵敏度损失无关，这一事实进一步突出了助听器在缓解这些特定的沟通挑战方面被证明是无效的，从而使老年听众面临挫折和社交退缩的风险。许多研究已经记录了噪声中言语感知的年龄相关变化，无论是通过报告显示这些困难的老年听众的百分比，还是通过使用客观的措施来量化老年人与年轻人相比的这些困难。此外，该小组成员开展的工作表明，嘈杂的环境对交流产生不利影响，除了通常被认为是主要问题的理解困难之外。例如，老年人对正确感知的语音表现出记忆缺陷，这些语音是特定于嘈杂环境的，并且未被当前标准听力或心理物理语音感知测量识别或欣赏。虽然许多研究试图了解为什么这些困难在噪音中发生，以及为什么它们在很大程度上与助听器可治疗的听力损失无关，但目前还没有有效的治疗方法来缓解这些问题。迄今为止，大多数研究都只从一个Vantage的角度来研究这个问题，无论是心理学，听力学，神经科学还是社会科学。目前的项目是第一个采取广泛的综合办法，将所有这些学科的知识和专长结合起来，以更充分和更全面地了解局势及其根本原因的项目。在这个项目的过程中，我们将寻求问题的答案，如：哪些环境情况下，老年人认为是最具破坏性的沟通，以及这些情况如何限制老年人的流动性和参与社会？在沟通的背景下，什么是重要的环境噪声源的有用的客观措施？哪些声音特征导致了背景声音干扰性的年龄差异？注意力下降如何与衰老中的听觉下降相互作用？不同的听觉和认知能力下降轨迹会导致不同的年龄相关缺陷吗？此外，考虑到我们日益多元文化的世界，许多老年人和护理人员必须在第二语言环境中工作，各种母语和非母语口音如何影响老年人的沟通？除了试图发现观察到的困难的潜在原因，本研究还旨在将研究更进一步，并通过提出和测试旨在减轻所表现出的困难的潜在应对策略，将我们对言语理解困难的各种原因的了解转化为对老年人的支持和补救。这些策略可能包括减少公共场所噪音的建筑建议、“倾听”培训程序或积极塑造噪音环境。该项目汇集了来自英国、芬兰、以色列和加拿大的研究人员的专门知识和知识，以解决大多数老年人面临的沟通困难，并提出应对战略建议，最终将有利于老年人的社会融合和生活满意度。

Conversation is crucial to many everyday activities, and most people have no difficulties engaging in one, at least not when they are young, the background is quiet and their hearing is good. However, as people get older, they can find it increasingly difficult to carry on a conversation, particularly if it is taking place in a background of noise. This is true even when they have no clinically significant hearing loss. The fact that difficulties of speech perception in noise tend to be unrelated to age-related loss in hearing sensitivity is further highlighted by the fact that hearing aids have proven rather ineffective at alleviating these particular communication challenges thus leaving older listeners at the risk of frustration and social withdrawal. Many studies have documented age-related changes for speech perception in noise, either by reporting the percentage of older listeners who show these difficulties or by using objective measures to quantify these difficulties in older adults, compared to young adults. Moreover, work carried out by members of this group has demonstrated that noisy environments have adverse effects on communication that occur in addition to the comprehension difficulties often stated as the main problem. For instance, older adults show memory deficits for correctly perceived speech which are specific to noisy environments, and which are not being identified or appreciated by current standard audiometric or psychophysical speech perception measures. Although many studies have tried to understand why these difficulties in noise occur, and why they are, for the most part, unrelated to hearing loss treatable with hearing aids, there are currently no effective treatments available to alleviate these problems. Most studies to date examine the question from one vantage point only, be that psychology, audiology, neuroscience or social sciences. The current project is the first of its kind that takes a broad integrative approach and combines knowledge and expertise of all of these disciplines to develop a fuller and more complete picture of the situation and its underlying causes. In the course of the project, we will be seeking answers to questions such as: Which environmental situations do older adults perceive as most disruptive to communication, and how do these situations restrict older adults' mobility and participation in society? What are useful objective measures of environmental noise sources important in the context of communication? Which voice characteristics drive the age difference in disruptiveness of background voices? How does attentional decline interact with auditory decline in aging? Do different individual trajectories of auditory and cognitive declines lead to different age-related deficits? Moreover, given our increasingly multi-cultural world in which many seniors and care-providers must function in a second-language environment, how do various native and non-native speech accents affect communication in old age?In addition to trying to uncover potential causes for the observed difficulties, this study also aims to take the research one step further and convert our knowledge about various causes of speech comprehension difficulties into support and remediation for older adults by proposing and testing potential coping strategies that aim to alleviate the demonstrated difficulties. These strategies may include architectural recommendations to reduce noise in public places, "listening" training procedures or the active shaping of noise environments. This project brings together expertise and knowledge of researchers from the UK, Finland, Israel and Canada in order to tackle communication difficulties faced by most older adults and to offer suggestions for coping strategies that will ultimately benefit older adults' social integration and life satisfaction.