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

交谈是许多日常活动的关键，大多数人参与其中都没有困难，至少在他们年轻的时候是这样，背景安静，听力良好。然而，随着人们年龄的增长，他们会发现进行对话越来越困难，特别是如果对话是在嘈杂的背景下进行的。即使他们没有临床上显著的听力损失，这一点也是正确的。事实上，在噪音中言语感知的困难往往与年龄相关的听力丧失无关，这一事实进一步突出了助听器在缓解这些特殊的沟通挑战方面相当无效的事实，从而使年长的听者面临沮丧和社交退缩的风险。许多研究记录了与年龄相关的噪音中言语感知的变化，要么是通过报告表现出这些困难的老年听众的百分比，要么是通过使用客观指标来量化与年轻人相比的老年人的这些困难。此外，该小组成员开展的工作表明，嘈杂的环境除了通常被认为是主要问题的理解困难外，还会对交流产生不利影响。例如，老年人对正确感知的言语表现出记忆缺陷，这是噪音环境特有的，目前标准的听力测量或心理物理言语感知测量无法识别或欣赏这种记忆缺陷。尽管许多研究试图了解为什么会出现这些噪音困难，以及为什么它们在很大程度上与听力损失无关，可以使用助听器治疗，但目前还没有有效的治疗方法来缓解这些问题。到目前为止，大多数研究都只从一个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。目前的项目是这类项目中的第一个，它采取广泛的综合办法，结合所有这些学科的知识和专门知识，以更全面、更全面地了解局势及其根本原因。在项目过程中，我们将寻求以下问题的答案：老年人认为哪些环境情况对沟通最具破坏性，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，对环境噪声源有哪些有用的客观衡量标准很重要？背景声音干扰程度的年龄差异是由哪些声音特征造成的？随着年龄的增长，注意力衰退和听觉衰退是如何相互作用的？听觉和认知衰退的不同个体轨迹是否会导致不同的年龄相关缺陷？此外，鉴于我们日益多元的文化世界，许多老年人和照顾者必须在第二语言环境中发挥作用，各种母语和非母语口音如何影响老年交流？除了试图揭示观察到的困难的潜在原因外，这项研究还旨在进一步研究，通过提出和测试旨在缓解已证明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知识转化为老年人的支持和补救措施。这些策略可能包括减少公共场所噪音的建筑建议、“倾听”训练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业知识，以解决大多数老年人面临的沟通困难，并为最终有利于老年人的社会融合和生活满意度的应对策略提供建议。

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.