Orienting Attention to Auditory and Visual Short-term Memory: The Roles of Age, Hearing Loss, and Cognitive Status

Aging decreases the precision of visual working memory

OBJECTIVES

As individuals age, cognitive abilities such as working memory (WM), decline. In the current study, we investigated the effect of age on WM, and elucidated sources of errors.

METHOD

A total of 102 healthy individuals, aged 18 to 71, participated in this research. We designed and administered a face-based visual WM task, collecting responses via a graded scale in a delayed match-to-sample reproduction task.

RESULTS

The error of participants increased significantly as they aged. Our analysis revealed a significant age-related rise in the standard deviation of error distribution. However, there was no significant change in uniform probability with age.

CONCLUSION

We found that WM performance declines through the lifespan. Investigating the sources of error, we found that the precision of WM decreased monotonously with age. The results also indicated that the probability of guessing the response as a measure of random response is not affected by age.

Visual Cognitive Assessment Test: Utility of the brief cognitive battery for early screening of cognitive impairment in Chongqing, China

OBJECTIVES

Early detection of cognitive impairment is essential for timely intervention. Currently, most widely used cognitive screening tests are influenced by language and cultural differences; therefore, there is a need for the development of a language-neutral, visual-based cognitive assessment tool. The Visual Cognitive Assessment Test (VCAT), a 30-point test that assesses memory, executive function, visuospatial function, attention, and language, has demonstrated its utility in a multilingual population. In this study, we evaluated the reliability, validity, and diagnostic performance of the VCAT for screening early cognitive impairment in Chongqing, China METHODS: A total of 134 individuals (49 healthy controls (HCs), 52 with mild cognitive impairment (MCI), and 33 with mild dementia) completed the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), VCAT, and domain-specific neuropsychological assessments. The diagnostic performances of MMSE, MoCA, and VCAT were evaluated using the area under the curve (AUC), sensitivity, and specificity. Construct validity of the VCAT was assessed with well-established domain-specific cognitive assessments. Reliability was measured using Cronbach's alpha.

RESULTS

The VCAT and its subdomains demonstrated both good construct validity and internal consistency (α = 0.577). The performance of VCAT was comparable to that of MoCA and MMSE in differentiating mild dementia from nondemented groups (AUC: 0.940 vs. 0.902 and 0.977, respectively; p = .098 and .053) and in distinguishing cognitive impairment (CI) from HC (AUC: 0.929 vs. 0.899 and 0.891, respectively; p = .239 and .161), adjusted for education level. The optimal score range for VCAT in determining dementia, MCI, and HC was 0-14, 15-19, and 20-30, respectively.

CONCLUSION

The VCAT proves to be a reliable screening test for early cognitive impairment within our cohort. Being both language and cultural neutral, the VCAT has the potential to be utilized among a wider population within China.

Development of an adaptive test of musical scene analysis abilities for normal-hearing and hearing-impaired listeners

Auditory scene analysis (ASA) is the process through which the auditory system makes sense of complex acoustic environments by organising sound mixtures into meaningful events and streams. Although music psychology has acknowledged the fundamental role of ASA in shaping music perception, no efficient test to quantify listeners' ASA abilities in realistic musical scenarios has yet been published. This study presents a new tool for testing ASA abilities in the context of music, suitable for both normal-hearing (NH) and hearing-impaired (HI) individuals: the adaptive Musical Scene Analysis (MSA) test. The test uses a simple 'yes-no' task paradigm to determine whether the sound from a single target instrument is heard in a mixture of popular music. During the online calibration phase, 525 NH and 131 HI listeners were recruited. The level ratio between the target instrument and the mixture, choice of target instrument, and number of instruments in the mixture were found to be important factors affecting item difficulty, whereas the influence of the stereo width (induced by inter-aural level differences) only had a minor effect. Based on a Bayesian logistic mixed-effects model, an adaptive version of the MSA test was developed. In a subsequent validation experiment with 74 listeners (20 HI), MSA scores showed acceptable test-retest reliability and moderate correlations with other music-related tests, pure-tone-average audiograms, age, musical sophistication, and working memory capacities. The MSA test is a user-friendly and efficient open-source tool for evaluating musical ASA abilities and is suitable for profiling the effects of hearing impairment on music perception.

Does age-related hearing loss deteriorate attentional resources?

Recent work suggests that age-related hearing loss (HL) is a possible risk factor for cognitive decline in older adults. Resulting poor speech recognition negatively impacts cognitive, social and emotional functioning and may relate to dementia. However, little is known about the consequences of hearing loss on other non-linguistic domains of cognition. The aim of this study was to investigate the role of HL on covert orienting of attention, selective attention and executive control. We compared older adults with and without mild to moderate hearing loss (26-60 dB) performing (1) a spatial cueing task with uninformative central cues (social vs. nonsocial cues), (2) a flanker task and (3) a neuropsychological assessment of attention. The results showed that overall response times and flanker interference effects were comparable across groups. However, in spatial cueing of attention using social and nonsocial cues, hearing impaired individuals were characterized by reduced validity effects, though no additional group differences were found between social and nonsocial cues. Hearing impaired individuals also demonstrated diminished performance on the Montreal Cognitive Assessment (MoCA) and on tasks requiring divided attention and flexibility. This work indicates that while response speed and response inhibition appear to be preserved following mild-to-moderate acquired hearing loss, orienting of attention, divided attention and the ability to flexibly allocate attentional resources are more deteriorated in older adults with HL. This work suggests that hearing loss might exacerbate the detrimental influences of aging on visual attention.

No Link Between Speech-in-Noise Perception and Auditory Sensory Memory - Evidence From a Large Cohort of Older and Younger Listeners

A growing literature is demonstrating a link between working memory (WM) and speech-in-noise (SiN) perception. However, the nature of this correlation and which components of WM might underlie it, are being debated. We investigated how SiN reception links with auditory sensory memory (aSM) - the low-level processes that support the short-term maintenance of temporally unfolding sounds. A large sample of old (N = 199, 60-79 yo) and young (N = 149, 20-35 yo) participants was recruited online and performed a coordinate response measure-based speech-in-babble task that taps listeners' ability to track a speech target in background noise. We used two tasks to investigate implicit and explicit aSM. Both were based on tone patterns overlapping in processing time scales with speech (presentation rate of tones 20 Hz; of patterns 2 Hz). We hypothesised that a link between SiN and aSM may be particularly apparent in older listeners due to age-related reduction in both SiN reception and aSM. We confirmed impaired SiN reception in the older cohort and demonstrated reduced aSM performance in those listeners. However, SiN and aSM did not share variability. Across the two age groups, SiN performance was predicted by a binaural processing test and age. The results suggest that previously observed links between WM and SiN may relate to the executive components and other cognitive demands of the used tasks. This finding helps to constrain the search for the perceptual and cognitive factors that explain individual variability in SiN performance.

Hearing aid use and gender differences in the auditory-cognitive cascade in the oldest old

OBJECTIVES

This study analyzed cognitive differences between hearing-aid (HA) and non-HA users. We hypothesized that HA-use attenuates the auditory-cognitive cascade, thereby, the latter is more conspicuous in non-HA users. Since hearing impairment (HI) shows male predominance, we hypothesized gender differences within the auditory-cognitive relationship.

METHODS

Non-frail community-dwellers ≥ 80 years were assessed for HI (pure tone audiogram-PTA; speech reception threshold-SRT) and global and domain-specific cognitive impairments (Mini-Mental State Examination-MMSE; Montreal Cognitive Assessment-MOCA; Reaction Time Test-RT1-4). Pearson and partial correlations (correcting for age and PTA) assessed auditory-cognitive associations within gender and HA subgroups. Fisher's z test compared correlations between HA and non-HA users.

RESULTS

126 participants (age range 80-91 years) were included. HA-use prevalence was 21%. HA-users were older with worse HI (mean PTA 49.5dBHL). HA-users exhibited no significant auditory (PTA, SRT) and cognitive (MMSE, MOCA, RT1- RT4) correlations. Male non-HA users, displayed a significant association between HI and global cognition, processing speed, selective and alternating attention. Significant differences were noted between MMSE and PTA and SRT (z-score 2.28, 3.33, p = 0.02, <0.01, respectively) between HA and non-HA users.

CONCLUSION

Male non-HA users displayed an association between HI and global and domain-specific (processing speed; selective and alternating attention) cognitive decline. Associations between global cognition and HI were significantly different between HA and non-HA users. This may be partially attributable to underlying subgroups sample sizes and statistical power disparity. If larger scale longitudinal or interventional studies confirm these findings, timely HI assessment and management may be the cornerstone for delaying cognitive decline.

Objective and Subjective Hearing Difficulties Are Associated With Lower Inhibitory Control

OBJECTIVE

Evidence suggests that hearing loss increases the risk of cognitive impairment. However, the relationship between hearing loss and cognition can vary considerably across studies, which may be partially explained by demographic and health factors that are not systematically accounted for in statistical models.

DESIGN

Middle-aged to older adult participants (N = 149) completed a web-based assessment that included speech-in-noise (SiN) and self-report measures of hearing, as well as auditory and visual cognitive interference (Stroop) tasks. Correlations between hearing and cognitive interference measures were performed with and without controlling for age, sex, education, depression, anxiety, and self-rated health.

RESULTS

The risk of having objective SiN difficulties differed between males and females. All demographic and health variables, except education, influenced the likelihood of reporting hearing difficulties. Small but significant relationships between objective and reported hearing difficulties and the measures of cognitive interference were observed when analyses were controlled for demographic and health factors. Furthermore, when stratifying analyses for males and females, different relationships between hearing and cognitive interference measures were found. Self-reported difficulty with spatial hearing and objective SiN performance were better predictors of inhibitory control in females, whereas self-reported difficulty with speech was a better predictor of inhibitory control in males. This suggests that inhibitory control is associated with different listening abilities in males and females.

CONCLUSIONS

The results highlight the importance of controlling for participant characteristics when assessing the relationship between hearing and cognitive interference, which may also be the case for other cognitive functions, but this requires further investigations. Furthermore, this study is the first to show that the relationship between hearing and cognitive interference can be captured using web-based tasks that are simple to implement and administer at home without any assistance, paving the way for future online screening tests assessing the effects of hearing loss on cognition.

Aging impairs primary task resumption and attentional control processes following interruptions

Attentional selection of working memory content is impaired after an interruption. Here we investigate the neural correlates underlying attentional selection within working memory. We focus especially on how older and younger adults differ in attentional selection processes during primary task resumption. Participants performed a working memory task, while being frequently interrupted with either a cognitively low- or high-demanding arithmetic task. Afterwards, a retrospective cue (retro-cue) indicated the working memory content required for later report. The detrimental effect of the interruption was evident in both age groups, but while younger adults were more strongly affected by a high- than by a low-demanding interruption, the performance deficit appeared independently of the cognitive requirements of the interruption task in older adults. A similar pattern was found regarding frontal-posterior connectivity in the theta frequency range, suggesting that aging decreases the ability to selectively maintain relevant information within working memory. The power of mid-frontal theta oscillations (~4-9Hz) featured a comparable effect of interruptions in both age groups. However, posterior alpha/beta power (~8-30Hz) following the retro-cue was more diminished by a preceding interruption in older adults. These results suggest an age-related deficit in the attentional selection and maintenance of primary task information following an interruption that appeared independent from the cognitive requirements of the interrupting task.

Differences in auditory associative memory between younger adults and older adults

Aging impairs visual associative memories. Up to date, little is known about whether aging impairs auditory associative memories. Using the head-related-transfer function to induce perceived spatial locations of auditory phonemes, this study used an audiospatial paired-associates-learning (PAL) paradigm to assess the auditory associative memory for phoneme-location pairs in both younger and older adults. Both aging groups completed the PAL task with various levels of difficulty, which were defined by the number of items to be remembered. The results showed that compared with younger participants' performance, older participants passed fewer stages and had lower capacity of auditory associative memory. For maintaining a single audiospatial pair, no significant behavioral differences between the two aging grous werefound. However, when multiple sound-location pairs were required to be remembered, older adults made more errors and demonstrated a lower working memory capacity than younger adults. Our study indicates aging impairs audiospatial associative learning and memory.