Multisensory integration is essential for the quick and accurate perception of our environment, particularly in everyday tasks like speech perception. Research has highlighted the importance of investigating bottom-up and top-down contributions to multisensory integration and how these change as a function of ageing. Specifically, perceptual factors like the temporal binding window and cognitive factors like attention and inhibition appear to be fundamental in the integration of visual and auditory information—integration that may become less efficient as we age. These factors have been linked to brain areas like the superior temporal sulcus, with neural oscillations in the alpha-band frequency also being implicated in multisensory processing. Age-related changes in multisensory integration may have significant consequences for the well-being of our increasingly ageing population, affecting their ability to communicate with others and safely move through their environment; it is crucial that the evidence surrounding this subject continues to be carefully investigated. This review will discuss research into age-related changes in the perceptual and cognitive mechanisms of multisensory integration and the impact that these changes have on speech perception and fall risk. The role of oscillatory alpha activity is of particular interest, as it may be key in the modulation of multisensory integration.

During multisensory integration, the time range within which visual and auditory information can be perceived as synchronous and bound together is known as the temporal binding window (TBW). With increasing age, the TBW becomes wider, such that older adults erroneously, and often dangerously, integrate sensory inputs that are asynchronous. Recent research suggests that attentional cues can narrow the width of the TBW in younger adults, sharpening temporal perception and increasing the accuracy of integration. However, due to their age-related declines in attentional control, it is not yet known whether older adults can deploy attentional resources to narrow the TBW in the same way as younger adults. This study investigated the age-related changes to the attentional modulation of the TBW. Thirty younger and 30 older adults completed a cued-spatial-attention version of the stream-bounce illusion, assessing the extent to which the visual and auditory stimuli were integrated when presented at three different stimulus-onset asynchronies, and when attending to a validly cued or invalidly cued location. A 2 × 2 × 3 mixed ANOVA revealed that when participants attended to the validly cued location (i.e., when attention was present), susceptibility to the stream-bounce illusion decreased. However, crucially, this attentional manipulation significantly affected audiovisual integration in younger adults, but not in older adults. These findings suggest that older adults have multisensory integration-related attentional deficits. Directions for future research and practical applications surrounding treatments to improve the safety of older adults’ perception and navigation through the environment are discussed.

Ageing is associated with increased multisensory integration and reduced attentional control during audiovisual processing, which can lead to inaccurate representations of dynamic environments and may contribute to fall risk in older adults. Alpha-band oscillatory activity (8-12 Hz), commonly interpreted as an index of inhibitory attentional control, is a plausible neural mechanism underlying age-related differences in multisensory attention. Here, we tested whether alterations in alpha oscillatory dynamics account for reduced attentional modulation of audiovisual integration in ageing, and whether these neural signatures relate to measures of fall risk. Thirty-six younger adults (18-35 years) and thirty-six older adults (60-80 years) completed a cued spatial-attention stream-bounce task assessing audiovisual integration at validly and invalidly cued locations, with stimulus-onset asynchronies of 0 ms and 300 ms. Concurrent EEG was recorded to quantify task-related alpha-band activity as a marker of inhibitory control. Balance and postural sway were assessed as indices of fall risk. Behaviourally, both age groups showed comparable attentional modulation of audiovisual integration. In contrast, electrophysiological data revealed age-related differences in neural control mechanisms: younger adults exhibited clear, cue-dependent modulation of alpha power, whereas older adults did not show such modulation. These findings demonstrate a dissociation between preserved behavioural performance and altered neural control mechanisms in ageing, highlighting the importance of neural measures for revealing age-related changes in attentional control that are not evident from behaviour alone. Together, these results implicate reduced flexibility of alpha-mediated inhibitory processes linking attentional control, multisensory processing, and balance in ageing.

The increased multisensory integration and weaker attentional control experienced by older adults during audiovisual processing can result in inaccurate perceptions of their dynamic, everyday environment. These inaccurate representations of our environment can contribute to increased fall risk in older adults. A neural correlate of the attentional difference between younger and older adults could be oscillatory alpha activity (8-12Hz), indexing inhibitory processes during multisensory integration. The current study investigated whether age-related changes in alpha activity underlie weaker attentional control in older adults during a multisensory task, and if alpha associates with fall risk. Thirty-six younger (18-35 years old) and thirty-six older (60-80 years old) adults completed a cued-spatial-attention stream-bounce task, assessing audiovisual integration when attending to validly-cued or invalidly-cued locations, at 0ms or 300ms stimulus-onset asynchronies. Oscillatory alpha activity was recorded throughout using EEG to index participants’ inhibitory abilities. Functional ability and balance were measured to index fall risk. Multiple linear regression models revealed that even when attending to the validly-cued location, less accurate multisensory integration was exhibited by older adults compared to younger adults, suggesting that older adults demonstrate weaker top-down modulation of multisensory integration through failing to inhibit task-irrelevant information. However, alpha power across the trials did not predict the extent of multisensory integration within the task. A significant interaction between age and functional ability scores predicted alpha power, suggesting that older adults may rely on attentional mechanisms for functional ability more than younger adults do. Potential implications in the design of clinical treatments to reduce falls are discussed.