Background/Objectives: Vulnerability to sound distraction is commonly reported in older adults with dementia and tends to be associated with adverse impacts on daily activity. However, study outcome heterogeneity is increasingly evident, with preserved resistance to distraction also evident. Contributory factors may include individual differences in distractibility in older adulthood per se, and failure to consider the influence of how difficult a person found the test. Methods: We therefore measured distractibility in a group of older adults by comparing the performance of a primary visual task (Swansea Test of Attentional Control), which includes an adaptive algorithm to take into account how difficult a person finds the test under both no-sound and sound conditions. Results: Analysis revealed no significant difference in group mean performance between no-sound versus sound conditions [t (33) = 0.181, p = 0.858; Cohen’s effect size d = −0.028], but individual differences in performance both within and between sound and no-sound conditions were evident, indicating that for older adults, distracting sounds can be neutral, detrimental, or advantageous with respect to visual task performance. It was not possible to determine individual thresholds for whether sound versus no-sound conditions affected a person’s actual behaviour. Conclusions: Nevertheless, our findings indicate how variable such effects may be in older adults, which in turn may help to explain outcome heterogeneity in studies including people living with dementia. Furthermore, such within-group heterogeneity highlights the importance of considering a person’s individual performance in order to better understand their behaviour and initiate interventions as required.

The world guidelines for fall prevention outline that 30% of older adults has a fall each year, with half this figure continuing to have more frequent and life changing falls. The impact of falls can lead to increased risk of injury, fractures, pain, prolonged immobility and a difficulty or inability to be independent. The overarching aim of this research is to increase our knowledge of why some older adults may be at higher risk of abnormal gait and risk of falls than others. The main hypothesis running through this set of studies and thesis, is that some older adults experience degradation in their ability to resist attentional capture from highly salient but irrelevant environmental sounds, resulting in the shift of attention and thus processing resources, away from walking and gait maintenance, thus reducing their integrity and raising risk of falls. This thesis will present the outcome of three research projects (i) confrontation naming of sounds. Older adults were required to rate their perceptions of environmental sounds based on distractibility and pleasantness. Moreover, older adults were asked to categorise the environmental sounds heard. (ii) Influence of environmental sounds on attention control. Older adults took part in a computer-based attention control task to understand the degree to which environmental sounds influenced performance. (iii) Influence on environmental sounds on gait. A walking study will be presented outlining how gait is altered when listening to environmental sounds. Moreover, to gain a full understanding of how individual difference influences gait, measures were taken for balance, hearing acuity, cognitive ability (MOCA), and polypharmacy. Measures will be presented for gait perturbation and the types of environmental sounds altering gait patterns. Results indicate environmental sounds can induce a startle like affect that influence how participants felt they performed. Moreover, environmental sound we capable of inducing gait perturbation in older adults.

The first sections cover the basic anatomy of the auditory system. This is followed by information on how auditory function is measured and what kinds of dysfunction can occur in this system. The general impact of auditory function upon a wide range of everyday functions is then discussed. This is followed by sections on living with hearing loss, dementia and cognitive impairment (with specific sections on several aetiologies of dementia). <!----> <!----> <!----> <!---->