Objectives: Previous research using non-invasive (magnetoencephalography, MEG) and invasive (electrocorticography, ECoG) neural recordings has demonstrated the progressive and hierarchical representation and processing of complex multi-talker auditory scenes in the auditory cortex. Early responses (85 ms) in higher-order non-primary areas selectively represent the attended talker with significantly higher fidelity than unattended talkers in NH and hearing–impaired (HI) listeners. Motivated by these findings, the objective of this study was to investigate the effect of a noise reduction scheme (NR) in a commercial hearing aid (HA) on the representation of complex multi-talker auditory scenes in distinct hierarchical stages of the auditory cortex by using high-density electroencephalography (EEG).Design: We addressed this issue by investigating early (85 ms) EEG responses recorded in 34 HI subjects fitted with HAs. The HA noise reduction (NR) was either on or off while the participants listened to a complex auditory scene. Participants were instructed to attend to one of two simultaneous talkers in the foreground while multi-talker babble noise played in the background (+3 dB SNR). After each trial, a two-choice question about the content of the attended speech was presented.Results: Using a stimulus reconstruction approach, our results suggest that the attention-related enhancement of neural representations of target and masker talkers located in the foreground, as well as suppression of the background noise in distinct hierarchical stages is significantly affected by the NR scheme. We found that the NR scheme contributed to the enhancement of the foreground and of the entire acoustic scene in the early responses, and that this enhancement was driven by better representation of the target speech. We found that the target talker in HI listeners was selectively represented in late responses. We found that use of the NR scheme resulted in enhanced representations of the target and masker speech in the foreground and a suppressed representation of the noise in the background in late responses. We found a significant effect of EEG time window on the strengths of the cortical representation of the target and masker.Conclusion: Together, our analyses of the early and late responses obtained from HI listeners support the existing view of hierarchical processing in the auditory cortex. Our findings demonstrate the benefits of a NR scheme on the representation of complex multi-talker auditory scenes in different areas of the auditory cortex in HI listeners.

Objective: The aim of this study was to examine how background noise and hearing aid experience affect the robust relationship between working memory and speech recognition. Design: Matrix sentences were used to measure speech recognition in noise. Three measures of working memory were administered. Study sample: 148 participants with at least 2 years of hearing aid experience. Results: A stronger overall correlation between working memory and speech recognition performance was found in a four-talker babble than in a stationary noise background. This correlation was significantly weaker in participants with most hearing aid experience than those with least experience when background noise was stationary. In the four-talker babble, however, no significant difference was found between the strength of correlations between users with different experience. Conclusion: In general, more explicit processing of working memory is invoked when listening in a multi-talker babble. The matching processes (cf. Ease of Language Understanding model, ELU) were more efficient for experienced than for less experienced users when perceiving speech. This study extends the existing ELU model that mismatch may also lead to the establishment of new phonological representations in the long-term memory.

Objective:In the present study, we investigated whether varying the task difficulty of the Sentence-Final Word Identification and Recall (SWIR) Test has an effect on the benefit of noise reduction, as well as whether task difficulty predictability affects recall. The relationship between working memory and recall was examined. Design:Task difficulty was manipulated by varying the list length with noise reduction on and off in competing speech and speech-shaped noise. Half of the participants were informed about list length in advance. Working memory capacity was measured using the Reading Span. Study sample:Thirty-two experienced hearing aid users with moderate sensorineural hearing loss. Results:Task difficulty did not affect the noise reduction benefit and task difficulty predictability did not affect recall. Participants may have employed a different recall strategy when task difficulty was unpredictable and noise reduction off. Reading Span scores positively correlated with the SWIR test. Noise reduction improved recall in competing speech. Conclusions:The SWIR test with varying list length is suitable for detecting the benefit of noise reduction. The correlation with working memory suggests that the SWIR test could be modified to be adaptive to individual cognitive capacity. The results on noise and noise reduction replicate previous findings.

Background: Age-related hearing loss affects a significant portion of older adults and is associated not only with communication difficulties but also with mobility impairments, including reduced walking ability. Prior research suggests that auditory cues contribute to stable and efficient walking, and hearing loss might increase reliance on cognitive resources, such as working memory, to regulate gait. However, it remains unclear whether individuals with hearing loss using hearing aids rely more heavily on visuospatial working memory to support gait performance than their normal-hearing peers. The present study aimed to investigate whether visuospatial working memory predicts gait performance in older adults and whether this relationship differs between individuals with hearing loss using hearing aids and age-matched normal-hearing controls. Methods: Data were drawn from the second wave of the longitudinal N200 study. A total of 190 adults, of which 104 with hearing loss using hearing aids and 86 with normal hearing, completed a visuospatial working memory task and the 2-minute walking test. Hierarchical robust regression analyses were conducted, controlling for age and sex, to examine the independent and interactive effects of hearing status and visuospatial working memory on walking speed. Results: Visuospatial working memory and hearing status were both significant predictors of walking speed, independent of age and sex. Better visuospatial working memory was associated with faster walking, and hearing aid users walked more slowly than normal-hearing participants, despite using their hearing devices during testing. The interaction between hearing status and visuospatial working memory did not reach statistical significance. Conclusions: Visuospatial working memory and hearing status independently contribute to gait performance in older adults. These findings underscore the importance of considering both sensory and cognitive factors in assessing mobility and fall risk in older adults with hearing loss.

Objectives: This data-driven study aimed to explore the characteristics and initial hearing aid (HA) fitting parameters among older adults in Mainland China. Methods: Data were extracted from Oticon’s internal database, focusing on 82,834 older adults aged 55 or above who sought HAs for the first time. Results: Demographic details (e.g., age and gender), hearing-related data (e.g., the severity of hearing loss), and HA parameters (i.e., laterality of fitting, HA style, earpieces, gain settings, directionality settings, and noise reduction settings) were analyzed. The mean age was 71. There were more males (54.7%) than females, and the majority (78.1%) had at least moderately severe hearing loss. Bilateral fittings were common (76.6%), with receiver-in-canal (RIC) HAs being the dominant style (80%) and open fittings prevalent (44.1%). HA gain was set to below prescribed targets, along with adaptive directionality (93.4%) and low noise reduction levels (>68%). Conclusions: These findings offer insights into the Chinese hearing healthcare market. Future research should incorporate data from follow-up sessions to provide a more comprehensive understanding of the landscape, such as adjustments needed after initial fitting after first-time users have spent some time adapting to the use of HAs.

Background: Age-related hearing loss increasingly affects older adults, especially in noisy social situations where speech understanding is most challenging. These difficulties contribute to reduced social participation, loneliness, and poorer quality of life. Many older adults use hearing aids but abandon them, reporting limited benefit – suggesting that peripheral hearing thresholds alone do not capture the full extent of their communication problems. This study examines whether a combination of hearing assessments can predict cognitive performance across several domains and whether neural factors contribute to inter individual differences in hearing in noise.Methods: We assessed 51 healthy aging males from a longitudinal birth cohort extensively evaluated with cognitive testing and MRI across the lifespan. At ages 70 and 71 (recruited in 2024), participants completed pure-tone audiometry (PTA), audible contrast threshold (ACT), speech-in-noise tests (HINT), cognitive assessments, and structural MRI scans. All participants had a prior visit at age 63 ± 1 years (recruited in 2015–2018) with the same cognitive test battery. Previously, AI models were used to identify cognitive decline, and participants were clustered into four cognitive trajectories. These predefined clusters were used to examine whether hearing measures (4PTA, ACT, HINT) predicted cognitive outcomes and brain volume.Findings: The combination of PTA and HINT was the strongest predictor of cognitive decline (p = 0.022). An XGBoost model with SHapley Additive exPlanations (SHAP) values identified temporal lobe volume as key MRI feature influencing ACT whereas cerebellum and fourth ventricle were key features influencing HINT. Interpretation: These findings highlight complex hearing–cognition–brain interactions and support integrating diverse auditory measures into cognitive aging research.