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Hearing Disorders: HELP
Articles by Margaret Kathleen Pichora-Fuller
Based on 20 articles published since 2010
(Why 20 articles?)
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Between 2010 and 2020, M. Kathleen Pichora-Fuller wrote the following 20 articles about Hearing Disorders.
 
+ Citations + Abstracts
1 Editorial Eriksholm Workshop on Hearing Impairment and Cognitive Energy. 2016

Pichora-Fuller, M Kathleen / Kramer, Sophia E. ·Department of Psychology, University of Toronto, Mississauga, Ontario, Canada, k.pichora.fuller@utoronto.ca Department of Otolaryngology-Head and Neck Surgery, Ear and Hearing Section and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. ·Ear Hear · Pubmed #27355766.

ABSTRACT: -- No abstract --

2 Review Hearing, self-motion perception, mobility, and aging. 2018

Campos, Jennifer / Ramkhalawansingh, Robert / Pichora-Fuller, M Kathleen. ·Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada; Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. Electronic address: Jennifer.Campos@uhn.ca. · Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada; Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON, M5G 2A2, Canada. · Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON, M5S 3G3, Canada. ·Hear Res · Pubmed #29661612.

ABSTRACT: Hearing helps us know where we are relative to important events and objects in our environment and it allows us to track our changing position dynamically over space and time. Auditory cues are used in combination with other sensory inputs (visual, vestibular, proprioceptive) to help us perceive our own movements through space, known as self-motion perception. Whether we are maintaining standing balance, walking, or driving, audition can provide unique and important information to help optimize self-motion perception, and consequently to support safe mobility. Recent epidemiological and experimental studies have provided evidence that hearing loss is associated with greater walking difficulties, poorer overall physical functioning, and a significantly increased risk of falling in older adults. Importantly, the mechanisms underlying the associations between hearing status and mobility are poorly understood. It is also critical to consider that age-related hearing loss is often concomitant with declines in other sensory, motor, and cognitive functions and that these declines may interact, particularly during realistic, everyday tasks. Overall, exploring the role of auditory cues and the effects of hearing loss on self-motion perception specifically, and mobility more generally, are important to both building fundamental knowledge about the perceptual processes underlying the ability to perceive our movements through space, as well as to optimizing mobility-related interventions for those with hearing loss so that they can function better when confronted by everyday, real-world, sensory-motor challenges. The goal of this paper is to explore the role of hearing in self-motion perception across a range of mobility-related behaviors. First, we briefly review the ways in which auditory cues are used to perceive self-motion and how sound inputs affect behaviors such as standing balance, walking, and driving. Next, we consider age-related changes in auditory self-motion perception and the potential consequences to performance on mobility-related tasks. We then describe how hearing loss is associated with declines in mobility-related abilities and increased adverse outcomes such as falls. We describe age-related changes to other sensory and cognitive functions and how these may interact with hearing loss in ways that affect mobility. Finally, we briefly consider the implications of the hearing-mobility associations with respect to applied domains such as screening for mobility problems and falls risk in those with hearing loss and developing interventions and training approaches targeting safe and independent mobility throughout the lifespan.

3 Review Speech comprehension training and auditory and cognitive processing in older adults. 2012

Pichora-Fuller, M Kathleen / Levitt, Harry. ·University of Toronto, Mississauga, Ontario, Canada. k.pichora.fuller@utoronto.ca ·Am J Audiol · Pubmed #23233521.

ABSTRACT: PURPOSE: To provide a brief history of speech comprehension training systems and an overview of research on auditory and cognitive aging as background to recommendations for future directions for rehabilitation. METHOD: Two distinct domains were reviewed: one concerning technological and the other concerning psychological aspects of training. Historical trends and advances in these 2 domains were interrelated to highlight converging trends and directions for future practice. RESULTS: Over the last century, technological advances have influenced both the design of hearing aids and training systems. Initially, training focused on children and those with severe loss for whom amplification was insufficient. Now the focus has shifted to older adults with relatively little loss but difficulties listening in noise. Evidence of brain plasticity from auditory and cognitive neuroscience provides new insights into how to facilitate perceptual (re-)learning by older adults. CONCLUSIONS: There is a new imperative to complement training to increase bottom-up processing of the signal with more ecologically valid training to boost top-down information processing based on knowledge of language and the world. Advances in digital technologies enable the development of increasingly sophisticated training systems incorporating complex meaningful materials such as music, audiovisual interactive displays, and conversation.

4 Article Detection of vision and /or hearing loss using the interRAI Community Health Assessment aligns well with common behavioral vision/hearing measurements. 2019

Urqueta Alfaro, Andrea / Guthrie, Dawn M / Phillips, Natalie A / Pichora-Fuller, M Kathleen / Mick, Paul / McGraw, Cathy / Wittich, Walter. ·School of Optometry, University of Montréal, Montréal, Quebec, Canada. · Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Quebec, Canada. · Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada. · Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada. · Department of Psychology, Concordia University, Montréal, Quebec, Canada. · Department of Psychology, University of Toronto, Mississauga, Ontario, Canada. · Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. · CRIR/Lethbridge-Layton-Mackay Rehabilitation Centre of West-Central Montreal,Montréal, Quebec, Canada. · CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montréal, Quebec, Canada. ·PLoS One · Pubmed #31581243.

ABSTRACT: This study's main objective was to assess the sensitivity and specificity of the interRAI Community Health Assessment (CHA) for detecting the presence of vision loss (VL), hearing loss (HL) or both (Dual Sensory Loss, DSL) when compared against performance-based measures of vision and hearing. The interRAI CHA and the Montreal Cognitive Assessment (MoCA) were administered to 200 adults (61+ years of age) who had VL, HL or DSL. We calculated the sensitivity and specificity of the interRAI CHA for detecting sensory impairments using as the gold standard performance based measurements of hearing (pure-tone audiogram) and vision (distance acuity) as determined from the rehabilitation centre record. Results were divided according to participants' cognitive status, as measured by the MoCA and the Cognitive Performance Scale (CPS, embedded within the interRAI CHA). Overall, sensitivity was 100% for VL, 97.1% for HL, and 96.9% for DSL. Specificity was at least 93% in all three groups. In participants who failed the MoCA (i.e., at risk of mild cognitive impairment), the sensitivity was 100% for VL, 96.8% for HL and 96.2% for DSL; in those who were not at risk, the sensitivity was 100% for VL, and 97.4% for HL and DSL. In participants classified by the CPS as borderline intact or mild cognitively impaired, sensitivity was 100% in all groups; in those classified as cognitively intact, sensitivity was 100% for VL, 97.0% for HL, and 96.8% for DSL. These results suggest that the interRAI CHA detects VL, HL, and DSL in high agreement with performance-based measurements of vision and hearing. The interRAI CHA shows high accuracy even in participants with mild cognitive difficulties. Since results were found in a specific population of older rehabilitation clients who all had sensory difficulties, further research is needed to understand its role in screening in other more diverse groups.

5 Article Hearing Aids Benefit Recognition of Words in Emotional Speech but Not Emotion Identification. 2018

Goy, Huiwen / Pichora-Fuller, M Kathleen / Singh, Gurjit / Russo, Frank A. ·1 Ryerson University, Toronto, Ontario, Canada. · 2 University of Toronto, Toronto, Ontario, Canada. · 3 Phonak AG, Stäfa, Switzerland. · 4 Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada. · 5 Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada. ·Trends Hear · Pubmed #30249171.

ABSTRACT: Vocal emotion perception is an important part of speech communication and social interaction. Although older adults with normal audiograms are known to be less accurate at identifying vocal emotion compared to younger adults, little is known about how older adults with hearing loss perceive vocal emotion or whether hearing aids improve the perception of emotional speech. In the main experiment, older hearing aid users were presented with sentences spoken in seven emotion conditions, with and without their own hearing aids. Listeners reported the words that they heard as well as the emotion portrayed in each sentence. The use of hearing aids improved word-recognition accuracy in quiet from 38.1% (unaided) to 65.1% (aided) but did not significantly change emotion-identification accuracy (36.0% unaided, 41.8% aided). In a follow-up experiment, normal-hearing young listeners were tested on the same stimuli. Normal-hearing younger listeners and older listeners with hearing loss showed similar patterns in how emotion affected word-recognition performance but different patterns in how emotion affected emotion-identification performance. In contrast to the present findings, previous studies did not find age-related differences between younger and older normal-hearing listeners in how emotion affected emotion-identification performance. These findings suggest that there are changes to emotion identification caused by hearing loss that are beyond those that can be attributed to normal aging, and that hearing aids do not compensate for these changes.

6 Article Combined impairments in vision, hearing and cognition are associated with greater levels of functional and communication difficulties than cognitive impairment alone: Analysis of interRAI data for home care and long-term care recipients in Ontario. 2018

Guthrie, Dawn M / Davidson, Jacob G S / Williams, Nicole / Campos, Jennifer / Hunter, Kathleen / Mick, Paul / Orange, Joseph B / Pichora-Fuller, M Kathleen / Phillips, Natalie A / Savundranayagam, Marie Y / Wittich, Walter. ·Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada. · Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada. · Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada. · Department of Psychology, University of Toronto, Toronto, Ontario, Canada. · Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. · Faculty of Medicine/Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada. · Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · School of Communication Sciences and Disorders, Western University, London, Ontario, Canada. · Department of Psychology, University of Toronto, Mississauga, Ontario, Canada. · Department of Psychology, Concordia University, Montreal, Quebec, Canada. · School of Health Studies, Western University, London, Ontario, Canada. · School of Optometry, University of Montreal, Montreal, Quebec, Canada. · CRIR/MAB-Mckay Rehabilitation Centre of West-Central Montreal Health, Montreal, Quebec, Canada. · CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montreal, Quebec, Canada. ·PLoS One · Pubmed #29447253.

ABSTRACT: OBJECTIVES: The objective of the current study was to understand the added effects of having a sensory impairment (vision and/or hearing impairment) in combination with cognitive impairment with respect to health-related outcomes among older adults (65+ years old) receiving home care or residing in a long-term care (LTC) facility in Ontario, Canada. METHODS: Cross-sectional analyses were conducted using existing data collected with one of two interRAI assessments, one for home care (n = 291,824) and one for LTC (n = 110,578). Items in the assessments were used to identify clients with single sensory impairments (e.g., vision only [VI], hearing only [HI]), dual sensory impairment (DSI; i.e., vision and hearing) and those with cognitive impairment (CI). We defined seven mutually exclusive groups based on the presence of single or combined impairments. RESULTS: The rate of people having all three impairments (i.e., CI+DSI) was 21.3% in home care and 29.2% in LTC. Across the seven groups, individuals with all three impairments were the most likely to report loneliness, to have a reduction in social engagement, and to experience reduced independence in their activities of daily living (ADLs) and instrumental ADLs (IADLs). Communication challenges were highly prevalent in this group, at 38.0% in home care and 49.2% in LTC. In both care settings, communication difficulties were more common in the CI+DSI group versus the CI-alone group. CONCLUSIONS: The presence of combined sensory and cognitive impairments is high among older adults in these two care settings and having all three impairments is associated with higher rates of negative outcomes than the rates for those having CI alone. There is a rising imperative for all health care professionals to recognize the potential presence of hearing, vision and cognitive impairments in those for whom they provide care, to ensure that basic screening occurs and to use those results to inform care plans.

7 Article Hearing Difficulty Is Associated With Injuries Requiring Medical Care. 2018

Mick, Paul / Foley, Danielle / Lin, Frank / Pichora-Fuller, M Kathleen. ·Division of Otolaryngology, Department of Surgery, University of British Columbia, Kelowna, British Columbia, Canada. · Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. · Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. · Department of Psychology, University of Toronto, Mississauga, Ontario, Canada. ·Ear Hear · Pubmed #29309398.

ABSTRACT: OBJECTIVE: Injuries are responsible for 11% of global disability-adjusted life years. Hearing difficulty may be a modifiable risk factor for injury. The primary aim was to determine whether subjective hearing difficulty is associated with increased incidence of injuries (all-type, workplace, and nonworkplace) serious enough to require health care among Americans aged 18 years and older. The secondary aim was to determine whether hearing difficulty is associated with increased use of health care for injuries. DESIGN: The analysis was performed using data from the 1999 to 2012 Medical Expenditure Panel Surveys-Household Component (MEPS-HC). Multivariable estimates are generalizable to the American noninstitutionalized adult population in 2006. Hearing difficulty was determined by computer-assisted personal interview. The primary outcome was number of separate injuries requiring health care (emergency department visits, hospital inpatient admissions, or medical office visits) during the follow-up period. Crude injury incidence rates were calculated with 95% confidence intervals (CIs). Multivariable negative binomial regression was performed to determine the relative incidence rate of injuries among the group reporting hearing difficulties relative to the group reporting no difficulty in hearing, adjusting for relevant confounders. Variance estimates were adjusted to take into account the complex sample design. Results were stratified by sex. RESULTS: Of the 121,453 participants in MEPS-HC panels 6-16, 107,352 (88.4%) had complete data and were included in the analysis. The average follow-up was 1.27 years. Seven thousand six hundred and twenty-four participants (7.1%) reported hearing difficulty at baseline. During the follow-up period, 10,727 participants (10.0%) had one or more injuries. In multivariable analyses, hearing difficulty was significantly associated with increased incidence of all-type (males: incidence rate ratio [IRR] 1.31, 95% CI 1.18-1.45, p value < 0.001; females: IRR 1.21, 95% CI 1.07-1.36, p value < 0.001), workplace (males: IRR 1.42, 95% CI 1.16-1.75, p value 0.001; females: IRR 1.61, 95% CI 1.12-2.31, p value 0.010), and nonworkplace injuries (males: IRR 1.24, 95% CI 1.09-1.42, p value 0.001; females: IRR 1.17, 95% CI, 1.02-1.34, p value 0.023). In multivariable analyses, hearing difficulty was associated with increased incidence of emergency department use in males (IRR 1.36, 95% CI 1.13-1.62, p value 0.001) and medical office visits in females (IRR 1.52, 95% CI 1.12-2.05, p value 0.007). CONCLUSIONS: The study results suggest the need to investigate the mechanisms underlying the measured associations so that efforts may be directed toward reducing the risk of injury for individuals with hearing difficulties.

8 Article Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users, the n200 study. 2016

Rönnberg, Jerker / Lunner, Thomas / Ng, Elaine Hoi Ning / Lidestam, Björn / Zekveld, Adriana Agatha / Sörqvist, Patrik / Lyxell, Björn / Träff, Ulf / Yumba, Wycliffe / Classon, Elisabet / Hällgren, Mathias / Larsby, Birgitta / Signoret, Carine / Pichora-Fuller, M Kathleen / Rudner, Mary / Danielsson, Henrik / Stenfelt, Stefan. ·a Department of Behavioural Sciences and Learning , Linköping University , Linköping , Sweden . · b Linnaeus Centre HEAD , Swedish Institute for Disability Research, Linköping University , Linköping , Sweden . · c Department of Clinical and Experimental Medicine , Linköping University , Linköping , Sweden . · d Eriksholm Research Centre , Oticon A/S, Rørtangvej 20, 3070 Snekkersten , Denmark . · e Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute, VU University Medical Center , Amsterdam , The Netherlands . · f Department of Building, Energy and Environmental Engineering , University of Gävle , Gävle , Sweden . · g Department of Psychology , University of Toronto , Toronto , Ontario , Canada . · h The Toronto Rehabilitation Institute, University Health Network , Toronto , Ontario , Canada , and. · i The Rotman Research Institute, Baycrest Hospital , Toronto , Ontario , Canada. ·Int J Audiol · Pubmed #27589015.

ABSTRACT: OBJECTIVE: The aims of the current n200 study were to assess the structural relations between three classes of test variables (i.e. HEARING, COGNITION and aided speech-in-noise OUTCOMES) and to describe the theoretical implications of these relations for the Ease of Language Understanding (ELU) model. STUDY SAMPLE: Participants were 200 hard-of-hearing hearing-aid users, with a mean age of 60.8 years. Forty-three percent were females and the mean hearing threshold in the better ear was 37.4 dB HL. DESIGN: LEVEL1 factor analyses extracted one factor per test and/or cognitive function based on a priori conceptualizations. The more abstract LEVEL 2 factor analyses were performed separately for the three classes of test variables. RESULTS: The HEARING test variables resulted in two LEVEL 2 factors, which we labelled SENSITIVITY and TEMPORAL FINE STRUCTURE; the COGNITIVE variables in one COGNITION factor only, and OUTCOMES in two factors, NO CONTEXT and CONTEXT. COGNITION predicted the NO CONTEXT factor to a stronger extent than the CONTEXT outcome factor. TEMPORAL FINE STRUCTURE and SENSITIVITY were associated with COGNITION and all three contributed significantly and independently to especially the NO CONTEXT outcome scores (R(2) = 0.40). CONCLUSIONS: All LEVEL 2 factors are important theoretically as well as for clinical assessment.

9 Article Development of the Word Auditory Recognition and Recall Measure: A Working Memory Test for Use in Rehabilitative Audiology. 2016

Smith, Sherri L / Pichora-Fuller, M Kathleen / Alexander, Genevieve. ·1Audiologic Rehabilitation Laboratory, Auditory Vestibular Research Enhancement Award Program, Veterans Affairs Medical Center, Mountain Home, Tennessee, USA; 2Department of Audiology and Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee, USA; 3Department of Psychology, University of Toronto, Mississauga, Ontario, Canada; 4Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; 5Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada; and 6Linneaus Centre HEAD, Linköping University, Sweden. ·Ear Hear · Pubmed #27438869.

ABSTRACT: OBJECTIVES: The purpose of this study was to develop the Word Auditory Recognition and Recall Measure (WARRM) and to conduct the inaugural evaluation of the performance of younger adults with normal hearing, older adults with normal to near-normal hearing, and older adults with pure-tone hearing loss on the WARRM. DESIGN: The WARRM is a new test designed for concurrently assessing word recognition and auditory working memory performance in adults who may have pure-tone hearing loss. The test consists of 100 monosyllabic words based on widely used speech-recognition test materials. The 100 words are presented in recall set sizes of 2, 3, 4, 5, and 6 items, with 5 trials in each set size. The WARRM yields a word-recognition score and a recall score. The WARRM was administered to all participants in three listener groups under two processing conditions in a mixed model (between-subjects, repeated measures) design. The between-subjects factor was group, with 48 younger listeners with normal audiometric thresholds (younger listeners with normal hearing [YNH]), 48 older listeners with normal thresholds through 3000 Hz (older listeners with normal hearing [ONH]), and 48 older listeners with sensorineural hearing loss (older listeners with hearing loss [OHL]). The within-subjects factor was WARRM processing condition (no additional task or with an alphabet judgment task). The associations between results on the WARRM test and results on a battery of other auditory and memory measures were examined. RESULTS: Word-recognition performance on the WARRM was not affected by processing condition or set size and was near ceiling for the YNH and ONH listeners (99 and 98%, respectively) with both groups performing significantly better than the OHL listeners (83%). The recall results were significantly better for the YNH, ONH, and OHL groups with no processing (93, 84, and 75%, respectively) than with the alphabet processing (86, 77, and 70%). In both processing conditions, recall was best for YNH, followed by ONH, and worst for OHL listeners. WARRM recall scores were significantly correlated with other memory measures. In addition, WARRM recall scores were correlated with results on the Words-In-Noise (WIN) test for the OHL listeners in the no processing condition and for ONH listeners in the alphabet processing condition. Differences in the WIN and recall scores of these groups are consistent with the interpretation that the OHL listeners found listening to be sufficiently demanding to affect recall even in the no processing condition, whereas the ONH group listeners did not find it so demanding until the additional alphabet processing task was added. CONCLUSIONS: These findings demonstrate the feasibility of incorporating an auditory memory test into a word-recognition test to obtain measures of both word recognition and working memory simultaneously. The correlation of WARRM recall with scores from other memory measures is evidence of construct validity. The observation of correlations between the WIN thresholds with each of the older groups and recall scores in certain processing conditions suggests that recall depends on listeners' word-recognition abilities in noise in combination with the processing demands of the task. The recall score provides additional information beyond the pure-tone audiogram and word-recognition scores that may help rehabilitative audiologists assess the listening abilities of patients with hearing loss.

10 Article Effects of Hearing Loss on Dual-Task Performance in an Audiovisual Virtual Reality Simulation of Listening While Walking. 2016

Lau, Sin Tung / Pichora-Fuller, M Kathleen / Li, Karen Z H / Singh, Gurjit / Campos, Jennifer L. ·Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. · Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada. · Department of Psychology, University of Toronto, Toronto, ON, Canada. · Centre de Recherche en Développement Humain, Montreal, QC, Canada. · Department of Psychology, Concordia University, Montreal, QC, Canada. · Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada. · Phonak Canada Ltd., Mississauga, ON, Canada. ·J Am Acad Audiol · Pubmed #27406663.

ABSTRACT: BACKGROUND: Most activities of daily living require the dynamic integration of sights, sounds, and movements as people navigate complex environments. Nevertheless, little is known about the effects of hearing loss (HL) or hearing aid (HA) use on listening during multitasking challenges. PURPOSE: The objective of the current study was to investigate the effect of age-related hearing loss (ARHL) on word recognition accuracy in a dual-task experiment. Virtual reality (VR) technologies in a specialized laboratory (Challenging Environment Assessment Laboratory) were used to produce a controlled and safe simulated environment for listening while walking. RESEARCH DESIGN: In a simulation of a downtown street intersection, participants completed two single-task conditions, listening-only (standing stationary) and walking-only (walking on a treadmill to cross the simulated intersection with no speech presented), and a dual-task condition (listening while walking). For the listening task, they were required to recognize words spoken by a target talker when there was a competing talker. For some blocks of trials, the target talker was always located at 0° azimuth (100% probability condition); for other blocks, the target talker was more likely (60% of trials) to be located at the center (0° azimuth) and less likely (40% of trials) to be located at the left (270° azimuth). STUDY SAMPLE: The participants were eight older adults with bilateral HL (mean age = 73.3 yr, standard deviation [SD] = 8.4; three males) who wore their own HAs during testing and eight controls with normal hearing (NH) thresholds (mean age = 69.9 yr, SD = 5.4; two males). No participant had clinically significant visual, cognitive, or mobility impairments. DATA COLLECTION AND ANALYSIS: Word recognition accuracy and kinematic parameters (head and trunk angles, step width and length, stride time, cadence) were analyzed using mixed factorial analysis of variances with group as a between-subjects factor. Task condition (single versus dual) and probability (100% versus 60%) were within-subject factors. In analyses of the 60% listening condition, spatial expectation (likely versus unlikely) was a within-subject factor. Differences between groups in age and baseline measures of hearing, mobility, and cognition were tested using t tests. RESULTS: The NH group had significantly better word recognition accuracy than the HL group. Both groups performed better when the probability was higher and the target location more likely. For word recognition, dual-task costs for the HL group did not depend on condition, whereas the NH group demonstrated a surprising dual-task benefit in conditions with lower probability or spatial expectation. For the kinematic parameters, both groups demonstrated a more upright and less variable head position and more variable trunk position during dual-task conditions compared to the walking-only condition, suggesting that safe walking was prioritized. The HL group demonstrated more overall stride time variability than the NH group. CONCLUSIONS: This study provides new knowledge about the effects of ARHL, HA use, and aging on word recognition when individuals also perform a mobility-related task that is typically experienced in everyday life. This research may help inform the development of more effective function-based approaches to assessment and intervention for people who are hard-of-hearing.

11 Article Hearing Impairment and Cognitive Energy: The Framework for Understanding Effortful Listening (FUEL). 2016

Pichora-Fuller, M Kathleen / Kramer, Sophia E / Eckert, Mark A / Edwards, Brent / Hornsby, Benjamin W Y / Humes, Larry E / Lemke, Ulrike / Lunner, Thomas / Matthen, Mohan / Mackersie, Carol L / Naylor, Graham / Phillips, Natalie A / Richter, Michael / Rudner, Mary / Sommers, Mitchell S / Tremblay, Kelly L / Wingfield, Arthur. ·1Department of Psychology, University of Toronto, Mississauga, Ontario, Canada; 2Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; 3Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA; 4EarLens Corporation, Menlo Park, California, USA; 5Department of Hearing & Speech Sciences, Vanderbilt Bill Wilkerson Center, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; 6Department of Speech & Hearing Sciences, Indiana University, Bloomington, Indiana, USA; 7Phonak AG, Science & Technology, Cognitive & Ecological Audiology; Stäfa, Switzerland; 8Linnaeus Centre HEAD, Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; 9Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark; 10Department of Philosophy, University of Toronto, Toronto, Ontario, Canada; 11School of Speech, Language and Hearing Sciences, San Diego State University, San Diego, California, USA; 12MRC/CSO Institute of Hearing Research, Scottish Section, Glasgow, United Kingdom; 13Department of Psychology, Concordia University, Montreal, Quebec, Canada; 14School of Natural Sciences, Liverpool John Moores University, Liverpool, United Kingdom; 15Department of Psychology, Washington University, St. Louis, Missouri, USA; 16Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA; and 17Department of Psychology and Volen National Center for Complex Systems, Brandeis University, Waltham, Massachusetts, USA. ·Ear Hear · Pubmed #27355771.

ABSTRACT: The Fifth Eriksholm Workshop on "Hearing Impairment and Cognitive Energy" was convened to develop a consensus among interdisciplinary experts about what is known on the topic, gaps in knowledge, the use of terminology, priorities for future research, and implications for practice. The general term cognitive energy was chosen to facilitate the broadest possible discussion of the topic. It goes back to who described the effects of attention on perception; he used the term psychic energy for the notion that limited mental resources can be flexibly allocated among perceptual and mental activities. The workshop focused on three main areas: (1) theories, models, concepts, definitions, and frameworks; (2) methods and measures; and (3) knowledge translation. We defined effort as the deliberate allocation of mental resources to overcome obstacles in goal pursuit when carrying out a task, with listening effort applying more specifically when tasks involve listening. We adapted Kahneman's seminal (1973) Capacity Model of Attention to listening and proposed a heuristically useful Framework for Understanding Effortful Listening (FUEL). Our FUEL incorporates the well-known relationship between cognitive demand and the supply of cognitive capacity that is the foundation of cognitive theories of attention. Our FUEL also incorporates a motivation dimension based on complementary theories of motivational intensity, adaptive gain control, and optimal performance, fatigue, and pleasure. Using a three-dimensional illustration, we highlight how listening effort depends not only on hearing difficulties and task demands but also on the listener's motivation to expend mental effort in the challenging situations of everyday life.

12 Article Noise Affects Performance on the Montreal Cognitive Assessment. 2016

Dupuis, Kate / Marchuk, Veronica / Pichora-Fuller, M Kathleen. ·Department of Psychology,University of Toronto. ·Can J Aging · Pubmed #27345572.

ABSTRACT: We investigated the effect of background noise on performance on the Montreal Cognitive Assessment (MoCA). Two groups of older adults (one with clinically normal hearing, one with hearing loss) and a younger adult group with clinically normal hearing were administered two versions of the MoCA under headphones in low and high levels of background noise. Intensity levels used to present the test were customized based on the hearing abilities of participants with hearing loss to yield a uniform level of difficulty across listeners in the high-level noise condition. Both older groups had poorer MoCA scores in noise than the younger group. Importantly, all participants had poorer MoCA scores in the high-noise (M = 22.7/30) compared to the low-noise condition (M = 25.7/30, p < .001). Results suggest that background noise in the test environment should be considered when cognitive tests are conducted and results interpreted, especially when testing older adults.

13 Article Is Hearing Loss Associated with Poorer Health in Older Adults Who Might Benefit from Hearing Screening? 2016

Mick, Paul / Pichora-Fuller, M Kathleen. ·1Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada; 2Kelowna General Hospital, Kelowna, British Columbia, Canada; 3Department of Psychology, University of Toronto, Toronto, Ontario, Canada; 4Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; and 5Rotman Research Institute, Toronto, Ontario, Canada. ·Ear Hear · Pubmed #26825862.

ABSTRACT: OBJECTIVES: Hearing screening programs may benefit adults with unacknowledged or unaddressed hearing loss, but there is limited evidence regarding whether such programs are effective at improving health outcomes. The objective was to determine if poorer audiometric hearing thresholds are associated with poorer cognition, social isolation, burden of physical or mental health, inactivity due to poor physical or mental health, depression, and overnight hospitalizations among older American adults with unacknowledged or unaddressed hearing loss. DESIGN: The authors performed a cross-sectional population-based analysis of older American adults with normal hearing or unacknowledged or unaddressed hearing loss. Data was obtained from the 1999 to 2010 cycles of the National Health and Nutrition Examination Survey. Participants with a pure-tone average (PTA in the better hearing ear of thresholds at 0.5, 1, 2, and 4 kHz) > 25 dB HL who self-reported their hearing ability to be "good" or "excellent" were categorized as having "unacknowledged" hearing loss. Those who had a PTA > 25 dB HL and who self-reported hearing problems but had never had a hearing test or worn a hearing aid were categorized as having "unaddressed" hearing loss. Multivariate regression was performed to account for confounding due to demographic and health variables. RESULTS: A 10 dB increase in PTA was associated with a 52% increased odds of social isolation among 60- to 69-year-olds in multivariate analyses (p = 0.001). The average Digit Symbol Substitution Test score dropped by 2.14 points per 10 dB increase in PTA (p = 0.03), a magnitude equivalent to the drop expected for 3.9 years of chronological aging. PTA was not associated significantly with falls, hospitalizations, burden of physical or mental health, or depression, or social isolation among those ages 70 years or older in these samples. CONCLUSION: Unacknowledged or unaddressed hearing loss was associated with a significantly increased risk of social isolation among 60- to 69-year-olds but not those 70 years or older. It was also associated with lower cognitive scores on the Digit Symbol Substitution Test among 60- to 69-year-olds. This study differs from prior studies by focusing specifically on older adults who have unacknowledged or unaddressed hearing loss because they are the most likely to benefit from pure-tone hearing screening. The finding of associations between hearing loss and measures of social isolation and cognition in these specific samples extends previous findings on unrestricted samples of older adults including those who had already acknowledged hearing problems. Future randomized controlled trials measuring the effectiveness of adult hearing screening programs should measure whether interventions have an effect on these measures in those who have unacknowledged or unaddressed pure-tone hearing loss.

14 Article Social Support Predicts Hearing Aid Satisfaction. 2015

Singh, Gurjit / Lau, Sin-Tung / Pichora-Fuller, M Kathleen. ·1Phonak Canada Ltd, Mississauga, Ontario, Canada; 2Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada; 3Department of Research, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; and 4Department of Psychology, University of Toronto Mississauga, Mississauga, Ontario, Canada. ·Ear Hear · Pubmed #26035144.

ABSTRACT: OBJECTIVES: The goals of the current research were to determine: (1) whether there is a relationship between perceived social support and hearing aid satisfaction, and (2) how well perceived social support predicts hearing aid satisfaction relative to other correlates previously identified in the literature. DESIGN: In study 1, 173 adult ((Equation is included in full-text article.)age = 68.9 years; SD = 13.4) users of hearing aids completed a survey assessing attitudes toward health, hearing, and hearing aids, as well as a questionnaire assessing Big-Five personality factors (Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) either using paper and pencil or the Internet. In a follow-up study designed to replicate and extend the results from study 1, 161 adult ((Equation is included in full-text article.)age = 32.8 years; SD = 13.3) users of hearing aids completed a similar survey on the Internet. In study 2, participants also completed a measure of hearing aid benefit and reported the style of their hearing aid. RESULTS: In studies 1 and 2, perceived social support was significantly correlated with hearing aid satisfaction (respectively, r = 0.34, r = 0.51, ps < 0.001). The results of a regression analysis revealed that in study 1, 22% of the variance in hearing aid satisfaction scores was predicted by perceived social support, satisfaction with one's hearing health care provider, duration of daily hearing aid use, and openness. In study 2, 43% of the variance in hearing aid satisfaction was predicted by perceived social support, hearing aid benefit, neuroticism, and hearing aid style. Overall, perceived social support was the best predictor of hearing aid satisfaction in both studies. After controlling for response style (i.e., acquiescence or the tendency to respond positively), the correlation between perceived social support and hearing aid satisfaction remained the same in study 1 (r = 0.34, p < 0.001) and was lower in study 2 (r = 0.39, p < 0.001), although the change in correlation was not significant. CONCLUSIONS: The results from study 1 provide evidence to suggest that perceived social support is a significant predictor of satisfaction with hearing aids, a finding that was replicated in a different sample of participants investigated in study 2. A significant relationship between perceived social support and hearing aid satisfaction was observed in both studies, even though the composition of the two samples differed in terms of age, relationship status, income, proportion of individuals with unilateral versus bilateral hearing impairment, and lifetime experience with hearing aids. The results from both studies 1 and 2 provide no support for the claim that participant response style accounts for the relationship between hearing aid satisfaction and perceived social support.

15 Article Cognitive Decline and Hearing Health Care for Older Adults. 2015

Pichora-Fuller, M Kathleen. · ·Am J Audiol · Pubmed #25856721.

ABSTRACT: PURPOSE: The purpose of this article is to consider the implications of age-related cognitive decline for hearing health care. METHOD: Recent research and current thinking about age-related declines in cognition and the links between auditory and cognitive aging are reviewed briefly. Implications of this research for improving prevention, assessment, and intervention in audiologic practice and for enhancing interprofessional teamwork are highlighted. CONCLUSIONS: Given the important connection between auditory and cognitive aging and given the high prevalence of both hearing and cognitive impairments in the oldest older adults, health care services could be improved by taking into account how both the ear and the brain change over the life span. By incorporating cognitive factors into audiologic prevention, assessment, and intervention, hearing health care can contribute to better hearing and communication as well as to healthy aging.

16 Article Effects of hearing and vision impairments on the Montreal Cognitive Assessment. 2015

Dupuis, Kate / Pichora-Fuller, M Kathleen / Chasteen, Alison L / Marchuk, Veronica / Singh, Gurjit / Smith, Sherri L. ·a Department of Psychology , University of Toronto , Toronto , ON , Canada. ·Neuropsychol Dev Cogn B Aging Neuropsychol Cogn · Pubmed #25325767.

ABSTRACT: Many standardized measures of cognition include items that must be seen or heard. Nevertheless, it is not uncommon to overlook the possible effects of sensory impairment(s) on test scores. In the current study, we investigated whether sensory impairments could affect performance on a widely used screening tool, the Montreal Cognitive Assessment (MoCA). Three hundred and one older adults (mean age = 71 years) completed the MoCA and also hearing and vision tests. Half of the participants had normal hearing and vision, 38% impaired hearing, 5% impaired vision, and 7% had dual-sensory impairment. More participants with normal sensory acuity passed the MoCA compared to those with sensory loss, even after modifying scores to adjust for sensory factors. The results suggest that cognitive abilities may be underestimated if sensory problems are not considered and that people with sensory loss are at greater risk of cognitive decline.

17 Article Age affects responses on the Speech, Spatial, and Qualities of Hearing Scale (SSQ) by adults with minimal audiometric loss. 2012

Banh, Jessica / Singh, Gurjit / Pichora-Fuller, M Kathleen. ·Department of Psychology, University of Toronto, Toronto, Canada. ·J Am Acad Audiol · Pubmed #22353676.

ABSTRACT: BACKGROUND: Age-related declines in auditory and cognitive processing may contribute to the difficulties with listening in noise that are often reported by older adults. Such difficulties are reported even by those who have relatively good audiograms that could be considered "normal" for their age (ISO 7029-2000 [ISO, 2000]). The Speech, Spatial, and Qualities of Hearing Scale (SSQ; Gatehouse and Noble, 2004) is a questionnaire developed to measure a listener's self-reported ability to hear in a variety of everyday situations, such as those that are challenging for older adults, and it can provide insights into the possible contributions of auditory and cognitive factors to their listening difficulties. The SSQ has been shown to be a sensitive and reliable questionnaire to detect benefits associated with the use of different hearing technologies and potentially other forms of intervention. Establishing how age-matched listeners with audiograms "normal" for their age rate the items on the SSQ could enable an extension of its use in audiological assessment and in setting rehabilitative goals. PURPOSE: The main purpose of this study was to investigate how younger and older adults who passed audiometric screening and who had thresholds considered to be "normal" for their age responded on the SSQ. It was also of interest to compare these results to those reported previously for older listeners with hearing loss in an attempt to tease out the relative effects of age and hearing loss. STUDY SAMPLE: The SSQ was administered to 48 younger (mean age = 19 yr; SD = 1.0) and 48 older (mean age = 70 yr, SD = 4.1) adults with clinically normal audiometric thresholds below 4 kHz. The younger adults were recruited through an introductory psychology course, and the older adults were volunteers from the local community. DATA COLLECTION AND ANALYSIS: Both age groups completed the SSQ. The differences between the groups were analyzed. Correlations were used to compare the pattern of results across items for the two age groups in the present study and to assess the relationship between SSQ scores and objective measures of hearing. Comparisons were also made to published results for older adults with hearing loss. RESULTS: The pattern of reported difficulty across items was similar for both age groups, but younger adults had significantly higher scores than older adults on 42 of the 46 items. On average, younger adults scored 8.8 (SD = 0.6) out of 10 and older adults scored 7.7 (SD = 1.2) out of 10. By comparison, scores of 5.5 (SD = 1.9) have been reported for older adults (mean age = 71 yr, SD = 8.1) with moderate hearing loss (Gatehouse and Noble, 2004). CONCLUSIONS: By establishing the best scores that could reasonably be expected from younger and older adults with "normal" hearing thresholds, these results provide clinicians with information that should assist them in setting realistic targets for interventions for adults of different ages.

18 Article Word recognition for temporally and spectrally distorted materials: the effects of age and hearing loss. 2012

Smith, Sherri L / Pichora-Fuller, Margaret Kathleen / Wilson, Richard H / Macdonald, Ewen N. ·Research and Development Service, Department of Veterans Affairs, James H. Quillen Veterans Affairs Medical Center, Mountain Home, TN 37684, USA. sherri.smith@va.gov ·Ear Hear · Pubmed #22343546.

ABSTRACT: OBJECTIVES: The purpose of Experiment 1 was to measure word recognition in younger adults with normal hearing when speech or babble was temporally or spectrally distorted. In Experiment 2, older listeners with near-normal hearing and with hearing loss (for pure tones) were tested to evaluate their susceptibility to changes in speech level and distortion types. The results across groups and listening conditions were compared to assess the extent to which the effects of the distortions on word recognition resembled the effects of age-related differences in auditory processing or pure-tone hearing loss. DESIGN: In Experiment 1, word recognition was measured in 16 younger adults with normal hearing using Northwestern University Auditory Test No. 6 words in quiet and the Words-in-Noise test distorted by temporal jittering, spectral smearing, or combined jittering and smearing. Another 16 younger adults were evaluated in four conditions using the Words-in-Noise test in combinations of unaltered or jittered speech and unaltered or jittered babble. In Experiment 2, word recognition in quiet and in babble was measured in 72 older adults with near-normal hearing and 72 older adults with hearing loss in four conditions: unaltered, jittered, smeared, and combined jittering and smearing. RESULTS: For the listeners in Experiment 1, word recognition was poorer in the distorted conditions compared with the unaltered condition. The signal to noise ratio at 50% correct word recognition was 4.6 dB for the unaltered condition, 6.3 dB for the jittered, 6.8 dB for the smeared, 6.9 dB for the double-jitter, and 8.2 dB for the combined jitter-smear conditions. Jittering both the babble and speech signals did not significantly reduce performance compared with jittering only the speech. In Experiment 2, the older listeners with near-normal hearing and hearing loss performed best in the unaltered condition, followed by the jitter and smear conditions, with the poorest performance in the combined jitter-smear condition in both quiet and noise. Overall, listeners with near-normal hearing performed better than listeners with hearing loss by ~30% in quiet and ~6 dB in noise. In the quiet distorted conditions, when the level of the speech was increased, performance improved for the hearing loss group, but decreased for the older group with near-normal hearing. Recognition performance of younger listeners in the jitter-smear condition and the performance of older listeners with near-normal hearing in the unaltered conditions were similar. Likewise, the performance of older listeners with near-normal hearing in the jitter-smear condition and the performance of older listeners with hearing loss in the unaltered conditions were similar. CONCLUSIONS: The present experiments advance our understanding regarding how spectral or temporal distortions of the fine structure of speech affect word recognition in older listeners with and without clinically significant hearing loss. The Speech Intelligibility Index was able to predict group differences, but not the effects of distortion. Individual differences in performance were similar across all distortion conditions with both age and hearing loss being implicated. The speech materials needed to be both spectrally and temporally distorted to mimic the effects of age-related differences in auditory processing and hearing loss.

19 Article Effects of aging and noise on real-time spoken word recognition: evidence from eye movements. 2011

Ben-David, Boaz M / Chambers, Craig G / Daneman, Meredyth / Pichora-Fuller, M Kathleen / Reingold, Eyal M / Schneider, Bruce A. ·Oral Dynamics Laboratory, Department of Speech-Language Pathology, 160-500 University Avenue, Toronto, Ontario M5G 1V7, Canada. boaz.ben.david@utoronto.ca ·J Speech Lang Hear Res · Pubmed #20689026.

ABSTRACT: PURPOSE: To use eye tracking to investigate age differences in real-time lexical processing in quiet and in noise in light of the fact that older adults find it more difficult than younger adults to understand conversations in noisy situations. METHOD: Twenty-four younger and 24 older adults followed spoken instructions referring to depicted objects, for example, "Look at the candle." Eye movements captured listeners' ability to differentiate the target noun (candle) from a similar-sounding phonological competitor (e.g., candy or sandal). Manipulations included the presence/absence of noise, the type of phonological overlap in target-competitor pairs, and the number of syllables. RESULTS: Having controlled for age-related differences in word recognition accuracy (by tailoring noise levels), similar online processing profiles were found for younger and older adults when targets were discriminated from competitors that shared onset sounds. Age-related differences were found when target words were differentiated from rhyming competitors and were more extensive in noise. CONCLUSIONS: Real-time spoken word recognition processes appear similar for younger and older adults in most conditions; however, age-related differences may be found in the discrimination of rhyming words (especially in noise), even when there are no age differences in word recognition accuracy. These results highlight the utility of eye movement methodologies for studying speech processing across the life span.

20 Unspecified Forum on the Brain and Hearing Aids. 2015

Pichora-Fuller, M Kathleen. · ·Am J Audiol · Pubmed #25863869.

ABSTRACT: PURPOSE: The purpose of this article is to introduce and provide an overview of the 3 articles presented in the invited forum "The Brain and Hearing Aids." METHOD: The main ideas of the articles presented by the 3 panelists are identified, and a commentary is provided to synthesize the ideas. CONCLUSIONS: Benefits from hearing aids and auditory training entail higher-level cortical and cognitive processing involved in categorizing and remembering sound. New approaches to predicting, designing, and evaluating technological and behavioral interventions will need to consider the brain and not just the ears of listeners.