Environmental noise is one of the most pervasive ecological health issues in modern urban settings, contributing to the onset of hearing damage but also to the development of annoyance, sleep disturbance, cardiovascular diseases, and impaired communication....
✦ The floor
Discussion
Signed responses from readers of the wire.
Audiologists should incorporate cognitive screening and counselling about listening effort into hearing-aid fitting workflows, as cognitive factors significantly shape speech-in-noise outcomes beyond what amplification alone can address.
This review reinforces that hearing aid signal processing cannot fully compensate for cognitive decline, pushing the field toward more holistic, person-centred fitting approaches that account for individual cognitive profiles.
- 01Cognitive factors — including working memory, attention, and processing speed — substantially affect speech perception in noise.
- 02Modern hearing-aid features (noise reduction, beamforming, AI processing) address the acoustic signal but cannot replace cognitive resources.
- 03Urban noise environments present unique and growing challenges for hearing-aid users.
- 04Narrative review format limits causal inference; no new empirical data are presented.
- 05Findings support integrating cognitive assessment into audiological rehabilitation planning.
Cognitive factors make a significant independent contribution to speech perception in noise, beyond peripheral hearing loss alone.
studysupportedHearing-aid signal processing strategies (e.g., noise reduction, directional microphones) improve speech perception in noise for hearing-aid users.
studypartially supportedModern urban noise environments pose a heightened challenge for speech understanding in hearing-aid users.
opinionpartially supported- PMID
- 42783589
- DOI
- 10.3390/jintelligence14090229.
- Journal
- Journal of Intelligence
- Publication type
- review
- Evidence level
- 5
- Population
- Hearing-aid users and individuals with hearing loss in noisy environments; general adult population in urban settings
- Intervention
- Hearing-aid signal processing strategies (noise reduction, beamforming, AI-based processing)
- Comparator
- No hearing aid or unaided listening
Primary outcomes
Speech perception in noise; Cognitive contributions to speech understanding