Evaluating perceptual evidence of cross-modal plasticity in older adults with hearing loss using an audio-visual word mismatch task

Older adults with age-related hearing loss (OAHL) are more strongly influenced by vision during audiovisual perception tasks compared to typical-hearing older adults, suggesting a greater weighting of visual input in the former group. This visual "bias" has been argued to arise through compensatory, top-down cross-modal neuroplasticity that strengthens visual perceptual processing in response to hearing loss....

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

The finding that age-related hearing loss drives measurable cross-modal plasticity (increased visual dominance in speech perception) supports prioritising earlier hearing aid fitting, but does not yet provide a specific new protocol to implement.

✦ Why It Matters ✦

Evidence of cross-modal plasticity in older adults with hearing loss has implications for cochlear implant candidacy decisions, rehabilitation timing, and the design of audiovisual speech training programmes.

✦ Key Points ✦

01Older adults with hearing loss showed greater reliance on visual speech cues than normal-hearing peers.
02An audio-visual word mismatch task was used to detect and quantify cross-modal plasticity.
03Findings suggest the aging brain reorganises sensory processing in response to hearing loss.
04Cross-modal plasticity may partially explain why hearing aid benefit varies among older adults.
05Study highlights the importance of addressing hearing loss before neural reorganisation becomes entrenched.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Older adults with age-related hearing loss display greater visual influence during audiovisual speech perception than normal-hearing controls.

studysupported

Greater visual dominance in audiovisual tasks reflects cross-modal plasticity driven by hearing loss.

studypartially supported

✦ Research metadata ✦

PMID: 42664863
DOI: 10.1016/j.heares.2026.109779.
Journal: Hearing Research
Publication type: research_article
Evidence level: 2b
Population: Older adults with age-related hearing loss
Intervention: Audio-visual word mismatch (McGurk-type) perceptual task
Comparator: Normal-hearing older adults

Primary outcomes

Degree of visual influence on audiovisual speech perception; Perceptual evidence of cross-modal plasticity

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