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 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.

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.

1. 01Older adults with hearing loss showed greater reliance on visual speech cues than normal-hearing peers.
2. 02An audio-visual word mismatch task was used to detect and quantify cross-modal plasticity.
3. 03Findings suggest the aging brain reorganises sensory processing in response to hearing loss.
4. 04Cross-modal plasticity may partially explain why hearing aid benefit varies among older adults.
5. 05Study highlights the importance of addressing hearing loss before neural reorganisation becomes entrenched.

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