Relationships between extended high frequency hearing, cognition, and speech-in-noise performance

Impaired speech-in-noise performance is a primary patient complaint in audiology clinics, and in addition to standard frequency (SF; 0.25-8 kHz) sensitivity, age, and cognition, recent work as focused on the association of extended high frequency (EHF, > 8 kHz) sensitivity with this degraded performance....

Continue reading at PubMed

✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

If extended high-frequency (EHF) hearing thresholds independently predict speech-in-noise performance and cognition, audiologists may have grounds to incorporate EHF testing into assessments for patients with normal standard audiograms but functional hearing complaints — but broader replication is needed before routine adoption.

✦ Why It Matters ✦

Demonstrating that extended high-frequency hearing contributes independently to speech-in-noise performance and cognition could strengthen the clinical and research case for routine EHF audiometry, particularly in subclinical hearing loss populations.

✦ Key Points ✦

01Study examined hearing at frequencies above the standard 8 kHz audiometric range (extended high frequencies).
02Investigated relationships between EHF thresholds, cognitive function, and speech-in-noise performance.
03Addresses a gap in understanding why some patients with normal audiograms struggle in noise.
04Published in Frontiers in Neuroscience (DOI: 10.3389/fnins.2026.1933436).
05Findings could support wider adoption of EHF audiometry in clinical and research settings.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Extended high-frequency hearing thresholds are related to speech-in-noise performance beyond what standard audiometric frequencies (0.25–8 kHz) explain.

studypartially supported

Extended high-frequency hearing thresholds are associated with cognitive function.

studypartially supported

✦ Research metadata ✦

PMID: 42978616
DOI: 10.3389/fnins.2026.1933436.
Journal: Frontiers in Neuroscience
Publication type: research_article
Evidence level: 2b
Population: Participants assessed for extended high-frequency hearing, cognition, and speech-in-noise performance (population details not fully specified in abstract)
Intervention: Extended high-frequency audiometric testing (above 8 kHz)
Comparator: Standard audiometric frequencies (0.25–8 kHz)

Primary outcomes

Extended high-frequency hearing thresholds; Cognitive function scores; Speech-in-noise performance

✦ Related stories ✦

PubMed·Journal article·Research (general)·3mo ago

Impaired speech-in-noise perception in individuals with a history of hearing symptoms after noise exposure

Audiologists should consider supplementing standard audiograms with speech-in-noise testing for patients reporting noise-exposure symptoms, as normal thresholds alone may miss clinically meaningful hearing dysfunction consistent with cochlear synaptopathy (hidden hearing loss).

PubMed·Journal article·Research (general)·5mo ago

Effects of Hearing Intervention on Cognitive Function in Patients with Presbycusis: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis provides the strongest available evidence that hearing intervention positively impacts cognitive function in older adults with age-related hearing loss; audiologists should use these findings to counsel patients and reinforce the...

PubMed·Journal article·Research (general)·4mo ago

The Genetic Causes of Auditory Neuropathy: A Systematic Review

Genetic testing for auditory neuropathy is clinically meaningful because the causative gene can influence cochlear implant candidacy and expected outcomes; audiologists should advocate for genetic workup in confirmed auditory neuropathy cases.

PubMed·Journal article·Research (general)·7d ago

Loneliness as a pathway linking hearing decline to cognitive aging: Longitudinal and genetic evidence

Audiologists should be aware that loneliness is a likely mediating pathway between hearing decline and dementia risk, reinforcing the case for early hearing intervention and social engagement counseling as part of comprehensive audiological care.

PubMed·Journal article·Research (general)·4mo ago

Hearing Loss in Adults With Diabetes and Prediabetes: A Systematic Review and Meta-Analysis

Audiologists should consider routine hearing screening for adult patients with known diabetes or prediabetes, as this meta-analysis provides strong epidemiological evidence linking both conditions to increased prevalence and severity of hearing loss.

PubMed·Journal article·Research (general)·6w ago

Increased listening effort and decreased speech perception at high presentation sound levels in older hearing-impaired adult listeners

Audiologists should avoid assuming that higher presentation levels always benefit older hearing-impaired listeners; fitting and counselling protocols should account for the paradoxical degradation in speech perception and increased listening effort at high levels.

PubMed·Clinical trial·Research (general)·7w ago

Effects of hearing intervention on blood-based biomarkers of neuroinflammation and neurodegeneration: a secondary analysis of the ACHIEVE randomised controlled trial

are secondary and exploratory — audiologists should not change practice based on these biomarker findings alone, but the study adds biological plausibility to hearing intervention as a potential tool for brain health preservation.

PubMed·Preprint·Research (general)·3mo ago

Older adults show overexaggerated and larger noise-related degradation in their neural tracking of speech

This finding suggests age-related declines in how the brain tracks speech in noise go beyond peripheral hearing loss; audiologists should be cautious attributing all speech-in-noise difficulty in older adults to the audiogram alone, though the preprint has not yet been...