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

A dispatch from PubMed — filed

The sounds we experience in our everyday communication can vary greatly depending on the environment. Paradoxically, increasing the sound level may lead to worse speech perception, especially in noise. This decline is known as "rollover." It is unclear how rollover is experienced differentially across aging groups, as well as for those with and without hearing loss....

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Discussion

Signed responses from readers of the wire.

Clinical Takeaway

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.

Why It Matters

This finding challenges standard clinical assumptions about amplification and could prompt revisions to hearing aid fitting targets and listening effort counselling for older adults.

Key Points
  1. 01Higher presentation sound levels paradoxically worsened speech perception in older hearing-impaired adults.
  2. 02Listening effort also increased at high presentation levels, adding cognitive load.
  3. 03Published in Hearing Research, a peer-reviewed audiology journal.
  4. 04Results have direct implications for hearing aid fitting targets and loudness management.
  5. 05Findings underscore that suprathreshold processing deficits in aging ears go beyond simple audibility.
Claims & Evidence

Increasing presentation sound levels worsens speech perception in older hearing-impaired adult listeners.

studysupported

Higher presentation sound levels increase listening effort in older hearing-impaired adult listeners.

studysupported
Research metadata
PMID
42759236
DOI
10.1016/j.heares.2026.109810.
Journal
Hearing Research
Publication type
research_article
Evidence level
2b
Population
Older adults with hearing impairment
Intervention
High presentation sound levels during speech perception tasks
Comparator
Lower presentation sound levels

Primary outcomes

Speech perception accuracy at varying presentation levels; Listening effort at varying presentation levels

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