PROJECT SUMMARY / ABSTRACT
Sensorineural hearing loss (SNHL) is among the most prevalent chronic conditions in aging and has a
profoundly negative effect on speech comprehension, leading to increased social isolation, reduced quality of
life, and increased risk for the development of dementia in older adulthood. Typical audiological tests and
interventions, which focus on measuring and restoring audibility, do not explain the full range of cognitive
difficulties that adults with hearing loss experience in speech comprehension. For example, adults with SNHL
have to work disproportionally harder to decode acoustically degraded speech. That additional effort is thought
to diminish shared executive and attentional resources for higher-level language processes, impacting
subsequent comprehension and memory, even when speech is completely intelligible. This phenomenon has
been referred to as listening effort (LE). There is a growing understanding that these cognitive factors are a
critical and often “hidden effect” of hearing loss. At the same time, the effects of LE on the neural mechanisms
of language processing and memory in SNHL are currently not well understood. In order to develop evidence-
based assessments and interventions to improve comprehension and memory in SNHL, it is critical that we
elucidate the cognitive and neural mechanisms of LE and its consequences for speech comprehension. In this
project, we adopt a multi-method approach, combining methods from clinical audiology, psycholinguistics, and
cognitive neuroscience to address this gap of knowledge. Specifically, we adopt a novel and innovative method
of co-registering pupillometry (a reliable physiological measure of LE) and language-related event-related brain
potential (ERP) measures during real-time speech processing to characterize the effects of acoustic challenge
and LE on high-level language processes (e.g., semantic retrieval, syntactic integration) and subsequent
speech memory in older adults with SNHL. This innovative work addresses a time-sensitive gap in the
literature regarding the identification of objective and reliable markers of specific neurocognitive processes
impacted by acoustic challenge and LE in age-related SNHL.