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A S f l A i P ti th LiA Successful Aging Perspective on the Linbetween Hearing, Cognition and Socia
P ti i ti th LifParticipation over the Lifespan
Kathy Pichora‐FullerProfessor, Dept. of Psychology, Univ. of Toronto Mississauga,
Adjunct Scientist, Toronto Rehabilitation Institute and Rotman Research InstituteGuest Professor, Linneaus Centre HeAD, Linkoping University, Sweden
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
Does treating hearing loss slow cognitive d li ?decline?
QuestionQuestionBackground Facts:Background Facts:1. Health in childhood can affect adult health.2. Hearing loss is related to poorer health in older
adults (dementia, falls, mortality….).
Question:Question:How important is it to promote health in children with h l h l h f ll d lhearing loss to help them age successfully as adults?
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
World Health Organization (WHO)Definition of Health (1948)
• Health is a complete state of well-being:
Definition of Health (1948)
• Health is a complete state of well-being:– Physical well being– Mental well being– Social well beingg
• Health is NOT merely the absence of disease or infirmitydisease or infirmity.
• State of optimum health is called “wellness”
Issues in Adult Development and Agingp g g
Perspective of an Older Adult who LivesPerspective of an Older Adult who Lives with Hearing Loss
“When you are hard of hearing you struggle to hear;y f g y gg ;When you struggle to hear you get tired;When you get tired you get frustrated;When you get tired you get frustrated;When you get frustrated you get bored;When you get bored you quit.
‐‐ I didn’t quit today.”I didn t quit today.
Avoid by withdrawal from social interaction!
A Model of Disability in Later LifeA Model of Disability in Later Life
• Disability:Effects of chronic conditions on– Effects of chronic conditions on people’s ability to engage in activities that are necessary expected andthat are necessary, expected, and personally desired in their society.
ENABLEMENT• ENABLEMENT
Total number of articles cited in PubMed: March 3 2014Total number of articles cited in PubMed: March 3, 2014
800035000
700030000Hearing
5000
600025000
bMed
)
4000
5000
15000
20000
ations (P
ub Hearing + (Cognition or Cognitive or memory or brain)
2000
3000
10000
15000
# Pu
blica
Hearing + (Social or
1000
2000
5000
g (psychosocial or "significant other" or stress or isolation or withdrawal or stigma or
)00
1940s 50s 60s 70s 80s 90s 2000s
stereotype)
Health isHealth is…“…the capacity of…the capacity of
people to adapt to, respond to orrespond to, or control life’s h ll dchallenges and
changes.”(Frankish et al., 1997)
Health states associated with being isolated: 1. Early mortality2. Cognitive impairmentg p3. Cardiovascular disease4. Depression p5. Physical decline
Sources: House et al Am J Epidemiol 1982, Green et al Int J Geriatr 2008,Oxman et al Am J Epidemiol 1992, Strogatz et al 1986
Health Promotion• “… is the process of enabling people to increase
& ”
Health Promotioncontrol over & to improve their health.”(WHO, 1986 – Canadian Charter on Health Promotion)Promotion)
• “ is any combination of educational… is any combination of educational, organizational, economic & environmental supports for actions conducive to health.” (Green & Kreuter, 1991)1991)
• programs enhance the “FIT” between people &• …. programs enhance the FIT between people & their surroundings (Sokols, 1996)
Coping with STRESS
• People respond differently to stress• People respond differently to stress– imbalance in person-environment fit
• The impact of any potentially stress event is greatly influenced by how a person appraises it (Lazarus & Folkman, 1984)– Primary Appraisal: Is the event harmful, threatening, or challenging?Primary Appraisal: Is the event harmful, threatening, or challenging?– Secondary Appraisal: What are my coping resources? Are they adequate?– Reappraisal – changes in the situation may change the appraisal
• Coping is the process of trying to manage demands that are appraised as taxing or exceeding one’s resources
• As vulnerability (lack of coping) increases, it takes less stress to trigger illnessit takes less stress to trigger illness
Life Cycle Model of StressLupien et al (2009) Nature 10 434‐ 445Lupien et al., (2009). Nature, 10, 434 445.
Figure 2 | The life cycle model of stress. How the effects of chronic or repeated exposure to stress (or a single exposure to severe stress) at different stages in life depend on the brain areas that are developing or declining at the time of the exposure. Stress in the prenatal period affects the development of many of the brain regions that are involved in regulating the hypothalamus‐pituitary‐adrenal (HPA) axis — that is, the hippocampus, the frontal cortex and the amygdala (programming effects)….. In adulthood and during aging the brain
i h d h id d li l f i ( d b ) hi hl l bl h ff f h Sregions that undergo the most rapid decline as a result of aging (red bars) are highly vulnerable to the effects of stress hormones. Stress during these periods can lead to the manifestation of incubated effects of early adversity on the brain (manifestation effects) or to maintenance of chronic effects of stress (maintenance effects). PTSD, post‐traumatic stress disorder.
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
What Changes in Cognitive DevelopmentWhat Changes in Cognitive Development over the Lifespan?
(Craik & Bialystock, Handbook of Cognitive Aging, 2008)
Younger OlderRepresentationControl
Younger Older
(KNOWLEDGE)(PROCESSING)
MemorySlowing
Context
(reliance, benefit from SUPPORTIVE ENVIRONMENT)
When Does Cognitive Aging Start?1.5
1.0
Synonym VocabularyPattern Comparison (Speed)Raven's (Reasoning)Recall (Memory)
84
on
ore
0.5
f Pop
ulat
i
Z-S
co
-0.5
0.0 50
cent
ile o
f
-1.0 16
Per
c
10 20 30 40 50 60 70 80 90-1.5
Chronological Age
Salthouse (2004) Current Directions in Psychological Science
Prevalence of Hearing LossPrevalence of Hearing Loss• Depends on measure and criteriap
– “Normal for age”Median audiometric thresholds (ISO 7029)– Median audiometric thresholds (ISO 7029)
Women Men
3kHz 3kHz
Auditory AgingAuditory Aging
(Mills, Schmeidt, Schulte, & Dubno, 2006)
• HF audiometric threshold elevation– OHC (also noise-induced hearing loss)– Endocochlear potentials ~ stria vascularisp
Neural loss of synchrony• Neural – loss of synchrony
Bottom‐Up &Top Down ProcessingBottom Up &Top Down Processing• Effortful listening
– Bottom‐up processing less efficient Knowledgep p g– Top‐down processing more necessary
Top D
• Bottom‐up (ear to brain)– Analysis of acoustic signal
• Better signal (faster)
Dow
n
g ( )• Poorer signal (slower) • @ amount & type of distortion
T d (b i t )
Meaning
up• Top‐down (brain to ear)– Priming (pre‐signal)
• expectations facilitate recognition (faster)Di bi ti ( t i l)
Bottom
u
– Disambiguation (post‐signal)• knowledge constrains alternatives (slower)
– Repair (post‐signal)Fill i t ( l )
Sound
• Fill in gaps or correct errors (slower)
1995
Low context sentences:3 dB
“John did not talk about the feast”
High context sentences: 3 dBg
“The wedding banquet was a feast”
Task: Repeat the last word of the sentence 6 dB
Old need 3 dB better S:N
h l ld 3 d
Good audiogram
Context helps old 3 dB more
Cohen (1987). Speech comprehension in the elderly. The effects of cognitive changes. BJA, 21, 221‐226.Rabbit (1990) Mild hearing loss can cause apparent memory failures which increase with age and reduce with IQRabbit (1990). Mild hearing loss can cause apparent memory failures which increase with age and reduce with IQ. Acta Otolryn., 476, S167‐176.Wingfield (1996). Cognitive factors in auditory performance: Context, speecd of processing and constraints of memory. JAAA, 7, 175‐182.
Effect of Simulated Auditory Aging on W ki M SWorking Memory Span
(Pichora‐Fuller, IJA, 2008; Brown & Pichora‐Fuller, Canadian Acoustics, 2000)
Context, Intelligibility & Brain Activation(Obleser, Wise, Dresner & Scott, 2006)
High vs. low predictability atg p yintermediate signal quality for younger adults listening to distorted (noise‐vocoded) SPIN sentences
Activation to HIGH‐CONTEXT > LOW‐CONTEXT speech
Various areas activated including theleft dorsolateral prefrontal cortex ( ki & i i )(working memory & semantic processing)
Cognitive Neuroscience of AgingCognitive Neuroscience of Aging
• Same performance achieved with different processing
• More widespread activation ~ brain reorganization• More widespread activation brain reorganization– Young brain activity more lateralizedOld brain activity more distributed– Old brain activity more distributed
• Deterioration or compensation?p
• HAROLD: Hemispheric asymmetry reduction in older adults(Cabeza, 2002)
• PASA: Posterior‐anterior shift in agingg g(Davis, Dennis, Daselaar, Fleck & Cabeza, 2008)
CompensationCompensation(Grady, 2012, Nature Reviews Neuroscience, 13, 491‐505)
low high
Cognitive Aging 6.0
7.0
SNR
)
2 3 dBg g g(Pichora‐Fuller, IJA, 2008;
Brown & Pichora‐Fuller, Canadian Acoustics, 2000) 3 0
4.0
5.0
Con
text
(dB
2‐3 dB
2000)
Gains: 1.0
2.0
3.0
enef
it fro
m C
Knowledge is preservedand context is helpful
0.0Younger
IntactYounger
JitterOlder Intact
B
Losses:Processing declines– Working memory
l i– Slowing– Attention/Inhibition
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
All cause mortality ~ Sensory impairment
Kaplan Meier plots for all-cause mortality rates by type of sensory impairment adjusted for relevant confounders
impairmentMales Females
100
90
al
80
No sensory impairment%su
rviv
a
70
y pVisual impairment onlyHearing loss only
%
60 Dual sensory lossN=4926 Icelandic individuals aged 67+
Years past sensory examination
Sources: Fisher et al, Age Ageing 2013, and Feeny et al J Clin Epidemiol 2012
Hearing loss is a risk factor for having automobile accidents i l h t f l k i Q b
Hearing status # who had at least 1 accident
Prevalence ratio (age adjusted)
95% CI
in a large cohort of male workers in Quebec
least 1 accident (age-adjusted)Normal 7473 1.0Just noticeable 1966 1.06 1.01, 1.11HL
,
Mild HL 777 1.13 1.05, 1.21M d t HL 559 1 18 1 08 1 27Moderate HL 559 1.18 1.08, 1.27Severe HL 622 1.31 1.20, 1.42Total 11397Total 11397
N=46030 male workers
Clear dose-response
Attributable risk of traffic accident to HL = 5.6%
Source: Picard et al, Traffic Injury Prevention 2008
Clear dose response
The impact of hearing loss on the driving performance of 107 seniors p g g pwith normal visual acuity and cognitive function tested on a closed road circuit
Mean driving score # signs correctly recognized
Normal/mild HL
Moderate/severe HL
None Visual Auditory None Visual AuditoryNone Visual Auditory
Type of distractionNone Visual Auditory
Type of distraction
Source: Hickson et al, JAGS 2010
Increased perceptual effort drains cognitive resources available for other purposesother purposes
Hearing loss Reduced perception of hazard noiseHearing loss p p
Falls ?
When Does Cognitive Aging Start?1.5
1.0
Synonym VocabularyPattern Comparison (Speed)Raven's (Reasoning)Recall (Memory)
84
on
ore
0.5
f Pop
ulat
i
Z-S
co
-0.5
0.0 50
cent
ile o
f
-1.0 16
Per
c
10 20 30 40 50 60 70 80 90-1.5
Chronological Age
Salthouse (2004) Current Directions in Psychological Science
Figure 1. Estimates of age‐specific prevalences of Alzheimer’s disease (AD), Mild Cognitive Impairment (MCI), and Non‐Affected (NAs), aged 60–85,Mild Cognitive Impairment (MCI), and Non Affected (NAs), aged 60 85, assuming 1.0% rate for conversion from NA to MCI at age 60. (Adapted with permission from Yesavage JA, O’Hara R, Kraemer H, et al. Modeling the prevalence and incidence of Alzheimer’s disease andModeling the prevalence and incidence of Alzheimer s disease and mild cognitive impairment. J Psychiat Res 2002;36:281‐286.)
Hearing Loss Prevalence & DementiaHearing Loss Prevalence & Dementia• Audiogramg
– Gold, Lightfoot & Hnath-Chisolm (1996)• 27 of 30 (90%) patients with Alzheimer’s had ( ) p
hearing impairment (pure-tone screen & HHIE)– Uhlmann et al. (1989)
• Case-control study with 100 pairs– Prevalence higher in those with Alzheimer’s-type dementia
Hearing loss significantly correlated with MMSE– Hearing loss significantly correlated with MMSE
• Central Auditory (DDT)Id i b i l (2011)– Idrizbegovic et al. (2011)
• Performance on DDT worse for those with MCI and worse still for those with DATworse still for those with DAT
Dual Sensory (Hearing & Vision) Lossy ( g )• DSI and cognitive decline
• Dual sensory loss associated with greatest odds for• Dual sensory loss associated with greatest odds for cognitive decline and for functional decline on five everyday activities over a period of four yearseveryday activities over a period of four years (Lin, MY et al., 2004)
“Central Auditory” (Speech in Noise)Central Auditory (Speech in Noise) Problems May PRECEDE Dementiay
• Longitudinal epidemiological studies– Gates et al. (1996)
• N >700, speech in competing speech test (SSI-ICM) in , p p g p ( )those without stroke, dementia, or HL (PTA 40 dB HL)
• MMSE administered 2, 4, 6 years later• Those with low scores on SSI-ICM were 6-12 times more
likely to develop clinical dementia– Gates et al. (2002, 2008)
• Similar results for longer follow-up period (3-12years)g p p ( y )
P re tone HL Related to Incident DementiaPure-tone HL Related to Incident Dementia
Lin, F. R., Metter, E. J., O’Brien, R. J., Resnick, S. M., Zonderman, A. B., & Ferrucci, L. (2011). Hearing loss and incident dementia. A hi N l 68(2) 214 220Archives Neurology, 68(2), 214-220.
• Lin FR Ferrucci L Metter EJ et al (2011) Hearing loss andLin FR, Ferrucci L, Metter EJ, et al. (2011). Hearing loss and cognition in the Baltimore Longitudinal Study of Aging. Neuropsychology, 25, 763-770.
• Lin FR. (2012). Hearing loss in older adults. Who’s listening? JAMA, 307, 1147-1148.,
• Lin FR, Yaffe K, Xia J, et al. (2013). Hearing loss and cognitive d li i ld d lt JAMA I t M d 173 293 299decline in older adults. JAMA Intern Med, 173, 293-299.
Hearing loss and cognitive declineHealth ABC cohort 2013
94
Health ABC cohort, 2013
92
90scor
e*
Normal hearing group90
88
ntal
sta
te
86
84min
i-men Hearing loss group
p=.004 for difference in change over time82
80Mod
ified
m
80M
Study year5 8 10 11
* Note: very similar results for the digit-symbol substitution test
Study year
Hearing loss and Incident DementiaHearing loss and Incident DementiaBaltimore Longitudinal Study of Aging cohort, 2011
10
12
ntia
n=639
8
10
nt d
emen HL severity HR (95% CI)
mild 1.89 (1.00-3.58)
4
6
of in
cide
n moderate 3.00 (1.43-6.00)severe or more 4.94 (1.09-22.4)Cox proportional hazards model adjusted
2
4
Haz
ard
o Cox proportional hazards model adjusted for age, sex, race, education, diabetes, smoking and HTN. Hazard ratios relative to normal hearing.
0 100806040200
Mild Mod SevereHearing loss, dB
Source: Lin et al, Arch Neurol 2011
Mild Mod Severe
MoCA
Montreal Cognitive gAssessment
www.mocatest.org
l/Visuo‐spatial/executiveNamingMemoryMemoryAttentionLanguageAb t tiAbstractionRepetitionOrientation
MoCA Repeat & Recall (D i t l b itt d)MoCA Repeat & Recall (Dupuis et al., submitted)
80All Participants Repeated_Recalled
Repeated Forgotten80
Good Hearing
25
30
50
60
70
80 Repeated_Forgotten
Not Repeated_Forgotten
40
50
60
70
15
20
25
10
20
30
40
0
10
20
30
0
5
10
0
Good Hearing – Hearing Loss
0Face Velvet Church Daisy Red
80
Hearing Loss
Face Velvet Church Daisy Red
50
60
70
80
10
20
30
40
0
10
Face Velvet Church Daisy Red
Increased perceptual effort drains cognitive resources available for other purposes
Social Isolation DementiaHearing loss DementiaHearing loss
Unknown commonUnknown common neurodegenerative
pathologyFrank Lin
Mild Cognitive Impairmentg p(e.g, Troyer & Murphy, 2007)
Kell M rph
• Active lifestyle ~ risk of future dementia– Cognitive engagement
Kelly Murphy
– Cognitive engagement• Tasks involving problem‐solving, decision‐making, learning, remembering new information
Ph i l ti it– Physical activity• Some activities are done in groups, with music
– Social interaction• Rich social stimulation and active social network• Participating in group activities and interactions
• Enriched environments• Enriched environments• Group interventions• Communication related disorders???• Communication‐related disorders???
Interactive Effects of Physical Activity and Diet
High exercise + great diet
No exercise + poor diet
Scarmeas et al. (2009) JAMA, 302, 627‐637.
Cognitive Benefits of Better HearingCognitive Benefits of Better HearingArlinger, Lunner, Lyxell, & Pichora‐Fuller, Scandinavian J Psych, 2009
• Slower cognitive decline in Alzheimer’s cases with better hearing(Peters, Potter, & Scholer, 1988; Wahl & Heyl, 2003)
• Reduced rate of decline in scores on a cognitive screening test over a six‐month period following intervention with hearing aids (Allen et al 2003)(Allen et al., 2003)
• Hearing aid use reduced problem behaviours judged by caregivers of adults with dementiadementia (Palmer et al., 1998)
• Older adults using hearing aids have better emotional and social well‐being andOlder adults using hearing aids have better emotional and social well being and greater longevity (Appolonio et al., 1996; Cacciatore et al., 1999; Naramura et al., 1999; Seniors Research Group, 1999)
Sensory Cognitive Communication TrioSensory‐Cognitive‐Communication Trio1. Hearing loss is associated with incident dementia
(e.g., Gates et al., 2002, 2010,2011; Lin, 2011; Lin et al., 2011a, 2011b, 2013; Peters et al., 1988; Uhlmann et al., 1989)
2. Hearing loss reduces communication functioning, g g,increasing risk for social isolation(e.g., Appollonio et al., 1996; Bess et al., 1989; Crews & Campbell, 2004; Keller et al., 1999; Laforge et al., 1992; Mulrow et al., 1990a, 1990b; Rudberg et al., 1993; Reuben et al., 1999; f g , ; , , ; g , ; , ;Sindhusake et al., 2001; Weinstein & Ventry, 1982)
3. Engagement in leisure activities is related to cognition and healthand health(e.g., Bassuk et al, 1999; Fabrigoule et al., 1995; Fratiglioni et al., 2000; Hultsch et al., 1993; Mousavi‐Nasab, 2012; Strawbridge et al., 1998; Wang et al. 2002)
Hypotheses(D i l D i Pi h F ll i )(Danielsson, Dupuis, Pichora‐Fuller, in prep)
1. Social withdrawal mediates th i ti b tthe association between hearing loss and cognitive decline
HearingLossdecline
2. Cognitive functioning mediates the association
Loss
mediates the association between hearing loss and social withdrawal
SocialWithdrawal
social withdrawal3. Social withdrawal can be
caused by hearing loss Cognitivecaused by hearing loss and/or cognitive decline (all effects of aging)
CognitiveDecline
(all effects of aging)
ParticipantsParticipants
Betula, Sweden Stigma, TorontoN 297 273Age (years) M = 67 (35‐90) M = 71 (56‐96)Education M = 14 YoE M = 16 YoE
(36% > secondary) (81% > secondary)Employed 62% 76%Female 45% 64%Married 73% 54%Good General Health 84% 82%
Hearing Variables Used in ModelsHearing Variables Used in Models• Pure‐tone thresholds (worse ear; 3,4,6,8 kHz)
SummarySummary
• Gradual gains and losses in aging– More signal to offset auditory loss (Technologies)g y ( g )– Compensate using contextual support (AR)
D t f HL• Downstream consequences of HL on memory– Information degradation (immediate)– Deprivation (long‐term)
• Social participation: HL mediated by memory• Social participation: HL mediated by memory
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
Overview of Self Management ApproachOverview of Self Management Approach
S lf M tSelf ManagementA person’s active participation in achieving their own best health and wellness through gainingown best health and wellness through gaining confidence, knowledge, and skills to manage physical, social and emotional aspects of lifephysical, social and emotional aspects of life
Self Management SupportSelf Management SupportThe range of organizational, community and provider strategies to support the activeprovider strategies to support the active participation of individuals in achieving their best health and wellness
CLSA: Conceptual framework:Models of healthy/successful agingode s o ea t y/success u ag g
http://www.clsa-elcv.ca
Literature dominated by two models:
Rowe and Kahn • Differentiates successful aging from usual aging• Based on the assumption that successful agers engage in• Based on the assumption that successful agers engage in
behaviours that modify risk factors to allow them to meet a high degree of physical, mental and social functioning
Baltes and Baltes• Selection, Optimization, Compensation, p , p• Based on the assumption that decline is an inevitable part
of aging, and that successful agers are those who engage in processes that help them to adapt to change in order to
t th i lmeet their own goals
A Framework for Maintaining and Enhancing Competence (Pp. 168 – 170)
A Framework for Maintaining and Enhancing Competence (Pp. 168 – 170)
• How to optimize the overall sense of competenceA l th k d ti h i f i– Apply three key adaptive mechanisms for aging• Selection
– Select subset of options to focus resources on (priorities)p (p )• Optimization
– Find best way to achieve goal (improve by practice)• Compensation• Compensation
– Use alternative route to find solution (vision, context)
Th SOC d l– The SOC model– http://www.margret-baltes-stiftung.de/PBB-Website/SOC.html
Good Hearing Health Could Promote Good (Cognitive) Health
PRESERVEcommunication and social interaction
ff i l i l i• stave off social isolation• slow cognitive decline
OutlineOutline
• Question about hearing and healthy aging• Define healthDefine health• Lifespan view• Hearing and health• Successful agingSuccessful aging• How to apply these ideas with children
HearingNot having HearingHearing Not havingillness
Hearing
DietExercise
HEALTHYAGING
GenesProductive
pursuits
SocialactivityHearing Hearingactivity Hearing
Health Promotion & Disease Prevention (Pp. 170 –171)
Health Promotion & Disease Prevention (Pp. 170 –171)
• Adopt a healthful lifestyle– make it part of your daily routine (exercise, diet)
• Stay active cognitively– keep an optimistic outlook and maintain yourkeep an optimistic outlook and maintain your
interest in things– cognitive reserve
• Maintain a social network and stay engaged with otherswith others
http://blogs.crikey.com.au/culture‐mulcher/2010/07/12/genius‐radio‐the‐nerve/ear‐brain/
Vancouver, British ColumbiaVancouver, British ColumbiaWorld Congress of Audiology
September 18‐22, 2016
Age and Modality IssuesAge and Modality Issues• MoCA total score 7
– ~ PTA(W) (p < .000)– ~ Age (p = .051) 5
6
7
• Correlations (p <.0005) 3
4NH
HL(p )
– MoCA DR x Aud FR .38– MoCA DR x Vis FR .42
0
1
2
– Aud FR x Vis FR .45 Aud Recall Vis Recall MoCA DR
• ANOVA for FR: Good vision only (N = 122)• Group (NH, HL): F(1,108) = 5.66, p = .019 • Modality (A,V): F(1,108) = 10.66, p = .001 • Group x Modality: F(1,108) = .53, p = .47
L i l d i i ti tiLexical decision reaction time in younger and older listeners:The effects of semantic context and the type and amount of acoustical distortion yp
Preceding context distorted or intact Target intactCongruent Stir your coffee with a spoon.Neutral Its name is feast.I t Stir your coffee with a riskIncongruent Stir your coffee with a risk.
‐ Measure RT when lexical decision correctMeasure RT when lexical decision correct‐ Facilitation (RT neutral context – RT congruent context)
Goy H Pelletier M Coletta M & Pichora Fuller M K (2013) Journal ofGoy, H., Pelletier, M., Coletta, M., & Pichora-Fuller, M.K. (2013). Journal of Speech, Language and Hearing Research.
Effects of Context and Distorting ItEffects of Context and Distorting It on Lexical Decision RT
More
Some
None
Effects of Distorting Context on Speed of Lexical Decision
90
45
• Older listeners’ RTs are more facilitated by context.y• Signal distortion reduces facilitation.
Spectrograms for Jittered and Intact Sentence in BabbleSentence in Babble