This retrospective analysis of existing data was derived from 957 members of a population-based
cohort who participated in a prior study of the prevalence of central auditory dysfunction.
Word recognition scores (WRS) at three intensity levels were compared to predicted
scores based on the Articulation Index (AI) and the Thornton-Raffin 95 percent critical
differences. In 112 (11.7 percent) participants, one or more word recognition scores
were significantly below the predicted score, which we consider a subtle sign of possible
auditory neuropathy. In contrast, classic signs of retrocochlear dysfunction were
found in only three people (0.3 percent) using rollover of the performance-intensity
function for phonetically balanced word lists, in two (0.2 percent) people using the
guideline of Yellin et al (1989), and in 54 people (5.6%) using a 20-point difference
between the AI (x 100) and the WRS. Subtle signs of possible auditory neuropathy were
more frequent than the classic signs. Comparing WRS at several high presentation levels
to the AI is suggested as a method to screen for subtle neuropathy. Elderly listeners
whose WRS fall below the Thornton-Raffin 95 percent critical difference based on AI
should be considered for further testing for age-related auditory neuropathy.
Key Words
Aging - articulation index - auditory neuropathy - presbycusis - word recognition
