Abstract
Age-related hearing loss (presbycusis) is the most common cause of hearing loss. The
audiometric profile of peripheral presbycusis is well known, but little attention
has been paid to the role of central auditory dysfunction in both the diagnosis and
management of presbycusis. Central presbycusis is typified by difficulty understanding
speech in noise. Central presbycusis appears to involve or arise from decrements in
executive functioning, which may be age-related or dementia-related. Tests employing
speech in noise are appropriate measures for identifying patients who understand speech
relatively normally in quiet but have undue difficulty understanding in background
noise. The message of this discussion is that such testing should be done routinely
for patients complaining of this problem. Identification of central presbycusis with
such testing is important for proper auditory rehabilitation.
Keywords
hearing loss - dementia - working memory - executive function - central auditory processing
