Decline of auditory-motor speech processing in older adults with hearing loss

Older adults often experience difficulties in understanding speech, partly because of age-related hearing loss. In young adults, activity of the left articulatory motor cortex is enhanced and it interacts with the auditory cortex via the left-hemispheric dorsal stream during speech processing. Little is known about the effect of ageing and age-related hearing loss on this auditory-motor interaction and speech processing in the articulatory motor cortex. It has been proposed that up-regulation of the motor system during speech processing could compensate for hearing loss and auditory processing deficits in older adults. Alternatively, age-related auditory deficits could reduce and distort the input from the auditory cortex to the articulatory motor cortex, suppressing recruitment of the motor system during listening to speech. The aim of the present study was to investigate the effects of ageing and age-related hearing loss on the excitability of the tongue motor cortex during listening to spoken sentences using transcranial magnetic stimulation and electromyography. Our results show that the excitability of the tongue motor cortex was facilitated during listening to speech in young and older adults with normal hearing. This facilitation was significantly reduced in older adults with hearing loss. These findings suggest a decline of auditory-motor processing of speech in adults with age-related hearing loss.