Age-related hearing loss, a bilateral sensorineural impairment affecting higher frequencies, is highly prevalent among older populations. Its impact extends beyond mere difficulties in speech comprehension, leading to increased listening effort and a decrease in cognitive resources available for other domains. Moreover, hearing loss is one of the primary risk factors for developing tinnitus, the phantom perception of sound, mostly perceived as ringing “in the ear” without external stimulation. Emerging research suggests a potential link between tinnitus perception and cognitive impairments, alongside difficulties in speech comprehension.

Thus, unravelling the underlying neuro-cognitive mechanisms is crucial, alongside the development of effective intervention strategies and targeted training programs. In this symposium we intend to address these challenges with the aim to untangle the complex interplay of age-related hearing loss, tinnitus, cognitive functions, and speech perception, utilizing results from behavioral assessments, neuroimaging and intervention studies.

Lukas Rüttiger (Tübingen) will provide new insights in the role of stimulus onset contributions to speech comprehension that exist dependent and independent of aging and hearing loss. Julian Ockelmann (Zürich) will explore the potential benefits of auditory-cognitive training for treating speech comprehension deficits in older adults. Stephanie Rosemann (Oldenburg) will delve into the effects of chronic tinnitus, accompanied by hearing loss, on speech-in-noise perception and cognitive functions. Rodrigo Donoso-San Martin (Tübingen) will elucidate the relation of fast auditory processing deficits and cortical changes in tinnitus using for the first time the optical pumped magnetometer (OPM) MEG technology that promised new cortical resolution highly relevant for hearing research.

Older adults with hearing loss often struggle to understand speech in noisy environments—a challenge that hearing aids alone do not fully address. One promising complementary approach is auditory-cognitive training, which targets age-related declines in top-down cognitive functions that support speech processing. In this talk, we explore the potential of gamified, adaptive, and self-guided auditory-cognitive training as a way to support speech-in-noise comprehension (SINC) in older adults with hearing loss.

Data come from a randomized controlled trial (N = 55; ages 65–82), in which participants completed either a four-week auditory-cognitive training program or an active control involving foreign language learning. Pre- and post-training assessments included a naturalistic SINC task using conversational speech masked by cafeteria noise, along with cognitive measures of working memory, selective and divided attention, and phonological short-term memory.

Participants in the experimental group showed greater gains in speech comprehension accuracy than controls, particularly under higher noise conditions. Improvements were also observed on trained cognitive tasks across memory and attentional domains. However, while SINC improvements were treatment-specific, cognitive enhancements were not consistently distinct between groups. Additionally, no effects were found for subjective hearing ratings, perceived listening effort, or standard speech-in-noise intelligibility.

These findings contribute to a growing body of research supporting the use of auditory-cognitive training to enhance communication in aging populations. They also highlight the need for future work to clarify mechanisms of transfer and optimize training protocols for broader cognitive and perceptual outcomes.

Tinnitus is the phantom perception of sound without any external stimulation and can be perceived as whistling, buzzing or ringing “in the ear”. It affects approximately 10-20% of the population and hearing loss is one of the primary risk factors. Chronic tinnitus significantly impacts the quality of life and mental health of these patients. Additionally, emerging research suggests a potential link between tinnitus perception and cognitive impairments, alongside difficulties in speech comprehension. In this talk, I will present data from a behavioral study in n=32 chronic tinnitus patients and n=32 control participants matched in age, sex and hearing loss. All participants underwent cognitive tasks covering general cognitive status, processing speed, cognitive flexibility, inhibition and working memory. In addition, we assessed speech-in-noise perception, listening effort, hearing handicap and hyperacusis. All tinnitus patients further filled in questionnaires targeting the history and distress of their tinnitus. We hypothesized that tinnitus patients exhibit deficits in cognitive abilities and speech-in-noise perception along with experiencing a higher listening effort. We further expected a negative correlation between tinnitus distress and cognitive abilities indicating higher distress with lower scores. Our preliminary data analysis (n=31 tinnitus patients and n=20 control participants) indicated significantly lower general cognitive abilities, worse speech-in-noise perception and slower processing speed. Further, better speech-in-noise perception seems to be related to higher general cognitive abilities, faster processing speed and better interference control. Hence, we demonstrate that the chronic tinnitus perception significantly impacts cognitive functions and speech-in-noise perception.