Effect of Contextual Information on Speech-In-Noise Perception among Young and Older Adults with Normal Hearing Sensitivity: Systematic Review and Meta-Analysis

PURPOSE: This study aimed to investigate the effect of contextual information on speech-in-noise perception among young and older adults with normal hearing sensitivity. METHOD: A comprehensive search was carried out in electronic databases, that is, Web of Science, Scopus, PubMed, and Embase, to identify relevant studies exploring the effects of context on speech-in-noise perception among younger and older adults. Studies comparing the perception of high- and low-context sentences in noise between young and older adults were included. Twenty studies involving 840 participants were included in the analysis. A mixed-method appraisal tool was employed for quality appraisal. RESULTS: Multitalker babble was found to be more challenging than other background noises. In high- and low-context conditions, young adults outperformed older adults. However, older adults benefited more from contextual cues. Meta-analysis showed that at moderate signal-to-noise ratios (SNRs), contextual information more significantly improved speech-in-noise perception in older adults compared with young adults (Cohen's d = 0.30, 95% CI [0.09, 0.51]). Effect sizes were larger but non-significant at low (Cohen's d = 0.66, 95% CI [-0.30, 1.61]) and high (Cohen's d = 1.34, 95% CI [-0.64, 3.33]) SNRs because of high heterogeneity. CONCLUSION: This systematic review revealed many studies reporting greater contextual benefit for older adults and few studies showing comparable or reduced benefit for younger adults. The meta-analysis findings revealed greater benefits at moderate SNRs among older adults.