Relatively effortless listening promotes understanding and recall of medical instructions in older adults

Communication success under adverse conditions requires efficient and effective recruitment of both bottom-up (sensori-perceptual) and top-down (cognitive-linguistic) resources to decode the intended auditory-verbal message. Employing these limited capacity resources has been shown to vary across the lifespan, with evidence indicating that younger adults out-perform older adults for both comprehension and memory of the message. This study examined how sources of interference arising from the speaker (message spoken with conversational vs. clear speech technique), the listener (hearing-listening and cognitive-linguistic factors), and the environment (in competing speech babble noise vs. quiet) interact and influence learning and memory performance using more ecologically valid methods than has been done previously. The results suggest that when older adults listened to complex medical prescription instructions with "clear speech," (presented at audible levels through insertion earphones) their learning efficiency, immediate, and delayed memory performance improved relative to their performance when they listened with a normal conversational speech rate (presented at audible levels in sound field). This better learning and memory performance for clear speech listening was maintained even in the presence of speech babble noise. The finding that there was the largest learning-practice effect on 2nd trial performance in the conversational speech when the clear speech listening condition was first is suggestive of greater experience-dependent perceptual learning or adaptation to the speaker's speech and voice pattern in clear speech. This suggests that experience-dependent perceptual learning plays a role in facilitating the language processing and comprehension of a message and subsequent memory encoding.