Parallel Session 2: Neurodegeneration| Wed 18 May, 1115 – 1230|2 Degraded speech comprehension is a ‘real-world audiogram’ for dementia

UCLThe recently recognised association between hearing impairment and dementia has important clinical and public health implications but remains poorly understood. In daily life, the most important sound we hear is speech: making sense of spoken messages that are ‘degraded’ by noise is fundamental to suc- cessful communication and depends on neural computations in the auditory brain that are vulnerable to neurodegenerative pathologies. Measuring degraded speech perception might therefore index both real-world hearing function and the underlying disease process in dementia.We administered tests of degraded speech and pure tone audiometry, before correlating these measures with questionnaire data on real-world hearing ability in healthy control participants and patients with Alzheimer’s disease (AD), frontotemporal dementia (FTD) and the primary progressive aphasias (PPA). Audiometric performance was modulated by auditory cognitive performance and correlated poorly with real-world hearing ability. Degraded speech tests were able to stratify syndromic groups and showed significantly better correlation with real-world hearing measures.Our findings suggest that auditory brain function is a critical determinant of daily life communication in people with dementia: tests of auditory cognition may constitute a ‘real-word audiogram’ for these diseases, adding value to standard audiometry and potentially detecting neurodegenerative patholo- gies earlier.