Cognitive control strategies in hearing impairment: a study with the AX-CPT

Objective: The present study investigated the impact of hearing impairment on the implementation of proactive and reactive cognitive control during the aging process. Methods: A cohort of 31 hearing-impaired (HI) individuals with one cochlear implant and 41 normal-hearing (NH) listeners of different ages performed the AX-CPT, a well-validated task to measure proactive and reactive cognitive control strategies. Data from both accuracy and response times (RT) were analyzed by mixed effect models that considered trial type, group, age and their interactions. Results: Both accuracy and RT analyses showed significant interactions between trial type, group and age. Specifically, with aging, the NH group had lower performance on AY and BX trials (i.e., the most conflicting trial types of the AX-CPT associated with proactive and reactive control). Conversely, HI participants yielded higher performance on the same trial types at older age. However, for the HI group only, the accuracy benefits observed for AY and BX trials were coupled with an age-related RT increase on both trial types (i.e., speed-accuracy tradeoff). Conclusion: The present findings show a different utilization of cognitive control strategies in HI participants, with specific behavioral patterns that also undergo different changes as compared to NH listeners with advancing aging.