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It is therefore potentially vulnerable to neurodegenerative diseases, particularly those led by communication deficits (primary progressive aphasia). However, how speech\u2010in\u2010noise perception is affected in these diseases is poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Here we addressed this in 59 patients representing typical Alzheimer's disease and canonical logopenic, nonfluent\/agrammatic and semantic variant syndromes of primary progressive aphasia, compared with 24 cognitively\u2010well, older controls. We administered a digit triplet test of speech\u2010in\u2010noise perception based on the task used in the UK Biobank study, alongside pure tone audiometry and a general neuropsychological assessment. Voxel\u2010based morphometry of patients' brain MRI scans was used to identify structural neuroanatomical associations of speech\u2010in\u2010noise perception.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After adjusting for age, peripheral hearing and general cognitive function, the Alzheimer's, logopenic and nonfluent primary progressive aphasia groups performed significantly worse on speech\u2010in\u2010noise perception than controls. The nonfluent primary progressive aphasia and Alzheimer groups additionally had significantly worse peripheral hearing function than controls. Speech\u2010in\u2010noise perceptual performance correlated with grey matter atrophy in the right supramarginal gyrus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Profiles of central (brain) and peripheral hearing impairment stratify major dementias, with implications for diagnosis and development of interventions to improve real\u2010world communication in people living with dementia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70701","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:16:23Z","timestamp":1784034983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Speech\u2010In\u2010Noise Perception in Alzheimer's Disease and Primary Progressive Aphasia"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2535-000X","authenticated-orcid":false,"given":"Sophie A.","family":"Froud","sequence":"first","affiliation":[{"name":"Dementia Research Centre, Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Levett","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Jiang","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy B.","family":"Core","sequence":"additional","affiliation":[{"name":"Dementia Research Centre, Queen Square Institute of Neurology University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehzat","family":"Koohi","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, Institute of Neurology University College London  London UK"},{"name":"The Ear Institute University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Tutton","sequence":"additional","affiliation":[{"name":"Eargym Ltd  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Green","sequence":"additional","affiliation":[{"name":"Eargym Ltd  London UK"},{"name":"Speech, Hearing and Phonetic Sciences, Chandler House University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris\u2010Eva","family":"Bamiou","sequence":"additional","affiliation":[{"name":"National Hospital for Neurology and Neurosurgery, Queen Square  London UK"},{"name":"National Institute for Health and Care Research, UCLH\/UCL Biomedical Research Centre (Hearing Theme)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles R.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Centre for Preventive Neurology Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-6492","authenticated-orcid":false,"given":"Chris J. 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