阿尔茨海默病中的功能性听力困难：与言语流畅性及痴呆行为和心理症状严重程度的选择性关联
Functional hearing difficulty in Alzheimer's disease: Selective links to verbal fluency and behavioral and psychological symptoms of dementia severity.
文献信息
| PMID | 42770466 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Makoto Uchiyama |
| 作者单位 | Department of Speech, Language and Hearing Sciences, Faculty of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan. |
| 期刊 | Journal of Alzheimer's disease : JAD |
| SCI 分区 | Q2 |
| IF | 4.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 听力损失是痴呆公认的危险因素。然而，阿尔茨海默病（AD）诊断后日常聆听困难的临床相关性仍未被充分理解，尤其是其与认知及痴呆行为和心理症状（BPSD）的关系。功能性听力困难指在日常聆听情境中感知到的困难，而标准听力学阈值未能完全捕捉这些困难。
目的： 探讨AD患者中照护者评定的功能性听力困难、临床实践中常用的认知测量指标以及总体BPSD严重程度之间的关联。
方法： 这项单中心横断面研究纳入101例在记忆门诊就诊、临床诊断为AD的患者。使用基于照护者的结构化访谈评估功能性听力困难。采用回归模型检验其与广泛使用的认知测量指标及BPSD严重程度（以神经精神科问卷五域总分表示）的关联，并校正相关协变量。
结果： 更严重的功能性听力困难选择性地与较差的言语流畅性相关，而与其他认知测量指标未观察到显著关联。功能性听力困难也与更严重的BPSD相关。探索性分析显示，其模式在统计学上与通过言语流畅性产生的间接关联一致。
结论： 在AD患者中，照护者评定的功能性听力困难选择性地与言语流畅性和BPSD严重程度相关。这些发现提示，功能性听力困难可能捕捉到与日常功能相关的沟通相关认知过程，而不仅限于整体疾病严重程度，但仍需纵向研究以阐明时间关系。
英文摘要
BackgroundHearing loss is a well-established risk factor for dementia. However, the clinical relevance of everyday listening difficulties after the diagnosis of Alzheimer's disease (AD) remains insufficiently understood, particularly in relation to cognition and behavioral and psychological symptoms of dementia (BPSD). Functional hearing difficulty refers to perceived difficulties in everyday listening situations that are not fully captured by standard audiometric thresholds.ObjectiveTo examine the associations between caregiver-rated functional hearing difficulty, cognitive measures commonly used in clinical practice, and overall BPSD severity in patients with AD.MethodsThis single-center cross-sectional study included 101 patients with clinically diagnosed AD attending a memory clinic. Functional hearing difficulty was assessed using a caregiver-based structured interview. Associations with widely used cognitive measures and BPSD severity, operationalized as the Neuropsychiatric Inventory five-domain total score, were examined using regression models adjusted for relevant covariates.ResultsGreater functional hearing difficulty was selectively associated with poorer verbal fluency, whereas no significant associations were observed with other cognitive measures. Functional hearing difficulty was also associated with greater BPSD severity. Exploratory analyses showed a pattern statistically consistent with an indirect association via verbal fluency.ConclusionsCaregiver-rated functional hearing difficulty was selectively linked to verbal fluency and BPSD severity in patients with AD. These findings suggest that functional hearing difficulty may capture communication-related cognitive processes relevant to everyday functioning beyond global disease severity, although longitudinal studies are needed to clarify temporal relationships.