听力、听觉处理与认知之间的关系：一项针对老年人的研究

文献信息

中文摘要

背景/目的： 从中年开始，与年龄相关的认知衰退可能对整体听力健康产生负面影响。因此，理解听力与认知之间的关系至关重要。尽管这一关系已受到相当多的关注，并且已有许多理论被提出用以解释它，但问题仍然存在。研究表明，50%的美国老年人面临严重听力损失，影响其日常交流，而阿尔茨海默病作为痴呆症的一个主要原因，影响约11%的65岁及以上美国人。柳叶刀委员会强调听力损失是痴呆症的主要可改变风险因素，贡献高达7%的风险。本研究的目的是增进我们对听力和认知中哪些具体领域相关的理解，从而为理论和临床实践提供信息。方法：参与者为99名老年人（平均年龄=73岁），招募自为期10年的认知变化指标研究。使用外周听力敏感性测量（四频率纯音平均听阈[PTA4]）和听觉处理测量（双耳分听句子识别[DSI]）来预测蒙特利尔认知评估（MoCA）和Cogstate简短电池（CBB）中多项测量的表现。结果：DSI在MoCA和CBB中均成为显著预测因子，超过了PTA4的预测能力。令人惊讶的是，听力与认知测量之间的关系在MoCA领域与CBB子测试之间有所不同，突显了这种关联的复杂性。结论：分离和识别竞争性听觉信息的能力可能是健康认知功能的必要组成部分。在临床实践中，评估双耳听觉处理可能为老年人的认知脆弱性提供早期指标。

英文摘要

Background/Objectives: Beginning in mid-life, age-related cognitive decline may negatively affect overall hearing health. Thus, understanding the relationship between hearing and cognition is of critical importance. Although the relationship has received considerable attention, and numerous theories have been posited to explain it, questions remain. Research indicates that 50% of older Americans grapple with severe hearing loss, affecting their daily communication, while Alzheimer's disease, a prevailing cause of dementia, affects approximately 11% of Americans aged 65 or older. The Lancet Commission underscores hearing loss as a leading modifiable risk factor for dementia, contributing up to 7% of the risk. The purpose of this study was to advance our understanding of the specific domains of hearing and cognition that are related, thus informing theory and clinical practice. Methods: Participants were 99 older adults (mean age = 73 years) recruited from the 10-year Indicators of Cognitive Change study. Measures of peripheral hearing sensitivity (four-frequency pure-tone average [PTA4]) and auditory processing (Dichotic Sentence Identification [DSI]) were used to predict performance on multiple measures from the Montreal Cognitive Assessment (MoCA) and Cogstate Brief Battery (CBB). Results: DSI emerged as a significant predictor across both MoCA and CBB, surpassing the predictive power of PTA4. Surprisingly, relationships between hearing and cognitive measures differed for MoCA domains versus CBB subtests, highlighting the complexity of this association. Conclusions: The ability to separate and identify competing auditory information may be necessary components of healthy cognitive function. In clinical practice, assessment of binaural auditory processing may provide an early indicator of cognitive vulnerability in older adults.