中年期未治疗单侧和双侧听力损失的认知影响：初步证据

文献信息

中文摘要

背景： 听力损失已被确定为认知衰退和痴呆的可改变风险因素，尽管大多数证据来自老年人研究。在中年期识别此类认知损害至关重要，因为它可作为理解晚年认知能力变化的基线。本研究旨在比较年龄和社会经济地位匹配的正常听力中年成人与未治疗听力损失中年成人的认知表现。方法：本研究纳入48名40-65岁参与者，包括24名正常听力成人和24名未治疗听力损失成人。在后一组参与者中，9人为单侧损失，15人为双侧损失。认知评估包括评估记忆（顺背和倒背数字广度及情境记忆测试）、通过Go/No-Go任务评估注意力，以及通过字母和类别流畅性任务评估执行功能。结果：结果显示，与正常听力对照相比，未治疗听力损失成人在所有认知任务上表现显著更差。记忆任务、类别流畅性任务和Go/No-Go准确性观察到较大效应量，字母流畅性任务为中等效应量。此外，多变量线性回归分析表明，较好耳纯音阈值独立预测认知表现，而年龄或教育程度则不能。结论：这些发现提供了中年期未治疗听力损失与认知表现之间关联的初步证据。然而，考虑到样本量适中且为横断面研究设计，需要纵向研究来确定听力损失与认知变化之间的时间关系。

英文摘要

Hearing loss has been identified as a modifiable risk factor for cognitive decline and dementia, although most of the evidence is derived from studies in older adults. Identifying such cognitive impairment in midlife is crucial, as it serves as a baseline for understanding changes in cognitive abilities that occur later in life. The present study aimed to compare the cognitive performance of age- and socioeconomic status-matched middle-aged adults with normal hearing and those with untreated hearing loss. This study included 48 participants aged 40-65 years, comprising 24 adults with normal hearing and 24 with untreated hearing loss. Among the latter participants, 9 had unilateral loss and 15 had bilateral loss. The cognitive evaluation involved assessing memory (forward and backward digit span and contextual memory test), attention via the Go/No-Go task, and executive function via the letter and category fluency tasks. Results showed that adults with untreated hearing loss performed significantly poorer on all the cognitive tasks compared to their normal-hearing counterparts. Large effect sizes were observed for memory tasks, the category fluency task and Go/No-Go accuracy, and a moderate effect size for the letter fluency tasks. Furthermore, multivariate linear regression analysis demonstrated that better-ear pure-tone thresholds independently predicted cognitive performance, but not age or education. These findings provide preliminary evidence on the association between untreated hearing loss and cognitive performance in middle age. However, considering the modest sample size and cross-sectional study design, longitudinal studies are needed to determine the temporal relationship between hearing loss and cognitive changes.