Harrison Bush Aryn L, Lister Jennifer J, Lin Frank R, Betz Joshua, Edwards Jerri D
1School of Aging Studies, University of South Florida, Tampa, Florida, USA; 2Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA; 3Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; 4Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; and 5Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Ear Hear. 2015 Jul-Aug;36(4):395-407. doi: 10.1097/AUD.0000000000000142.
Research has increasingly suggested a consistent relationship between peripheral hearing and selected measures of cognition in older adults. However, other studies yield conflicting findings. The primary purpose of the present study was to further elucidate the relationship between peripheral hearing and three domains of cognition and one measure of global cognitive status. It was hypothesized that peripheral hearing loss would be significantly associated with poorer performance across measures of cognition, even after adjusting for documented risk factors. No study to date has examined the relationship between peripheral hearing and such an extensive array of cognitive measures.
Eight hundred ninety-four older adult participants from the Staying Keen in Later Life study cohort were eligible, agreed to participate, and completed the baseline evaluation. Inclusion criteria were minimal to include a sample of older adults with a wide range of sensory and cognitive abilities. Multiple linear regression analyses were conducted to evaluate the extent to which peripheral hearing predicted performance on a global measure of cognitive status, as well as multiple cognitive measures in the domains of speed of processing (Digit Symbol Substitution and Copy, Trail Making Test Part A, Letter and Pattern Comparison, and Useful Field of View), executive function (Trail Making Test Part B and Stroop Color-Word Interference Task), and memory (Digit Span, Spatial Span, and Hopkins Verbal Learning Test).
Peripheral hearing, measured as the three-frequency pure-tone average (PTA) in the better ear, accounted for a significant, but minimal, amount of the variance in measures of speed of processing, executive function, and memory, as well as global cognitive status. Alternative measures of hearing (i.e., three-frequency PTAs in the right and left ears and a bilateral, six-frequency PTA [three frequencies per ear]) yielded similar findings across measures of cognition and did not alter the study outcomes in any meaningful way.
Consistent with literature suggesting a significant relationship between peripheral hearing and cognition, and in agreement with our hypothesis, peripheral hearing was significantly related to 10 of 11 measures of cognition that assessed processing speed, executive function, or memory, as well as global cognitive status. Although evidence, including the present results, suggests a relationship between peripheral hearing and cognition, little is known about the underlying mechanisms. Examination of these mechanisms is a critical need to direct appropriate treatment.
研究越来越多地表明,老年人的外周听力与特定认知指标之间存在一致的关系。然而,其他研究得出了相互矛盾的结果。本研究的主要目的是进一步阐明外周听力与认知的三个领域以及一项整体认知状态指标之间的关系。研究假设,即使在对已记录的风险因素进行调整之后,外周听力损失仍会与认知指标表现较差显著相关。迄今为止,尚无研究考察外周听力与如此广泛的认知指标之间的关系。
来自“晚年保持敏锐”研究队列的894名老年参与者符合条件,同意参与并完成了基线评估。纳入标准很宽松,以纳入具有广泛感官和认知能力的老年人样本。进行了多元线性回归分析,以评估外周听力在多大程度上预测了整体认知状态指标以及加工速度(数字符号替换与抄写、连线测验A部分、字母与图案比较以及有用视野)、执行功能(连线测验B部分和斯特鲁普颜色-词语干扰任务)和记忆(数字广度、空间广度和霍普金斯言语学习测验)领域的多项认知指标。
以较好耳的三频率纯音平均听阈(PTA)衡量的外周听力,在加工速度、执行功能、记忆以及整体认知状态指标的变异中占显著但极小的比例。听力的替代指标(即左右耳的三频率PTA以及双耳六频率PTA[每耳三个频率])在各项认知指标上得出了相似的结果,并且没有以任何有意义的方式改变研究结果。
与表明外周听力和认知之间存在显著关系的文献一致,并且与我们的假设相符,外周听力与评估加工速度、执行功能或记忆以及整体认知状态的11项认知指标中的10项显著相关。尽管包括本研究结果在内的证据表明外周听力与认知之间存在关系,但对于潜在机制知之甚少。对这些机制的研究是指导适当治疗的迫切需求。