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助听器对听力受损的阿尔茨海默病患者及其照顾者的痴呆行为和心理症状以及生活质量有影响吗?

Do Hearing Aids Influence Behavioral and Psychological Symptoms of Dementia and Quality of Life in Hearing Impaired Alzheimer's Disease Patients and Their Caregivers?

作者信息

Adrait Arnaud, Perrot Xavier, Nguyen Marie-France, Gueugnon Marine, Petitot Charles, Collet Lionel, Roux Adeline, Bonnefoy Marc

机构信息

Geriatric Medicine Unit, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, Université Claude Bernard, Lyon1, France.

Institute of Sciences and Techniques for Rehabilitation (ISTR), Université Claude Bernard, Lyon1, France.

出版信息

J Alzheimers Dis. 2017;58(1):109-121. doi: 10.3233/JAD-160792.

Abstract

BACKGROUND

It has been suggested that age-related hearing loss (ARHL) and Alzheimer's disease (AD) are commonly associated.

OBJECTIVE

The Alzheimer Disease, Presbycusis and Hearing Aids (ADPHA) clinical trial assessed the influence of hearing aids (HAs) on patients affected by ARHL and AD, as judged by behavioral symptoms and functional abilities, as well as patient and caregiver quality of life (QoL).

METHODS

A multicenter double-blind randomized placebo-controlled trial, with a semi-crossover procedure over 12 months, was conducted from 2006 to 2012. For the first 6 months, the active group was treated with active HAs and the placebo group with inactive HAs. For the last 6 months, HAs in the placebo group were activated. Assessment was conducted at baseline, 6 months, and 12 months. We performed intergroup and intragroup comparisons. Behavioral symptoms were assessed by neuropsychiatric inventory (NPI), functional abilities by instrumental activities of daily living, and QoL by Zarit, Alzheimer's disease related quality of life, and simplified Duke scales.

RESULTS

Fifty-one patients were included and randomized: 22 in active group (mean NPI 17.6; mean age 83±6.2) and 26 in placebo group (mean NPI 25.8; mean age 82.3±7.2) were fitted with HAs. At 6-month follow-up, all scores worsened without significant difference between the two groups. In placebo group, activation of HAs had no effect on the change of these scores.

CONCLUSION

These findings do not provide evidence of improvement in behavioral symptoms, functional status, or QoL of hearing impaired AD patients and their caregivers after 6 months of HA use. However, we cannot exclude that HAs may have a positive effect in patients aged less than 75 years.

摘要

背景

有人提出年龄相关性听力损失(ARHL)与阿尔茨海默病(AD)通常有关联。

目的

阿尔茨海默病、老年性聋与助听器(ADPHA)临床试验评估了助听器(HAs)对受ARHL和AD影响患者的影响,评估依据为行为症状、功能能力以及患者和照护者的生活质量(QoL)。

方法

2006年至2012年进行了一项多中心双盲随机安慰剂对照试验,采用为期12个月的半交叉程序。在前6个月,活性组接受活性助听器治疗,安慰剂组接受无活性助听器治疗。在最后6个月,安慰剂组的助听器被激活。在基线、6个月和12个月时进行评估。我们进行了组间和组内比较。行为症状通过神经精神科量表(NPI)评估,功能能力通过日常生活活动能力量表评估,生活质量通过扎里特量表、阿尔茨海默病相关生活质量量表和简化杜克量表评估。

结果

纳入51例患者并进行随机分组:活性组22例(平均NPI为17.6;平均年龄83±6.2岁),安慰剂组26例(平均NPI为25.8;平均年龄82.3±7.2岁)佩戴了助听器。在6个月随访时,所有评分均恶化,两组间无显著差异。在安慰剂组,激活助听器对这些评分的变化没有影响。

结论

这些研究结果并未提供证据表明使用助听器6个月后,听力受损的AD患者及其照护者的行为症状、功能状态或生活质量有所改善。然而,我们不能排除助听器可能对75岁以下患者有积极影响。

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