Uchida Yasue, Sugiura Saiko, Nishita Yukiko, Saji Naoki, Sone Michihiko, Ueda Hiromi
Department of Otorhinolaryngology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan; Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan.
Department of Otorhinolaryngology, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan; Toyota Josui Mental Clinic, 86-2 Minamidaira, Josui-cho, Toyota, Aichi, 470-0343, Japan.
Auris Nasus Larynx. 2019 Feb;46(1):1-9. doi: 10.1016/j.anl.2018.08.010. Epub 2018 Sep 1.
The amount of attention to age-related hearing loss (ARHL) has been growing, not only from the perspective of being one of the most common health conditions affecting older adults, but also from the perspective of its relation to cognition. Results from a number of epidemiological and laboratory studies have demonstrated a significant link between ARHL and cognitive decline. The Lancet International Commission on Dementia, Prevention, Intervention, and Care has estimated that mid-life hearing loss, if eliminated, might decrease the risk of dementia by nine percent, since hearing loss is a modifiable age-associated condition linked to dementia. Despite numerous research efforts, elucidation of the underlying causal relationships between auditory and cognitive decline has not yet reached a consensus. In this review article, we focused on the hypotheses of etiological mechanisms between ARHL and cognitive decline: (1) cognitive load hypothesis; (2) common cause hypothesis; (3) cascade hypothesis; and (4) overdiagnosis or harbinger hypothesis. Factual evidence obtained in previous studies was assessed to understand the link between ARHL and cognitive decline or dementia. Additionally, an overview of the conceivable effects of hearing intervention, e.g., hearing aids and cochlear implants, on cognition were presented, and the role of hearing aid use was considered for the relevant hypotheses. We should continue to strive for social enlightenment towards the importance of 'hearing well', and cultivate a necessity for hearing screening among patients at risk of cognitive decline.
对年龄相关性听力损失（ARHL）的关注程度一直在增加，这不仅是因为它是影响老年人的最常见健康状况之一，还因为它与认知的关系。一些流行病学和实验室研究的结果表明，ARHL与认知衰退之间存在显著联系。《柳叶刀》痴呆症预防、干预和护理国际委员会估计，如果消除中年听力损失，可能会使痴呆症风险降低9%，因为听力损失是一种与痴呆症相关的可改变的年龄相关状况。尽管进行了大量研究，但对听觉衰退和认知衰退之间潜在因果关系的阐释尚未达成共识。在这篇综述文章中，我们重点关注了ARHL与认知衰退之间病因机制的假设：（1）认知负荷假设；（2）共同病因假设；（3）级联假设；以及（4）过度诊断或先兆假设。我们评估了先前研究中获得的事实证据，以了解ARHL与认知衰退或痴呆症之间的联系。此外，还概述了听力干预（如助听器和人工耳蜗）对认知的可能影响，并考虑了使用助听器在相关假设中的作用。我们应继续努力提高社会对“听力良好”重要性的认识，并培养对有认知衰退风险患者进行听力筛查的必要性。
