Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
Translational Gerontology Branch, Longitudinal Studies Section, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
J Gerontol A Biol Sci Med Sci. 2020 Feb 14;75(3):574-580. doi: 10.1093/gerona/gly268.
Hearing impairment (HI) could be a risk factor for cognitive decline, but cognition could plausibly also affect psychoacoustic assessment of hearing with audiometry. We examined the temporal sequence of hearing and cognitive function among nondemented, community-dwelling older adults.
Hearing and cognition were assessed between 2012 and 2015 and 2 years thereafter in 313 nondemented participants aged ≥60 years in the Baltimore Longitudinal Study of Aging. Poorer hearing was defined by pure-tone average of 0.5-4 kHz tones in the better-hearing ear. Cognitive measures with either visual or auditory inputs were Trail-making Test Part B; Digit Symbol Substitution Test; California Verbal Learning Test immediate recall, short delay, and long delay; Digit Span Forward/Backward; Benton Visual Retention Test; and Mini-Mental State Examination. We used linear regression models for cross-sectional associations at each timepoint and autoregressive, cross-lagged models to evaluate whether baseline hearing impairment (Time 1) predicted cognitive performance 2 years after baseline (Time 2) and vice versa.
Cross-sectionally, there were no associations between poorer hearing and cognitive performance. Longitudinally, poorer hearing was associated with declines in California Verbal Learning Test immediate (β = -0.073, SE = 0.032, p = .024), short-delayed (β = -0.134, SE = 0.043, p = .002), long-delayed (β = -0.080, SE = 0.032, p = .012) recall, and Digit Span Forward (β = -0.074, SE = 0.029, p = .011).) from Time 1 to Time 2. Cognitive performance at Time 1 did not predict change in hearing status at Time 2.
Audiometric hearing impairment predicted short-term cognitive declines in both California Verbal Learning Test and auditory stimuli for attention.
听力障碍（HI）可能是认知能力下降的一个危险因素，但认知能力也可能通过听力测试中的听觉心理声学评估来影响听力。我们研究了无痴呆的社区居住的老年人群中听力和认知功能的时间顺序。
在巴尔的摩老龄化纵向研究中，对 313 名年龄在 60 岁及以上、无痴呆的参与者进行了 2012 年至 2015 年期间以及此后 2 年的听力和认知评估。较好耳的 0.5-4 kHz 纯音平均听力较差定义为听力较差。具有视觉或听觉输入的认知测量包括连线测试 B 部分；数字符号替代测试；加利福尼亚语言学习测试即刻回忆、短延迟和长延迟；数字广度正向/倒背；本顿视觉保持测试；以及简易精神状态检查。我们使用线性回归模型在每个时间点进行横断面关联分析，并使用自回归、交叉滞后模型来评估基线听力障碍（时间 1）是否预测基线后 2 年（时间 2）的认知表现，反之亦然。
横断面研究中，听力下降与认知表现之间没有相关性。纵向研究中，听力下降与加利福尼亚语言学习测试即刻回忆（β=-0.073，SE=0.032，p=0.024）、短延迟（β=-0.134，SE=0.043，p=0.002）、长延迟（β=-0.080，SE=0.032，p=0.012）和数字广度正向（β=-0.074，SE=0.029，p=0.011）的下降相关。从时间 1 到时间 2。时间 1 的认知表现并不能预测时间 2 听力状况的变化。
听力测试中的听力障碍预测了加利福尼亚语言学习测试和注意力听觉刺激的短期认知下降。
