Panza Francesco, Lozupone Madia, Sardone Rodolfo, Battista Petronilla, Piccininni Marco, Dibello Vittorio, La Montagna Maddalena, Stallone Roberta, Venezia Pietro, Liguori Angelo, Giannelli Gianluigi, Bellomo Antonello, Greco Antonio, Daniele Antonio, Seripa Davide, Quaranta Nicola, Logroscino Giancarlo
Department of Basic Medical Sciences, Neurosciences, and Sense Organs, Neurodegenerative Disease Unit, University of Bari 'Aldo Moro', Piazza Giulio Cesare 11, 70100, Bari, Italy.
Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
Ther Adv Chronic Dis. 2018 Nov 9;10:2040622318811000. doi: 10.1177/2040622318811000. eCollection 2019.
The peripheral hearing alterations and central auditory processing disorder (CAPD) associated with age-related hearing loss (ARHL), may impact cognitive disorders in older age. In older age, ARHL is also a significant marker for frailty, another age-related multidimensional clinical condition with a nonspecific state of vulnerability, reduced multisystem physiological reserve, and decreased resistance to different stressors (i.e. sensorial impairments, psychosocial stress, diseases, injuries). The multidimensional nature of frailty required an approach based on different pathogeneses because this clinical condition may include sensorial, physical, social, nutritional, cognitive, and psychological phenotypes. In the present narrative review, the cumulative epidemiological evidence coming from several longitudinal population-based studies, suggested convincing links between peripheral ARHL and incident cognitive decline and dementia. Moreover, a few longitudinal case-control and population-based studies also suggested that age-related CAPD in ARHL, may be central in determining an increased risk of incident cognitive decline, dementia, and Alzheimer's disease (AD). Cumulative meta-analytic evidence confirmed cross-sectional and longitudinal association of both peripheral ARHL and age-related CAPD with different domains of cognitive functions, mild cognitive impairment, and dementia, while the association with dementia subtypes such as AD and vascular dementia remained unclear. However, ARHL may represent a modifiable condition and a possible target for secondary prevention of cognitive impairment in older age, social isolation, late-life depression, and frailty. Further research is required to determine whether broader hearing rehabilitative interventions including coordinated counseling and environmental accommodations could delay or halt cognitive and global decline in the oldest old with both ARHL and dementia.
与年龄相关性听力损失（ARHL）相关的外周听力改变和中枢听觉处理障碍（CAPD），可能会影响老年人的认知障碍。在老年人群中，ARHL也是衰弱的一个重要标志，衰弱是另一种与年龄相关的多维度临床状况，具有非特异性的脆弱状态、多系统生理储备减少以及对不同应激源（如感官损伤、心理社会压力、疾病、损伤）的抵抗力下降。衰弱的多维度性质需要基于不同发病机制的方法，因为这种临床状况可能包括感官、身体、社会、营养、认知和心理表型。在本叙述性综述中，来自多项基于人群的纵向研究的累积流行病学证据表明，外周ARHL与认知能力下降和痴呆症的发生之间存在令人信服的联系。此外，一些纵向病例对照研究和基于人群的研究还表明，ARHL中与年龄相关的CAPD可能是导致认知能力下降、痴呆症和阿尔茨海默病（AD）发病风险增加的关键因素。累积的荟萃分析证据证实了外周ARHL和与年龄相关的CAPD与认知功能的不同领域、轻度认知障碍和痴呆症之间的横断面和纵向关联，而与AD和血管性痴呆等痴呆症亚型的关联仍不明确。然而，ARHL可能是一种可改变的状况，也是老年认知障碍、社会隔离、晚年抑郁和衰弱二级预防的一个可能靶点。需要进一步的研究来确定更广泛的听力康复干预措施，包括协调咨询和环境适应，是否可以延缓或阻止患有ARHL和痴呆症的最年长者的认知和整体衰退。
