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用于支持痴呆风险老年人认知功能的助听器: HearCog 试验-临床方案。

Hearing aids to support cognitive functions of older adults at risk of dementia: the HearCog trial- clinical protocols.

机构信息

Ear Science Institute Australia, 1 Salvado Road, Subiaco, WA, 6008, Australia.

Ear Sciences Centre, Faculty of Health and Medical Sciences, University of Western Australia, 35 Stirling Highway, Perth, WA, 6009, Australia.

出版信息

BMC Geriatr. 2020 Nov 26;20(1):508. doi: 10.1186/s12877-020-01912-1.

Abstract

BACKGROUND

Globally, about 50 million people were living with dementia in 2015, with this number projected to triple by 2050. With no cure or effective treatment currently insight, it is vital that factors are identified which will help prevent or delay both age-related and pathological cognitive decline and dementia. Observational data have suggested that hearing loss is a potentially modifiable risk factor for dementia, but no conclusive evidence from randomised controlled trials is currently available.

METHODS

The HearCog trial is a 24-month, randomised, controlled clinical trial aimed at determining whether a hearing loss intervention can delay or arrest the cognitive decline. We will randomise 180 older adults with hearing loss and mild cognitive impairment to a hearing aid or control group to determine if the fitting of hearing aids decreases the 12-month rate of cognitive decline compared with the control group. In addition, we will also determine if the expected clinical gains achieved after 12 months can be sustained over an additional 12 months and if losses experienced through the non-correction of hearing loss can be reversed with the fitting of hearing aids after 12 months.

DISCUSSION

The trial will also explore the cost-effectiveness of the intervention compared to the control arm and the impact of hearing aids on anxiety, depression, physical health and quality of life. The results of this trial will clarify whether the systematic correction of hearing loss benefits cognition in older adults at risk of cognitive decline. We anticipate that our findings will have implications for clinical practice and health policy development.

TRIAL REGISTRATION

Australian and New Zealand Clinical Trials Registry ( ANZCTR: 12618001278224 ), registered on 30.07.2018.

摘要

背景

全球范围内,2015 年有 5000 万人患有痴呆症,预计到 2050 年这一数字将增加两倍。由于目前尚无治愈或有效治疗方法,因此确定有助于预防或延缓与年龄相关和病理性认知能力下降及痴呆症的因素至关重要。观察性数据表明,听力损失是痴呆症的一个潜在可改变的危险因素,但目前尚无来自随机对照试验的明确证据。

方法

HearCog 试验是一项为期 24 个月的随机对照临床试验,旨在确定听力损失干预是否可以延缓或阻止认知能力下降。我们将随机招募 180 名患有听力损失和轻度认知障碍的老年人,将他们分为助听器组或对照组,以确定佩戴助听器是否可以降低 12 个月时的认知下降速度,与对照组相比。此外,我们还将确定在 12 个月后获得的预期临床收益是否可以持续 12 个月以上,以及通过不纠正听力损失而导致的损失是否可以在 12 个月后通过佩戴助听器来逆转。

讨论

该试验还将探索与对照组相比,干预措施的成本效益,以及助听器对焦虑、抑郁、身体健康和生活质量的影响。该试验的结果将阐明系统纠正听力损失是否有益于有认知能力下降风险的老年人的认知能力。我们预计,我们的研究结果将对临床实践和卫生政策制定产生影响。

试验注册

澳大利亚和新西兰临床试验注册中心(ANZCTR:12618001278224),于 2018 年 7 月 30 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e0d/7690174/6de0af95c95d/12877_2020_1912_Fig1_HTML.jpg

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