Wimmer Del Solar Jonathan, Delgado Carolina, Torrente Mariela C, Délano Paul H
Departamento de Neurociencia, Universidad de Chile, Santiago, Chile.
Departamento de Otorrinolaringología, Hospital Clínico de la Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2020 Aug;148(8):1128-1138. doi: 10.4067/S0034-98872020000801128.
In the last decades, there has been an increase in life expectancy in the world, with the consequent modification in the proportion of adults over 60 years. This is accompanied by an increase in pathologies for which aging is the main risk factor, such as dementia and hearing loss, which profoundly affect the quality of life of individuals and their family and impact health system costs. Given the lack of disease-modifying treatments for dementia, the study of mechanisms to prevent its occurrence has become a world priority. In the year 2017, the Lancet "Commission for dementia prevention, intervention, and care" proposed a model, in which hearing loss emerged as a new modifiable risk factor for the development of dementia. This result undoubtedly has important consequences for the understanding the multifactorial nature of dementia, our daily clinical practice and public policies aimed at its prevention and treatment. In this article, we review the current evidence supporting the association between dementia and hearing loss, discussing the available strategies for prevention, detection and treatment of hearing loss and its possible impact on the natural course of dementia. A flow chart for the clinical management of different subgroups of patients is proposed.
在过去几十年中,全球预期寿命有所增加,60岁以上成年人的比例也随之发生变化。与此同时,以衰老为主要风险因素的疾病有所增加,如痴呆症和听力损失,这些疾病深刻影响着个人及其家庭的生活质量,并影响卫生系统成本。鉴于缺乏针对痴呆症的疾病修饰治疗方法,研究预防其发生的机制已成为全球优先事项。2017年,《柳叶刀》“痴呆症预防、干预和护理委员会”提出了一个模型,其中听力损失成为痴呆症发展的一个新的可改变风险因素。这一结果无疑对理解痴呆症的多因素性质、我们的日常临床实践以及旨在预防和治疗痴呆症的公共政策具有重要意义。在本文中,我们回顾了支持痴呆症与听力损失之间关联的现有证据,讨论了预防、检测和治疗听力损失的可用策略及其对痴呆症自然病程的可能影响。我们还提出了一个针对不同亚组患者的临床管理流程图。