Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital, Bochum 44787, Germany.
Department of Geriatric Medicine, Ruhr-University Bochum, Marien Hospital Herne, Herne 44625, Germany.
Clin Interv Aging. 2020 Dec 30;15:2453-2467. doi: 10.2147/CIA.S281627. eCollection 2020.
Due to the aging society, the incidence of age-related hearing loss (ARHL) is strongly increasing. Hearing loss has a high impact on various aspects of life and may lead to social isolation, depression, loss of gain control, frailty and even mental decline. Comorbidity of cognitive and sensory impairment is not rare. This might have an impact on diagnostics and treatment in the geriatric setting.
The aim of the study was to evaluate the impact of hearing impairment on geriatric assessment and cognitive testing routinely done in geriatrics.
This review is based on publications retrieved by a selective search in Medline, including individual studies, meta-analyses, guidelines, Cochrane reviews, and other reviews from 1960 until August 2020.
Awareness of sensory impairment is low among patients and health professionals working with elderly people. The evaluation of the hearing status is not always part of the geriatric assessment and not yet routinely done in psychiatric settings. However, neurocognitive testing as an important part can be strongly influenced by auditory deprivation. Misunderstanding of verbal instructions, cognitive changes, and delayed central processes may lead to a false diagnosis in up to 16% of subjects with hearing loss. To minimize this bias, several neurocognitive assessments were transformed into non-auditory versions recently, eg the most commonly used Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA). However, most of them still lack normative data for elderly people with hearing loss.
Hearing loss should be taken into consideration when performing geriatric assessment and cognitive testing in elderly subjects. Test batteries suitable for ARLH should be applied.
由于社会老龄化，与年龄相关的听力损失（ARHL）的发病率正在大幅上升。听力损失对生活的各个方面都有很大的影响，可能导致社交孤立、抑郁、增益控制丧失、虚弱甚至精神衰退。认知和感觉损伤的合并症并不少见。这可能会对老年人群的诊断和治疗产生影响。
本研究旨在评估听力障碍对老年评估和认知测试的影响，这些测试在老年医学中常规进行。
本综述基于从 1960 年到 2020 年 8 月在 Medline 中进行选择性搜索检索到的出版物，包括个体研究、荟萃分析、指南、Cochrane 综述和其他综述。
患者和老年人群健康专业人员对感觉障碍的认识程度较低。听力状况的评估并不总是老年评估的一部分，也尚未在精神科环境中常规进行。然而，作为重要组成部分的神经认知测试可能会受到听觉剥夺的强烈影响。由于对口头指令的误解、认知变化和中枢过程延迟，高达 16%的听力损失患者可能会被误诊。为了最大限度地减少这种偏差，最近已经将几种神经认知评估转化为非听觉版本，例如最常用的听力障碍蒙特利尔认知评估（HI-MoCA）。然而，它们大多数仍然缺乏针对听力损失老年人的规范数据。
在对老年受试者进行老年评估和认知测试时，应考虑听力损失。应使用适用于 ARHL 的测试组合。
