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音乐训练对晚年言语感知和认知的益处。

Benefit of Musical Training for Speech Perception and Cognition Later in Life.

机构信息

Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison.

Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison.

出版信息

J Speech Lang Hear Res. 2021 Jul 16;64(7):2885-2896. doi: 10.1044/2021_JSLHR-20-00588. Epub 2021 Jun 28.

Abstract

Purpose The aim of this study was to determine the long-term associations of musical training with speech perception in adverse conditions and cognition in a longitudinal cohort study of middle-age to older adults. Method This study is based on Epidemiology of Hearing Loss Study participants. We asked participants at baseline (1993-1995) about their musical training. Speech perception (word recognition in competing message; Northwestern University Auditory Test Number 6), cognitive function (cognitive test battery), and impairment (self-report or surrogate report of Alzheimer's disease or dementia, and/or a Mini-Mental State Examination score ≤ 24) were assessed up to 5 times over the 20-year follow-up. We included 2,938 Epidemiology of Hearing Loss Study participants who had musical training data and at least one follow-up of speech perception and/or cognitive assessment. We used linear mixed-effects models to determine associations between musicianship and decline in speech perception and cognitive function over time and Cox regression models to evaluate associations of musical training with 20-year cumulative incidence of speech perception and cognitive impairment. Models were adjusted for age, sex, and occupation and repeated with additional adjustment for health-related confounders and education. Results Musicians showed less speech perception decline over time with stronger effects in women (0.16% difference, 95% confidence interval [CI] [0.05, 0.26]). Among men, musicians had, on average, better speech perception than nonmusicians (3.41% difference, 95% CI [0.62, 6.20]) and were less likely to develop a cognitive impairment than nonmusicians (hazard ratio = 0.58, 95% CI [0.37, 0.91]). Conclusions Musicians showed an advantage in speech perception abilities and cognition later in life and less decline over time with different magnitudes of effect sizes in men and women. Associations remained with further adjustment, indicating that some degree of the advantage of musical training is independent of socioeconomic or health differences. If confirmed, these findings could have implications for developing speech perception intervention and prevention strategies. Supplemental Material https://doi.org/10.23641/asha.14825454.

摘要

目的 本研究旨在通过一项中年至老年人群的纵向队列研究,确定音乐训练与在不利条件下的言语感知以及认知的长期关联。

方法 本研究基于听力损失流行病学研究参与者。我们在基线(1993-1995 年)时询问参与者是否接受过音乐训练。言语感知(竞争信息中的单词识别;西北大学听觉测试 6 号)、认知功能(认知测试组合)和损伤(自我报告或替代报告的阿尔茨海默病或痴呆,以及/或简易精神状态检查评分≤24)在 20 年的随访期间最多进行了 5 次评估。我们纳入了 2938 名有音乐训练数据且至少有一次言语感知和/或认知评估随访的听力损失流行病学研究参与者。我们使用线性混合效应模型来确定音乐训练与随时间推移言语感知和认知功能下降之间的关联,并使用 Cox 回归模型来评估音乐训练与 20 年言语感知和认知损伤累积发生率之间的关联。模型调整了年龄、性别和职业,并重复进行了调整,纳入了与健康相关的混杂因素和教育。

结果 与非音乐家相比,音乐家的言语感知随时间的下降幅度较小,且女性的效果更强(差异 0.16%,95%置信区间[CI] [0.05, 0.26])。在男性中,音乐家的言语感知平均优于非音乐家(差异 3.41%,95% CI [0.62, 6.20]),且发生认知损伤的可能性低于非音乐家(风险比=0.58,95% CI [0.37, 0.91])。

结论 音乐家在言语感知能力和认知方面表现出优势,且随时间推移,男性和女性的效应大小不同,言语感知能力的下降幅度也较小。进一步调整后,关联仍然存在,这表明音乐训练的某种优势在一定程度上独立于社会经济或健康差异。如果得到证实,这些发现可能对制定言语感知干预和预防策略具有重要意义。

补充材料 https://doi.org/10.23641/asha.14825454.

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