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评估慢性耳鸣老年患者的整体认知和情绪状态。

The evaluation of global cognitive and emotional status of older patients with chronic tinnitus.

机构信息

Institute of Otolaryngology, Fondazione Policlinico Agostino Gemelli, IRCCS, Rome, Italy.

Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Brain Behav. 2021 Aug;11(8):e02074. doi: 10.1002/brb3.2074. Epub 2021 Jul 21.

Abstract

OBJECTIVES

Tinnitus is a common symptom largely impactful on quality of life, especially in the elderly. Our aim was to evaluate the efficacy of self-administered screening tests to correlate the severity of subjective perception of tinnitus with emotional disorders and the overall cognitive status.

METHODS

Patients aged ≥ 55 years with chronic tinnitus were recruited and submitted to a complete audiological evaluation; Tinnitus Handicap inventory (THI); Hospital Anxiety and Depression Scale (HADS-A and HADS-D) and Mini-Mental State Examination (MMSE). Demographic and audiological features of patients with and without cognitive impairment (MMSE score cut-off of 24/30) were analyzed in order to reveal the relationship among tinnitus, emotional disorders, and cognitive dysfunction.

RESULTS

102 patients were recruited (mean age: 70.4 ± 9.6). THI score was directly related to HADS-A score (r = .63) HADS-D score (r = .66), whereas there was no relationship between tinnitus severity and MMSE (r = .13). CI and n-CI groups did not differ in the characteristics of tinnitus (p > .05), however, hearing threshold (p = .049) and anxious depressive traits measured with HADS-A (p = .044) and HADS-D (p = .016) were significantly higher in the group with cognitive impairment. Furthermore, age ≥ 75 years (p = .002, OR = 13.8), female sex (p = .032; OR = 6.5), severe hearing loss (p = .036; OR = 2.3), and anxiety (p = .029; OR = 9.2) resulted risk factors for CI. Therefore, in CI group MMSE score was inversely related to age (r = -.84).

CONCLUSIONS

Cognitive impairment and psychiatric discomfort should be considered in tinnitus patients, related to increasing age, female sex, and severe hearing loss. Thus, self-administered questionnaires can be useful in addressing clinical approach.

摘要

目的

耳鸣是一种常见症状,对生活质量影响很大,尤其是在老年人中。我们的目的是评估自我管理的筛查测试的功效,以将耳鸣的主观感知严重程度与情绪障碍和整体认知状态相关联。

方法

招募年龄≥55 岁的慢性耳鸣患者,并进行全面的听力学评估;耳鸣残疾量表(THI);医院焦虑和抑郁量表(HADS-A 和 HADS-D)和简易精神状态检查(MMSE)。分析有和无认知障碍(MMSE 评分 24/30 分界值)患者的人口统计学和听力学特征,以揭示耳鸣、情绪障碍和认知功能障碍之间的关系。

结果

共招募了 102 名患者(平均年龄:70.4±9.6)。THI 评分与 HADS-A 评分(r=.63)和 HADS-D 评分(r=.66)直接相关,而耳鸣严重程度与 MMSE 之间无相关性(r=.13)。CI 和 n-CI 组在耳鸣特征方面无差异(p>.05),然而,认知障碍组的听力阈值(p=.049)和 HADS-A(p=.044)和 HADS-D(p=.016)测量的焦虑抑郁特征明显更高。此外,年龄≥75 岁(p=.002,OR=13.8)、女性(p=.032;OR=6.5)、严重听力损失(p=.036;OR=2.3)和焦虑(p=.029;OR=9.2)是认知障碍的危险因素。因此,在 CI 组中,MMSE 评分与年龄呈负相关(r=-.84)。

结论

认知障碍和精神不适应在耳鸣患者中考虑,与年龄增长、女性和严重听力损失有关。因此,自我管理问卷在解决临床方法时可能有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d80a/8413806/c550b5cb3288/BRB3-11-e02074-g002.jpg

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