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老年人听力损失尤其是高频听力损失与认知衰退之间的相关性

The Correlation Between Hearing Loss, Especially High-Frequency Hearing Loss and Cognitive Decline Among the Elderly.

作者信息

Diao Tongxiang, Ma Xin, Zhang Junbo, Duan Maoli, Yu Lisheng

机构信息

Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China.

Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, China.

出版信息

Front Neurosci. 2021 Nov 15;15:750874. doi: 10.3389/fnins.2021.750874. eCollection 2021.

Abstract

The relation between cognition and hearing loss has been increasingly paid high attention, however, few studies have focused on the role of high-frequency hearing loss in cognitive decline. This study is oriented to role of hearing loss especially high-frequency hearing loss in cognitive impairment among elderly people (age ≥ 60 years). The Montreal Cognitive Assessment Scale (MoCA) and pure tone audiometry were used to investigate the hearing loss and cognitive function of 201 elderly people older than 60 years. Factors possibly related to cognitive impairment including age, years of education, occupation, living conditions, history of otologic diseases, and high blood pressure were registered. This study consisted of two parts. First, univariate analysis and multiple linear regressions were performed to analyze the possible influencing factors of cognitive function among the 201 elderly people. Second, average hearing thresholds of low frequencies (250, 500 Hz), intermediate frequencies (1 k, 2 kHz), and high frequencies (4 k, 8 kHz) were calculated to screen out 40 cases with high-frequency hearing loss alone and 18 cases with normal hearing. Univariate analysis was used to compare the general condition, cognitive function, and each cognitive domain between the two groups, analyzing the relation between high-frequency hearing loss and cognitive function. We found that age, years of education, pure tone average (PTA), occupation, living condition, history of otologic diseases, years of self-reported hearing loss, and hypertension history were related to cognitive function. Furthermore, age, education experience, duration of self-reported hearing loss, and hypertension were independent factors ( < 0.05). PTA was negatively related with attention, orientation, and general cognition ( < 0.05). There were only 18 cases (9.0%) with normal hearing, and 40 cases (19.9%) with abnormal high-frequency hearing alone. The overall cognitive function showed no significant difference between them ( > 0.05); in contrast, the speech and abstract ability were significantly decreased in cases with high-frequency hearing loss ( < 0.05). The increase of PTA among the elderly may affect the overall cognition by reducing attention and orientation. High-frequency hearing loss alone can affect the language and abstract ability to a certain extent, which is worthy of more attention.

摘要

认知与听力损失之间的关系已越来越受到高度关注,然而,很少有研究关注高频听力损失在认知衰退中的作用。本研究旨在探讨听力损失尤其是高频听力损失在老年人(年龄≥60岁)认知障碍中的作用。采用蒙特利尔认知评估量表(MoCA)和纯音听力测定法对201名60岁以上老年人的听力损失和认知功能进行调查。记录可能与认知障碍相关的因素,包括年龄、受教育年限、职业、生活条件、耳科疾病史和高血压。本研究包括两部分。首先,进行单因素分析和多元线性回归,以分析这201名老年人认知功能的可能影响因素。其次,计算低频(250、500Hz)、中频(1k、2kHz)和高频(4k、8kHz)的平均听力阈值,筛选出仅高频听力损失的40例和听力正常的18例。采用单因素分析比较两组的一般情况、认知功能和各认知领域,分析高频听力损失与认知功能的关系。我们发现年龄、受教育年限、纯音平均听阈(PTA)、职业、生活条件、耳科疾病史、自我报告的听力损失年限和高血压病史与认知功能有关。此外,年龄、教育经历、自我报告的听力损失持续时间和高血压是独立因素(P<0.05)。PTA与注意力、定向力和总体认知呈负相关(P<0.05)。仅18例(9.0%)听力正常,40例(19.9%)仅高频听力异常。两组的总体认知功能无显著差异(P>0.05);相反,高频听力损失患者的言语和抽象能力显著下降(P<0.05)。老年人PTA的升高可能通过降低注意力和定向力影响总体认知。单纯高频听力损失可在一定程度上影响语言和抽象能力,值得更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00b7/8634596/c3011ef28099/fnins-15-750874-g001.jpg

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