Gerontology Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Aging Ment Health. 2023 Jan;27(1):184-192. doi: 10.1080/13607863.2021.2007355. Epub 2021 Dec 23.
This study analyzed cognitive differences between hearing-aid (HA) and non-HA users. We hypothesized that HA-use attenuates the auditory-cognitive cascade, thereby, the latter is more conspicuous in non-HA users. Since hearing impairment (HI) shows male predominance, we hypothesized gender differences within the auditory-cognitive relationship.
Non-frail community-dwellers ≥ 80 years were assessed for HI (pure tone audiogram-PTA; speech reception threshold-SRT) and global and domain-specific cognitive impairments (Mini-Mental State Examination-MMSE; Montreal Cognitive Assessment-MOCA; Reaction Time Test-RT1-4). Pearson and partial correlations (correcting for age and PTA) assessed auditory-cognitive associations within gender and HA subgroups. Fisher's z test compared correlations between HA and non-HA users.
126 participants (age range 80-91 years) were included. HA-use prevalence was 21%. HA-users were older with worse HI (mean PTA 49.5dBHL). HA-users exhibited no significant auditory (PTA, SRT) and cognitive (MMSE, MOCA, RT1- RT4) correlations. Male non-HA users, displayed a significant association between HI and global cognition, processing speed, selective and alternating attention. Significant differences were noted between MMSE and PTA and SRT (z-score 2.28, 3.33, = 0.02, <0.01, respectively) between HA and non-HA users.
Male non-HA users displayed an association between HI and global and domain-specific (processing speed; selective and alternating attention) cognitive decline. Associations between global cognition and HI were significantly different between HA and non-HA users. This may be partially attributable to underlying subgroups sample sizes and statistical power disparity. If larger scale longitudinal or interventional studies confirm these findings, timely HI assessment and management may be the cornerstone for delaying cognitive decline.
本研究分析了助听器（HA）使用者和非 HA 使用者之间的认知差异。我们假设 HA 使用会减弱听觉认知级联，因此，后者在非 HA 使用者中更为明显。由于听力损伤（HI）表现出男性优势，我们假设听觉认知关系中存在性别差异。
对≥80 岁的非虚弱社区居住者进行 HI（纯音听力图-PTA；言语接受阈-SRT）和整体及特定领域认知障碍（简易精神状态检查-MMSE；蒙特利尔认知评估-MOCA；反应时间测试-RT1-4）评估。Pearson 和偏相关（校正年龄和 PTA）评估了性别和 HA 亚组内的听觉认知关联。Fisher z 检验比较了 HA 和非 HA 用户之间的相关性。
纳入了 126 名参与者（年龄范围 80-91 岁）。HA 使用的患病率为 21%。HA 用户年龄较大，听力损伤更严重（平均 PTA 为 49.5dBHL）。HA 用户的听觉（PTA、SRT）和认知（MMSE、MOCA、RT1-RT4）相关性无显著差异。男性非 HA 用户，HI 与整体认知、处理速度、选择性和交替注意力之间存在显著关联。HA 和非 HA 用户之间的 MMSE 和 PTA 以及 SRT 之间存在显著差异（z 分数分别为 2.28、3.33，=0.02，<0.01）。
男性非 HA 用户 HI 与整体和特定领域认知（处理速度；选择性和交替注意力）下降之间存在关联。HA 和非 HA 用户之间整体认知与 HI 之间的相关性存在显著差异。这可能部分归因于潜在亚组样本量和统计能力差异。如果更大规模的纵向或干预研究证实了这些发现，及时进行 HI 评估和管理可能是延缓认知衰退的基石。
