Goodwin Maria V, Hogervorst Eef, Maidment David W
Loughborough University, Loughborough, United Kingdom.
Alzheimers Dement. 2021 Dec;17 Suppl 12:e058571. doi: 10.1002/alz.058571.
There is a growing body of evidence demonstrating hearing loss in middle-aged and older adults is independently associated with an increased risk of developing cognitive-decline and dementia. Verbal memory is one of the most common functions to decline early in Alzheimer's disease, the most common form of dementia Whilst the exact mechanisms underlying this association remain unclear, poorer test performance may reflect an overarching sensory deficit, as, for instance, most verbal memory tests are predominantly delivered auditorily. Therefore, this study aimed to investigate whether different modes of presentation (i.e., visual, or auditory) influence verbal memory screening test performance in those who failed a hearing screener.
The study was conducted via online video-conferencing due to the COVID-19 pandemic. Participants (N= 63) completed a validated hearing screener, which was a digit-in-noise test delivered via the hearWHO smartphone application. Three cognitive tests were also administered: (1) the Modified Telephone Interview for Cognitive Status (TICS-M), presented auditorily; (2) the Hopkins Verbal Learning Test (HVLT), presented visually; and (3) a verbal fluency task as a control. All tests have been used as dementia screening tests.
Separate ANCOVAs revealed that, when controlling for age, gender, and education level, adults who failed the hearing screener performed more poorly on the TICS-M compared to individuals who passed (p<.001). No differences between hearing groups were found for the other cognitive tests administered (p≥ .132).
This study provides support for the notion that the presentation mode of cognitive tests may account for some of the deficits observed in older adults with hearing loss. As such, researchers and clinicians should be mindful of the sensory deficits experienced by individuals when interpreting cognitive test performance, to avoid the overestimation of cognitive deficits and dementia in adults with hearing loss.
越来越多的证据表明，中老年成年人的听力损失与认知能力下降和痴呆症风险增加独立相关。言语记忆是阿尔茨海默病（最常见的痴呆症形式）早期最常下降的功能之一。虽然这种关联的确切机制尚不清楚，但测试表现较差可能反映了一种总体感觉缺陷，例如，大多数言语记忆测试主要通过听觉进行。因此，本研究旨在调查不同的呈现方式（即视觉或听觉）是否会影响听力筛查未通过者的言语记忆筛查测试表现。
由于COVID-19大流行，该研究通过在线视频会议进行。参与者（N = 63）完成了一项经过验证的听力筛查，这是一项通过hearWHO智能手机应用程序进行的噪声数字测试。还进行了三项认知测试：（1）听觉呈现的改良认知状态电话访谈（TICS-M）；（2）视觉呈现的霍普金斯言语学习测试（HVLT）；（3）作为对照的言语流畅性任务。所有测试都已用作痴呆症筛查测试。
单独的协方差分析显示，在控制年龄、性别和教育水平后，听力筛查未通过的成年人在TICS-M上的表现比通过者更差（p <.001）。在其他进行的认知测试中，未发现听力组之间存在差异（p≥.132）。
本研究支持这样一种观点，即认知测试的呈现方式可能是导致听力损失的老年人出现某些缺陷的原因之一。因此，研究人员和临床医生在解释认知测试表现时应注意个体所经历的感觉缺陷，以避免高估听力损失成年人的认知缺陷和痴呆症。
