Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
PLoS One. 2021 Dec 31;16(12):e0261207. doi: 10.1371/journal.pone.0261207. eCollection 2021.
Dementia currently affects 50 million people globally with this expected to triple by 2050. Even though hearing loss is associated with cognitive decline, the underlying mechanisms are not fully understood. Considering hearing loss is the largest modifiable risk factor for developing dementia, it is essential to study the effect of hearing aids on cognitive function.
To systematically review the existing literature to examine the evidence for using hearing aids intervention as a treatment for deteriorating cognitive function.
A search of PubMed, Cochrane Library, Embase and grey literature was conducted revealing 3060 unique records between 1990-2020. Two reviewers independently selected longitudinal studies observing the effects of hearing aids on cognitive function in persons without dementia at onset of the study. Due to the heterogeneity of the data, a meta-analysis could not be performed. Outcomes are described in a summary of findings table and portrayed diagrammatically.
We identified 17 unique studies, spanning 30 years of research and 3526 participants. The included studies made use of 50 different cognitive function tests. These tests were grouped into separate cognitive domains according to the DSM-V classification for further analysis. The most beneficial impact of hearing aids seems to be in the cognitive domain of executive function, with six studies showing improvement, two studies being inconclusive and three studies not demonstrating a significant effect. Three of five studies demonstrated significant improvement when screening for brief mental status. The least beneficial impact is seen in domain of complex attention, with eight studies showing no significant effects, compared with one demonstrating improvement with intervention.
Based on this systematic review, we conclude that there is controversy about the effects of hearing aids on cognition. Additional research through randomized clinical trials with standardized cognitive assessment and longer follow-up is warranted to further elucidate this relationship.
目前全球有 5000 万人患有痴呆症，预计到 2050 年这一数字将增加两倍。尽管听力损失与认知能力下降有关，但其中的机制尚未完全阐明。鉴于听力损失是导致痴呆症的最大可改变风险因素，因此研究助听器对认知功能的影响至关重要。
系统综述现有文献，以评估助听器干预作为治疗认知功能下降的证据。
检索了 PubMed、Cochrane 图书馆、Embase 和灰色文献，在 1990 年至 2020 年间共发现 3060 条独特的记录。两名审查员独立选择了纵向研究，观察在研究开始时没有痴呆症的人群中助听器对认知功能的影响。由于数据的异质性，无法进行荟萃分析。结果以发现摘要表和图示的形式描述。
我们确定了 17 项独特的研究，涵盖了 30 年的研究和 3526 名参与者。纳入的研究使用了 50 种不同的认知功能测试。根据 DSM-V 分类，将这些测试分为单独的认知域，以便进一步分析。助听器最有益的影响似乎是在执行功能认知域，其中 6 项研究显示出改善，2 项研究结果不确定，3 项研究未显示出显著效果。5 项筛查简短精神状态测试中有 3 项显示出显著改善。助听器的影响最小的是在复杂注意力域，其中 8 项研究显示没有显著效果，而 1 项研究显示干预后有改善。
基于这项系统综述，我们得出结论，助听器对认知的影响存在争议。需要通过随机临床试验进行进一步研究，使用标准化认知评估和更长的随访时间，以进一步阐明这种关系。
