Center for Research in Human Development (CRDH)/Department of Psychology, Concordia University, Montreal, Quebec, Canada.
Department of Psychology, University of Toronto, Mississauga, Ontario, Canada.
Ear Hear. 2023;44(4):751-767. doi: 10.1097/AUD.0000000000001322. Epub 2022 Dec 29.
Hearing loss (HL) in older adults is associated with a decline in performance on cognitive tasks and the risk of developing dementia. However, very few studies have investigated sex-related effects on these associations. A previous study of cognitively healthy older adults showed an association between HL and lower cognitive performance in females only. In the present study, we examined the effects of sex and hearing on cognition in individuals with mild cognitive impairment (MCI). We predicted that females with HL would be more likely to show poorer performance on the cognitive measures compared to females with normal hearing (NH), while cognitive performance in males would not depend on hearing. We further predicted that these auditory-cognitive associations would not depend on test modality, and would thus be observed in females for both auditory and visual tests.
Participants were 101 older adults with amnestic MCI (M = 71 years, 45% females) in the Canadian Consortium on Neurodegeneration in Aging (CCNA) COMPASS-ND study. Performance on the Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning (RAVLT), and Brief Visuospatial Memory Test-Revised (BVMT-R) was analyzed to investigate sex-related differences and/or hearing-related differences. Participants were categorized as having NH or HL using two different measures: pure-tone hearing screening results (normal based on a pure-tone threshold < 25 dB HL at 2000 Hz in the worse ear) and speech-in-noise speech reception thresholds (SRTs; normal < -10 dB SNR on the Canadian Digit Triplet Test [CDTT]).
Males and female groups did not differ in age, years of education, or other relevant covariates. Yet, females with better hearing on either pure-tone or speech-in-noise measures outperformed their worse hearing counterparts on the MoCA total score. Additionally, females with better hearing were more likely to recall several words on the MoCA delayed recall trial relative to those with worse hearing. Females with NH showed significant correlations between CDTT SRTs and both MoCA and RAVLT scores, while no correlations were observed in males. In contrast, males but not females showed an effect of hearing group on BVMT-R test status.
There were sex-specific differences in auditory-cognitive associations in individuals with MCI. These associations were mostly observed in females and on auditory tests. Potential mechanisms and implications are discussed.
老年人听力损失(HL)与认知任务表现下降和痴呆风险增加有关。然而,很少有研究调查这些关联的性别相关影响。先前对认知健康的老年人的研究表明,HL 与女性认知表现下降之间存在关联,而与男性无关。在本研究中,我们研究了性别和听力对轻度认知障碍(MCI)个体认知的影响。我们预测,与听力正常的女性(NH)相比,有 HL 的女性在认知测试上的表现更差,而男性的认知表现则不受听力影响。我们进一步预测,这些听觉认知关联与测试模式无关,因此在女性中,听觉和视觉测试都能观察到。
参与者为加拿大神经退行性变老化联盟(CCNA)COMPASS-ND 研究中的 101 名有遗忘症的 MCI 老年人(M=71 岁,45%为女性)。使用蒙特利尔认知评估(MoCA)、 Rey 听觉言语学习测验(RAVLT)和简短视觉空间记忆测验修订版(BVMT-R)来分析认知表现,以研究性别相关差异和/或听力相关差异。参与者根据两种不同的测量方法分为 NH 或 HL:纯音听力筛查结果(根据较差耳 2000 Hz 处的纯音阈值<25dBHL 进行正常分类)和言语噪声中的言语接收阈值(SRT;加拿大数字三字母测试[CDTT]上的正常< -10dB SNR)。
男性和女性组在年龄、受教育年限和其他相关协变量方面无差异。然而,在纯音或言语噪声测量中听力较好的女性在 MoCA 总分上优于听力较差的女性。此外,听力较好的女性在 MoCA 延迟回忆试验中更有可能回忆起几个单词,而听力较差的女性则较少。NH 女性的 CDTT SRT 与 MoCA 和 RAVLT 评分之间存在显著相关性,而男性则没有。相比之下,只有男性而不是女性的听力组对 BVMT-R 测试状态有影响。
MCI 个体的听觉认知关联存在性别特异性差异。这些关联主要在女性和听觉测试中观察到。讨论了潜在的机制和意义。