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中年感音神经性听力损失患者的血管因素与轻度认知障碍进展。

Vascular Factors in Patients with Midlife Sensorineural Hearing Loss and the Progression to Mild Cognitive Impairment.

机构信息

Section of Audiology, Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini, 5, 80131 Naples, Italy.

Otolaryngology Institute, Department of Head and Neck, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy.

出版信息

Medicina (Kaunas). 2023 Feb 28;59(3):481. doi: 10.3390/medicina59030481.

Abstract

: Midlife hearing loss (HL) has been considered as a major modifiable risk factor for a later-life progression to dementia. Our aim was to detect a link between precocious sensorineural hearing loss (SNHL) and mild cognitive impairment (MCI) and their association to putative risk factors for a common pathology. In this study, a retrospective case-control study was carried out. A total of 112 patients were enrolled as following: 81 patients with bilateral SNHL and 31 subjects with normal hearing, whose ages ranged from 50 to 65 years. Both groups performed pure tone audiometry, a tinnitus handicap inventory (THI), Mini-Mental State examination (MMSE), and the Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS-A and HADS-D). The mean age was 58 ± 5.2 in SNHL patients and 53.2 ± 4.8 in the control group. The mean pure tone average in the SNHL group was 40.2 ± 18.7 dB HL on the right side and 41.2 ± 17.2 dB HL on the left side, while in the control group it was 12.5 ± 2.8 dB HL on right side and 12.4 ± 3.1 dB HL on left side. About 64% of patients with SNHL exhibited comorbidities, and the most common condition was hypertension. Altered MoCA test scores were significantly related to the pure tone averages in patients with SNHL compared to the control group ( = 0.0004), while the differences in the HADS-A and HADS-D were not significant. Furthermore, a significant correlation was observed in SNHL patients between an altered MoCA test and hypercholesterolemia ( = 0.043). Hearing impairment and screening tests to detect MCI should be considered in the midlife in order to carry out strategies to prevent the progression to dementia. Hypertension and hypercholesterolemia are two risk factors in the development of endothelial dysfunction, oxidative stress, and vascular inflammation, and may represent the common pathology linking the inner ear and brain damage.

摘要

中年听力损失(HL)已被认为是晚年痴呆进展的一个主要可改变风险因素。我们的目的是检测早发性感觉神经性听力损失(SNHL)与轻度认知障碍(MCI)之间的联系及其与常见病理的潜在危险因素的关联。在这项研究中,进行了一项回顾性病例对照研究。共纳入 112 名患者,分为 81 名双侧 SNHL 患者和 31 名听力正常的受试者,年龄在 50 岁至 65 岁之间。两组均进行纯音测听、耳鸣残疾量表(THI)、简易精神状态检查(MMSE)和蒙特利尔认知评估(MoCA)、医院焦虑和抑郁量表(HADS-A 和 HADS-D)。SNHL 患者的平均年龄为 58±5.2 岁,对照组为 53.2±4.8 岁。SNHL 组右侧平均纯音平均为 40.2±18.7dB HL,左侧为 41.2±17.2dB HL,而对照组右侧为 12.5±2.8dB HL,左侧为 12.4±3.1dB HL。约 64%的 SNHL 患者存在合并症,最常见的疾病是高血压。与对照组相比,SNHL 患者的 MoCA 测试评分明显与纯音平均值相关( = 0.0004),而 HADS-A 和 HADS-D 的差异则不显著。此外,在 SNHL 患者中,MoCA 测试改变与高胆固醇血症之间存在显著相关性( = 0.043)。为了预防痴呆的进展,应该在中年时考虑听力障碍和认知障碍的筛查测试。高血压和高胆固醇血症是内皮功能障碍、氧化应激和血管炎症发展的两个危险因素,可能代表内耳和脑损伤的共同病理。

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